In: Categories » » Human body » Human body MEDIAL SIDE OF THE THIGH
1. Identify and clean the gracilis which is a strap-like muscle passing from the pubic bone to the medial side of the upper end of the tibia. Next detach the gracilis muscle from its origin and reflect it downwards.
2. Now turn your attention to the adductor muscles which are arranged in three layers. The pectineus arises from the superior ramus of the pubis and is inserted into the back of the femur below the lesser trochanter. The adductor longus arises by a tendon from the body of the pubis and is inserted into the medial lip of the linea aspera. Observe that these two muscles lie edge to edge and constitute the anterior layer.
3. Cut the pectineus and adductor longus close to their origin from the pubic bone and turn them downwards taking care to preserve the anterior division of the obturator nerve, which lies on the adductor brevis. This muscle forms the middle layer. Study the attachments of the adductor brevis muscle. It arises from the body and inferior ramus of the pubis and is inserted into the upper half of the linea aspera. Detach the adductor brevis from its origin and reflect it downwards.
4. Find the posterior division of the obturator nerve lying on the adductor magnus muscle which forms the posterior layer. Trace the posterior division of the obturator nerve proximally and note that it enters the adductor compartment by piercing the obturator externus muscle.
5. Note that the obturator nerve supplies all the adductor muscles as well as the obturator externus and gracilis.
6. Study the attachments of the adductor magnus and obturator externus muscles:
(a)The adductor magnus, which is a composite muscle, arises from the ischiopubic ramus and the ischial tuberosity. From here, the muscle fibres fan out to gain insertion into the back of the femur along the medial lip of the linea aspera and the medial supracondylar line down to the adductor tubercle. The upper horizontal portion forms the true adductor part which is supplied by the obturator nerve, while the lower fibres which mainly arise from the ischial tuberosity and run vertically downwards to the adductor tubercle constitute the hamstring part. This part of the muscle is supplied by the tibial part of the sciatic nerve (see later).
(b) The obturator externus arises from the external surface of the obturator membrane and the adjoining bone. Its insertion will be seen later.
7. Follow the iliopsoas towards its insertion into the lesser trochanter of the femur.
8. Trace the passage of the profunda femoris artery between the pectineus and adductor longus and subsequently deep to the adductor longus where it gives off perforating arteries as it lies on the adductor brevis and adductor magnus.
Summary
The musculature of the anterior and medial aspects of the thigh consists chiefly of the extensor and adductor groups. The quadriceps femoris belonging to the extensor group comprises of the rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. They cover the anterior, lateral and medial sides of the shaft of the femur. The quadriceps, as well as the sartorius and pectineus, are innervated by the femoral nerve arising from the dorsal divisions of L2, 3,
Why are the extensors, i.e. quadriceps, well developed in humans? The adductor muscles comprise of an anterior layer formed by pectineus and adductor longus, a middle layer formed by the adductor brevis and a posterior layer consisting of the adductor magnus. In addition to these, the gracilis and obturator externus are also included in this group as they are all supplied by a common nerve, i.e. obturator nerve derived from the ventral divisions of L2, 3,
4. It will be observed that the anterior division of the obturator nerve lies between the superficial and middle layers, while the posterior division lies between the middle and posterior layers, i.e. the two divisions are separated by the adductor brevis. The femoral and obturator nerves do not proceed beyond the thigh region. However, the saphenous nerve might be regarded as a continuation of the femoral nerve into the medial side of the leg and foot. The femoral nerve lies lateral to the femoral artery in the femoral triangle and the saphenous nerve accompanies the artery in the adductor canal. The femoral artery runs from the midinguinal point towards the apex of the femoral triangle, where the femoral artery, the femoral vein, profunda vein and profunda artery lie in this order from before backwards. In its further course the femoral artery lies in the adductor canal, which is in fact a groove between the vastus medialis and the adductors. The artery then leaves the canal to enter the popliteal region through an opening in the tendon of the adductor magnus. The profunda femoris artery and its branches provide the major arterial supply to the thigh.
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