ADDUCTOR CANAL AND

MEDIAL COMPARTMENT OF
THE THIGH
By Olayemi Olamide Samuel (BS.c
(Osun) MS.c (Lagos)
 It is a narrow intermuscular canal located
in the middle 1/3rd of the medial aspect
of the thigh .
 It extends from apex of femoral triangle
to the fifth osseo-aponeurotic opening in
adductor magnus.
 It allows the passage of femoral vessels
from femoral triangle to the popliteal
fossa.
 Boundaries
 Adductor canal is triangular in section
and therefore has three walls.
 Anterolaterally it is bounded by vastus
medialis.
 Medially (roof) it is formed by sartorius
muscle beneath which lies subsartorial
plexuses over a fascial sheath.
 Posteriorly it is bounded by adductor
longus (in upper part) and adductor
magnus (in lower part)boundaries of
adductor canal.
 Adductor canal (Hunter's canal or the
subsartorial canal) is a key anatomical
structure in the thigh that allows for the
passage of important neurovascular
elements from the anterior compartment
to the posterior compartment of the leg.
 CONTENTS

 The canal transmits several critical

neurovascular structures:
 ARTERIES AND VEINS
 Femoral Artery:

 The femoral artery, which becomes the popliteal artery after

passing through the adductor hiatus, is a major blood vessel
supplying the lower limb.
 Important: It provides blood supply to the anterior and medial
compartments of the thigh through its branches, including
the profunda femoris artery.
 Femoral Vein:

 The femoral vein accompanies the femoral artery and drains

blood from the lower limb, eventually becoming the popliteal
vein after passing through the adductor hiatus.
 Important: It collects deoxygenated blood from the thigh and
leg.
 Nerves that participate in
formation of subsartorial plexus

 Saphenous nerve
 Medial cutaneous nerve of thigh
 Anterior division of obturator nerve
 Saphenous Nerve:

 This is a branch of the femoral nerve.

 Important: It provides sensory innervation to the
medial aspect of the leg and foot. The nerve runs
alongside the femoral artery within the canal and then
becomes more superficial as it passes through the
canal to supply sensation to the medial side of the leg.
 Nerve to Vastus Medialis:

 This is a branch of the femoral nerve that provides

motor innervation to the vastus medialis muscle.
 Important. It is involved in knee extension.
 Please note that all the contents enter
the canal through the apex of femoral
triangle but femoral vessels leave it
through the opening in adductor hiatus
(lower end), saphenous nerve by piercing
the roof and the nerve to vastus medialis
by entering vastus medialis (anterolateral
wall).
 Clinical Relevance
 The adductor canal is a key site for certain
medical procedures, such as catheterization or
injections. For instance, a femoral artery
catheterization or a local anesthetic injection
for regional anesthesia (e.g., adductor canal
block) can be performed here.
 Local anaesthetic can be administered in the
adductor canal to block the saphenous nerve
in isolation, or together with the nerve to the
vastus medialis to provide anaesthesia for
procedures involving the distal thigh, knee and
lower leg on the medial side.
 Injury or Compression: Conditions affecting the structures
within the adductor canal, such as trauma or tumors, can
lead to vascular or nerve symptoms, including altered
sensation or motor function in the lower limb.
 Surgical Considerations: Surgeons need to be aware of
the adductor canal's boundaries and contents to avoid
complications during surgeries involving the thigh or
knee.
 Femoral artery can be easily approached and ligated in
the adductor canal during surgery of popliteal aneurysm.
Following ligation of femoral artery, blood can reach
popliteal artery through the anastomotic channels around
the knee. This was first described in the eighteenth
century by John Hunter.
 Summary

 Canal Shape: The adductor canal is generally

described as a narrow, elongated space running
obliquely from the femoral triangle to the adductor
hiatus.
 Opening: The canal ends at the adductor hiatus, an
opening in the adductor magnus muscle through
which the femoral vessels pass to enter the
popliteal fossa behind the knee.
 Understanding the anatomy of the adductor canal is
essential for clinicians dealing with lower limb
vascular or nerve conditions and for performing
procedures that involve the medial thigh region.
 MEDIAL COMPARMENTS OF THE THIGH
 Contents of the Medial Fascial
Compartment of the Thigh
• Muscles: Gracilis, adductor longus,
adductor brevis, adductor magnus
• Blood vessels: Profunda femoris
artery and vein & obturator artery
and vein
• Nerves : Obturator nerve
 Muscles of the medial compartment
of the thigh
1. Gracilis.
2. Adductor longus.
3. Adductor brevis.
4. Pubic part of
Adductor magnus.
 Gracilis
Origin: Inferior pubic ramus and
ischial ramus (pubic arch close
to its margin).
Insertion: Upper part of the
medial surface of the shaft of
the tibia.
Nerve Supply: Anterior division of

obturator nerve
Action: Adduction of the thigh.
Flexion of the leg.
 Adductor Longus
Origin:
Body of the pubic bone
just below and medial to
the pubic tubercle.
Insertion:
Linea aspera of the femur
lateral to the origin of
vastus medialis.
Nerve Supply:
Anterior division of the
obturator nerve.
Action:
Adduction of the thigh.
Helps lateral rotation of
the thigh.
 Adductor Brevis
Origin:
inferior ramus of the pubic bone.
Insertion:
Linea aspera of the femur.
Nerve Supply:
Anterior division of the
obturator nerve.
Action:
Adduction of the thigh.
Helps in lateral rotation
of the thigh.
 Adductor Magnus
Origin:
Pubic part: from Inferior pubic ramus.
Ischial part: from Ischial ramus and lateral part of the lower area of
ischial tuberosity.
Insertion:
Pubic part: linea aspra and medial supracondylar line
Ischial part: Adductor tubercle of the femur.
Nerve Supply:
Pubic part: posterior division of the obturator nerve.
Ischial part: Sciatic nerve.
Action:
Pubic part: Adduction of the thigh.
Ischial part: Extension of the thigh.

The adductor hiatus is a gap in the attachment of this muscle to the

femur, which permits the femoral vessels to pass from the adductor
canal downward into the popliteal space.
 Profunda Femoris Artery
• It is a large artery that arises from the
femoral artery in the femoral triangle, about
1.5 in. (4 cm) below the inguinal ligament.
• It descends in the interval between the
adductor longus and adductor brevis and
then lies on the adductor magnus, where it
ends as the fourth perforating artery.
 Branches of the profunda femoris artery
• Medial circumflex femoral artery: This passes backward
between the muscles that form the floor of the femoral
triangle and gives off ascending and transverse branches . It
takes part in the formation of the cruciate anastomosis.
• Lateral circumflex femoral artery: This passes laterally
between the terminal branches of the femoral nerve. It
gives off ascending, transverse and descending branches. It
takes part in the formation of the cruciate anastomosis.
• Four perforating arteries: Three of these arise as branches
of the profunda femoris artery; the fourth perforating
artery is the terminal part of the profunda artery.
 Profunda Femoris Vein
The profunda femoris vein receives
tributaries that correspond to the
branches of the artery.
It drains into the femoral vein.
 Obturator Artery
• It is a branch of the internal iliac artery.
• It passes forward on the lateral wall of the pelvis and
accompanies the obturator nerve through the obturator
canal.
• On entering the medial compartment of the thigh, it divides
into medial and lateral branches, which pass around the
margin of the outer surface of the obturator membrane. It
gives off muscular branches and an articular branch to the
hip joint.
• Obturator Vein
• The obturator vein receives tributaries that correspond to
the branches of the artery. It drains into the internal iliac
vein.
 Obturator Nerve
• The obturator nerve arises from the
lumbar plexus (L2, 3, and 4) and emerges
on the medial border of the psoas major
muscle within the abdomen.
• It runs forward on the lateral wall of the
pelvis to reach the upper part of the
obturator foramen, where it divides into
anterior and posterior divisions.
 Branches of the obturator nerve
The anterior division passes downward in front of the obturator
externus and the adductor brevis and behind the pectineus and
adductor longus.
• It gives muscular branches to the gracilis, adductor brevis, and
adductor longus, and occasionally to the pectineus.
• It gives articular branches to the hip joint and terminates as a small
nerve that supplies the femoral artery.
The posterior division passes downward behind the adductor
brevis and in front of the adductor magnus.
• It terminates by descending through the opening in the adductor
magnus to supply the knee joint.
• It gives muscular branches to the obturator externus, to the adductor
part of the adductor magnus.
 Nerve and Vessel Pathways

 Adductor Canal:
 Description: The adductor canal is an
important passageway for the femoral
artery and vein and the saphenous nerve.
 Clinical Relevance: It is significant for
procedures like adductor canal block,
which provides anesthesia to the medial
side of the thigh and the knee.
 FASCIAL STRUCTURES

 Fascia Lata:
 Description: A thick connective tissue layer
surrounding the muscles of the thigh.
 Function: It encloses the muscles of the medial
compartment, providing support and contributing to
the formation of the iliotibial band.
 Clinical Relevance:
 Injuries: The anatomy of the medial thigh is
important for diagnosing injuries such as adductor
strains or tears. The knowledge of the medial
thigh's anatomy is crucial for surgical procedures,
including hip and knee surgeries.
 Nerve Injuries: Damage to the obturator
nerve can lead to difficulty with thigh
adduction and sensory loss in the medial
thigh.
 Summary

 Muscle Group: The medial compartment

is primarily involved in thigh adduction
and also assist in hip flexion and knee
movement.
 Nerve Supply: The obturator nerve is the
primary nerve supplying the medial thigh
muscles.
 Blood Supply: The obturator artery and
the profunda femoris artery supply the
medial thigh muscles.
 The medial side of the thigh is integral to
various movements and stabilizing
actions of the lower limb.


T for thanks