LOWER LIMB + HIP/GLUTEAL REGION

Femoral Nerve (L2-L4) course: Originates within psoas major; descends posterolaterally through pelvis to
midpoint of inguinal ligament; passing deep to inguinal ligament & enters femoral triangle lateral to femoral
vessels; divides into branches to ant. thigh muscles + articular branches to hip & knee joints + cutaneous
branches to anteromedial thigh; terminal cutaneous branch of femoral nerve – saphenous nerve
Femoral Triangle:
Superiorly: Inguinal ligament
Medially: Adductor longus (lat border)
Laterally: Sartorius
Floor: Iliopsoas (laterally), Pectineus (medially)
Roof: Fascia lata, cribiform fascia, subcutaneous tissue, skin
Contents: Femoral Neve, Artery (+branches) & Vein (+tributaries, GSV, profundal femoris), deep inguinal lymph
nodes & vessels

Femoral Sheath:
passes deep to inguinal ligament and terminates inferiorly by blending with adventitia of femoral vessels; formed
by inferior prolongation of transversalis & ilopsoas fascia
Lateral Compartment: Femoral artery
Intermediate Compartment: Femoral vein
Medial Compartment: Femoral canal – loose connective tissue, fat, lymphatics (extends distally to level of prox
edge of saphenous opening)

Adductor Canal:
extends from apex of femoral triangle to adductor hiatus
Anteriorly: Sartorius
Posteromedially: Adductor longus & magnus
Laterally: Vastus medialis
Contents: Femoral artery & vein, saphenous nerve, nerve to vastus medialis

Adductor Hiatus:
gap between femur & adductor magnus, ~8-13.5cm superficial to adductor tubercle
allows passage of femoral vessels from ant thigh to post thigh to popliteal fossa

Hip Joint:
Stabilised:

1. Acetabulum & acetabular labrum

2. Joint capsule & Ligaments (iliofemoral, pubofemoral, ischiofemoral)
3. Muscles – medial flexors anteriorly, medial rotators posteriorly (rectus femoris, iliopsoas, pectineus,
sartorius)

Vascular Supply: medial & lateral circumflex arteries, artery to head of femur
Innervated: femoral nerve, obturator nerve, superior gluteal nerve, nerve to quadratus femoris
Knee Joint:
Stabilised:

1. Ligaments – ACL, PCL, MCL, LCL

2. Muscles/tendons – Pes anserinus, quadriceps femoris, popliteus, biceps femoris, semi membranosus
3. Menisci, tibiofemoral joint

Vascular Supply: Genicular anastomoses supplied by femoral & popliteal arteries

Innervated: Femoral, tibial, common fibular nerves
Ankle Joint:
Stabilised:

1. Ligaments (bound by retinacula): medial ligament (deltoid, calcaneonavicular), lateral ligament (ant
talofibular, post talofibular, calcaneofibular)
2. Articulation of talus with the mortise (bounded by tibia & fibula)

Vascular Supply: Malleolar branches of ant & post tibial arteries & fibular artery
Innervation: Tibial, Deep fibular nerves
Popliteal Fossa:
Superolaterally: Biceps femoris
Superomedially: Semimembranosus
Infeorlaterally & Inferomedially: Lateral & medial heads of gastrocnemius
Posteriorly: Popliteal fascia, skin
Contents: Termination of SSV, popliteal arteries & veins, tibial & common fibular nerves, posterior cutaneous
nerve of thigh, popliteal lymph nodes & vessels