Obturator derives from the latin verb obturare denoting to occlude or cover over. It has been estimated that this accessory obturator nerve. Inner surface of obturator foramen and the obturator membrane to attach. The obturator nerve arises from the anterior division of l2l4 ventral rami. It arises from the bony boundaries of the obturator foramen, including the inferior ramus of the pubis, the ischial ramus, the pelvic surface of the hip bone and the upper part of the greater sciatic foramen. The posterior lateral wall of the lesser pelvis is divided by the sacrotuberous and sacrospinous ligaments into the sciatic foramina, and the anterolateral obturator foramen is filled by the obturator membrane. From an embryologic point of view, since the foramen and membrane represent an area of incomplete bone formation, the obturator foramen is a lacuna while the obturator canal is the real. In most individuals, the nerve divides into an anterior branch and posterior branch before exiting the pelvis through the obturator foramen. Obturator foramen an overview sciencedirect topics.
Obturator foramen is a large gap in the hip bone, situated anteroinferior to acetabulum, between the pubis and the ischium. Researchers have also studied the obturator region to analyze the relationships of the transobturator sling and anatomical structures within the obturator region 6. In the male it is large and of an oval form, its longest diameter slanting obliquely from before backward. Foramen obturatum definition of foramen obturatum by. The obturator foramen is located between the ischium and the pubis. The foramen is so named because it is covered over by muscles and a ligamentous membrane. It exits the pelvis through the obturator canal in the upper part of the obturator foramen, where it. Mr imaging features of obturator internus bursa of the hip. The obturator nerve is a mixed sensory and motor branch of the lumbar plexus and derives from the anterior divisions of the ventral rami of l2, l3, and l4 figure 631. It typically emerges from the medial border of the psoas muscle at the level of the pelvic brim, and divides in the obturator canal into anterior and posterior branches. Researchers have also studied the obturator region to analyze the relationships of the trans obturator sling and anatomical structures within the obturator region 6. Obturator foramen synonyms, obturator foramen pronunciation, obturator foramen translation, english dictionary definition of obturator foramen. Bypass grafts using the obturator foramen, in haimovici h ed. The obturator canal is a passageway formed in the obturator foramen by part of the obturator membrane.
One hypothesis was that the entrapment of the obturator nerve, which is an awkward issue, if the anatomy is known and. Foramen obturatum definition of foramen obturatum by the. Obstructed obturator hernia in immediate postoperative period. Near the obturator canal, it divides into the anterior and posterior divisions. The obturator nerve may have additional roots from the first or fifth lumbar nerves. The abdominal muscles and skeletal boundaries sciencedirect. The obturator nerve is clinically relevant in certain pathologic conditions and. The accessory obturator nerve is an inconstant nerve that arises from l3 and l4. It is formed by the rami of the ischium and pubis and, except in the area of the obturator canal, is covered by the obturator membrane. You may not embed one of our images on your web page without a link back to our site. In these circumstances an alternate pathway for revascularization is required. Obturator foramen questions and study guide quizlet. In the buttock, it passes close to the posterior capsule of the hip joint.
It travels through the obturator foramen an opening in the pelvic bone before entering the thigh, where it branches. The obturator foramen lies inferior to the acetabulum of the pelvis and is an opening between the ischium and pubic bones. The obturator foramen latin foramen obturatum is the large opening created by the ischium and pubis bones of the pelvis through which nerves and blood vessels pass. It is closed by the obturator membrane which is attached to its margins, except at the obturator groove where the obturator vessels and nerve pass out of the pelvis.
Obturator foramen definition of obturator foramen by the. The ob turator foramen is the large, obliquely oriented, ovoid aperture located at the anterior aspect of both sides of the pelvis, bounded by parts of the ischium and pubis. Be familiar with the pelvic girdle and lower limb bones from lecture or the textbook. Obturator hernia sac passes through obturator foramen following the path of obturator nerve and vessels. Table 3 shows the shortest distance between the obturator artery and the femoral artery, as well as the length of the obturator nerve exposed between the obturator foramen and the adductor longus. Pronunciation of obturator foramen with 1 audio pronunciation, 7 translations and more for obturator foramen. Obturator foramens article about obturator foramens by the. Obturator hernia irina kovatch, md brooklyn va hospital. This book is distributed under the terms of the creative commons. The presence of a plate of bone in the obturator foramen. The obturator foramen is the large opening created by the ischium and pubis bones of the pelvis through which obturator nerve and blood vessels pass. Surgical anatomy of obturator foramen hypothesis aims of study the aim of the study was to know the anatomy of the obturator foramen and the relations of incontinence suburetral tension free slings as passing it.
A 62yearold man presented with a 2week history of continuous pain in the left lower abdomen radiating to the groin. Recently, the mr imaging features of a number of uncommon bursae, such as, obturator externus bursa, subgluteus medius bursa, and subgluteus minimus bursa, have been described 4, 6. Carefully read the introductory material and examine the entire lab content. What is the obturator foramen and what is its function.
It enters the thigh by passing through the obturator foramen accompanied by the obturator artery. Obturator foramen dr sachintha hapugoda and assoc prof craig hacking et al. Variability of the obturator artery with its surgical. Obturator foramen medical definition merriamwebster.
Obturator herniae are uncommon presentations of abdominal pain, comprising obturator hernia occurs when abdominal contents traverse the obturator foramen. Obturator canal bypass grafts for septic lesions of the. Obturator membrane is a thin fibrous sheet that almost completely closes the obturator foramen of hip bone, leaving only a small gap, the obturator canal, for the passage of obturator nerve and vessels. The obturator foramen is the hole created by the ischium and pubic bones of the pelvis through which nerves and muscles pass. The obturator foramen is the large, obliquely oriented, ovoid aperture located at the anterior aspect of both sides of the pelvis, bounded by parts of the ischium and pubis. Each hip bone, in turn, is firmly joined to the axial skeleton via its attachment to the sacrum of the vertebral column. For several weeks, he had complained of general malaise, including tiredness and poor appetite, and diarrhoea once to twice per day. Foramen is the latin term designating a holelike opening. Although the femoral canal is the standard entrance route for vascular grafts to the lower extremity, several situations may arise that preclude the use of this route. It is large and oval in males, and small and triangular in females. The epiploic foramen also called the foramen of winslow is a passage between the greater general peritoneal space and lesser sac omental bursa, allowing communication between these two spaces. To the best of our knowledge, there are about seventeen similar cases reported in the literature. It is bounded by a thin, uneven margin, to which a strong membrane is attached, and presents, superiorly, a deep groove, the obturator groove, which runs from the pelvis obliquely. Take samples for histopathology see figures 317 and 318.
The obturator foramen is present below the pubic and above the ischiopubic ramus, which is an oval male or triangular female opening. Jun, 2016 from an embryologic point of view, since the foramen and membrane represent an area of incomplete bone formation, the obturator foramen is a lacuna while the obturator canal is the real lumen. Md consult obturator nerve entrapment a cause of groin. It typically emerges from the medial border of the psoas muscle at the level of the pelvic brim, and divides in the obturator canal into anterior and posterior branches figure 632, although variations are common with a.
Apr 22, 2007 the obturator foramen is the hole created by the ischium and pubic bones of the pelvis through which nerves and muscles pass. The obturator internus muscle originates widely from the margin of the obturator foramen, obturator. Conversion of obturator groove into bony foramen has been reported 2. As it goes through the foramen it divides into anterior and posterior branches. Obturator foramen definition of obturator foramen by. Obturator internus muscle an overview sciencedirect topics. It is derived from the latin forare meaning to bore or perforate. The obturator foramen is the largest bony foramen in the human body. The sciatic nerve leaves the pelvis through the greater sciatic foramen sciatic notch passing below the piriformis muscle and over the obturator internus muscle fig. It is covered almost entirely by the obturator membrane. Md consult obturator nerve entrapment a cause of groin pain. This space is largely filled in by a layer of connective.
The mean length of the obturator nerve exposed between the obturator foramen and the adductor longus was 41. As this is a small opening in the pelvis, there is an increased propensity for these herniae to get incarcerated and subsequently strangulated obturator hernia. A small gap is left between the superior margin of the obturator membrane and the pelvic bone above, known as the obturator canal, which allows a few vessels and. A morphometric study of the obturator nerve around the. The pelvic girdle hip girdle is formed by a single bone, the hip bone or coxal bone coxal hip, which serves as the attachment point for each lower limb. The obturator foramen latin foramen obturatum is the large opening created by the ischium. Some muscle fibers arise from the anteromedial inner surface of. Anatomy and exposures of spinal nerves pp 8183 cite as. Obturator foramen bypass in the management of infected prosthetic vascular grafts. The obturator nerve begins at the medial border of the psoas major muscle. The large opening in the anteroinferior hip bone between the ischium and pubis is the obturator foramen. The obturator nerve forms in the lumbar plexus from the anterior primary rami of the l2l4 roots and descends to the pelvis on the medial side of the psoas muscle. The shortest mean distance between the femoral artery and the obturator nerve exit zone was 30.
A bursa is a sac lined with synovial cells that typically forms in an area of tendon friction. If you would like a large, unwatermarked image for your web page or. Anatomy, abdomen and pelvis, obturator nerve statpearls ncbi. Obturator foramens article about obturator foramens by. Obturator internus originates within the pelvic region where it forms part of the anterolateral wall of the true pelvis. Remove muscles from ventral aspect of pelvis, find obturator foramina, and nip. Obturator foramen left neural foramen bilateral neural foramen obturator internus injury and causes. The obturator foramen is a large aperture, situated between the ischium and pubis in the male it is large and of an oval form, its longest diameter slanting obliquely from before backward. Obturator foramen doctor answers on healthcaremagic. The obturator internus muscle, supplied by the l5 and s1 nerves, abducts the thigh when flexed, and rotates laterally the extended thigh. A large opening in the pelvis, between the ischium and the pubis, that gives passage to vessels and nerves. Pdf the obturator foramen is large oval aperture in males or irregularly triangular. The superior and inferior pubic rami contribute to the boundaries of the obturator foramen. The right and left hip bones also converge anteriorly to attach to each other.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. The branch from the main trunk of the nerve to obturator externus may pass to the. Describe the openings of the pelvis and the boundaries of the greater and lesser pelvis. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. It is covered by thin fibrous membrane, the obturator membrane, which is covered on the internal and external surfaces by the muscles obturator internus and obturator externus respectively.
The fibers of the obturator membrane are arranged mainly in transverse direction. Developmentally, the true obturator foramen becomes incorporated into a precursor thyroid fenestra, which forms via a remodeling of the pubis and ischium, at its superior margin and these bones fuse beneath the fenestra to enclose the foramen commonly seen in mammals, thereby expanding the puboischiadic plate for the attachment of. The obturator internus muscle lies on the intrapelvic side of the obturator membrane, a fibrous membrane that covers the obturator foramen. The tendon of the obturator internus muscle traverses the lesser sciatic foramen to insert on the greater trochanter of the femur, facilitating lateral thigh rotation. Inferiorly the walls end in the boundaries of the inferior aperture of the pelvis or the boundaries of the perineum. The obturator nerve arises from the lumbar plexus and provides sensory and. A duplicate obturator foramen a report of rare variation.
It courses medial to the psoas major muscle, along the sidewall. Foramen obturatum article about foramen obturatum by the. The obturator membrane is a thin fibrous sheet, which almost completely closes the obturator foramen its fibers are arranged in interlacing bundles mainly transverse in direction. Obturator nerve block atlas of pain medicine procedures. The vascular anatomy of the pelvis has in the retro pubic space one the most dangerous artery. The sciatic nerve is the major nerve arising from the lumbosacral plexus. The epiploic foramen also called the foramen of winslow is a passage between the greater general peritoneal space and lesser sac omental bursa, allowing communication between these two spaces gross anatomy boundaries. Its fibers originate from the l4 to s3 spinal roots. The obturator foramen is indicated in this diagram the obturator foramen lies inferior to the acetabulum of the pelvis and is an opening between the ischium and pubic bones. The relations of the femoral and abdominal inguinal rings, seen from within the abdomen. A cause of groin pain in athletes article pdf available in the american journal of sports medicine 253. Pdf bony spurs projecting in the obturator foramen researchgate. The obturator foramen has been studied in detail to find out the potential risks to the dorsal nerve of the penis and to the obturator canal when different slings are used.
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