Transcript Pectineus

Pectineus
•Innervation
•Femoral Nerve
•Origin
•Pectineal line of the pubis
•Insertion
•Along the pectineal line of the femur,
between the lesser trochanter and
the linea aspera
•Blood supply
•Medial femoral circumflex branch of
the deep femoral artery
Pectineus
•How to find the muscle
•Find the origin by locating the
pectineal line of the pubis
•A ridge on the superior ramus of
the pubic bone (Figure A)
•Find the insertion by probing the
inferior side of the femur
intermediate to the lesser trochanter
and linea aspera. This will be the
pectineal line of the femur (Figure B)
•How to find the nerves
•Anterior cutaneous branches of the
femoral nerve can be found
longitudinally adjacent to the great
saphenous vein.
•How to find the vessels
•Visualize the posterolateral aspect of
the femoral artery 3-4 cm inferior to
the inguinal ligament to find the
profunda femoris artery.
•The lateral and medial femoral
circumflex arteries branch from the
profunda femoris.
Fig. A
Fig. B
Adductors
•Consist of the longus, brevis and
magnus
•Innervation
• Obturator Nerve
•Origins
•Various
•Insertions
•Various
•Blood supply
•Obturator Artery
•Deep Femoral Artery
•Medial Circumflex Femoral
Adductors
•Longus
•How to find the muscle
•Find the origin by probing the
anterior pubic crest at the symphisis.
•Find the insertion on the posterior
femur in the central third of the
linea aspera
•How to find the nerves
•Deep to the pectineus is the
obturator canal in which lies the
obturator nerve. Can also be found
by cutting the adductor longus 3cm
below its origin. Reflection of the
distal part will display its motor
nerve entering the deep surface.
•How to find the blood vessels
•The deep femoral can be found
anterior to the pectineus in the
femoral triangle. It continues along
the surface of the adductor brevis
muscle adjacent to the femoral
diaphysis.
•The obturator artery can be found
as it branches anteriorly and
posteriorly at the obturator
foramen.
Adductors
•Brevis
•How to find the muscle
•Find the origin between the gracilis
and the obturator externus on the
outer surface of the inferior pubic
ramus.
•Find the insertion along the
pectineal line of the femur and
upper pat of the linea aspera behind
the pectineus.
•What nerves innervate it?
•Obturator Nerve
•What blood vessels supply it
•Deep femoral artery
•Obturator Artery
Fig. B
Adductors
•Magnus
•How to find the muscle
•Posterior to the adductor longus
•Origin found on the inferior ramus
of the pubis as well as the ischial
ramus and tuberosity
•Insertion is located on the medial
lip of the upper two thirds of the
linea aspera
•What nerves innervate it?
•Obturator Nerve
•What blood vessels supply it
•Deep femoral artery
•Obturator Artery
•Medial Femoral Circumflex
Fig. A
Gracilis
•Innervation
•Obturator Nerve
•Origin
•Body of the pubis and the adjacent
inferior pubic ramus
•Insertion
•Upper part of the medial surface of
the tibia below the medial condyle
•Blood supply
•Obturator Artery
Gracilis
•How to find the muscle
•Long, narrow and flat
•Origin sits inferior to the origin of the
adductor longus
•Insertion is medial tendon that
stretches over the medial condyle of
the femur and attaches between the
sartorius and the semitendinosus
•What nerve innervates it
•Obturator Nerve
•What blood vessels supply it
•Obturator Artery
Obturator externus
•Innervation
•Obturator Nerve
•Origin
•Medial part of the outer surface of
the obturator membrane and the
medial margin of the obturator
foramen
•Obturator membrane is a thin
fibrous sheet that nearly closes off
the obturator foramen
•Insertion
Fig. A
•Trochanteric fossa of the femur
•Blood supply
•Obturator Artery
•Inferior Gluteal Artery
•Medial Circumflex Femoral
•Lateral Circumflex Femoral
Fig. B