Download THE MEDIAL COMPARTMENT OF THIGH

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.
GRACILIS
Origin of Gracilis
Origin:
•
Edge of inferior ramus of pubis
•
Adjoining ischial ramus.
Insertion :
•
Insertion of Gracilis
Nerve supply:
Anterior division of obturator nerve.
Action:
Adduction of thigh.
Upper part of medial surface of shaft of tibia
just behind sartorius.
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.
Nerve supply:
Anterior division of
obturator nerve.
Adductor Longus
Insertion
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 INSER
• 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.
Origin
Obturator
Externus
Insertion:
Medial surface of greater tronchanter of femur in to
trochantric fossa.
Obturator Externus
Insertion
Nerve supply:
Posterior division of the obturator nerve.
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.
REFERENCES
•
Clinically oriented anatomy
•
6 edition
th
• KLM
• Ch. 5- lower limb
• Pgs. 548-558
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