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The Obturator Nerve (n. obturatorius) arises from the ventral divisions of the second, third, and fourth lumbar nerves; the branch from the third is the largest, while that from the second is often very small.
It descends through the fibers of the Psoas major, and emerges from its medial border near the brim of the pelvis; it then passes behind the common iliac vessels, and on the lateral side of the hypogastric vessels and ureter, which separate it from the ureter, and runs along the lateral wall of the lesser pelvis, above and in front of the obturator vessels, to the upper part of the obturator foramen. Here it enters the thigh, and divides into an anterior and a posterior branch, which are separated at first by some of the fibers of the Obturator externus, and lower down by the Adductor brevis.
The anterior branch (ramus anterior) leaves the pelvis in front of the Obturator externus and descends in front of the Adductor brevis, and behind the Pectineus and Adductor longus; at the lower border of the latter muscle it communicates with the anterior cutaneous and saphenous branches of the femoral nerve, forming a kind of plexus. It then descends upon the femoral artery, to which it is finally distributed. Near the obturator foramen the nerve gives off an articular branch to the hipjoint. Behind the Pectineus, it distributes branches to the Adductor longus and Gracilis, and usually to the Adductor brevis, and in rare cases to the Pectineus; it receives a communicating branch from the accessory obturator nerve when that nerve is present.
Occasionally the communicating branch to the anterior cutaneous and saphenous branches of the femoral is continued down, as a cutaneous branch, to the thigh and leg. When this is so, it emerges from beneath the lower border of the Adductor longus, descends along the posterior margin of the Sartorius to the medial side of the knee, where it pierces the deep fascia, communicates with the saphenous nerve, and is distributed to the skin of the tibial side of the leg as low down as its middle.
The posterior branch (ramus posterior) pierces the anterior part of the Obturator externus, and supplies this muscle; it then passes behind the Adductor brevis on the front of the Adductor magnus, where it divides into numerous muscular branches which are distributed to the Adductor magnus and the Adductor brevis when the latter does not receive a branch from the anterior division of the nerve. It usually gives off an articular filament to the knee-joint.
The articular branch for the knee-joint is sometimes absent; it either perforates the lower part of the Adductor magnus, or passes through the opening which transmits the femoral artery, and enters the popliteal fossa; it then descends upon the popliteal artery, as far as the back part of the knee-joint, where it perforates the oblique popliteal ligament, and is distributed to the synovial membrane. It gives filaments to the popliteal artery.