The NEP of pectineus muscle branch (PMB) from the femoral nerve was revealed from lateral aspect.
The accessory obturator nerve and the innervation of the pectineus muscle. Anat.
On physical examination, it is difficult to palpate the hernia sac as it is usually concealed beneath the
pectineus muscle. The only meaningful sign seems to be Howship-Romberg sign, which refers to pain along the distribution of the obturator nerve caused by compression of the hernia sac,[sup][1] as exhibited in our case.
[8] A branch to the
pectineus muscle is given off as the femoral nerve enters the femoral triangle.
The hernia sac finally lies on top of obturator externus muscle beneath
pectineus muscle.
A triangular region bordered by the superior pubic ramus, posterior margin of the
pectineus muscle and anterior aspect of the external obturator muscle containing the obturator vessels and nerve was defined and later used clinically to perform obturator nerve block with ultrasound guidance.
1 = gracilis muscle branch of the obturator nerve; 2 = adductor longus muscle branch; 3 = adductor brevis muscle branch; 4 = adductor magnus muscle branch; 5 =
pectineus muscle branch; 6 = femoral nerve trunk.
The
pectineus muscle is innervated by the nerve to pectineus branch of the femoral nerve.
It perforated the
pectineus muscle and the articular capsule of the coxofemoral joint.
L5 = fifth lumbar vertebrae, L6 = sixth lumbar vertebrae, L7 = seventh lumbar vertebrae, FN = femoral nerve, ON = obturator nerve, IN = ischiatic nerve, bpm = branch to the
pectineus muscle, bqm = branch to the quadriceps muscle, bsm = branch to the sartorius muscle.