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Presentation
Multiple Muscle Variations Altering Femoral Nerve Course and Distal Attachment of Iliopsoas
37th Annual Meeting of the American Association of Clinical Anatomists (2020)
  • Daniel W Copeland, Philadelphia College of Osteopathic Medicine
  • Philip A. Fabrizio, Philadelphia College of Osteopathic Medicine
Abstract
INTRODUCTION. Typically, the psoas major muscle originates via slips from the transverse processes of lumbar vertebrae and the iliacus muscle originates from the iliac fossa. Fusion of psoas and iliacus muscles occurs inferior to the inguinal ligament before attaching to the lesser trochanter. In the present case, a variant psoas muscle belly and an unusual iliacus minimus muscle compressing the femoral nerve were discovered. RESOURCES. The variant muscles were found during routine dissection of an 83-yearold female cadaver during the Physical Therapy anatomy course. Typical dissection techniques were utilized to expose the inguinal and pelvic regions. DESCRIPTION. Iliacus minimus (length 151.01 mm, widest width 92.73 mm) coursed across the iliac fossa in a manner overlaying the femoral nerve. Iliacus minimus tapered in its course and was 31.92 mm wide at the point where the femoral nerve emerged from beneath it. The variant psoas muscle (length 49.27 mm), found medially at the distal third of the psoas major muscle belly, fused with the psoas major muscle at a point 71.4 mm lateral to the ipsilateral pubic tubercle. Distally, iliacus and iliacus minimus tendons fused and remained separate from the combined tendon of psoas major and the accessory psoas muscle. Thus, preventing the formation of an iliopsoas tendon of attachment. SIGNIFICANCE. An iliacus minimus muscle the size of the current finding has not been reported especially in combination with a previously unreported psoas muscle. The location of the femoral nerve, deep to iliacus minimus, invites speculation of possible femoral nerve entrapment leading to altered sensation along the femoral nerve cutaneous pathways and altered function of the quadriceps muscles. Further, the variant muscles preventing the conjoining of the iliopsoas muscle also invite speculation regarding altered hip flexor function and possible pain generating sources of two separate tendons attaching to the lesser trochanter.
Publication Date
July, 2020
Location
New York, NY
DOI
https://doi.org/10.1002/ca.23694
Citation Information
Daniel W Copeland and Philip A. Fabrizio. "Multiple Muscle Variations Altering Femoral Nerve Course and Distal Attachment of Iliopsoas" 37th Annual Meeting of the American Association of Clinical Anatomists (2020)
Available at: http://works.bepress.com/philip-fabrizio/16/