Medial compartment of thigh

Anatomy of medial compartment of thigh

1. Medial compartment of
thigh
Dr Rajiv Ranjan
RIMS, RanchiDr Rajiv Ranjan

2. ThighDr Rajiv Ranjan

3. Medial compartment
•The c of the medial compartment of the thigh
•• Muscles: these comprise the hip adductors: gracilis,
p
ectineus, adductor longus, adductor brevis, adductor
magnus& Obturatorexternus
•• Arteries: profunda f
emoris(artery to the adductors) as
well as its medial circumflex femoral and perforating
branches and the obturator artery.
• Veins: profunda femoris and obturator veins.
• Nerves: the anterior and posterior divisions of the
obturatornerveDr Rajiv Ranjan

4. Medial compartment
of the thighDr Rajiv Ranjan

5. Medial compartment of the
thigh
(Dissected view)Dr Rajiv Ranjan

6. PECTINEUS
•Origin : Pecten pubi s
•Insertion : alo
ng a line from the lesser
trochanter to the lineaaspera
•Innervated : dua
l innervation
•femoral nerve, L2 and 3, and
•accessory o
L3
•Actions -a

the pelvisDr Rajiv Ranjan

7. Pectineus
•Actions -
A
dducts the thigh and flexes it on the
pelvisDr Rajiv Ranjan

8. GRACILIS
(l. slender)
•Origin : in
adjoining part of the ischial ramus
•Insert –p
anserinus
•Innervation : obturator n
erve, L2,3Dr Rajiv Ranjan

9. Action
Adductor of the thigh
Flexes the leg and rotates it
m
ediallyDr Rajiv Ranjan

10. ADDUCTOR LONGUS
•Arises by a narrow tendon (ossified
R
ider’s bone) from body of pubis bet
n
crest and symphysis
•Inserts by a
linea
asperain the middle third of the femur
•Lies be

n
Femoral and Profunda
Femorisvessels
•Innervation -a
nterior division of the
Obturator Nerve, L2, 3 and 4Dr Rajiv Ranjan

11. Action
Adductor & medial rotators of the thighDr Rajiv Ranjan

12. ADDUCTOR BREVIS
•Arises from body and inferior ramus of
the
pubis
•Insert along a line from the lesser
tr
ochanter to the lineaaspera
•Relations-
Anteriorly anterior branch of the
o
bturator nerve
Posteriorly posterior branch of the
o
bturator nerve
•Innervation-o
bturator nerve, L2 and 3Dr Rajiv Ranjan

13. Action
•Adduct and flex the femur at the h ipDr Rajiv Ranjan

14. ADDUCTOR MAGNUS
•Origin
•Adductor part inferior pubis ramus &
conjoined ischial ramus
•Hamstring partinferolateralaspect of the
ischialtuberosity
•short, horizontal fi bresfrom the pubic ramus
are inserted into the medial margin of the
glutealtuberosityof the femur
•The fi
from the ischial ramus insert via a
broad aponeurosis into the linea asperaand
the proximal part of the medial supracondylar
line
•fibresf

which descends almost vertically to its
attachment to the adductor tubercle on the
medial condyle of the femur
M.Dr Rajiv Ranjan

15. Cont…..
•The long, linear attachment of the muscle
i
s interrupted by a series of osseo-
aponeuroticopenings, bridged by
tendinousarches attached to the bone.
•The upper four are small and transmit the
per
forating branches and the termination
of the profundafemorisartery.
•
The lowest is large and allows the femoral
vessels to cross to the poplitealfossa.
•Innervation-do ubly innervated by the
obturator nerve and the tibialdivision of
the sciatic nerve (L2, 3 and 4)Dr Rajiv Ranjan

16. ADDUCTOR MAGNUS
Action
Adductor & medial rotators of the thighDr Rajiv Ranjan

17. Obturator Externus
•Arises from whole of obturator membrane
an
d from ant. Bony margin of obturator
foramen
•Inserted on the medial surface of greater
tr
ochanter into a deep pit ( trochanteric
fossa)
•Innervation –p
ost. div. of obturator N L3,4
•Action stabilizer and Lat. Rotator of thighDr Rajiv Ranjan

18. Obturatorartery
•Emerge from obturator foramen with the nerve
a
nd divide into ant. and post. branches
•They anastomose with each other and with
me
dial circumflex art.
•From the post br. Articular twig to hip joint
a
rises which runs in the lig. of head femur and
supply the fovea.Dr Rajiv Ranjan

19. Obturator nerve
•arises from the ventral branches of the L2-4
•Near the foramen it divides into anterior and
po
sterior branches, separated at first by part of
obturatorexternusand lower down by
adductor brevis
•Anterior branch–
•Near the ob
foramen the anterior
branch supplies the hip joint
•Behind pe
it supplies adductor longus ,
gracilis, usually adductor brevisand often
pectineus
•At the lower border of adductor longus it forms
su
bsartorialplexusDr Rajiv Ranjan

20. Dr Rajiv Ranjan

21. Obturator nerve
•Posterior branch –
•pierces ob
externusanteriorly,
supplies it and passes behind adductor
brevisto the front of adductor magnus,
dividing into branches to this
•usually sends an articular filament to the
kne
e joint Dr Rajiv Ranjan

22. TROCHANTERIC ANASTOMOSIS
lies near the trochanteric fossa of femur
It is an anastomosis between
ascending branch of medial circumflex femoral A
ascending branch of lateral circumflex femoral A
descending branch of superior gluteal A
descending branch inferior gluteal A
1
st
perforating artery may also contributeDr Rajiv Ranjan

23. TROCHANTERIC ANASTOMOSIS
•Creating an 'arterial ring of the femoral neck'
•Branches from this ring, the r
etinacularvessels, pierce the capsule and ascend along the
femoral neck to give the main blood supply to the head of the femurDr Rajiv Ranjan

24. CRUCIATE ANASTOMOSIS
Lies @ t
It is an anastomosis b
et
n
transverse br. of medial circumflex femoral A
transverse br. of lateral circumflex femoral A
descending br. of inferior gluteal A
ascending br. of first perforating ADr Rajiv Ranjan

25. Route for collateral circulationDr Rajiv Ranjan