Muscles Of The Medial Compartment Of The Thigh

The muscles in the medial compartment of the thigh are primarily adductors of the hip because of their medial orientation. The obturator nerve (L2-L4) innervates most of the muscles in the medial compartment of the thigh. However, each muscle does not necessarily receive each spinal nerve level between L2 and L4 (Figure 36-2A and B).

Pectineus muscle. Attaches to the pectineal line of the pubis and the posterior surface of the proximal femur. The pectineus muscle adducts and flexes the thigh at the hip joint. The femoral nerve (L2 and L3) innervates this muscle, with occasional branches from the obturator nerve.

Adductor longus muscle. Attaches proximally to the body of the pubis; distally, the muscle attaches on the linea aspera. The adductor longus muscle adducts and medially rotates the thigh at the hip joint. The obturator nerve (L2-L4) innervates this muscle.

Adductor magnus muscle. Consists of an adductor part and a hamstring part. Proximally, the adductor part attaches to the ischiopubic ramus, and the hamstring part attaches to the ischial tuberosity. Distally, the adductor part of the muscle attaches on the linea aspera, and the hamstring part attaches on the adductor tubercle. The adductor magnus muscle is the largest and deepest muscle of the muscles of the medial compartment of the thigh. It adducts and medially rotates the thigh at the hip joint. The obturator nerve (L2-L4) innervates the adductor part of the muscle, and the tibial division of the sciatic nerve (L4) and the obturator nerve (L2 and L3) innervate the hamstring part of the muscle.

Adductor brevis muscle. Attaches proximally to the inferior pubic ramus and the linea aspera. The adductor brevis muscle adducts and medially rotates the thigh at the hip joint. The obturator nerve (L2-L4) innervates this muscle. Gracilis muscle. Attaches to the inferior pubic ramus and the medial surface of the proximal shaft of the tibia (pes anserinus). The gracilis muscle adducts the thigh at the hip joint and flexes the leg at the knee joint. The obturator nerve (L2 and L3) innervates this muscle.

Obturator externus muscle. Attaches to the external surface of the obturator membrane, adjacent bone, and trochanteric fossa. The obturator externus muscle laterally rotates the femur at the hip joint. The obturator nerve (L3 and L4) innervates this muscle.

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