Medial circumflex femoral artery

Course

The medial femoral circumflex branch runs medially and posteriorly, initially passing between the tendon of iliopsoas muscle and the pectineus muscle. It then continues its course around the neck of the femur while passing between the obturator externus and adductor brevis muscles. Upon reaching the superior margin of the adductor magnus muscle, the medial circumflex femoral artery terminates by dividing into two branches.

Branches and supply

The branches of the medial circumflex artery vary greatly across the literature in terms of nomenclature, number and supply.

According to some authors, the medial circumflex artery gives off two terminal branches; an ascending and descending branch. However, most authors describe additional three to four branches that can arise either from the medial circumflex femoral artery directly, or via its descending branch. 

At the superior border of the adductor brevis muscle, the medial circumflex femoral artery branches into two:

• The ascending branch runs superiorly across the tendon of the obturator externus muscle. It terminates in the trochanteric fossa by anastomosing with the inferior gluteal artery and lateral circumflex femoral artery (trochanteric anastomosis).
• The descending branch courses between the quadratus femoris and adductor magnus muscles. It provides small muscular branches that supply the muscles of the posterior compartment of the thigh. This branch contributes to the cruciate anastomosis.

The descending branch continues to course deep to the adductor brevis and to supply the adductor magnus muscle before giving off three further branches:

• The superficial branch courses between the pectineus and adductor longus muscles.
• The deep branch runs superiorly towards the intertrochanteric crest to the head of the femur. A constant branch, the trochanteric branch, emerges at the superior border of the quadratus femoris muscle going to the lateral aspect of the greater trochanter. This branch signifies the level of the tendon of obturator externus muscle.
• The acetabular branch enters the hip joint along with the acetabular branch of the obturator artery to supply the femoral head and other structures at the hip joint. It gives off the foveolar artery (medial epiphyseal artery).

To learn more about the nerves and vessels of the hip and thigh check out our other articles, videos, quizzes and labeled diagrams.

Anatomical variations

The medial circumflex femoral artery typically arises as an independent branch either from the deep femoral artery, or directly the femoral artery itself. Occasionally, it can arise as a common trunk with the superficial, deep femoral and lateral circumflex femoral arteries.