Bones Muscle & Fascia of THe hips Flashcards
Where do the gluetal muscle arise from in the hip? Define their specific origins
Gluteal muscles arise from the lateral asepct of the the hip bone, ilium. Specifically three gluteal muscles arise from three lines on teh ilium.
- Posterior gluteal line - Gluteus maximus ( most pwoerful hip extensor)
- Anterior gluteal line - GLuteus medius
- Inferior Gluteal ine -
Where are the attachments of the inguinal ligament
Attaches from the ASIS to the pubic tubercle
Which is the bony bit we sit on, but also serves as a muscular attachment?
Ischial Tubersotiy
Avulsion fractures, wht are they?
Where the muscles attaching to the bone are often stronger than the bone at the epiphyses, thus contributing to the fractures.
Vastus Intermedialis
Smooth muscle on the surface of the femur, thus the surface of the femur is very smooth.
Spiral Line
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
Describe the path downward from greater trochanter?
Greater trochanter –> gluteal tubercle–> Lateral lip of linear aspera –> lateral supracondylar ridge –> lateral condyle
What is the deep fascia of the thigh called? When it thickens laterally what does it become? Where else do it penetrate?
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
Anterior Compartment
Name which muscles?
Name nerve supply?
- Hip flexors and knee extensors
2. Femoral Nerve
Posterior comparment
Name which muscles?
Nerve supply?
Hip extensors + knee flexors + hamstring
Supplied by the sciatic nerve
Medial compartment
Which muscles
Which nerve supply
Contains adductor muscles
Obturator nerve
Which muslces constitute the femoral triangle
- sartorius
- adductor longus
- inguinal ligament
What are the muscles in the subsartorial comparment
Structures which pass from medial high to the leg
What are the 7 Muscular compartment
Femoral triangle Subsartorial canal Anterior comparemtn Medial COmpartment Gluteal region POsterior comparment of thigh popliteal fossa
Describe the popliteal fossa?
Tendons from hamstring above
Two heads of the gastrocnemius from below
Iliopsoas consits of?
Iliacus and Psoas major
Desribe features of Psoas Major
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.
Where does the iliacus arise from?
Illiacus arises from teh iliac fossa
Illiospsoas Fascia
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
Describe the bursa
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.
How does hipflexor function as a trunk flexor?
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
Anterior Compartment Muscles, name them?
What are their origins and insertions?
- 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
Name the 4 muscles in the quadriceps
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
What is the function of the rectus femoris? WHat is the function of the vastus group of muscles?
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
What is teh injury of the patellar ligament called? What happens?
Excessive jumping can cause inflammation of the patella ligament, inflammation of the patellar ligament at the tibial tuberosity
It is caleld OSgod Schlatter disease
Where is the articularis Genu and what does it do?
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
Articularis GEnu
LIes superificial to the vastus intermedius, its function is to pull the suprapaterllar bursa superiorly
Name the Adductor muscles
Origins & Insertions
Actions
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
What is the common pathology assocaited with
Inflammation at the origin of the adudctor muscles
Gluteal Muscles, which compartments do they form? What is primarly their action?
Forms the lateral compartment & Posterior Compartment
- Causes hip abduction and medial rotation of the thigh
Gluteus Maximus
Actions
- upright locomotion
- Capacity to run
Origin: Ilium of hip bone
Insertion:
- Back of the femur to Gluteal tuberosity
- Iliotibial tract
Gluteus Medius, Gluteus Minimus
Origin
Insertion
Action
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
Tensor Fascia Lata
Origin- Iliac Crest
Insertion - Illiotibial band
Action - Knee extension
What type of muscle is the piriformis? Where does the Piriformis run, what ar ethe ekye landmarks
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
Where is the origin of the obturator internus? Where its insertion?
The origin of the obturatory internus is the ischiopubic ramus & obturator membrane
It goes through lesser sciatic foramen and inserts into the greater trochanter.
Name the three muscles in the extensor compartment of the leg. Origins & Insertisons and their actions
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
What type of injuries are these three muscles susceptible to?
Because they cross 2 joints, susceptible to strain and tear
Avulsion fractiure at ischium can happen in children
