Hunter's Canal: Difference between revisions

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* '''Lateral''': [[Vastus Medialis|Vastus medialis]].
* '''Lateral''': [[Vastus Medialis|Vastus medialis]].


* '''Posterior''': Adductor longus and [[Adductor Magnus|adductor magnus]].
* '''Posterior''': [[Adductor longus]] and [[Adductor Magnus|adductor magnus]].
The apex of the adductor canal is marked by the adductor hiatus – a gap between the adductor and [[Hamstrings|hamstring]] attachments of the adductor magnus.<ref name=":1" />
The apex of the adductor canal is marked by the adductor hiatus – a gap between the adductor and [[Hamstrings|hamstring]] attachments of the [[Adductor Magnus|adductor magnus]].<ref name=":1" />


It is covered in by a strong aponeurosis, the anteromedial intermuscular septum (subsartorial fascia) which extends from the vastus medialis, across the femoral vessels to the adductor longus and adductor magnus. Lying on the aponeurosis is the sartorius (tailor's) muscle.<ref name=":0" />
It is covered in by a strong aponeurosis, the anteromedial intermuscular septum (subsartorial fascia) which extends from the [[Vastus Medialis|vastus medialis]], across the femoral vessels to the [[adductor longus]] and [[Adductor Magnus|adductor magnus]]. Lying on the aponeurosis is the [[sartorius]] (tailor's) muscle.<ref name=":0" />


== Content ==
== Content ==
The canal contains the following:
The canal contains the following:
* Femoral artery,
* [[Femoral Artery|Femoral artery]],
* Femoral vein,  
* Femoral vein,  
* Branches of the [[Femoral Nerve|femoral nerve]] (specifically, the saphenous nerve, and the nerve to the vastus medialis).<ref>Sauerland, Eberhardt K.; Patrick W. Tank; Tank, Patrick W. (2005). Grant's dissector. Hagerstown, MD: Lippincott Williams & Wilkins. p. 128. <nowiki>ISBN 0-7817-5484-4</nowiki>.</ref>
* Branches of the [[Femoral Nerve|femoral nerve]] (specifically, the saphenous nerve, and the nerve to the [[Vastus Medialis|vastus medialis]]).<ref>Sauerland, Eberhardt K.; Patrick W. Tank; Tank, Patrick W. (2005). Grant's dissector. Hagerstown, MD: Lippincott Williams & Wilkins. p. 128. <nowiki>ISBN 0-7817-5484-4</nowiki>.</ref>
[[File:Adductor Canal 2.JPG|thumb|Adductor Canal represented in green region.]]  
[[File:Adductor Canal 2.JPG|thumb|Adductor Canal represented in green region.]]  


It consists of three foramina: superior, anterior and inferior.  
It consists of three foramina: superior, anterior and inferior.  


The femoral artery with its vein and the saphenous nerve enter this canal through the superior foramen. Then, the saphenous nerve and artery and vein of genus descendens exit through the anterior foramen, piercing the vastoadductor intermuscular septum. Finally, the femoral artery and vein exit via the inferior foramen (usually called the hiatus) through the inferior space between the oblique and medial heads of adductor magnus.<ref name=":0" />
The [[Femoral Artery|femoral artery]] with its vein and the saphenous nerve enter this canal through the superior foramen. Then, the saphenous nerve and artery and vein of genus descendens exit through the anterior foramen, piercing the vastoadductor intermuscular septum. Finally, the femoral artery and vein exit via the inferior foramen (usually called the hiatus) through the inferior space between the oblique and medial heads of [[Adductor Magnus|adductor magnus]].<ref name=":0" />


== Clinical Relevance  ==
== Clinical Relevance  ==


==== Adductor Canal Block ====
==== Adductor Canal Block ====
In the adductor canal block, local anaesthetic is administered in the adductor canal to block the saphenous nerve in isolation, or together with the nerve to the vastus medialis. The block can be used to provide sensory anaesthesia for procedures involving the distal thigh and [[femur]], [[knee]] and lower leg on the medial side. The sartorius and femoral artery are used as anatomical landmarks to locate the saphenous nerve.<ref name=":1" />
In the adductor canal block, local anaesthetic is administered in the adductor canal to block the saphenous nerve in isolation, or together with the nerve to the [[Vastus Medialis|vastus medialis]]. The block can be used to provide sensory anaesthesia for procedures involving the distal thigh and [[femur]], [[knee]] and lower leg on the medial side. The [[sartorius]] and [[Femoral Artery|femoral artery]] are used as anatomical landmarks to locate the saphenous nerve.<ref name=":1" />


==== Adductor Canal Compression Syndrome ====
==== Adductor Canal Compression Syndrome ====
Adductor canal compression syndrome describes entrapment of the neurovascular bundle within the adductor canal. A rare condition, it is usually caused by hypertrophy of adjacent muscles such as vastus medialis. It is most common in young males, who may present with claudication symptoms due to femoral artery occlusion (more common) or neurological symptoms due to entrapment of the saphenous nerve.<ref name=":1" />
Adductor canal compression syndrome describes entrapment of the neurovascular bundle within the adductor canal. A rare condition, it is usually caused by hypertrophy of adjacent muscles such as vastus medialis. It is most common in young males, who may present with claudication symptoms due to [[Femoral Artery|femoral artery]] occlusion (more common) or neurological symptoms due to entrapment of the saphenous nerve.<ref name=":1" />


== References  ==
== References  ==

Revision as of 19:50, 12 July 2020

Original Editor - Edema Emmanuel Oluwatosin

Top Contributors - Edema Emmanuel, Mande Jooste, Kim Jackson and Leana Louw  

Introduction[edit | edit source]

The Hunter's canal (subsartorial, adductor canal) is an aponeurotic tunnel in the middle third of the thigh, extending from the apex of the femoral triangle to the opening in the adductor magnus, the adductor hiatus.[1]

It is 15cm long and serves as a passageway for structures moving between the anterior thigh and posterior leg.[2]

[3]

Structure[edit | edit source]

Boundaries of the adductor canal.

The Hunter's canal is bordered by muscular structures:

The apex of the adductor canal is marked by the adductor hiatus – a gap between the adductor and hamstring attachments of the adductor magnus.[2]

It is covered in by a strong aponeurosis, the anteromedial intermuscular septum (subsartorial fascia) which extends from the vastus medialis, across the femoral vessels to the adductor longus and adductor magnus. Lying on the aponeurosis is the sartorius (tailor's) muscle.[1]

Content[edit | edit source]

The canal contains the following:

Adductor Canal represented in green region.

It consists of three foramina: superior, anterior and inferior.

The femoral artery with its vein and the saphenous nerve enter this canal through the superior foramen. Then, the saphenous nerve and artery and vein of genus descendens exit through the anterior foramen, piercing the vastoadductor intermuscular septum. Finally, the femoral artery and vein exit via the inferior foramen (usually called the hiatus) through the inferior space between the oblique and medial heads of adductor magnus.[1]

Clinical Relevance[edit | edit source]

Adductor Canal Block[edit | edit source]

In the adductor canal block, local anaesthetic is administered in the adductor canal to block the saphenous nerve in isolation, or together with the nerve to the vastus medialis. The block can be used to provide sensory anaesthesia for procedures involving the distal thigh and femur, knee and lower leg on the medial side. The sartorius and femoral artery are used as anatomical landmarks to locate the saphenous nerve.[2]

Adductor Canal Compression Syndrome[edit | edit source]

Adductor canal compression syndrome describes entrapment of the neurovascular bundle within the adductor canal. A rare condition, it is usually caused by hypertrophy of adjacent muscles such as vastus medialis. It is most common in young males, who may present with claudication symptoms due to femoral artery occlusion (more common) or neurological symptoms due to entrapment of the saphenous nerve.[2]

References[edit | edit source]

  1. 1.0 1.1 1.2 IMAIOS. Adductor Canal - Canalis Adductorius. https://www.imaios.com/en/e-Anatomy/Anatomical-Parts/Adductor-canal (accessed 25 June 2018).
  2. 2.0 2.1 2.2 2.3 Songo Lolomari. The Adductor Canal. http://teachmeanatomy.info/lower-limb/areas/adductor-canal/ (accessed on 25 June 2018).
  3. The Funky Professor. Adductor Canal - Anatomy Tutorial. Available from: http://www.youtube.com/watch?v=NsnVLiIZJmE [last accessed 25/6/2018]
  4. Sauerland, Eberhardt K.; Patrick W. Tank; Tank, Patrick W. (2005). Grant's dissector. Hagerstown, MD: Lippincott Williams & Wilkins. p. 128. ISBN 0-7817-5484-4.