THE THIGH REGION.

The thigh region, located between the hip and the knee, is a critical part of the lower limb. Here’s a detailed
overview of its anatomy, including bones, muscles, nerves, and blood vessels:

1. Bones

Femur: The only bone in the thigh, the femur, is the longest and strongest bone in the human body. It
articulates with the pelvis at the hip joint and with the tibia and patella at the knee joint.

Proximal End: Features the head, which articulates with the acetabulum of the pelvis, and the greater and
lesser trochanters, which serve as muscle attachment points.

Shaft: Slightly convex anteriorly, providing strength and leverage for muscle attachments.

Distal End: Forms the medial and lateral condyles, articulating with the tibia to form the knee joint.

2. Muscles

The muscles of the thigh are divided into three compartments: anterior, medial, and posterior.

Anterior Compartment: Responsible for knee extension and hip flexion.

Quadriceps Femoris:
 A group of four muscles (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius) that
extend the knee.
 Note that some of the tendinous fibers of the vastus lateralis and vastus medialis form bands, or
retinacula, which join the capsule of the knee joint and strengthen it.
 The lowest muscle fibers of the vastus medialis are almost horizontal and prevent the patella from
being pulled laterally during contraction of the quadriceps muscle.
 The tone of the quadriceps muscle greatly strengthens the knee joint.
 The rectus femoris muscle is the only component of the quadriceps that crosses the hip joint, and it
flexes the hip in addition to extending the knee.
MUSCLE ORIGIN INSERTION INNERVATION ACTION

Rectus femoris The ASIS(as for the Extension of the leg

straight head) and at the knee joint;
the ilium superior to flexes the thigh at the
the acetabulum( as hip joint
for the reflected
head)
Quadriceps tendon
Vastus lateralis Greater trochanter into patella then Extension of the leg
and lateral lip of the Femoral nerve (L2, at the knee joint
via the ligamentum
linear aspera of the L3, L4)
patellae to the
femur tubercle of the
tibia
Vastus medialis Intertrochanteric Extension of the leg
line and the medial at the knee joint;
lip of the linear stabilizes the patella
aspera of the femur ie prevents the patella
from being
‘displaced’ laterally
 when the quadriceps
femoris muscles
contract

Vastus intermedius Anterior and lateral Extension of the leg

surfaces of the shaft at the knee joint;
of the femur articularis genus
retracts synovial
membrane

Sartorius The ASIS Superior part of Femoral nerve Flexes, abducts, and
the medial part of laterally rotates the
the tibia thigh at the hip joint;
flexes and medially
rotates the leg at the
knee joint

Psoas Originates from T12, Inserts in the lesser Innervated by the

-L2 vertebrae trochanter together lumbar plexus L1, Flexing the thigh on
with the iliacus L2, and L3 the trunk, if the thigh
muscle is fixed it flexes the
trunk on the thigh as
Iliacus The iliac fossa if the The lesser Femoral nerve L2, in sitting up from
ilium trochanter of the L3 lying down
femur

Medial Compartment: Involved in thigh adduction.

Adductor Longus, Brevis, and Magnus: These muscles adduct the thigh at the hip joint.

Gracilus: A thin muscle that assists in thigh adduction and flexes the knee.

Pectineus: Flexes and adducts the thigh.

MUSCLE ORIGIN INSERTION INNERVATION ACTION

Adductor Magnus Adductor part; inferior Adductor part; Adductor part; Adducts the thigh
ramus of the pubis and gluteal obturator nerve L2,
Adductor part; flexes
ramus of the ischium tuberosity,linear L3, L4, and branches
the thigh
aspera, and middle of the posterior
Hamstring part; ischial
supracondylar line division Hamstring part;
tuberosity
extends the thigh
Hamstring part; Hamstring part;
adductor tubercle of Tibial part of the
the femur sciatic nerve(L4)
Obturator externus Margin of the Trochanteric fossa of Obturator nerve (L3, Laterally rotates the
obturator foramen and the femur(just below L4) thigh; steadies the head
obturator membrane the greater trochanter of the femur in the
on the anterior view) acetabulum

Adductor Brevis Body and inferior Pectineal line and the Adducts the thigh
ramus of the pubis; proximal part of the
near the crest of the linear aspera of
pubic arch femur Obturator nerve and
branch of anterior
Adductor Longus Body of the pubis Middle third of the division (L2, L3, L4 Adducts thigh; to some
inferior to the pubic linear aspera of extent flexes it
crest(the projection femur
near the pubic arch)

Gracilis The pubic arch Superior part of the Obturator nerve (L2, Adducts the thigh;
medial surface of L3) flexes it and helps
tibia rotates is medially

Pectineus Superior ramus of the Upper end of the Femoral nerve and Flexes and abducts the
pubic ramus linear aspera of shaft sometimes the thigh at the hip joint.
of femur obturator nerve L2,
L3.

Note :
 The Gracilis, Sartorius attachment, Semitendinosus attachment, the point where this three attach is
called the pes anserinus
 The adductor hiatus is a gap in the attachment of this muscle to the femur, which permits the femoral
vessels to pass from the adductor canal downward into the popliteal space
 The obturator nerve splits into two as it emerges from the obturator canal and enters the medial
compartment.
 The divisions pass posterior and anterior to the adductor brevis. This is useful in identifying the
muscle during dissections and in anatomical cross sections

Posterior Compartment: Involved in hip extension and knee flexion.

Hamstring Muscles: Comprised of biceps femoris, semitendinosus, and semimembranosus, these muscles
extend the hip and flex the knee.

MUSCLE ORIGIN INSERTION INNERVATION ACTION

Semitendinosus Medial surface of

superior part of the
tibia
Ischial tuberosity Tibial division of Extends thigh; flex leg
Semimembranosus Posterior part of sciatic nerve part and rotates it medially
medial condyle of of tibia (L5, S1, when knee is flexed ie
tibia. Reflected S2) when the thigh and the
 attachment forms knee are flexed.
oblique popliteal
These muscles can
ligament (to lateral
extend the trunk
femoral condyle)

Biceps femoris Long head; ischial Lateral side of head Long head; tibial Flexes leg and rotates it
tuberosity of fibula. Tendon is division of sciatic laterally when knee is
split at this site by nerve (L5, S1, S2) flexed;extends thigh ie
fibular collateral acceleration mass
ligament of knee during first step of gait

Short head;
Short head; linea aspera
common fibular
and lateral
division of sciatic
supracondylar line of
nerve (L5, S1, S2)
femur

3. Nerves

The thigh is primarily innervated by nerves from the lumbar and sacral plexuses.

1. Femoral Nerve (L2-L4):

◦ Innervates the anterior compartment, particularly the quadriceps, allowing for knee extension
and hip flexion.
◦ The femoral nerve divides into two in the thigh ie the medial cutaneous nerve of the thigh and
the intermediate cutaneous nerve (the anterior division)
◦ The medial cutaneous nerve supplies the skin of medial surfaces
◦ The intermediate cutaneous nerve supplies the anterior surfaces of the thigh

2. Obturator Nerve (L2-L4): Supplies the medial compartment, controlling the adductor muscles.
◦ Remember that it divides into two when at the adductor brevis

3. Sciatic Nerve (L4-S3): The largest nerve in the body, it innervates the posterior compartment,
including the hamstring muscles, and is responsible for hip extension and knee flexion.

Femoral Nerve (L2-L4)

 Motor Branches:
 Innervates the anterior thigh muscles, including:
 Quadriceps Femoris (Vastus Medialis, Vastus Intermedius, Vastus lateralis and
Rectus Femoris) : extends the knee.
 Sartorius (Originates from the ASIS): flexes and laterally rotates the hip, flexes the
knee.
 Iliopsoas: primary hip flexor.
 Sensory Branches:
 Anterior Cutaneous Branches: Supply the skin of the anterior and medial thigh.
 Saphenous Nerve (the posterior division of the femoral nerve): The longest sensory branch,
which supplies the medial aspect of the lower leg and foot.
 Autonomic Branches:
  Carries sympathetic fibers that regulate blood vessels and sweat glands in the thigh and knee
region.
Obturator Nerve (L2-L4)
 Motor Branches:
 Supplies the adductor muscles of the thigh:
 Adductor Longus, Adductor Brevis, Adductor Magnus (adductor portion).
 Gracilis and Obturator Externus.
 Sensory Branches:
 Cutaneous Branch: Supplies the medial thigh skin.
 Autonomic Branches:
 Contains sympathetic fibers for vascular control in the thigh’s medial compartment.
Sciatic Nerve (L4-S3)
 Largest nerve in the body, divides into tibial and common peroneal (fibular) nerves near the knee.
 Motor Branches:
 Innervates the hamstrings (semitendinosus, semimembranosus, biceps femoris) and adductor
magnus (hamstring portion), which extend the hip and flex the knee.
 Sensory Branches:
 No primary sensory branches until it divides.
 Autonomic Branches:
 Supplies sympathetic fibers for the posterior thigh.

4. Blood Supply

Femoral Artery: The main artery of the thigh, supplying oxygenated blood to the anterior and medial
compartments. It continues as the popliteal artery behind the knee.

Profunda Femoris Artery(related to the femoral artery): A major branch of the femoral artery, it supplies
deep structures of the thigh, including the hamstrings.
It divides into 4 branches after the inguinal ligaments
 Medial femoral circumflex artery; supplies the muscles that form the floor of the femoral
triangle and also associated with cruciate anastomosis
 Lateral femoral circumflex artery; passes laterally between the branches of terminal of
femoral nerve and also forms part of the cruciate anastomosis
 Four perforating arteries; They supply the muscles and terminate by anastomosing with one
another and with the inferior gluteal artery and the circumflex femoral arteries above and the
muscular branches of the popliteal artery below.

Obturator Artery(related to the internal iliac artery): Supplies blood to the medial compartment,
particularly the adductor muscles.

5. Veins

Femoral Vein: Drains blood from the lower limb back to the heart, running alongside the femoral artery.
Profunda Femoris Vein
The profunda femoris vein receives tributaries that correspond to the branches of the artery. It drains
into the femoral vein in the femoral triangle

Great Saphenous Vein: A superficial vein that runs along the length of the leg, it drains into the femoral vein
in the thigh region.

6. Fascia
Fascia Lata: The deep fascia of the thigh, it surrounds the muscles and forms a sheath, providing structural
support. It thickens laterally to form the iliotibial band (IT band), which plays a role in stabilizing the knee
during walking and running.

7. Key Landmarks

Inguinal Ligament: Marks the superior border of the thigh and the transition between the abdomen and the
lower limb.

Greater Trochanter: A prominent projection of the femur, palpable at the lateral aspect of the hip, serving
as a key attachment point for muscles.

Medial and Lateral Condyles: Bony prominences at the distal femur that articulate with the tibia and
patella to form the knee joint

The Saphenous Opening:

The femoral triangle:

Clinical Notes

Femur

 The part of the femur that’s not intra-acetabular can be palpated (on the anterior aspect of the thigh just
inferior to the inguinal ligament and just lateral to the pulsating femoral artery) and if tender it can
indicate arthritis of the femur
