00:01
So now let's have a look
at a lot more detail
of this arterial
supply of the thigh.
00:07
So here we can see we have the
anterior aspects of the thigh.
00:11
We can also see some
aspects of the pelvis,
as we've got the
aorta bifurcated.
00:16
Here, we can see the
external iliac artery.
00:19
And the external iliac artery courses
deep to the inguinal ligament.
00:23
We can see this as it passes
through the vascular lacuna,
that medial compartment
of that sub lingual space.
00:32
The femoral artery then appears
within the femoral triangle
and we can see the
femoral triangle here.
00:37
Remember, the borders of the femoral
triangle are the inguinal ligaments,
the sartorius muscle and
also adductor longus.
00:44
So we can see within the femoral
triangle, we have the femoral artery.
00:47
And then we'll immediately
position, we have the femoral vein.
00:50
Laterally, we find
the femoral nerve.
00:53
But importantly the femoral artery there
is sitting within the femoral triangle.
00:58
It then runs down through
the adductor canal
before piercing
through a small hole.
01:03
Remember, the two parts
of adductor magnus -
the adductor portion and
the hamstring portion.
01:09
They created this little hiatus
that allowed the femoral
artery to pass through
at the distal end of
the adductor canal.
01:17
As the femoral artery
then pass posteriorly,
it became the popliteal artery and
sits within the popliteal fossa.
01:25
If we then look at
the femoral artery,
there are a number of branches
that come away from it.
01:29
Here we can see we've got the
superficial epigastric arteries,
these will ascend along the
anterior abdominal wall.
01:36
We also have the superficial
external pudendal artery
help supply some of the skin
around the external genitalia.
01:43
And then we have the superficial
circumflex iliac artery
which is running around
to supply structures
on the lateral
aspect of the hip.
01:52
The femoral artery importantly gives
rise to the deep artery of the thigh.
01:56
Sometimes it's called
the profunda femoris.
01:59
But this deep artery of the thigh occurs
typically at the level of pectineus.
02:04
So looking at the
femoral triangle,
the floor of the femoral
triangle where we have pectineus,
you'll see the deep artery of the
thigh emerging from this location.
02:13
It then runs deep to
quadriceps femoris
as the femoral artery then continues
down along adductor longus.
02:20
Here we can see the terminal end
of the deep artery of the thigh.
02:23
And we'll see this in more detail
when we look at the posterior aspect.
02:27
But the deep artery of the thigh
really stays within the thigh,
it doesn't pass into the leg
like the femoral artery does.
02:35
Coming off though the
deep artery of the thigh,
we see the medial
circumflex artery here.
02:41
And we'll also see the lateral
circumflex femoral artery here.
02:45
The lateral circumflex femoral
lottery actually has two branches.
02:49
It has an ascending branch, which goes
up to anastomoses gluteal blood vessels.
02:54
And a descending branch, which will go
into anastomoses perforating branches,
which we'll see in
more detail here.
03:01
But importantly, we've got a
circumflex arrangement of arteries
that lead from the deep artery of
the thigh, which we can see here.
03:08
Medial and lateral,
with the lateral giving off some
additional branches as well.
03:13
These perforating
arteries are important
as they go on to supply the
posterior aspects of the thigh.
03:19
And they have to really supply the
deep structures within the thigh
that are surrounding the femur.
03:26
So now let's rotate
the skeleton here.
03:28
And what we're doing is we're actually
looking into the right hemipelvis,
but from the left hand side.
03:34
So what we're looking at is
the right internal iliac artery
once it's bifurcated off
the right common iliac.
03:41
And there we can see
the right iliacus.
03:44
So we've removed the left ilium bone
so we can see into the pelvis here.
03:49
And this is important because it gives
us a nice view of the obturator artery
running anteriorly towards
the obturator foramen,
where it's joined by
the obturator nerve.
03:59
Both of these structures pass
through via the obturator canal
to pass into the
adductor compartment.
04:04
We can also add in here
some important veins,
which have very
similar distribution
and a very similar name to
their accompanying arteries.
04:13
Here now we can remind ourselves
of that obturator canal,
which allows both the
obturator nerve artery and vein
to pass from the pelvis into the
adductor compartment of the thigh.
04:24
Here we can now see
the obturator artery
as we look at this right
pelvis from the lateral aspect.
04:30
So now we're looking at the external
surface of the obturator membrane,
and we can see the obturator
artery lying on top of it.
04:37
Here we can see
it's anterior branch
and here we can see
a posterior branch.
04:41
Branches are coming away
from the obturator artery
once it's emerged through the obturator
canal onto the external surface.
04:49
If we have a slightly different
image to look at that now
we can see how the obturator canal is
giving rise to the obturator artery.
04:56
And here is both those anterior
and posterior branches.
05:00
And these will form an anastomotic
loop around that obturator foramen
lying on the external surface
of the obturator membrane.
05:08
This is important because it allows
some redundancy in the blood supply
that passes towards
the hip joint.
05:14
Now the hip joint is a
really important joint
and it needs to receive as
much blood supply as it can.
05:20
Joints typically are quite
difficult to supply with blood
because they're highly mobile.
05:25
So we have lots of anastomotic rings
that help to supply the hip joint.
05:29
And this is one of them that's
helping supply the head of the femur.
05:33
We've got the obturator artery, it's
anterior and posterior branches,
forming an anastomoses.
05:38
And here we can see the ligament
of the head of the femur
which is containing
that acetabular branch.
05:43
And this runs towards
the head of the femur.
05:46
So interestingly here,
we've got the femur supplied via the
acetabulum from this obturator artery.
05:53
A direct branch into
the head of the femur
via the ligaments of
the head of the femur.
06:00
So now let's have a look continuing
at this blood supply to the thigh
and overview the muscles that are
supplied by this femoral artery.
06:08
So here we see the femoral
artery supplying the muscles
of this anterior compartment.
06:13
The obturator arteries supply muscles
in this medial or adductor compartment.
06:18
And here we can see
the deep femoral artery
is going to supply muscles in all three
compartments with its various branches.