Anatomy
Origin:
Adductor part: Ischiopubic ramus.
Hamstring part: Ischial tuberosity.
Insertion:
Adductor part: Gluteal tuberosity, linea aspera and the medial supracondylar line.
Hamstring part: Adductor tubercle and supracondylar line.
Key Relations:
-One of the six muscles of the medial compartment of the thigh.
-Anterior to adductor magnus are pectineus, adductor brevis, adductor longus and the posterior branch of the obturator nerve.
-The sciatic nerve lies posterior to the muscle.
-A large circular opening exists inferiorly, between the insertion of the adductor and hamstring parts of adductor magnus. This is called the adductor hiatus and allows passage of the femoral vessels from the adductor canal on the anteromedial knee through to the popliteal fossa.
-A series of smaller openings exist up along the adductor part for passage of the perforating arteries (branches of the deep artery of the thigh).
Functions
-Adducts (adductor part) and extends (hamstring part) the thigh at the hip joint.
-Also medially rotates the thigh at the hip joint.
Supply
Nerve Supply:
Adductor part: Obturator nerve (L2, L3, L4)
Hamstring part: Tibial division of sciatic nerve (L2, L3, L4)
Blood Supply:
-Deep femoral artery
–Obturator artery.
Clinical
Hip adductor injuries (groin strains) are common sporting injuries and may involve any one of the adductor muscles of the thigh (pectineus, adductor brevis, adductor longus, gracillis, adductor magnus). Damage can occur when high demands are placed upon the muscles such as changing direction rapidly. Another common cause observed with soccer players is forced abduction of the thigh during an intended adduction. This scenario can occur when the player trying to kick the ball in one direction meets resistance, such as a player attempting to kick it in the opposite direction. Treatment is generally non-operative. Rest and anti-inflammatory medication are used early on, followed by increasing exercise and range of motion work.
The adductor muscles of the thigh are tested as a functional group. The patient is requested to lie with their knees extended on the opposite side of that to be tested. The physician will abduct the leg on the side being tested, and then ask the patient to adduct the leg against resistance.
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