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