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MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

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Page 1: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 2: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 3: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

1. Ilioinguinal nerve (L1).2. Cutaneous branch of obturator nerve

(L2,3,4).3. Posterior branch of medial cutaneous

nerve of the thigh (L2,3)

Page 4: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

There are 3 adductor muscles arranged from anterior to posterior:

1. Adductor longus.2. Adductor brevis.3. Adductor magnus. More superficial to the 3 adductors there

is a gracilis muscle.

Page 5: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

                          

Page 6: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 7: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

origin Insertion N.S. actionsAdd. longus

Front of body of pubis below pubic tubercle

Linea aspra Anterior branch of obturator nerve

Adduction.

Flexion.

Lat.rotation.

Add. brevis

Body of pubis + inf. Pubic ramus

Lower part of line between lesser trochanter and L. aspra + L.aspra

Anterior branch of obturator

Adduction

Flexion

Lat. rotation

Add magnus

Pubic part (conjoint ramus)

Ischial part (ischial tuberosity

Pubic part (gluteal tuberosity, L.aspra, med.Supracondylr ridge)

Ischial part(add. tubercle of femur)

Pubic part (post. Branch of obturator).

Ischial part (sciatic n.)

Pub.part; addction, flexion, lat, rotation)

Ischial part; extension of hip)

gracilis Conjoint ram. tibia Ant. B.otur. Add. Thigh

Flex knee

Page 8: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Origin: It is a branch of the lumbar plexus. It arises from the ventral divisions of the

ventral rami of L2,3,4.

Page 9: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

A- Origin

Page 10: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 11: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 12: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Course& relations: It reaches the thigh by passing through

the obturator canal. Immediately it divides into anterior

and posterior branches. The anterior branch descends infront of the adductor brevis and infront of adductor longus and pectineus.

The posterior branch passes through the obturator externus and then behind adductor brevis and infront of adductor magnus.

Page 13: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Anterior division

femoral artery

Page 14: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Adductor longus (cut)

Adductor longus (cut)

Gracilis

Adductor brevis

Pectineus

Anterior division

Page 15: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Anterior branch: It gives the following branches:1. Articular branch to the hip.2. Muscular branch to adductor brevis.3. Muscular branch to adductor longus.4. Muscular branch to gracilis.5. Cutaneous branch which supplies the

skin on the middle 1/3 of the medial side of the thigh.

Page 16: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Posterior division

Page 17: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 18: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Posterior branch: It gives the following branches:1. Muscular branch to obturator

externus.2. Muscular branch to pubic part of

adductor magnus.3. Genicular branch.N.B. Obturator nerve carries

vasoconstrictor fibers from the lumbar part of sympathetic trunk to the obturator artery and its branches.

Page 19: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of
Page 20: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

An occasional branch of the lumbar plexus.

Only found in 12% of subjects. It descends close to medial side of psoas

major muscle behind inguinal ligament. It gives branches to pectineus and hip

joint.

Page 21: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

A- Origin

Page 22: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

It leads to marked weakness of adduction of thigh however slight degree of adduction can be done by pectineus.

Page 23: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Origin:It is a branch of anterior division of the internal iliac artery.Course & relations:It enters the thigh by passing through obturator canal and immediately divides into anterior and posterior branches.The two branches diverge and runs on the outer aspect of obturator membrane along the margin of obturator foramen and under cover of obturator externus.

Page 24: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of

Distribution:The two branches anastomose together to form an arterial circle.It gives the following branches:1.Muscular branches to:Obturator externus, adductors, pectineus and gracilis.2.Acetabular branch, to the hip joint.3.Anastomotic twigs to the medial circumflex femoral and inferior gluteal artery.

Page 25: MEDIAL SIDE OF THE THIGH 1. Ilioinguinal nerve (L1). 2. Cutaneous branch of obturator nerve (L2,3,4). 3. Posterior branch of medial cutaneous nerve of