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Medial compartment of the thigh

  • Muscle
    • gracillis
    • adductors longus
    • adductor brevis
    • adductor magnus
    • obturator externus
  • Nerve
    • obturator nerve
  • Vessels
    • produnda femoris & obturator artery
  • Action of all adductors
    • Less important in prime movement of adduction than in synergic activities associated with posture & gait

Gracillis

  • most superficial muscle
  • Origin
    • Edge of inferior pubic ramus & adjoining ischial ramus
  • Insertion
    • Upper part of medial surface of shaft of tibia just behind sartorius
  • Nerve Supply
    • Anterior division of obturator nerve

Adductor longus

  • most superficial of 3 adductors
  • upper border lies between the femoral & profunda femoris vessels
  • Origin
    • Circular area on body of pubis, in angle of pubic crest & symphysis
    • Tendon is sometimes ossified (rider’s bone)
  • Insertion
    • Via apneurotic flat tendon into middle third of linea aspera of femur
  • Nerve Supply
    • Anterior division of obturator nerve

Adductor brevis

  • Anterior division of obturator nerve passes downwards on its anterior surface & posterior division passes behind it
  • Origin
    • Body & inferior ramus of pubis, deep to pectineus & adductor longus
  • Insertion
    • Upper part of linea aspera immediately behind insertion of pectineus & adductor longus
  • Nerve Supply
    • Anterior division of obturator nerve

Adductor magnus

  • Composite muscle formed by fusion of adductor & hamstring muscle masses, each with their own nerve supply
  • Medial circumflex femoral artery passes between upper border of adductor magnus & lower border of quadratus femoris to reach the cruciate anastomosis
  • Near the top of the medial supracondylar line, there is a gap in the muscle attachment through which the femoral vessels pass, changing to the popliteal vessels
  • Along the linea aspera attachment there are 4 small openings, the lowest for the end of the profunda femoris vessels & the others for their perforating branches
  • Origin & Insertion
    • Hamstring
    • Ischial tuberosity attaching to adductor tubercle of femur & medial supracondylar line
  • Adductor
    • Ischial tuberosity & ischiopubic ramus inserting progressively higher along the medial supracondylar line, the linea aspera, up to gluteal tuberosity
  • Nerve Supply
    • Hamstring
      • Tibial part of sciatic nerve
    • Adductor
      • Posterior division of obturator (L2,3)

Obturator externus

  • Origin
    • Obturator membrane & anterior bony margin of obturator foramen
    • muscle passes laterally & posteriorly beneath neck of femur where it narrows into a tendon that spirals in contact with the back of the femoral neck
  • Insertion
    • Medial surface of greater trochanter into a deep pit, the trochanteric fossa
  • Nerve Supply
    • Posterior division of obturator nerve
  • Action
    • With other short muscles around hip, stabilizes & supports the proximal part of limb
    • Lateral rotator of femur

Obturator artery & nerve