Lab 5 - Module 2 - Hip and Anterior Thigh - Muscles, Nerves and Vessels: Page 2 of 8
Nerves and Vessels
Add the Femoral nerve.
Add the Abdominal Aorta.
Add the Common Iliac Arteries. These are the terminal branches of the abdominal aorta. The aorta divides at the level of the fourth lumbar vertebra, just to the left of the midline. The common iliac arteries descend infero-laterally, ending just anterior to the sacro-iliac joint at the level of the sacral promontory by dividing into internal and external iliac arteries.
The artery is covered in peritoneum anteriorly and medially. The superior hypogastric plexus lies anterior to the upper end. The superior rectal vessels cross the artery on the left side. The ureter passes anterior to the artery near or at its point of division. Behind lies the sympathetic trunk, the bodies of the fourth and fifth lumbar vertebrae and the intervening discs. The obturator nerve, lumbosacral trunk and iliolumbar artery are situated more deeply. On the right, the lower end of the inferior vena cava, the right common iliac vein and the psoas major muscle lies laterally from above downwards. On the left, the common iliac vein lies medial to and slightly behind the artery, with psoas major lying at its lateral aspect.
Add the External Iliac Artery. This artery arises from the bifurcation of the common iliac artery and runs obliquely downwards and laterally along the medial border of psoas major to a point mid-way between the anterior superior iliac spine and the pubic symphysis. It passes behind the inguinal ligament to enter the thigh, where it becomes the femoral artery. It runs along the linear terminalis of the pelvis, enclosed in a thin fascial sheath with its accompanying vein. The external iliac artery gives off two large branches, the inferior epigastric artery and the deep circumflex iliac artery.
Add the Internal Iliac Artery. This artery is short and ends in anterior and posterior divisions. Each arises at the bifurcation of the common iliac artery and is about 4cms in length. It descends to the upper margin of the greater sciatic foramen. The anterior trunk continues down towards the ischial spine and the posterior trunk passes backwards towards the greater sciatic foramen.
Superior Gluteal Artery is the terminal branch of the posterior division of the internal iliac artery. It enters the gluteal region superior to the piriformis muscle.
Inferior Gluteal Artery is the terminal branch of the anterior division of the internal iliac artery. It enters the gluteal region inferior to the piriformis muscle.
The Obturator Artery usually comes off of the internal iliac artery. It surrounds the obturator foramen and passes for a short distance into the thigh on the medial aspect. It also has a branch going to the acetabulum.
Add the Femoral Artery. This artery is the direct continuation of the external iliac artery at the point where the latter crosses deep to the inguinal ligament; the vessel passes behind the ligament halfway along a line between the anterior superior iliac spine and the pubic symphysis. It passes vertically down the anterior medial aspect of the thigh, to end at the adductor hiatus, where it becomes the popliteal artery.
Add the Inguinal Ligament. The femoral artery enters the femoral triangle where, for the first few centimeters of its course, it is enclosed in the femoral sheath (a funnel-shaped sleeve of fascia). It lies superficial as it crosses the femoral triangle where it is covered only by skin and fascia. Behind, from above downwards, are the tendon of psoas major and the pectineus, adductor longus and adductor magnus muscles.
Add the Femoral Vein. This vein follows the path of the femoral artery, iliac arteries as the blood returns to the inferior vena cava. The femoral vein and profunda vessels lie between the femoral artery and pectineus, with the femoral vein lying between the artery and adductor longus. The femoral vein lies medial to the artery in the upper part of the femoral triangle and posterior to it in the lower part.
