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بسم الله الرحمن الرحيم. Medial Side Of The Thigh. Cutaneous nerve supply:. Ilioinguinal nerve (L1). Cutaneous branch of obturator nerve (L2,3,4). Posterior branch of medial cutaneous nerve of the thigh (L2,3). Adductor muscles.

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Presentation Transcript
cutaneous nerve supply
Cutaneous nerve supply:
  • Ilioinguinal nerve (L1).
  • Cutaneous branch of obturator nerve (L2,3,4).
  • Posterior branch of medial cutaneous nerve of the thigh (L2,3)
adductor muscles
Adductor muscles
  • There are 3 adductor muscles arranged from anterior to posterior:
  • Adductor longus.
  • Adductor brevis.
  • Adductor magnus.
  • More superficial to the 3 adductors there is a gracilis muscle.
obturator nerve l2 3 4
Obturator nerve (L2,3,4)

Origin:

  • It is a branch of the lumbar plexus.
  • It arises from the ventral divisions of the ventral rami of L2,3,4.
slide12

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.
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Anterior division

femoral artery

slide14

Pectineus

Anterior division

Adductor longus (cut)

Adductor brevis

Gracilis

Adductor longus (cut)

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Anterior branch:

  • It gives the following branches:
  • Articular branch to the hip.
  • Muscular branch to adductor brevis.
  • Muscular branch to adductor longus.
  • Muscular branch to gracilis.
  • Cutaneous branch which supplies the skin on the middle 1/3 of the medial side of the thigh.
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Posterior branch:

  • It gives the following branches:
  • Muscular branch to obturator externus.
  • Muscular branch to pubic part of adductor magnus.
  • Genicular branch.

N.B. Obturator nerve carries vasoconstrictor fibers from the lumbar part of sympathetic trunk to the obturator artery and its branches.

accessory obturator nerve
Accessory obturator nerve:
  • 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.
injury of obturator nerve
Injury of obturator nerve:
  • It leads to marked weakness of adduction of thigh however slight degree of adduction can be done by pectineus.
obturator artery
Obturator artery:

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 obturatorexternus.
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Distribution:

The two branches anastomose together to form an arterial circle.

It gives the following branches:

  • Muscular branches to:

Obturatorexternus, adductors, pectineus and gracilis.

  • Acetabular branch, to the hip joint.
  • Anastomotic twigs to the medial circumflex femoral and inferior gluteal artery.