Examine the muscles & neurovasculature of the anterior compartment of thigh

Find these structures:

• • Anterior thigh muscles

    • Sartorius m.

    • Iliopsoas m.

    • Quadriceps femoris m. [rectus femoris, vastus lateralis, intermedius, & medialis]

    • Tensor fasciae latae

  • Femoral n.

  • Femoral a.

    • Deep artery of thigh (profunda femoris a., deep femoral a.)

  • Femoral v.

    • Deep vein of thigh (profunda femoris v., deep femoral v.)

3.) Make a vertical incision through the fascia lata of the anterior compartment sagittally, and remove the fascia.

4.) Identify muscles of the anterior compartment: sartorius m., quadriceps femoris m., iliopsoas m., and tensor fasciae latae m.

 Photo 2. Muscles of anterior compartment of thigh, superficial

5.) Unilaterally, reflect the sartorius m. to view iliopsoas m. Rectus femoris m. (the superficial and intermediate portion of quadriceps femoris m.) must be moved or unilaterally reflected to view the vastus intermedius m. (deep, intermediate portion of quadriceps femoris m).

Note: Quadriceps femoris m. is actually a group of four muscles: rectus femoris m. (superficial & intermediate), vastus lateralis m. (lateral), vastus medialis m. (medial), and vastus intermedius m. (deep & intermediate).

Photo 3. Muscles of anterior compartment of thigh, deep

6.) Explore the contents of the femoral triangle.

Note: The boundaries of the femoral triangle are: inguinal ligament (superior), medial border of sartorius m. (lateral), and medial border of adductor longus m. (medial). The neurovasculature is organized within the triangle from medial to lateral: femoral Vein, Artery, and Nerve (VAN).

Note: The femoral a. is the continuation of the external iliac a., and the femoral v. drains into the external iliac v. The femoral n. (L2-L4) is a branch of the lumbar plexus.

Photo 4. Neurovasculature of femoral triangle

Examine the muscles & neurovasculature of the medial compartment of thigh

Find these structures:

• • Adductor longus m.

  • Adductor magnus m.

  • Gracilis m.

  • Obturator n. (medial thigh compartment)

7.) Locate and clean the medial compartment of the thigh. In order to locate the obturator n. and deeper adductor musculature, move or unilaterally reflect the adductor longus m.

Photo 5. Medial compartment of thigh - muscles (superficial)

Photo 6. Medial compartment of thigh - muscles (deep); obturator n.

Examine the muscles & neurovasculature of the anterior & lateral compartments of the leg

Find these structures:

• • Anterior compartment of leg

    • Tibialis anterior m.

    • Extensor hallucis longus m.

    • Extensor digitorum longus m.

    • Deep fibular (peroneal) n.

    • Anterior tibial a. & vv.

  • Lateral compartment of leg

    • Fibularis longus m.

    • Fibularis brevis m.

    • Superficial fibular (peroneal) n.

8.) Remove the crural fascia to observe the anterior and lateral compartments of the leg.

9.) Examine the muscles of the anterior compartment of the leg: tibialis anterior m., extensor hallucis longus m., and extensor digitorum longus m. These muscles all lie lateral to the anterior border of the tibia.

Photo 7. Anterior compartment of leg

10.) Unilaterally, reflect (or, move) the tibialis anterior m. to locate the deep fibular n. and anterior tibial a.

Note: The deep fibular n. is a branch of the common fibular n. The anterior tibial a. is a branch of the popliteal a.

Photo 8. Anterior compartment of leg - deep

 11.) Examine the muscles of the lateral compartment of the leg: fibularis mm. Locate the common fibular n. superiorly as it wraps around the neck of the fibula, and the superficial fibular n. (typically visible just deep to the fibularis longus m.).

 Note: The common fibular n. is the smaller, terminal branches of the sciatic n.  The superficial fibular n. is a branch of the common fibular n. (one of the terminal branches of the sciatic n.).

Photo 9. Lateral compartment of leg

Turn the donor to a prone position, and remove skin and subcutaneous tissue (superficial fascia) of the posterior lower limb

Examine the muscles in the superficial gluteal region

Find these structures:

• • Gluteus maximus m.

  • Gluteus medius m.

12.) Clean and identify the gluteus maximus & medius mm. A portion of the gluteus medius m. is visible superior to the superior-most extent of gluteus maximus m.

Photo 10. Gluteal region muscles

Examine the muscles and neurovasculature in the posterior thigh

Find these structures:

• • Biceps femoris m.

  • Semimembranosus m.

  • Semitendinosus m.

  • Sciatic n.

  • Deep artery of thigh

  • Deep vein of thigh

13.) Clean and identify the three hamstring mm. Separate the muscles in order to identify the deep neurovasculature: sciatic n., deep artery of thigh, and deep vein of thigh.

 Note: The deep artery of the thigh is the largest caliber branch of the femoral a. This artery gives off 3-4 perforating arteries, and supplies most structures of the thigh.

Note: The deep vein of the thigh is formed by the perforating tributaries of the thigh and drains into the femoral vein, inferior to the inguinal ligament.

Photo 11. Posterior compartment of thigh

Examine the popliteal region

Find these structures:

• • Hamstring mm. tendons

  • Popliteal a. & vv.

  • Tibial n.

  • Common fibular (peroneal) n.

  • Gastrocnemius m.

14.) Locate the boundaries of the popliteal fossa, and remove fat in order to identify the neurovascular structures.

Note: Boundaries of the popliteal fossa:

• • Hamstring mm. tendons (superomedial and superolateral)

  • Gastrocnemius m. heads (inferomedial and inferolateral)

Note: The neurovascular structures are organized in the popliteal fossa from superficial to deep:

• • Cutaneous nn. and superficial vv.

  • Bifurcation of sciatic n.

    • Tibial n. (medial)

    • Common fibular n. (lateral)

  • Popliteal v.

  • Popliteal a.

Photo 12. Popliteal region

Open the posterior compartment of the leg, and examine the muscles and neurovasculature

Find these structures:

• • Triceps surae m.

    • Gastrocnemius m.

    • Soleus m.

    • Calcaneal (Achilles) tendon

  • Deep layer of posterior compartment of leg

  • Posterior tibial a. & vv.

  • Tibial n.

15.) Reflect the deep fascia of the posterior compartment, and identify the superficial muscle group (triceps surae m.).

 Note: The calcaneal (Achilles) tendon is the shared tendon of the gastrocnemius and soleus mm. It is wider proximally, but thickens distally. It attaches to the calcaneal tuberosity of the calcaneus.

Photo 13. Posterior compartment of leg, superficial

 15.) Unilaterally, reflect the triceps surae m. to locate the deep layer of the posterior compartment of the leg. Locate to the tibial n. and posterior tibial a. & vv.

Photo 14. Posterior compartment of leg, deep