Bones Muscle & Fascia of THe hips

Question 1

Where do the gluetal muscle arise from in the hip? Define their specific origins

Answer 1

Gluteal muscles arise from the lateral asepct of the the hip bone, ilium. Specifically three gluteal muscles arise from three lines on teh ilium.

1. Posterior gluteal line - Gluteus maximus ( most pwoerful hip extensor)
2. Anterior gluteal line - GLuteus medius
3. Inferior Gluteal ine -

Question 2

Where are the attachments of the inguinal ligament

Answer 2

Attaches from the ASIS to the pubic tubercle

Question 3

Which is the bony bit we sit on, but also serves as a muscular attachment?

Answer 3

Ischial Tubersotiy

Question 4

Avulsion fractures, wht are they?

Answer 4

Where the muscles attaching to the bone are often stronger than the bone at the epiphyses, thus contributing to the fractures.

Question 5

Vastus Intermedialis

Answer 5

Smooth muscle on the surface of the femur, thus the surface of the femur is very smooth.

Question 6

Spiral Line

Answer 6

Ridge going inferiorly from teh lesser trochanter, becomes coontinuous with the medial margin of a ridge on teh back of the bone called the LINEAR ASPERA ( medial margin is called the medial liP) –>medial supracondylar ridge –> adductor tubercle

Question 7

Describe the path downward from greater trochanter?

Answer 7

Greater trochanter –> gluteal tubercle–> Lateral lip of linear aspera –> lateral supracondylar ridge –> lateral condyle

Question 8

What is the deep fascia of the thigh called? When it thickens laterally what does it become? Where else do it penetrate?

Answer 8

The deep fascia is called the fascia lata. It thickens laterally to become the ITB. The deep fascia also penetrates the thigh to form the intramuscular septa

Question 9

Anterior Compartment
Name which muscles?
Name nerve supply?

Answer 9

1. Hip flexors and knee extensors

2. Femoral Nerve

Question 10

Posterior comparment
Name which muscles?
Nerve supply?

Answer 10

Hip extensors + knee flexors + hamstring

Supplied by the sciatic nerve

Question 11

Medial compartment
Which muscles
Which nerve supply

Answer 11

Contains adductor muscles

Obturator nerve

Question 12

Which muslces constitute the femoral triangle

Answer 12

• sartorius
• adductor longus
• inguinal ligament

Question 13

What are the muscles in the subsartorial comparment

Answer 13

Structures which pass from medial high to the leg

Question 14

What are the 7 Muscular compartment

Answer 14

Femoral triangle
Subsartorial canal
Anterior comparemtn
Medial COmpartment
Gluteal region
POsterior comparment of thigh
popliteal fossa

Question 15

Describe the popliteal fossa?

Answer 15

Tendons from hamstring above

Two heads of the gastrocnemius from below

Question 16

Iliopsoas consits of?

Answer 16

Iliacus and Psoas major

Question 17

Desribe features of Psoas Major

Answer 17

Originates from T12 - L5, it creates tendinuos arches between its various origins. Nerves of the lumba plexus will exit the vertebral canal from between these arches anf form plexus within the psoas. The muscles inserts into the lesser trochanter of the femur.

Question 18

Where does the iliacus arise from?

Answer 18

Illiacus arises from teh iliac fossa

Question 19

Illiospsoas Fascia

Answer 19

Both the Psoas Major and the iliacus are covered by iliopsoas fascia, this provides a pathway for abcess to travel from lumbar spine to the lower limb

Question 20

Describe the bursa

Answer 20

Part of the head of the femur is outside the hip joint, hence this is reinfroced by byrsa, It lies between lesser trochanter and capsule of the hipjoint.

Question 21

How does hipflexor function as a trunk flexor?

Answer 21

Illiospsoas is powerful hipflexor, but when the thigh muscle is fixed, we can use it to flex the trunk on the thigh. E.g. when doign sit up exercises.

This creates compressive and shear forces on the
Shear forces on lumbar spine l5, S1 - one vertebrae wantes to pull over another

Question 22

Anterior Compartment Muscles, name them?

What are their origins and insertions?

Answer 22

1. Sartorius
   Origin: ASIS
   Insertion: anteromedial upper tibia ( part of pes anserinus)

Pectineus
Origin: Pectineal line of the pubis
Insertion: Pectineal line of the femur

Info: it inserts into the division betwene the anteror and medial compartments of the femur. hence the dual nerve supply

• Femoral nerve
• obturator nerve

Question 23

Name the 4 muscles in the quadriceps

Answer 23

Rectus femoris
- Origin = ASIS
Vastus medialis
- Origin = Medial lip of the linear aspera 
Vastus lateralis
- Origin = Lateral lip of the linear aspera of the posterior femur
Vastus intermedius
- Anterior femur

Insertion: All 4 quadricepts muscles come togehte rot the form the quadriceps tendon –> This attached to the patella –> patella ligament –> Inserts into tibial tuberosrity

Vastus medialis and vastus lateralis also give retinacular fibres

• Vastus medialis prevent susblaxation of patella laterally

Question 24

What is the function of the rectus femoris? WHat is the function of the vastus group of muscles?

Answer 24

The rectus femoris stretches over both the hip and the knee, so its function is is hip flexion and knee extension.

Vastus Group - Catalyses Knee extension

Question 25

What is teh injury of the patellar ligament called? What happens?

Answer 25

Excessive jumping can cause inflammation of the patella ligament, inflammation of the patellar ligament at the tibial tuberosity

It is caleld OSgod Schlatter disease

Question 26

Where is the articularis Genu and what does it do?

Answer 26

The articularis genui pulls the suprapatellar bursa superiorly, this is out of the way of knee extension prventing impingement of synovial membrane betwene the patella and the femur

Question 27

Articularis GEnu

Answer 27

LIes superificial to the vastus intermedius, its function is to pull the suprapaterllar bursa superiorly

Question 28

Name the Adductor muscles
Origins & Insertions
Actions

Answer 28

Gracillis

• Origin: Inferior pubic ramus
• insertion: medial tibia
• Action:

Adductor magnus ( deepest part)

• Origin - pubics and ischium
• Insertion : Adductor tubercle of femur inferiorly & medial linear aspera superioryl ( of femur)
• Action
• linear aspeara portion: Causes hip abduction, and flexion
• Adductor tubercle: Causes hip adducction and extension

Creates the adductor hiatus –> allowing vessels to pass from medial thigh to posterior thigh

Adductor longus ( Most anteiror adductor muscle)
- Origin: Anterior pubis body

Adductor Brevis (intermediate)
Origin - Anteiror pubis body

Obturator Externus
- LIes deep to adductor magnus

Question 29

What is the common pathology assocaited with

Answer 29

Inflammation at the origin of the adudctor muscles

Question 30

Gluteal Muscles, which compartments do they form? What is primarly their action?

Answer 30

Forms the lateral compartment & Posterior Compartment

- Causes hip abduction and medial rotation of the thigh

Question 31

Gluteus Maximus

Answer 31

Actions

• upright locomotion
• Capacity to run

Origin: Ilium of hip bone
Insertion:
- Back of the femur to Gluteal tuberosity
- Iliotibial tract

Question 32

Gluteus Medius, Gluteus Minimus
Origin
Insertion
Action

Answer 32

Originate more laterally than the gluteus maximus on the ilium

They both insert into the greater trochanter

Action
- They are both really important in walking, the contract and act to balance the weight more evenly.
- Contraction pulls on the lateral side
This is important to prevent the pelvis falling away towards the limb which is hanging in mid air.
- This is called Trendellenberg Gait, if it falls towards the side of the free limb

Question 33

Tensor Fascia Lata

Answer 33

Origin- Iliac Crest
Insertion - Illiotibial band
Action - Knee extension

Question 34

What type of muscle is the piriformis? Where does the Piriformis run, what ar ethe ekye landmarks

Answer 34

Originates in the sacrum, and passes out through the greater sciatic foramen & inserts into the greater trochanter

• sciatic nerve passes below
• Superior gluteal artery and vein passes above
• inferior gluteal artery and vein passes below

Question 35

Where is the origin of the obturator internus? Where its insertion?

Answer 35

The origin of the obturatory internus is the ischiopubic ramus & obturator membrane

It goes through lesser sciatic foramen and inserts into the greater trochanter.

Question 36

Name the three muscles in the extensor compartment of the leg. Origins & Insertisons and their actions

Answer 36

Common origin of these except short head of biceps which originates from the psoterior femur is the ischial tuberosity of the hip.

Biceps femoris
- Both long and short heads insert into head of fibula

Semtendonosis
- inserts into medial tibia, inferomedially

SEmimembranosus
- Medidal condyle of the tibia, inserts and gives expansion to the oblique poolpliteal ligeament
iies deep to semitendonosis

All three act to extend at hip and flex at the knee

Question 37

What type of injuries are these three muscles susceptible to?

Answer 37

Because they cross 2 joints, susceptible to strain and tear

Avulsion fractiure at ischium can happen in children