Quadriceps femoris muscle

Origin and insertion

The rectus femoris is a fusiform muscle that consists of two heads. It originates from two sites on the ilium; the anterior inferior iliac spine (straight head) and supraacetabular groove (reflected head). The two heads unite into a common muscle belly that courses down the thigh in an almost vertical fashion, covering the anterior aspect of this region. 

The muscle fibers converge towards a thick tendon which inserts into the base of patella. Occasionally, the rectus femoris can have a third head that originates from the iliofemoral ligament.

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Relations

The proximal part of rectus femoris muscle lies deep to tensor fasciae latae, sartorius and iliacus muscles. All the contents of the anterior compartment of the thigh lie deep to rectus femoris. These include the capsule of the hip joint, vastus intermedius, anterior margins of vastus lateralis and vastus intermedius, lateral circumflex femoral artery and some branches of the femoral nerve.

Blood supply

The rectus femoris muscle is supplied by the artery of the quadriceps, which can stem from three sources; femoral, deep femoral or lateral circumflex femoral arteries. The lateral circumflex femoral and superficial circumflex iliac arteries also contribute to the blood supply of rectus femoris, but to a lesser extent.

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Origin and insertion

The vastus medialis muscle originates from several landmarks of the proximal femur; the inferior part of the intertrochanteric line, pectineal line of femur, medial lip of linea aspera and proximal half of the medial supracondylar line. It descends obliquely through the thigh, with its fibers spiraling around the long axis of the muscle. 

The lowermost fibers lie in an almost horizontal plane, forming a noticeable bulge superior to the medial side of the patella. This particular part of vastus medialis is often referred to as the vastus obliquus by some authors. Finally, the muscle inserts into the base of patella via the quadriceps femoris tendon. Some of its tendinous fibers continue downwards and insert into the medial condyle of tibia.

Relations

Vastus medialis lies medial to rectus femoris and is partially covered by it. The sartorius muscle also crosses the superficial surface of vastus medialis. In the middle third of the thigh, vastus medialis forms the lateral wall of the adductor canal (Hunter’s canal). This canal is completed by adductor longus and adductor magnus posteriorly, and by sartorius medially. It transmits the femoral artery, femoral vein, saphenous nerve and nerve to vastus medialis (both being branches of femoral nerve).

Blood supply

Vastus medialis is supplied by three muscular branches of the femoral artery. It also receives some minor contributions from the deep femoral and descending genicular arteries.

Origin and insertion

Vastus lateralis is the largest of all four quadriceps femoris muscles. It originates via a broad aponeurosis from various sites on the femur, such as the proximal half of the intertrochanteric line, anterior and inferior borders of the greater trochanter, lateral lip of the gluteal tuberosity and proximal half of the lateral lip of linea aspera. The aponeurosis overlies the upper three-quarters of the muscle, with many muscle fibers originating from its deep surface.

The muscle descends through the lateral part of the anterior thigh compartment and inserts to the base of patella via the quadriceps tendon. Some of its tendinous fibers descend all the way to the proximal tibia and blend with the iliotibial tract to insert into the lateral condyle of tibia.

Relations

The vastus lateralis muscle lies superficial to the biceps femoris muscle, from which it is separated by the lateral intermuscular septum. The lateral side of the muscle is covered by the tensor fasciae latae and gluteus maximus. Its medial surface is related to vastus intermedius, from which it is separated by the lateral femoral circumflex artery and branches of the femoral nerve.

Blood supply

Vastus lateralis receives its blood supply from three sources; 

• The superior medial artery, which is a branch of the lateral circumflex femoral artery.
• The inferior medial artery, a branch of the artery of the quadriceps.
• The lateral artery, which is actually the first perforator of the deep femoral artery.

Origin and insertion

The vastus intermedius muscle lies between vastus lateralis and vastus medialis. It originates from the anterior surface of the femur, more specifically from the proximal two-thirds of its shaft. The muscle descends over the anterior surface of femur, filling the interval between vastus medialis and lateralis. It gives off a wide aponeurosis at the level of the distal femur, via which it attaches to the base of patella via the common quadriceps tendon. It also inserts into the lateral condyle of tibia. 

Relations

Vastus intermedius is completely surrounded by the other muscles of the quadriceps femoris. Rectus femoris covers its anterior surface, while vastus lateralis and medialis lie on its lateral and medial surfaces, respectively.

Blood supply

The blood supply to the vastus intermedius comes from the artery of the quadriceps and deep femoral artery.