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CHAPTER 36: Thigh

THIGH

BIG PICTURE

The femur is the longest and strongest bone in the body and primary bone of the thigh. The femur articulates with the acetabulum (hip joint) and tibia and patella (knee joint). The knee joint enables flexion, extension, and minimal rotation and supports the weight of the body during static positions and dynamic movement during gait.

ACTIONS OF THE KNEE COMPLEX

The articulations between the femur, tibia, and patella form the knee joint and enable the following actions (Figure 36-1A):

  • Flexion. Bending the knee joint.

  • Extension. Straightening the knee joint.

  • Internal and external rotation. Small rotational movements in the vertical axis.

Figure 36-1:

A. Actions of the knee joint. B. Compartments of the thigh. C. Muscles of the anterior compartment of the thigh.

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MUSCLES OF THE THIGH

BIG PICTURE

The muscles of the thigh are divided by their fascial compartments (anterior, medial, and posterior) and act on the joint(s) the individual muscles cross (Figure 36-1B and Table 36-1).

TABLE 36-1.Muscles of the Thigh
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TABLE 36-1. Muscles of the Thigh
Muscle Proximal Attachment Distal Attachment Action Innervation
Anterior compartment of the thigh
Psoas minor T12–L1 vertebral bodies and discs Pectin pubis Lumbar spine flexion, posterior pelvic tilt Anterior rami (L1)
Psoas major T12–L5 transverse processes, vertebral bodies, and discs Lesser trochanter of femur Flexes and externally rotates thigh at hip joint; flexes trunk (psoasmajor) Anterior rami (L1–L3)
Iliacus Iliac fossa Femoral n. (L2, L3)
Sartorius Anterior superior iliac spine Inferomedial to tibial tuberosity (pes anserinus) Flexes thigh at hip joint and flexes leg at knee joint Femoral n. (L2, L3)
Rectus femoris Anterior inferior iliac spine Flexes thigh at hip joint and extends leg at knee joint Femoral n. (L2–L4)
Vastus lateralis Lateral part of intertrochanteric line, margin of greater trochanter, lateral margin of gluteal tuberosity, lateral lip of linea aspera Quadriceps femoris tendon Extends leg at knee joint
Vastus medialis Medial part of intertrochanteric line, pectineal line, medial lip of linea aspera, and medial supracondylar ridge
Vastus intermedius Femur: upper two-thirds of anterior and lateral surfaces
Medial compartment of the thigh
Pectineus Pectineal line Oblique line extending from base of lesser trochanter to linea aspera on posterior surface of proximal femur Adducts and flexes thigh at hip joint Femoral n. (L2, L3)
Adductor longus Body of pubis Linea aspera Adducts and medially rotates thigh at hip joint Obturator n. (anterior division) (L2–L4)
Adductor brevis Body of pubis and inferior pubic ramus Obturator n. (anterior division) (L2, L3)
Adductor magnus

Adductor part: ischiopubic ramus

Hamstring part: ischial tuberosity

Adductor part: linea aspera

Hamstring part: Adductor tubercle

 Adducts and medially rotates thigh at ...

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