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Updated: Jan 1 2022

Adductor magnus

4.0

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Images
https://upload.orthobullets.com/topic/10067/images/adductor thumbnail.jpg
https://upload.orthobullets.com/topic/10067/images/adductor nerve1500.jpg
https://upload.orthobullets.com/topic/10067/images/adductor blood1500.jpg
https://upload.orthobullets.com/topic/10067/images/upthigh1500.jpg
https://upload.orthobullets.com/topic/10067/images/lowthigh1500.jpg
https://upload.orthobullets.com/topic/10067/images/thighsections1500.jpg
https://upload.orthobullets.com/topic/10067/images/adductorinnervation1500.jpg
  • Summary
      • Adductor magnus
      • Origin
      • Inferior pubic ramus, ischial ramus, and inferolateral area of ischial tuberosity
      • Insertion
      • 2 separate insertions:
      • 1) Gluteal tuberosity of femur, medial lip of linea aspera, medial supracondylar ridge, 2) Adductor tubercle
      • Action
      • Powerful thigh adductor; superior horizontal fibers also help flex the thigh, while vertical fibers help extend the thigh
      • Innervation
      • Posterior division of obturator nerve innervates most of the adductor magnus; Hamstring portion innervated by tibial nerve (L2, L3, L4)
      • Arterial supply
      • Medial circumflex femoral artery, inferior gluteal artery, 1st - 4th perforating arteries, obturator artery, and some superior muscular branches of popliteal artery
  • Innervation
    • Adductor magnus is innervated by the
      • obturator nerve (L2-L4) - adductor part
      • tibial nerve (L4-S3) - hamstring part
    • Primary nerves of the anterior thigh
      • obturator nerve
        • origin
          • L2-4 of lumbar plexus
        • motor
          • medial compartment of thigh
            • adductor longus
            • adductor brevis
            • adductor magnus
            • gracilis
        • sensory
          • cutaneous branch innervates skin of medial thigh
        • course
          • descends through psoas and emerges at medial border
          • runs posterior to common iliac arteris to the obturator foamen
          • enters thigh through obturator canal
            • splits into anterior and posterior divisions
          • anterior division - descends between adductor longus and brevis
            • pierces fascia lata to become the cutaneous branch of obturator nerve
          • posterior division - descends through obturator externus muscle
            • passes anterior to adductor magnus and gives off branches to supply it
      • tibial nerve
    • Adductor magnus is supplied by the
      • obturator artery
      • femoral artery
      • medial femoral circumflex
      • direct and perforating branches of the deep femoral artery
    • Obturator artery
      • arises from internal iliac artery in pelvis
      • bifurcates in medial thigh into two branches
        • anterior branch - pectineus, obturator externus, adductor muscles and gracilis
        • posterior branch - deep gluteal muscles
    • Femoral artery
      • branches in thigh
        • profunda femoris
          • direct and perforating branches
        • medial femoral circumflex
        • lateral femoral circumflex
    • Cross section
      • high thigh
      • mid thigh
      • low thigh
    • Adductor magnus lies in the medial compartment of the thigh.
    • medial thigh compartment consists of
      • adductor brevis (obturator n.)
      • adductor longus (obturator n.)
      • adductor magnus (obturator n.)
      • gracilis (obturator n.)
    • adductor magnus is bordered by
      • anterior
        • pectineus
        • adductor longus
        • adductor brevis
        • sartorius (anterior/medial)
      • medial
        • gracilis
        • sartorius (anterior/medial)
      • superior
        • obturator externus
        • quadratus femoris
      • posterior surface
        • semitendinosus
        • semimembranosus
        • biceps femoris
        • gluteus maximus
  • Relevant Surgical Approaches
    • Hip Medial Approach
  • Clinical Images
    • Obturator nerve block
      • used for management of post-op pain from lower limb surgery or for chronic hip pain
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