With latissimus dorsi transfer, the ipsilateral facial nerve stump was used as the recipient nerve in three patients, and a cross-face nerve graft was selected as the recipient nerve in six. Nerve Supply. Gracilis-origin- anterior pubis-insertion- medial proximal tibia-nerve supply- obturator nerve(l2,3,4) Action- adduction of femur at hip ,assist flexion and medial rotation of flexed knee-palpation- a few inches below pubic bone on medial side of thigh during active hip adduction.tendon palpated on medial side of posterior knee ,medial to semitendinosus tendon Gracilis Muscle Strain|Causes|Symptoms|Treatment From the sacral plexus, the lower motor neuron travels down the sciatic nerve. The muscle adducts, medially rotates (with hip flexion), laterally rotates, and flexes the hip as above, and also aids in flexion of the knee. Like other muscles of the medial compartment, the adductor part is innervated by the posterior division of the obturator nerve (L2, L4 The hamstring part, sometimes considered a part of the hamstring group of muscles, is also innervated accordingly by the tibial . Functional upgrading in incomplete lesions is achieved by cross-face nerve grafting with distal end-to-side neurorrhaphy or by functional muscle transplantation with ipsilateral facial nerve supply. Gracilis. Once transferred to the upper arm, the gracilis has the capacity to mimic the function of the biceps and brachialis muscles. What action does the Gracilis muscle initiate? The gra-cilis is a superficial muscle that lies on the medial aspect of the thigh. The gracilis is a spiral unipennate muscle in the medial thigh compartment, which is innervated by the anterior branch of the obturator nerve and receives its vascular supply from the medial circumflex femoral artery, superficial femoral artery, deep femoral artery, descending genicular artery, and the anterior branch of the obturator artery. Just posterior towards the tendons of the gracilis and sartorius muscles acting as a part of the pes anserinus, the tendon loops above the medial condyle of the tibia and also enters the medial side of the tibia. Along with the muscle itself, a gracilis free flap procedure involves transplanting the associated blood supply and nerve into a patient's face. There are multiple motor nerves in the head and neck that can be used to provide innervation to the GFMT, either alone or in combination. A muscle flap. The gracilis and adduc- This is one muscle, two nerves, and three actions! Importantly, the nerve and blood vessels that supply the gracilis muscle are carefully removed along with the muscle. Clinical significance. The hamstrings, that is the posterior thigh, comprises of three muscles, namely; semitendinous, semimebranous and biceps femoris . The gracilis assists with hip adduction, knee . ). In this video you will find the origin insertion nerve supply and action of the gracilis muscle. Actions of Gracilis on the thigh (femur): a. Artery: Usually small caliber, from 1 to 2 mm. Synonym(s): musculus gracilis [TA] . The Pectineus (fig. The best way of preventing Gracilis Muscle Strain is by stretching the groin regularly. An exceptional length of this muscle often exceeds 50cm. Deep femoral artery (via artery to the adductors). [ 5 ] Function. It is carefully harvested with its blood and nerve supply. Gracilis Muscle Transplant (Free Flap): The gracilis muscle is located in the inner aspect of the thigh. Therefore, a new muscle must be used in order to restore smile and lower face movement. The semitendinosus muscle lies medially to the biceps femoris and covers the majority of the semimembranosus. Muscle Name Origin Insertion Action Innervation Muscles of Upper Extremity . It originates on the medial aspect of the ischiopubic ramus and joins together with the sartorius and semitendinosus muscle tendons to form the pes anserine, which inserts on the superior medial tibia, medial to the tibial tuberosity.The gracilis is a long, thin muscle located in the medial compartment of the . Blood is supplied to the Gracilis Muscle by the obturator artery and is innervated by the obturator nerve. Only a small, thin segment of the gracilis muscle is taken from the thigh along with its blood and nerve supply. Blood supply: Gracilis vessels from the medial femoral circumflex system. Removing part of the muscle does not appear to affect any functions of the leg during regular activities. The sartorius muscle is a thin, long, superficial muscle in the anterior compartment of the thigh. Pedicle length: up to 6 cm. In approximately 70 percent of cases, useful elbow flexion is restored to the previously paralyzed limb. The long saphenous does not make a significant contribution to drainage but may be used as a landmark as the gracilis muscle is commonly the first muscle to be found posterior to the vein. Since the gracilis is a long and flat muscle with good blood supply, it can be used as a harvest muscle during reconstructive surgery. Additionally, it's a flexor of the knee joint and a medial rotator of the leg. Action: Flexes and medially rotates the leg and adducts the thigh. (It also flexes the leg at the knee and medially rotates leg when knee is flexed.) MOTOR Gracilis Adductor longus Adductor brevis Adductor magnus Pectineus Obturator externus FEMORAL NERVE L2, L3, L4 Largest branch of the lumbar plexus Enters the thigh via the femoral triangle Supplies all the mucles of the anterior compartment of the thigh MOTOR and SENSORY FEMORAL NERVE Anterior Division Cutaneous branch Medial cutaneous . During this initial surgery, a long nerve is harvested from . The gracilis is a long, thin muscle located in the medial compartment of the thigh. This nerve is formed by portions of the lumbar plexus, which is a complex network of nerves that emerge from the lumbar region of the spine, which is in your lower back. In 1990, O'Brien was the first to report the use of the gracilis free flap for single-stage facial reanimation. Gracilis free tissue transfer. Inferior margin of pubic symphysis, inferior ramus of pubis, and adjacent ramus of ischium. The pectoralis minor is an ideal shape, has adequate bulk, and possesses a dual nerve supply that allows for independent movements of its upper and . See Tweets about #superficial_muscle on Twitter. Gracilis Muscle Strain can be caused due to injury and overuse. The femoral nerve innervates both the hip flexor and quadriceps muscle groups. Both pedicled and free flaps can be muscular or musculocutaneos (the socalled "composite flaps"). The pectoralis minor muscle seems to have the best qualities of both the gracilis and extensor digitorum brevis muscles, previous choices for facial reanimation, but without their disadvantages. Demonstration of intramuscular artery and nerve distribution in the same whole mount gracilis muscles Red arrow heads showed after entering the muscle the descending branches of the main arterial pedicle anastomosed with the ascending branches of the accessory arterial pedicle forming a whole arterial system in the muscle. A dducts thigh at hip. - nerve supply: obturator, L2, L3, L4; (see innervation. cervical nerves C3 and C4 receive information about pain in this muscle: Retraction and elevation of scapula. The gracilis muscle has the advantages of a rich blood supply and reliable motor innervation, and FFMT surgery involves minimal donor site morbidity and little to no impairment of leg function. Nerve supply: ( double nerve supply) Adductor part: posterior division of obturator nerve Hamstring part: tibial part of the sciatic nerve Action: Lower part of adductor magnus helps in Extension of hip Flexion of knee. In such long muscles not all muscle fibres run through the whole length of the . major nerve supply is the cranial nerve XI. Gracilis muscle harvest. The gracilis is innervated by the anterior branch of obturator nerve (L2-L4). Origin: Inferior ramus of the pubis The muscle is then moved to the paralyzed side of the face where it is connected to local nerves and blood vessels. The adductor muscles of the thigh have been known jointly as custodes virginitatis (i.e., custodian of virginity). Blood supply:- Gracilis receives the majority of its vascular supply from the 'artery to the adductors', which is a branch of the deep femoral artery. 49.1 and Fig 13.1 , Fig 13.2 , Fig 13.19 ) Motor: The motor supply is from the anterior branch of the obturator nerve. The muscle from the thigh, called the gracilis muscle, is one of 7 muscles that brings the thigh inward and is not critical to function. Gracilis muscle View Related Images. 643) is a flat, quadrangular muscle, situated at the front of the upper and medial part of the thigh. See what people are saying and join the conversation. The muscle that runs from the pubis to the medial aspect of the femur is the adductor brevis. multifascicular nerve (enabling separation of muscle functions), and expendability.1-7 Most studies of the gracilis muscle have focused on blood supply5,8-11 and surgical approach.6,12 By comparison, however, the ad-ductor longus has rarelybeen mentioned inthe literature for reconstructive microsurgery. ⚡CONNECT WITH ME ⬇️.Instagram:h. Gracilis muscle anatomy. Function of the Semitendinosus Flexion of the knee […] A branch of the obturator nerve that enters the muscle 6 to 12 cm from its . One supply is from the femoral nerve, and the second supply is from a branch of the obturator nerve. In this case, it is attached to the masseter nerve on the same side as the paralyzed face. Gracilis contrac tion is partly responsible for flexion of the thigh and adduction of the lower limb. The incision is around 7-8cm long on the upper inner thigh, which allows the surgeon to remove part of the gracilis muscle together with the controlling nerve and the blood vessels that supply it. The nerve fibers then slowly grow into the transferred gracilis muscle to allow it to contract over time, usually in 4-9 months or more. Innervation: Branch from the obturator nerve to gracilis. muscle from the inner thigh, the gracilis muscle, and transplant it. Here are some key points: Location: 2-3 fingers medial and posterior to adductor longus ; Origin is Broad: pubic symphysis, inferior pubic ramus, ischium. Innervation: Anterior division of obturator nerve. Innervation. Abstract. Origin. This is known as a cross-face nerve graft. The muscle from the thigh, called the gracilis muscle, is one of 7 muscles that brings the thigh inward and is not critical to function. Flexes the knee, adducts the thigh, and helps to medially rotate the tibia on the femur. It arises from the L2-L3 spinal nerves. Synergist: Prime Movers: Iliopsoas, Pectineus, Tensor . Millerʼs Anatomy of The femoral nerve (motor divisions and branches) innervates the following muscles: Anterior Division - Motor. Medial surface of tibial shaft, just posterior to sartorius. Bilateral facial palsy is treated by bilateral free gracilis muscle transplantation with the masseteric nerve branches for motor reinnervation. The gracilis is liable for hip […] Gracilis -Medial Body of pubis Medial surface of tibia Adduct hip, flexes knee Obturator Gracilis Muscle Strain can be caused due to injury and overuse. A graft consisting of muscle, nerve, and blood supply, is taken from the thigh and moved to a paralyzed (non-working) portion of the face. Only a small, thin segment of the gracilis muscle is taken from the thigh along with its blood and nerve supply. Description [edit | edit source]. This muscle is supplied by branches from three large arterial sources; The semitendinosus muscle is located in the posterior portion of the thigh and also it is medial towards the biceps femoris muscle. Nerve [edit | edit source] The gracilis muscles is innervated by the anterior branch of the obturator nerve (L2-L4). By the anterior section of obturator nerve. Together with adductor longus, adductor Magnus, gracilis, as well as pectineus muscles, it comprises a group of muscles known as the adductors of the thigh. The anterior branch of the obturator nerve also innervates the adductor longus, and sometimes adductor brevis. The nerve supply of the adductor magnus muscle is reflected by its position in both the medial and the posterior compartment. It adducts the thigh. Flexion of knee Medial rotation (when knee is semi flexed) What is the origin and insertion of the Gracilis muscle ? Using microsurgical techniques, the gracilis muscle's blood supply is connected to local vessels in the chest and a donor nerve from the patient's neck or chest is attached to the gracilis muscle's nerve supply. A lower motor neuron exits to the sacral plexus exiting through the spinal levels L5-S2. Obturator nerve (L2-L3). Innervation is provided by a branch of the obturator nerve (lumbar plexus). Nerve supply: ( double nerve supply) Adductor part: posterior division of obturator nerve Hamstring part: tibial part of the sciatic nerve Action: Lower part of adductor magnus helps in Extension of hip Flexion of knee. Origin: Inferior margin of pubic symphysis, inferior ramus of pubis, and adjacent ramus of ischium. This surgery is typically performed in two (2) stages. The gracilis originate at the external point of the ischiopubic ramus and extends down to the upper medial shaft of the tibia. Gracilis Muscle . 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