Hannington-Kiff sign | |
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Differential diagnosis | Obturator hernia |
The Hannington-Kiff sign is a clinical sign in which there is an absent adductor reflex in the thigh in the presence of a positive patellar reflex. It occurs in patients with an obturator hernia, due to compression of the obturator nerve. [1]
The adductor reflex is elicited by tapping over either the medial epicondyle of the femur or the medial condyle of the tibia, which should cause the adductor muscles of the hip to contract, moving the leg inwards. [2]
The sign was described by John G Hannington-Kiff in 1980. [3]
The human leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.
In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb.
The deep femoral artery also known as the deep artery of the thigh, or profunda femoris artery, is a large branch of the femoral artery. It travels more deeply ("profoundly") than the rest of the femoral artery. It gives rise to the lateral circumflex femoral artery and medial circumflex femoral artery, and the perforating arteries, terminating within the thigh.
The pectineus muscle is a flat, quadrangular muscle, situated at the anterior (front) part of the upper and medial (inner) aspect of the thigh. The pectineus muscle is the most anterior adductor of the hip. The muscle's primary action is hip flexion; it also produces adduction and internal rotation of the hip.
In human anatomy, the groin also known as the inguinal region or iliac region, is the junctional area between the torso and the thigh. The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdominal wall meets the thigh. A fold or crease is formed at this junction known as the inguinal groove, or crease. This is also the area of the medial compartment of the thigh that contains attachments of the adductor muscles of the hip or the groin muscles. The groin is the common site for a hernia.
In vertebrate anatomy, hip refers to either an anatomical region or a joint.
The external obturator muscle, obturator externus muscle is a flat, triangular muscle, which covers the outer surface of the anterior wall of the pelvis.
The adductor brevis is a muscle in the thigh situated immediately deep to the pectineus and adductor longus. It belongs to the adductor muscle group. The main function of the adductor brevis is to pull the thigh medially. The adductor brevis and the rest of the adductor muscle group is also used to stabilize left to right movements of the trunk, when standing on both feet, or to balance when standing on a moving surface. The adductor muscle group is used pressing the thighs together to ride a horse, and kicking with the inside of the foot in soccer or swimming. Last, they contribute to flexion of the thigh when running or against resistance.
In the human body, the adductor longus is a skeletal muscle located in the thigh. One of the adductor muscles of the hip, its main function is to adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall of the femoral triangle.
The iliopsoas muscle refers to the joined psoas major and the iliacus muscles. The two muscles are separate in the abdomen, but usually merge in the thigh. They are usually given the common name iliopsoas. The iliopsoas muscle joins to the femur at the lesser trochanter. It acts as the strongest flexor of the hip.
The adductor muscles of the hip are a group of muscles in the medial compartment of the thigh mostly used for bringing the thighs together.
The lumbar plexus is a web of nerves in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve. Additionally, the ventral rami of the fourth lumbar nerve pass communicating branches, the lumbosacral trunk, to the sacral plexus. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.
The obturator nerve in human anatomy arises from the ventral divisions of the second, third, and fourth lumbar nerves in the lumbar plexus; the branch from the third is the largest, while that from the second is often very small.
The obturator artery is a branch of the internal iliac artery that passes antero-inferiorly on the lateral wall of the pelvis, to the upper part of the obturator foramen, and, escaping from the pelvic cavity through the obturator canal, it divides into an anterior branch and a posterior branch.
The medial circumflex femoral artery is an artery in the upper thigh that arises from the profunda femoris artery. It supplies arterial blood to several muscles in the region, as well as the femoral head and neck.
The saphenous nerve is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (upper) thigh and travels along the adductor canal. Upon exiting the adductor canal, the saphenous nerve terminates by splitting into two terminal branches: the sartorial nerve, and the infrapatellar nerve. The saphenous nerve is responsible for providing sensory innervation to the skin of the anteromedial leg.
The anterior branch of the obturator nerve is a branch of the obturator nerve found in the pelvis and leg.
An obturator hernia is a rare type of hernia, encompassing 0.07-1% of all hernias, of the pelvic floor in which pelvic or abdominal contents protrudes through the obturator foramen. The obturator foramen is formed by a branch of the ischial as well as the pubic bone. The canal is typically 2-3 centimeters long and 1 centimeters wide, creating a space for pouches of pre-peritoneal fat.
The subsartorial plexus is a plexus of nerves that is located under the sartorius muscle.
In human anatomy, the adductor minimus is a small and flat skeletal muscle in the thigh which constitutes the upper, lateral part of the adductor magnus muscle. It adducts and laterally rotates the femur.