SWerEciaI srterml iludErdal vsin
Msdial cutsnEous ralr! 0, hifltt
{F They are provided by valves to allow the passage of the blood from the
superficial system to the deep system.
They are variable in number & site.
- Between the lower third & middle third of the thigh.
- lt is called Hunter perforator as it is presents near to
- 2, 4 and 6 inches above medial malleolus.
- Between lower third & middle third of the leg.
- The only one from short saphenous vein.
. Above & below knee perforators can be called communicafors as they join
the long saphenous directly, while the ankle & lateral perforators join
branches of long & short saphenous respectively.
. Communicators = direct pertorators.
o Perforafors = indirect perforators.
They are present below the inguinal ligament and they consist of two groups:
A-superficial Inquinal Glands (
1 ) H o rizontal {tran s\lerse)glra u p :
- Sife: 1 cm below & parallel to inguinal ligament.
. Skin from the umbilicus & the lower back.
' ln d: penis, scrotum and mucous membrane of
{S - Errerentr;,J*,iT::i11;1ff'[nna
. Runs along the saphenous vein.
. Receives lymph from the entire lower limb.
. The only glands in the body which may be normally palpable.
B-Deep inquinal lvmph qlands (Cloquet)
o Deep to the fascia lata & on the inner aspect of the femoral vein
2. Lymph vessels running with the femoral vein.
o lt drains to the external iliac LNs.
ln the lvmph drainaqe of the lower limb:
- The deep vessels pass with the limb arteries.
- The popliteal nodes receive afferents from the area drained by the small
The femoral nerve is the largest branch of the lumbar plexus. lt is formed from
the posterior divisions of L2, L3 & L4 roots of lumbar plexus.
It descends through the fibers of the psoas major, emerging from the muscle at
the lower part of its lateral border, and passes down between it and the iliacus
It then runs beneath the inguinal ligament, into the thigh, and splits into an
anterior division and a posterior division.
Under the inguinal ligament, it is separated from the femoral artery by a portion
4 to muscles: iliacus, sartorius, pectinus and quadriceps.
3 cutaneous: intermdiate cutaneous nerve of thigh, medial cutaneous nerve of
2 articular. branch to hip joint and branch to knee joint.
o lnability to extend the knee (quadriceps femoris).
o Sensory loss over the medial and intermediate aspects of thigh & the
Ankrlu ruprrt0r llhc epln6 ---....=;.
It is a branch of the femoral nerve in the adductor canal.
It leaves adductor canal under sartorius ) to medial side of the
knee ) accompanies great saphenous vein.
It supplies sensation to the medial side of leg and foot up to ball of big
It is the longest nerve in the body & can be used as nerve graft.
- lt is a mixed nerve arising from the ventral divisions of L2, L3 and L4.
- It enters the thigh through obturator canal.
The Obturator nerve is responsible for the sensory innervation of the skin of
the medial aspect of the thigh.
It is also responsible for the motor innervation of the adductor muscles of the
lower extremity (external obturator, adductor longus, adductor brevis, adductor
. Mainly interferes with adduction of hip joint.
. Rarely produces sensory loss.
t hnfirfrilullgrrCffilt &rilrllElrllt&rum
oLies on the posterior wall of the pelvis in front of piriformis muscle.
o Forr_ned by lumbo-sacral tlunk (L4 & L5) and ventral rami of S1 , 52, 53 & part
. Branches From The Ventral Divisions
) Nerve to quadratus femoris & gemellus inferior (L4, L5 & 51).
t Nerve to obturator internus & gemellus superior (L5, 51 & S2).
) Pudendal nerve (S2, 53 & S4).
) Muscular branches to levator ani, coccygeus & sphincter ani externus
) Pelvic splanchnic nerve (S2, 53 & S4).
. Branches From The Dorsal Divisions
) Superior gluteal nerve (L4, L5 & 51).
) Perforating cutaneous nerve (S2 & S3).
- Tibial nerve (medial popliteal) from ventral divisions of L4, L5, 51, 52
- Common peroneal (lateral popliteal) from dorsal divisions of L4, L5,
) Posterior femoral cutaneous nerve from the ventral divisions of 52, 53
& dorsal divisions of 51 & 52.
No comments:
Post a Comment
اكتب تعليق حول الموضوع