But the depth from skin surface of these NEPs and the NEPs of
pectineus still remain unexplored.
Similarly, the femoral nerve also innervates the
pectineus muscle [28].
On physical examination, it is difficult to palpate the hernia sac as it is usually concealed beneath the
pectineus muscle.
[6,7] Bowel herniating through the obturator foramen and lying between the
pectineus and obturator muscles is a key finding on CT and determines the diagnosis.
[8] A branch to the
pectineus muscle is given off as the femoral nerve enters the femoral triangle.
Pectineus muscle atrophy may contribute to femoral hernia development, creating a potential space for the hernia to form.
There was herniation of a bowel loop of length 3.5 cm through left obturator foramen extending inferiorly between
pectineus muscle anteriorly and obturator externus muscle posteriorly, suggestive of obturator hernia (Figures 3, 4(a), and 4(b)).
C, Axial T2W fat-suppressed image acquired inferior to the pubis shows avulsion and retraction of the adductor origin (arrow), with associated strain of the obturator externus,
pectineus and adductor longus muscles (arrowheads).
(8) The anterior aspect of the pubic symphysis is not disturbed, preserving the attachments of the
pectineus, adductor longus and brevis, and gracilis muscles.
Although, abdominal ultrasound was found to be normal, computed tomography of the abdominal cavity showed bilateral psoas abscess that extended to
pectineus muscle and also involved the iliopsoas muscle on the right.
The
pectineus muscle generates low forces easily counteracted by other thigh muscles, and the saphenous and medial cutaneous sensory nerves are unessential to standing.
The iliopsoas muscle works in tandem with iliacus, rectus femoris,
pectineus, tensor fascia latae and sartorius (5).