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Anatomy > Anatomy: Hip Part 2 > Flashcards

Anatomy: Hip Part 2 Flashcards

1
Q

Medial Compartment

A
  • Separated from the anterior compartment by the medial IMS
  • Separated from the poster compartment of the thigh by the fascial plane between the Adductor Magnus and the Hamstrings (no IMS intervenes)
  • Muscular contents
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2
Q

Gateways into the lower limb: Obturator Canal

A
  • Connects abdominopelvic region with medial thigh

- Obturator nerve and vessels

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3
Q

Gateways into the lower limb: Greater Sciatic Foramen

A
  • Route for passage b/t pelvis and gluteal region
  • Piriformis m.
  • Superior gluteal n. and vessels above.
  • Sciatic n., inf gluteal n. and vessels, pudendal, etc. below.
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4
Q

Gateways into the Lower Limb: Lesser Sciatic Foramen

A

-Connects gluteal region w/ perineum

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5
Q

Gateways into the Lower Limb: Gap between the Inguinal Ligament and the Pelvic Bone

A
  • Route b/t abdomen and ant. thigh
  • Psoas maj., Iliacus, Pectineus m.
  • Femoral artery, vein, nerve
  • Lymphatics
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6
Q

Femoral Triangle

A
  • Superior=Inguinal Ligament
  • Medial= Adductor Longus
  • Lateral= Sartorius

Contents (lateral to medial):
-Femoral Nerve-Artery-Vein

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7
Q

Femoral Pulse

A

Palpation of Femoral Pulse

  • Place patient supine in some hip flexion and external rotation. Palpate distal to inguinal ligament, in-between Adductor Longus and Sartorius
  • Superficial Inguinal Lymph nodes here.
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8
Q

Adductor Canal

A
  • Subsartorial Canal/Hunter’s Canal
  • A músculo-fascial canal which descends medially down the thigh and posteriorly through the adductor hiatus to pass posterior into the knee region.
  • Borders
    • Posterior Wall
      • Superiorly formed by the adductor Longus
      • Inferiorly formed by the adductor magnus
    • Lateral wall is Vastus Medialis
    • Roof is formed by the sartorius
    • Contents: Femoral Artery, vein and saphenous nerve.
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9
Q

Adductor Hiatus

A
  • An opening in the tendon of insertion of the adductor magnus muscle.
  • Boundaries
    • Medial-portion of the tendon of adductor magnus that attaches to the adductor tubercle.
    • Later- Insertion of the adductor magnus into the linea aspera
    • Inferior- Femur
  • Contents: femoral artery and vein, which then turns in to popliteal artery and vein.
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10
Q

Muscular Patterns

A
  • Muscles of the hip/thigh can be grouped based on innervation
    • Peripheral nerve patterns
    • Root level patterns
  • Muscles of the hip/thigh can be grouped based on function
    • Action on the hip
    • Action on the knee
  • Muscles of the hip/thigh can be grouped on location
    • Compartment
    • Location with respect to the joints.
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11
Q

Muscles of Hip Flexion

A
  • Psoas Major
  • Iliacus
  • Rectus Femoris
  • Sartorius
  • TFL
  • Psoas Minor-secondary
  • Adductor Longus
  • Pectineus- secondary

Iliacus and psoas become the iliopsoas

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12
Q

Psoas Major

A
  • PA: TPs, Vertebral Bodies and Adjoining discs of T12-L5
  • DA: Lesser Trochanter
  • Innervation: Ventral Rami L1-L3(4)
  • Actions: hip flexion, Hip ER, Trunk Ipsilateral SB, Spinal Flexion during Sit-ups, Spinal Stabilzation
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13
Q

Iliacus

A
  • PA: superior 2/3 of iliac fossa; Anterior SI Ligaments
  • DA: Lesser Trochanter of Femur
  • Innervation: Femoral nerve L2-L3
  • Actions: Flexes Hip, externally rotates the flexed hip
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14
Q

Rectus Femoris

A
  • PA: Straight Head-AIIS; Reflected Head- groove on ilium superior to acetabulum, fibrous capsule of hip joint
  • DA: Patella by quadriceps tendon, tibial tuberosity by patellar tendon (ligament)
  • Action: extends the knee and flexes the hip
  • Innervation: Femoral Nerve L2,3,4

-Unique Feature: two joint muscle

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15
Q

Sartorius (Tailor’s Muscles)

A
  • PA: ASIS
  • DA: Proximal medial surface of tibia at pes anserine
  • Innervation: Femoral Nerve L2-3
  • Actions: Flex, ER and Abduct the hip; Flex and IR knee (more so of the Tibia)
  • Muscles that meet at the Pes Anserine:
    • Sartorius
    • Gracilis
    • Semitendinosus
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16
Q

Tensor Fascia Latae

A
  • PA: Anterior Iliac Crest, Lateral Surface of ASIS, and a portion of the border of the notch below it.
  • DA: Iliotibial Band (ITB) and hence to the lateral tibial condyle at Gerdy’s Tubercle of tibia
  • Actions: Extends and Laterally rotates the knee; flexes, abducts and internally rotates the hip
  • Innervation: Superior Gluteal Nerve L4,5, S1

Unique Features: considered part of gluteal region, ITB is a very thick tissue

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17
Q

Muscles of Hip Extension

A
  • Gluteus Maximus
  • Hamstrings
    1. Semitendinosus
    2. Semimembranosus
    3. Biceps Femoris
  • Adductor Magnus
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18
Q

Gluteus Maximus

A
  • PA: Posterior gluteal line of ilium, posterior sacrum, sacrotuberous ligament
  • DA: Gluteal tuberosity of femur and ITB
  • Innervation: Inferior Gluteal Nerve (L5,S1,S2)
  • Actions: Hip Extension, ABD, and ER; assists in stabilization of knee through action of ITB
19
Q

Biceps Femoris

A
  • PA: Long Head-Upper Ischial Tuberosity; Short Head-Lateral lip of linea aspera inferior to gluteus maximus attachment, proximal 1/2 of lateral supracondylar line
  • DA: Fibular Head, LCL of knee, Lateral Tibial Condyle
  • Actions: Flexes knee, extends hip, secondarily laterally rotates hip and knee
  • Innervation: Long Head-Tibial division of sciatic L5, S1-2; Short Head- Common peroneal division of sciatic L5, S1-2

Unique Features: 2 heads, shares proximal tendon with semitendinosus

20
Q

Semitendinosus

A
  • PA: Inferomedial aspect of Ischial Tuberosity
  • DA: Medial aspect of proximal tibia at pes anserine
  • Actions: Flexes knee, extends hip, secondarily medially rotates hip and knee
  • Innervation: Tibial division of sciatic nerve L5, S1-2

Unique Features: Named in reference to its long tendon, shares proximal tendon with biceps femoris, forms posterior most portion of pes anserine.

21
Q

Semimembranosus

A
  • PA: Superolateral aspect of ischial tuberosity
  • DA: Posterior Aspect of medial tibial condyle
  • Actions: Flexes knee, extends hip, secondarily IR hip and knee
  • InnervationL Tibial division of sciatic nerve L5, S1-S2

Unique Features: Name in reference to its membranous PA

22
Q

Adductor Magnus

A
  • PA: Inferior ramus of pubis, inferior ramus of ischium, and ischial tuberosity
  • DA: linea Aspera, medial suprcondylar line and adductor tubercle
  • InnervationL Obturator and tibial division of sciatic, L2-L4
  • Actions: Hip adduction and extension
  • Largest and deepest of the adductor muscles
  • Palpate while patient is laying prone
23
Q

Muscles of Hip Adduction

A
  • Adductor Magnus
  • Adductor Longus
  • Adductor Brevis
  • Pectineus
  • Gracilis
24
Q

Adductor Longus

A
  • PA: Anterior Pubic Body
  • DA: middle 1/3 of medial lip of line aspera
  • Innervation: Obturator nerve, L2-L4
  • Actions: hip adduction and flexion
  • Medial Compartment
25
Q

Adductor Brevis

A
  • PA: Inferior Ramus of Pubis
  • DA: Pectineal line and proximal 1/2 of medial lip of linea aspera
  • Innervation: Obturator, L2-L3
  • Actions: Adducts Hip
  • lies deep to the pectineus and longus
26
Q

Pectineus

A
  • PA: pectineal line on superior ramus of pubis
  • DA: Pectineal line between the lesser trochanter and the linea aspera
  • Innervation: Femoral nerve L2-L3
  • Actions: hip adduction and flexion

-Forms the floor of the triangle

27
Q

Gracilis

A
  • PA: Lower 1/2 of pubic body, lower aspect of inferior pubic ramus and adjoining ischial ramus
  • DA: proximal medial surface of tibia at the pes anserine
  • Actions: Flexes and medially rotates knee; adducts the hip
  • Innervation: Obturator Nerve L2,3

Unique Features: Forms intermediate tendon of pes anserine, most superficial, only adductor that crosses the knee joint

28
Q

Muscles of Hip Abduction

A
  • Gluteus Medius
  • Gluteus Minimus
  • Gluteus Maximus
  • TFL
  • Sartorius
29
Q

Gluteus Medius

A
  • PA: Lateral Ilium between posterior and anterior gluteal lines
  • DA: lateral aspect of greater trochanter
  • Innervation: Superior gluteal nerve, L4-S1
  • Action All FIbers: Hip Abduction
  • Action Posterior Fibers: External rotation
  • Action Anterior FIbers: Medial Hip Rotation
  • Action in Single Limb Support: keeps pelvis level (trendelenburg sign)

-Limits a lot of valgus movements of the knee.

30
Q

Gluteus Minimus

A
  • PA: Lateral Ilium deep to Gluteus medius between anterior and inferior gluteal line
  • DA: anterolateral aspect of Greater Trochanter
  • Innervation: Superior Gluteal L4-S1
  • Actions: Hip Abduction, internal rotation
  • Lies underneath the glute med.
31
Q

Hip Abductor Muscles

A
  • TFL
  • Sartorius
  • Gluteus Maximus
32
Q

Muscles of Hip ER

A
  • Piriformis
  • Gemellus Superior/Inferior
  • Obturator Internus/Externus
  • Quadratus Femoris
  • Gluteus Maximus
  • Posterior Fibers of Gluteus medius
  • Sartorius
  • Biceps Femoris
33
Q

Muscles: Deep Group

A
  1. Piriformis
  2. Gemellus Superior
  3. Obturator Externus
  4. Gemellus Inferior
  5. Obturator Internus
  6. Quadratus Femoris

Only need to know the P and Q

34
Q

Piriformis

A

Piriformis is the only 1 of the 6 that is superficial to the sciatic nerve

  • PA: Anterior surface of sacrum at level of S2-S4
  • DA: Superior and medial aspect of Greater Trochanter
  • Innervation: Ventral Rami L5, S1, S2
  • Actions: Hip ER; Abducts a flexed hip
35
Q

Hip ERs

A

Hip Lateral Rotators

  • Gogo’s bellies are too deep to palpate. All insert on greater trochanter.
  • Gemellus Superior
  • Obturator Externus
  • Gemellus Inferior
  • Obturator Internus
36
Q

Quadratus Femoris

A
  • PA: Lateral Border of ischial tuberosity
  • DA: Intertrochanteric crest and quadrate tubercle of femur
  • Innervation: Nerve to quadratus muscle L4-S1
  • Action: Hip ER
37
Q

Muscles of Hip Internal Rotation

A
  • TFL
  • Anterior Fibers of Gluteus Medius
  • Gluteus Minimus
38
Q

Hip Muscles Grouped by Attachment: Ilium and Ischium

A

Ilium:

  • TFL
  • Rectus Femoris
  • Iliacus
  • Sartorius
  • Gluteus Maximus
  • Gluteus Medius and Minimus
  • Piriformis

Ischium:

  • LH of Biceps Femoris
  • Semitendinosus
  • Semimembranosus
  • Gemellus Superior/Inferior
  • Adductor Magnus
39
Q

Hip Muscles Grouped by Attachment: Pubis and Femur

A

Pubis:

  • Adductor Longus
  • Adductor Brevis
  • Pectineus
  • Gracilis

Femur:

  • Iliopsoas
  • PGOGOQ’s
  • Gluteals- all 3
  • Biceps Femoris-Short Head
  • Pectineus
  • Adductor Longus
  • Adductor Brevis
  • Adductor Magnus
40
Q

Femoral Nerve

A
  • Arises from the dorsal divisions L2-L4 nerves
  • Passes beneath the Inguinal Ligament, into the thigh, and splits into an anterior and a posterior division
  • Anterior
41
Q

The Sciatic Nerve

A
  • Descends b/t the greater trochanter of the femur and ischial tuberosity
  • At about lower 1/3 of posterior thigh, it divides into tibial and common peroneal nerves
    • This division may take place at any point between the sacral plexus and the lower third of the thigh
  • Typically comes out inferior to the piriformis
  • Levels are L4-S3
  • Posterior thigh and lateral lower leg
  • Biceps femoris innervated by both sections.
42
Q

The Sciatic Nerve: Branches

A
  • Accompanied by the posterior femoral cutaneous nerve
  • The nerve gives off articular and muscular branches
    • The articular branches arise from the upper part of the nerve and supply the hip-joint
    • The muscular branches
      • The nerve to the short head of the Biceps femoris comes from the common peroneal part of the sciatic,
      • While the other muscular branches arise from the tibial portion of the sciatic nerve
43
Q

The Obturator Nerve

A
  • Arises from the anterior branches of L2,3,4 primary rami
  • Exits pelvis through the superior part of the obturator foramen as anterior and posterior divisions
  • Supplies muscles in medial compartment of thigh
  • The nerve supplies innervation to the knee joint

Anatomy (10 decks)

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