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Dr. Ebraheim’s educational animated video describes the anatomy of the Obturator nerve. The obturator nerve is the second major nerve that arises from L2, L3 and L4 ventral rami of the lumbar plexus. The obturator nerve travels under the psoas major muscle and lies on the medial side of the psoas major. The obturator nerve then runs between the psoas and iliacus muscles through the pelvis towards the obturator foramen. The obturator foramen is covered by the obturator membrane. The obturator externus muscle arises from the obturator membrane. Structures that run under the inguinal ligament: The obturator canal is an opening in the obturator membrane at its superior lateral aspect. The obturator nerve is accompanied with vessels that exit the pelvis through the obturator canal. The obturator nerve and artery are at risk of injury from the placement of a retractor beneath the transverse acetabular ligament. With an “open book” reduction, the reduction clamp is usually inserted through the medial side of the foramen away from the neurovascular bundle. Outside the foramen in the proximal part of the thigh, the obturator nerve divides into anterior and posterior divisions. The anterior division passes in front of the abductor brevis muscle and the posterior division passes behind the muscle. Branches Anterior division •Adductor brevis •Adductor longus •Sensory branch •Gracilis Posterior division •Obturator externus •Adductor Magnus One-third of the population will have an accessory obturator nerve arising from L3-L4. The accessory obturator nerve passes over the superior pubic rami and then dives below the pectineus muscle and joins the anterior division of the obturator nerve. The accessory obturator nerve supplies the pectineus muscle which is usually innervated by the femoral nerve. Test for obturator nerve- adductor muscle assessment While in a sitting position, the examiner has the patient squeeze the thighs with resistance placed at the inside of the knees. Weak thigh adduction indicates obturator nerve injury. Become a friend on facebook: / drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC