Medial and posterior thigh

PUBLIC

1. MEDIAL &POSTERIOR COMPARTMENT OF THIGH Presented by AASMA MEHAK Presented to SIR IDREES AHMAD DPT BATCH-I,SEM-II KIHST 1

2. MEDIAL COMPARTMENT OF THIGH Medial compartment of thigh is separated from anterior compartment by medial intermuscular septa. It is separated from posterior compartment by posterior intermuscular septa. Medial compartment also called adductor compartment. 2

3. Muscles of Medial Compartment of thigh Adductor longus Adductor brevis Adductor magnus Gracilis Pectineus 3

4. ADDUCTOR LONGUS Origin External surface of body of pubis. Insertion Line aspera on middle one-third of femur. Innervation Obturator nerve(ant. Division). Action Adducts and medial rotates thigh at hip joint. 4

5. Adductor brevis Origin External surface of body of pubis & inferior pubis ramus. Insertion Posterior surface of upper femur & upper one third of line aspera . Innervation Obturator nerve(ant. Division). Action Adducts & medial rotates thigh 5

6. Adductor Magnus 6 Origin Adductor part: ishiopubic ramus Hamstring part: ischial tuberosity Insertion Line aspera , medial supracondylar line & adductor tubercle Innervation Sciatic nerve & obturator nerve( post.division ) Action Adduction of thigh & hamstring part extends thigh and flexes knee

7. Gracilis Origin External surface of body of pubis, inferior pubic ramus & ramus of ischium Insertion Medial surface of proximal tibia. Innervation obturator nerve (ant. Division) Action Adducts thigh & flexes knee 7

8. Pectineus Origin Pectineal line of femur Insertion line extending from lesser tronchanter of femur Innervation Femoral nerve Action Adducts & flexes thigh 8

9. NERVE SUPPLY TO MEDIAL COMPARTMENT THIGH OBTURATOR NERVE Chief nerve of adductor compartment. It is branch of lumbar plexus. formed by anterior division of ventral primary rami of L 2, L 3 & L 4 Enters thigh by passing through obturator canal. Divides into anterior and posterior nerve by adductor brevis muscle. 9

10. BLOOD SUPPLY TO MEDIAL THIGH OBTURATOR ARTERY Branch of internal iliac artery. Enters the thigh through obturator canal. Gives off two branches anterior and posterior at upper margin of obturator canal. Posterior branches anastomoses with medial circumflex femoral artery around the obturator membrane. 10

11. POSTERIOR COMPARTMENT OF THIGH 11

12. POSTERIOR COMPARMENT OF THIGH Posterior compartment is separated from ant. Compartment by lateral intermuscular septa & separated from medial compartment by posterior intermuscular septa. It also called flexor compartment. 12

13. Muscles of Posterior Muscles of posterior compartment also called hamstring muscles. Properties of hamstring muscles. Originates from ischial tuberosity. Insert at bone of leg. All muscles are innervated by tibial part of sciatic nerve. The muscles act as flexors of knee and extensors of hip. Muscles Semitendinosus. Semimembranosus. Biceps femoris . Adductor magnus . 13

14. Semitendinosus Origin Upper part of ischial tuberosity. Insertion Medial surface of upper tibia behind Sartorius & gracilis . Innervation Tibial part of sciatic nerve. Action Flexor of knee and weak extensor of hip joint. (insertion of semitendinosus, gracilis & Sartorius is like goose feet called pes aserinus ) 14

15. Semimembranosus Origin upper part of ischial tuberosity. Insertion Medial condyle of tibia. Innervation Tibial part of sciatic nerve. Action Flexes the knee & weak extensor of hip. 15

16. Biceps femoris Origin Long head: ischial tuberosity. Short head: lateral lip of line aspera . Insertion head of fibula. Innervation Long head is innervated by tibial part & short head is innervated by common peroneal nerve. Action Chief flexor of knee, lateral rotator of thigh & weak extensor of hip. 16

17. NERVE SUPPLY OF POSTERIOR THIGH SCIATIC NERVE Largest branch of sacral plexus. The root value is L 4 to S 3. it has two parts The Tibial part formed by ventral division of anterior primary rami L 4 to S 3. The common peroneal part formed by dorsal division of ant. Primary rami of L 4 to S 2 17

18. SCIATIC NERVE TIBIAL PART Before separation from common peroneal nerve it supplies all the muscles in posterior thigh except short head of biceps femoris . It supplies Posterior leg. Skin of posterolateral aspect of lower leg, lateral side of ankle, little toe and skin of sole. COMMON PERONEAL NERVE Supplies short head biceps femoris . It supplies Anterior and lateral compartment of leg. Skin over lateral leg, ankle dorsal of foot and toes. 18

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20. POPLITEAL FOSSA It is a diamond shaped depression behind the knee. It is formed Superomedially by semitendinosus & semimembranosus. Superolaterally by biceps femoris . Inferomedially by medial head of gastrocnemius. Inferolaterally by lateral head of gastrocnemius supplemented by plantris . Roof is formed by deep fascia. floor by popliteal surface of femur and capsule of knee joint. 20

21. Contents of popliteal fossa Popliteal artery and its branches Popliteal vein and its tributaries Popliteal lymph nodes Tibial nerve and its branches Posterior cutaneous nerve of thigh Position of structure. In upper part from medial to lateral A,V,N In middle from behind forward N,V,A In lower part from medial to lateral N,V,A 21

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