* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project
THE MEDIAL COMPARTMENT OF THIGH LEARNING OBJECTIVES At the end of today’s class, the student will be able to • Have good concept of the medial compartment of the thigh. • Understand the nerve supply of these muscles. • Describe the actions of the muscles of medial compartment of thigh. MEDIAL COMPARTMENT OF THIGH • Also called adductor compartment. • Separated from anterior compartment of thigh by medial intramuscular septum. MEDIAL COMPARTMENT OF THIGH Consists of following muscles, 1. Gracilis. 2. Adductor Longus. 3. Adductor Brevis 4. Adductor Magnus. 5. Obturator Externus Nerve of compartment : Obturator Nerve. Artery: Profunda Femoris Assisted By Obturator Artery. Origin: • Edge of inferior ramus of pubis • Adjoining ischial ramus. Origin of Gracilis Insertion : • Insertion of Gracilis Upper part of medial surface of shaft of tibia just behind sartorius. Nerve supply: Anterior division of obturator nerve. Action: Adduction of thigh. ADDUCTOR LONGUS Origin: • Circular area on body of pubis in angle between pubic crest and symphysis pubis. • Rounded tendon some times ossify to be called rider’s bone. Adductor longus Origin Insertion: • Aponeurotic flat tendon into the medial third of linea aspera of femur. Adductor Longus Insertion Nerve supply: Anterior division of obturator nerve. Action: Adduction of thigh. ADDUCTOR BREVIS Origin: Body and inferior ramus of pubic bone. Insertion: • Upper part of the linea aspera behind the insertion of pectineus and adductor longus. ADDUCTOR BREVIS ORIGIN Nerve supply: Anterior division of obturator nerve. Action: Adduction of thigh. ADDUCTOR BREVIS INSERTION ADDUCTOR MAGNUS It has two parts. • Hamstring part Origin: Ischial tuberosity. Insertion: Adductor tubercle and expands to medial supracondylar line of femur. • Adductor part in continuity with hamanstring part. Origin: Ischiopubic ramus. • ADDUCTOR MAGNUS ORIGIN Insertion: Upward along supracondylar line, the linea aspera and up to the gluteal tuberosity. ADDUCTOR MAGNUS INSERTION • Near the top of the medial supracondylar line there is a gap in the muscle- attachment through which femoral vessels pass and name is changed to popliteal vessels. Nerve supply: o Hamstring part by tibial part of sciatic nerve, o Rest of magnus by posterior division of obturator nerve. Action: Adduction Obturator Externus Origin: • Obturator Membrane. • Anterior Bony Margin Of The Obturator Foramen. • Passes Laterally And Posteriorly Beneath The Neck Of Femur. Insertion: Medial surface of greater tronchanter of femur in to trochantric fossa. Obturator Externus Insertion Nerve supply: Posterior division of the obturator nerve. Origin Obturator Externus Action: With other muscles stabilizes and supports the lower limb and is lateral rotator of the femur. OBTURATOR NERVE • From lumber plexus L2,3,4. • Divides in the obturator notch and anterior division passes anteriorly to obturator externus and posterior division through it. ANTERIOR DIVISION Of OBTURATOR NERVE • Gives articular branch to hip joint. • Passes down over anterior surface of adductor brevis. • Supplies to adductor longus brevis and gracilis. • End in subsartorial plexus its branches also supply medial side of thigh. POSTERIOR DIVISION Of OBTURATOR NERVE : • Emerges through obturator Externus and supplies it. • Run down on adductor magnus supplies its ischial part. • It gives terminal branch, which supplies to capsule of knee joint. PROFUNDA FEMORIS ARTERY: • Normally this vessel supply to all thigh muscles. • Arise from lateral side of femur 3-4 cm distal to the inguinal ligament. • Spiral down between pectineus and adductor longus. MEDIAL CIRCUMFLEX FEMORAL ARTERY: • • Passes laterally beneath the branches of femoral nerve and sartorius muscle. divides in three branches. • • • ASCENDING BRANCH: Gives a branch to trochantric anastomosis Ends by anastomosing with superficial and deep circumflex iliac artery and an iliac branch of iliolumber and superior branch of superior gluteal artery. b. TRANSVERSE BRANCH: Passes across to form one limb of to cruciate anastomosis. c. DESCENDING BRANCH: Supplies to vastus lateralis and medialis and end by sending twigs to knee joint. 2. MEDIAL CIRCUMFLEX FEMORAL BRANCH: • Passes between quaradatus femoris and adductor magnus to gluteal region. • Gives – A. Ascending branch to trochantric anastomosis and – B. Horizontal branch to cruciate anastomosis. 3. FOUR PERFORATING BRANCHES: • Supply adductors • Make series of anastomosis with one another and with cruciate anastomosis. Learning Resources Last’s Anatomy, Gray’s anatomy, Keith L Moore’s Anatomy, Clinical Anatomy by Richard S Snell and Atlas of human anatomy by Frank H Netter with thanks.