Neurovascular Structures

The femoral neurovascular structures (nerve, artery, and vein) exit the pelvis under the inguinal ligament halfway between the anterior superior iliac spine and the pubic tubercle (Figure 6.6). They are relatively anterior to the hip joint, with the nerve being the most lateral. These structures lie on the anterior surface of the iliopsoas muscle, and thus the muscle separates the femoral neurovascular structures from the hip.

The lateral femoral cutaneous nerve originates from the lumbar plexus and exits the pelvis under the inguinal ligament close to the anterior superior iliac spine (see Figure 6.6). This nerve is known to be sensitive to external compression (meralgia paresthetica). It is also known to be vulnerable to injury during harvesting of iliac crest bone graft when the harvest site is carried too close to the anterior superior iliac spine and to damage by improperly placed arthroscopic portals.

The lateral circumflex femoral artery arises from the profunda femoris (deep femoral artery) shortly af

Rectus Femoris Site

Rectus femoris reflected & direct heads

Pectineus Iliopsoas

Adductor magnus Adductor longus

Adductor brevis Gracilis

Rectus femoris reflected & direct heads

Pectineus Iliopsoas

Adductor magnus Adductor longus

Adductor brevis Gracilis

FIGURE 6.5. Deep structures (anterior view).

Lateral Femoral Circumflex Artery
FIGURE 6.6. Neurovascular structures (anterior view).

ter it takes off from the femoral artery (see Figure 6.6). The ascending branch of the lateral circumflex femoral artery has an oblique course along the direction of the intertrochanteric line.

The superior gluteal nerve and artery are the most superior of 10 neurovascular structures that exit through the sciatic notch (Figure 6.7). They course transversely in a posterior to anterior direction between the deep surface of the gluteus medius and the superficial surface of the gluteus minimus, innervating and supplying blood to both. The sciatic nerve exits the notch under the piriformis tendon and then lies posterior to the other short external rotators in a vertical direction as it courses distally (see Figure 6.7).

An intricate vascular anastomosis converges at the lower border of the quadratus femoris consisting of the ascending branch of the first perforating artery, the descending branch of the inferior gluteal artery, and transverse branches of the medial and lateral circumflex femoral arteries (see Figure 6.7).

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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