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Pectineus muscle
Pectineus muscle
Pectineus muscle
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Pectineus
The pectineus and nearby muscles
Structures passing behind the inguinal ligament (pectineus visible at bottom right.)
Details
OriginPectineal line of the pubic bone
InsertionPectineal line of the femur
ArteryObturator artery
NerveFemoral nerve, sometimes obturator nerve
ActionsThigh - flexion, adduction, external rotation
Identifiers
Latinmusculus pectineus
TA98A04.7.02.025
TA22627
FMA22440
Anatomical terms of muscle

The pectineus muscle (/pɛkˈtɪniəs/, from the Latin word pecten, meaning comb)[1] is a flat, quadrangular muscle, situated at the anterior (front) part of the upper and medial (inner) aspect of the thigh. The pectineus muscle is the most anterior adductor of the hip. The muscle's primary action is hip flexion; it also produces adduction and external rotation of the hip.

It can be classified in the medial compartment of thigh[2] (when the function is emphasized) or the anterior compartment of thigh (when the nerve supply is emphasized).[3]

Structure

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The pectineus muscle arises from the pectineal line of the pubis and to a slight extent from the surface of bone in front of it, between the iliopectineal eminence and pubic tubercle, and from the fascia covering the anterior surface of the muscle; the fibers pass downward, backward, and lateral, to be inserted into the pectineal line of the femur which leads from the lesser trochanter to the linea aspera.

Relations

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The pectineus is in relation by its anterior surface with the pubic portion of the fascia lata, which separates it from the femoral artery and vein and internal saphenous vein, and lower down with the profunda femoris artery.

By its posterior surface with the capsule of the hip joint, and with the obturator externus and adductor brevis, the obturator artery and vein being interposed.

By its external border with the psoas major, the femoral artery resting upon the line of interval.

By its internal border with the outer edge of the adductor longus.

Obturator foramen is situated directly behind this muscle, which forms one of its coverings.[4]

It forms part of the floor of the femoral triangle.

Innervation

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The lumbar plexus is formed from the anterior rami of nerves L1 to L4 and some fibers from T12. With only five roots and two divisions, it is less complex than the brachial plexus and gives rise to a number of nerves including the femoral nerve and accessory obturator nerve. The pectineus muscle is considered a composite muscle as the innervation is by the femoral nerve (L2 and L3) and occasionally (20% of the population) a branch of the obturator nerve called the accessory obturator nerve. When it is present, the accessory obturator nerve innervates a portion of the pectineus muscle, entering the muscle on its dorsomedial aspect. The greater nerve to the muscle is the femoral nerve. Unlike the obturator accessory nerve, the femoral nerve is always present and provides the sole innervation for the pectineus muscle in over 90% of cases. The muscle is also innervated by the accessory obturator nerve in the 8.7% of cases in which the nerve occurs.[5]

Function

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Its primary functions are contributing to hip flexion and hip adduction. Secondarily, it also internally rotates the thigh.[6]

Additional images

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  • Right hip bone. External surface.
    Right hip bone. External surface.
  • Structures surrounding right hip-joint.
    Structures surrounding right hip-joint.
  • Muscles of the iliac and anterior femoral regions.
    Muscles of the iliac and anterior femoral regions.
  • Deep muscles of the medial femoral region.
    Deep muscles of the medial femoral region.
  • The left femoral triangle.
    The left femoral triangle.
  • The lumbar plexus and its branches.
    The lumbar plexus and its branches.
  • Pectineus muscle
    Pectineus muscle
  • Pectineus muscle
    Pectineus muscle
  • Pectineus muscle
    Pectineus muscle
  • Pectineus muscle
    Pectineus muscle
  • Pectineus muscle
    Pectineus muscle
  • Muscles of thigh. Anterior views
    Muscles of thigh. Anterior views
  • Muscles of thigh. Anterior views.
    Muscles of thigh. Anterior views.

See also

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This article uses anatomical terminology.

References

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Notes

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[edit]
Revisions and contributorsEdit on WikipediaRead on Wikipedia

Pectineus muscle

View on Grokipedia
from Grokipedia
The pectineus muscle is a flat, quadrangular situated in the upper anterior compartment of the , at the base of the , where it acts as a transitional between the anterior and medial regions. It originates from the pectineal line of the pubis on the superior ramus and inserts onto the posterior surface of the along its pectineal line, immediately inferior to the lesser . Primarily innervated by the (L2-L4 spinal segments), it may also receive branches from the in some individuals. Its blood supply derives from the (a branch of the ) and the obturator artery. Functionally, the pectineus muscle contributes to hip joint flexion, adduction, and medial rotation of the , assisting in movements such as bringing the leg toward the midline or lifting the . Positioned deep to the and adjacent to the and adductor longus muscles, it forms part of the medial boundary of the , an important anatomical landmark for clinical assessments. Clinically, injuries or strains to the pectineus can result in , particularly in athletes involved in sports requiring rapid directional changes, and it is implicated in conditions like due to interactions with nearby tendons over the iliopectineal eminence. Its proximity to the femoral canal also makes it relevant in evaluating femoral hernias.

Anatomy

Origin and insertion

The pectineus muscle originates from the pectineal line (pecten pubis) on the superior ramus of the pubis, extending between the and the iliopectineal eminence. It also arises to a slight extent from the anterior surface of the pubis between these landmarks and from the overlying this region. The muscle inserts onto the pectineal line of the , an oblique ridge on the posterior surface of the proximal shaft that begins at the base of the lesser and extends distally toward the . This insertion lies immediately inferior to the lesser and follows the rough line leading to the . The pectineus presents as a flat, quadrangular muscle situated in the medial compartment of the , with its fibers oriented downward, backward, and laterally from origin to insertion. Anatomical variations in attachments may include a more extensive origin onto the anterior surface of the pubic .

Macroscopic structure and relations

The pectineus muscle is a flat, quadrangular, fleshy muscle situated at the superomedial aspect of the anterior , spanning from the pubis to the proximal just distal to the lesser . In cadaveric studies, it measures approximately 12 cm in length with a of about 2.3 cm², reflecting its relatively compact build. Superficially, the muscle is enveloped by the deep layer of the , which separates its anterior surface from overlying structures such as the , vein, and . It occupies a position in the anterior-medial , contributing to the floor of the alongside the adductor longus. In terms of spatial relations, the pectineus lies posterior to the femoral , with its anterior surface in close proximity to these structures. It is positioned anterior to the adductor brevis, adductor magnus, and obturator externus muscles, and medial to the psoas major and sartorius. Laterally, it relates to the medial femoral vessels, while medially it adjoins the adductor longus and gracilis muscles. At its medial border, near the pubic origin, the muscle is adjacent to the , which extends from the to the pecten pubis. Common anatomical variations include partial fusion of the pectineus muscular fibers with the adductor longus, as well as occasional division into superficial and deep layers or formation of a hiatus potentially affecting nearby vascular structures.

Innervation

The pectineus muscle receives its primary innervation from the medial division of the , derived from spinal segments L2-L4. A branch of this nerve typically arises within the , passing posterior to the femoral vessels before entering the deep surface of the muscle to supply its motor fibers. This innervation pattern reflects the muscle's transitional role between the anterior and medial compartments. In addition to the , accessory innervation occurs in up to 30% of cases from the anterior division of the (L2-L4 spinal segments) or, less commonly, the accessory obturator nerve. When present, this accessory branch often enters the muscle from its medial or superficial aspect, forming a dual innervation pattern where the contribution remains dominant in terms of branch extent and coverage. Such dual supply can preserve partial muscle function in scenarios of isolated or damage, aiding in hip flexion and adduction. Anatomical variations include rare instances of complete innervation by the alone or absence of the femoral contribution, though the latter is exceptional given the femoral nerve's consistent presence across dissections. These variations, observed in approximately 10-12% of specimens for dual patterns, underscore the need for awareness in surgical approaches near the .

Vascular supply

The pectineus muscle primarily receives its arterial blood supply from branches of the , a major branch of the (profunda femoris artery), which courses along the medial aspect of the to nourish the adductor compartment muscles including the pectineus. This artery typically originates from the in approximately 57% of cases, though variations occur where it arises directly from the common (39.3%) or other nearby vessels. These branches enter the muscle primarily through its anterior surface, often near the midpoint, facilitating to the muscle fibers. In addition to the medial circumflex femoral artery, the pectineus may receive supplementary arterial supply from direct branches of the or from the obturator artery, particularly in individuals with anatomical variations. The obturator artery, originating from the , contributes via its anterior branch, which anastomoses with femoral system vessels to support medial thigh musculature; this becomes more prominent in cases of aberrant femoral circulation where the is hypoplastic or absent. Such variations highlight the dual vascular territories influencing pectineus , with the obturator pathway providing collateral flow. Venous drainage of the pectineus muscle follows the course of its arterial supply, with accompanying venae comitantes draining deoxygenated blood parallel to the arteries and ultimately converging into the within the . This parallel venoarterial arrangement ensures efficient return of blood from the medial thigh compartment, integrating with the broader lower limb venous system without notable independent tributaries specific to the pectineus.

Function

Primary actions

The pectineus muscle primarily functions to the at the , drawing the lower limb toward the body's midline in the . This action is facilitated by its position as part of the medial musculature, contributing to stability during weight-bearing activities. As a secondary function, the pectineus assists in flexion, particularly when the starts from an extended position, helping to lift the toward the chest in the . Its oblique line of pull, extending from the pectineal line of the pubis to the pectineal line and of the , enables this dual-plane contribution to movement. Although weaker than the adductor magnus—the largest and most powerful adductor—the pectineus provides essential fine control during adduction. Electromyographic (EMG) evidence demonstrates its activation during adduction tasks, with peak activity reaching up to 62.8% of maximum voluntary isometric contraction (MVIC) in hip flexion exercises and highest relative activation when the hip is flexed to 90 degrees during clinical adductor tests.

Biomechanical role

The pectineus muscle plays a key role in hip stabilization during dynamic activities such as walking and running, where it helps counter mediolateral forces that could lead to excessive abduction of the . By contributing adduction torque, it assists in maintaining pelvic alignment and balancing the trunk over the stance limb, particularly during the single-support phase of when gravitational and inertial forces threaten lateral deviation. This stabilizing function is evident in electromyographic studies showing pectineus activation to support joint integrity against abduction perturbations. In compound movements like , the pectineus synergizes with other hip adductors, such as the adductor longus, and flexors, including the , to generate coordinated force for controlled descent and ascent. This integration enhances overall lower limb power transfer and pelvic stability, allowing efficient load distribution across the during tasks. Additionally, when the is flexed, the pectineus contributes to medial (internal) of the , a function confirmed by 2025 MRI and cadaveric studies showing significant shortening during internal . This aids in fine-tuning limb orientation for balanced multiplanar motion. Biomechanical models quantify the pectineus's leverage through its moment arms, which measure approximately 3.2 cm for adduction and 3.6 cm for flexion at neutral positions, enabling effective production despite its relatively small size. These values, derived from cadaveric analyses, underscore its mechanical efficiency in generating joint moments for both primary actions. In athletic contexts, such as kicking or rapid directional changes in like soccer, the pectineus supports explosive hip adduction and stabilization, facilitating precise application and during high-demand maneuvers.

Clinical significance

Injuries and pathology

The pectineus muscle, as a hip adductor and flexor, is susceptible to acute strains, particularly during activities involving sudden or forceful hip adduction, such as kicking in soccer or rapid directional changes in . These injuries are graded I to III based on severity: grade I involves mild with minimal disruption and on ; grade II features partial tears with moderate , swelling, and reduced strength; and grade III indicates complete rupture with severe , significant swelling, bruising, and loss of function. Symptoms typically include localized exacerbated by movement, tenderness along the muscle's course from the pubic ramus to the , and possible limping due to weakness in adduction. Chronic overuse injuries, such as at the pectineus's pubic origin, arise from repetitive stress in endurance sports or activities with prolonged flexion and adduction, leading to degenerative changes in the insertion. This condition manifests as insidious-onset that worsens with activity, often accompanied by and tenderness at the , without acute trauma. Histologically, it involves thickening, mucoid degeneration, and neovascularization, contributing to persistent discomfort in the medial . Referred pain to the pectineus region can mimic primary muscle pathology, originating from hip osteoarthritis, where joint degeneration causes anterior discomfort radiating along the muscle's distribution due to shared innervation and biomechanical stress. Similarly, lumbar radiculopathy, particularly at L2-L4 levels, may produce referred and medial pain resembling pectineus strain through irritation of the femoral or roots, often with associated and sensory changes. Nerve-related pathologies affecting the pectineus include femoral neuropathy, which impairs innervation from the (L2-L4), resulting in hip flexion weakness, including reduced pectineus function, along with anterior sensory loss and involvement. Obturator nerve entrapment, often at the obturator canal or within the adductor compartment, can cause adductor weakness affecting the pectineus, presenting as medial pain, numbness, and gait instability during sports. The pectineus muscle is implicated in , where its tendon may snap over the iliopectineal eminence, causing audible snaps and pain during hip flexion. Its position near the femoral canal also makes it relevant in the assessment of femoral hernias. Diagnostic imaging plays a key role in confirming pectineus , with (MRI) preferred for detecting , , or partial disruptions, offering high sensitivity for soft tissue detail in grades II-III strains. Ultrasound is effective for initial assessment of acute strains, visualizing dynamic muscle integrity, hematomas, or tendinopathic changes at the origin, and is particularly useful in athletes for its portability. Pectineus injuries contribute to athletic pain, with involvement noted in up to 20% of pubalgia cases in one study, often diagnosed within broader adductor strain categories.

Surgical and therapeutic considerations

Conservative management forms the cornerstone of treatment for pectineus muscle strains, beginning with the protocol—rest to avoid aggravating activities, ice application for 10-20 minutes every 1-2 hours to reduce swelling, compression with a to limit , and elevation of the affected limb above heart level. This initial phase typically lasts 48-72 hours, followed by that incorporates gentle stretching to restore flexibility and progressive strengthening exercises, including eccentric contractions to enhance muscle resilience and prevent recurrence. For persistent at the pectineus origin, injection therapies offer targeted relief; injections can provide short-term effects to alleviate pain, while (PRP) injections promote tissue healing through delivery, showing superior mid-term efficacy in adductor-related tendinopathies. These interventions are ultrasound-guided to ensure precise delivery and are considered when conservative measures fail after 4-6 weeks. Surgical intervention is reserved for cases, such as chronic causing persistent , where pectineus release via relieves tension and yields good functional outcomes with return to activity in 3-6 weeks post-procedure. In severe tears, removes damaged tissue to facilitate repair, though this is uncommon for isolated pectineus injuries. During hip arthroplasty, the pectineus is routinely retracted anteriorly to expose the joint, with care taken to avoid formation, a rare postoperative complication. Rehabilitation protocols emphasize progressive loading, starting with isometric adduction holds in the acute phase (weeks 1-2) to build tolerance without strain, advancing to dynamic exercises like side-lying leg lifts and cable adductions by weeks 3-6, and incorporating sport-specific drills by weeks 8-12, with full return to activity guided by pain-free strength restoration. Non-operative management is successful for most mild pectineus-related strains, enabling return to prior function in 4-8 weeks for the majority of patients.

References

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  3. https://humananatomy.host.dartmouth.edu/BHA/public_html/part_3/chapter_15.html
  4. https://www.imaios.com/en/e-anatomy/anatomical-structures/pectineus-muscle-14224040
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