The obturator nerve in
human anatomy
The human body is the structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organ systems. They ensure homeostasis and the viability of the human body.
It comprises a he ...
arises from the
ventral
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Th ...
divisions of the second, third, and fourth
lumbar nerves
The lumbar nerves are the five pairs of spinal nerves emerging from the lumbar vertebrae. They are divided into posterior and anterior divisions.
Structure
The lumbar nerves are five spinal nerves which arise from either side of the spinal cord b ...
in the
lumbar plexus
The lumbar plexus is a web of nerves (a nervous plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the Ventral ramus of spinal nerve, divisions of the first four lumbar nerves (L1-L4) and ...
; the branch from the third is the largest, while that from the second is often very small.
Structure
The obturator nerve originates from the anterior divisions of the
L2,
L3, and
L4 spinal nerve roots. It descends through the fibers of the
psoas major
The psoas major ( or ; from grc, ψόᾱ, psóā, muscles of the loins) is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis. It joins the iliacus muscle to form the iliop ...
, and emerges from its medial border near the
brim of the pelvis
The pelvic brim is the edge of the pelvic inlet. It is an approximately Mickey Mouse head-shaped line passing through the prominence of the sacrum, the Arcuate line (ilium), arcuate and pectineal line (pubis), pectineal lines, and the upper margin ...
. It then passes behind the
common iliac arteries
The common iliac artery is a large artery of the abdomen paired on each side. It originates from the aortic bifurcation at the level of the 4th lumbar vertebra. It ends in front of the sacroiliac joint, one on either side, and each bifurcates in ...
, and on the lateral side of the
internal iliac artery
The internal iliac artery (formerly known as the hypogastric artery) is the main artery of the pelvis.
Structure
The internal iliac artery supplies the walls and viscera of the pelvis, the buttock, the reproductive organs, and the medial compart ...
and vein, and runs along the lateral wall of the
lesser pelvis
The pelvic cavity is a body cavity that is bounded by the bones of the pelvis. Its oblique roof is the pelvic inlet (the superior opening of the pelvis). Its lower boundary is the pelvic floor.
The pelvic cavity primarily contains the reproducti ...
, above and in front of the
obturator vessels, to the upper part of the
obturator foramen
The obturator foramen (Latin foramen obturatum) is the large opening created by the ischium and pubis (bone), pubis bones of the pelvis through which nerves and blood vessels pass.
Structure
It is bounded by a thin, uneven margin, to which a str ...
.
Here it enters the thigh, through the
obturator canal
The obturator canal is a passageway formed in the obturator foramen by part of the obturator membrane and the pelvis. It connects the pelvis to the thigh.
Structure
The obturator canal is formed between the obturator membrane and the pelvis. Th ...
, and divides into an anterior and a posterior branch, which are separated at first by some of the fibers of the
obturator externus
The external obturator muscle, obturator externus muscle (; OE) is a flat, triangular muscle, which covers the outer surface of the anterior wall of the pelvis.
It is sometimes considered part of the medial compartment of thigh, and sometimes ...
, and lower down by the
adductor brevis
The adductor brevis is a muscle in the thigh situated immediately deep to the pectineus and adductor longus. It belongs to the adductor muscle group. The main function of the adductor brevis is to pull the thigh medially. The adductor brevis ...
.
An accessory obturator nerve may be present in approximately 8% to 29% of the general population.
Branches
*
Anterior branch of obturator nerve
The anterior branch of the obturator nerve is a branch of the obturator nerve found in the pelvis and leg.
It leaves the pelvis in front of the obturator externus and descends anterior to the adductor brevis, and posterior to the pectineus and ...
*
Posterior branch of obturator nerve
The posterior branch of the obturator nerve pierces the anterior part of the obturator externus, and supplies this muscle; it then passes behind the adductor brevis on the front of the adductor magnus, where it divides into numerous muscular branch ...
*
Cutaneous branch of the obturator nerve
Occasionally the communicating branch to the anterior cutaneous and saphenous branches of the femoral is continued down, as a cutaneous branch, to the thigh and leg, as the cutaneous branch of the obturator nerve.
When this is so, it emerges fro ...
Function
The obturator nerve is responsible for the sensory innervation of the skin of the medial aspect of the
thigh
In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb.
The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone ...
.
The nerve is also responsible for the motor innervation of the adductor muscles of the
lower limb
The human leg, in the general word sense, is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb ext ...
(
external obturator
The external obturator muscle, obturator externus muscle (; OE) is a flat, triangular muscle, which covers the outer surface of the anterior wall of the pelvis.
It is sometimes considered part of the medial compartment of thigh, and sometimes ...
,
[Moore, K.L., & Agur, A.M. (2007). ''Essential Clinical Anatomy: Third Edition.'' Baltimore: Lippincott Williams & Wilkins. 336. ] adductor longus
In the human body, the adductor longus is a skeletal muscle located in the thigh. One of the adductor muscles of the hip, its main function is to adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall of the fem ...
,
adductor brevis
The adductor brevis is a muscle in the thigh situated immediately deep to the pectineus and adductor longus. It belongs to the adductor muscle group. The main function of the adductor brevis is to pull the thigh medially. The adductor brevis ...
,
adductor magnus Adductor may refer to:
* One of the anatomical terms of motion
* Adductor muscle (disambiguation)
* Adductor canal
The adductor canal, also known as the subsartorial canal or Hunter’s canal, is an aponeurotic tunnel in the middle third of the th ...
,
gracilis) and the
pectineus (inconstant). It is, notably, not responsible for the innervation of the
obturator internus
The internal obturator muscle or obturator internus muscle originates on the medial surface of the obturator membrane, the ischium near the membrane, and the rim of the pubis.
It exits the pelvic cavity through the lesser sciatic foramen.
The i ...
, despite the similarity in name.
[Moore, K.L., & Agur, A.M. (2007). ''Essential Clinical Anatomy: Third Edition.'' Baltimore: Lippincott Williams & Wilkins. 345. ]
Clinical significance
An obturator
nerve block
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, u ...
may be used during
knee
In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the hu ...
surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
and
urethral
The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra con ...
surgery in combination with other
anaesthetics
An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia — in other words, to result in a temporary loss of sensation or awareness. They may be divided into two ...
.
Additional images
Image:Gray837.png, Sacral plexus of the right side.
Image:Gray236.png, Right hip bone. Internal surface.
Image:Gray404.png, Left Levator ani from within.
Image:Gray436.png, The Obturator externus.
Image:Gray539.png, The arteries of the pelvis.
Image:Gray541.png, Variations in origin and course of obturator artery.
Image:Gray547.png, The relations of the femoral and abdominal inguinal rings, seen from within the abdomen. Right side.
Image:Lumbar_plexus.svg, Plan of lumbar plexus.
Image:Gray823.png, The lumbar plexus and its branches.
Image:Gray824.png, Deep and superficial dissection of the lumbar plexus.
Image:Gray829.png, Dissection of side wall of pelvis showing sacral and pudendal plexuses.
File:Slide12w.JPG, Obturator nerve
File:Slide7z.JPG, Obturator nerve
File:Slide1erer.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view.
File:Slide2erer.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view.
File:Slide3erer.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view.
File:Slide4erer.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view.
File:Slide2ewew.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view.
File:Slide3ewew.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view.
File:Slide1gt.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view
File:Slide2gt.JPG, Lumbar and sacral plexus. Deep dissection.Anterior view
References
External links
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*
*
* ()
cutaneous field at neuroguide.com
{{DEFAULTSORT:Obturator Nerve
Nerves of the lower limb and lower torso