Hip and thigh: bones and muscles

Question 1

Describe the boundaries of the gluteal region?

Answer 1

From iliac crest above to gluteal fold below

Question 2

Describe the trochanters of the femur?

Answer 2

Greater: anterolateral, more prominent

Lesser: posteromedial, less prominent

Question 3

How are the trochanters of the femur joined?

Answer 3

Trochanteric line anteriorly (rough)

Trochanteric crest posteriorly (smooth)

Question 4

Describe the features of the shaft of the humerus?

Answer 4

Smooth anteriorly

Linea aspera posteriorly > splits into supra-condylar lines

Question 5

Describe the outer surface of the ilium?

Answer 5

Gluteal surface

Gives rise to gluteal muscles

Three lines: inferior, anterior and posterior (delineate attachments of gluteal muscles)

Question 6

What is the significance of the ischeal tuberosity?

Answer 6

Bears weight in sitting position

Attachments for key muscles

Question 7

Describe the ischeal ramus?

Answer 7

projects forward from ischeal tuberosity

Completes loop of bone when it joins with inferior pubic ramus

Question 8

Describe the actions of the muscles of the gluteal region?

Answer 8

Extend, rotate and abduct the thigh at the hip joint

Also minmise pelvi tilt during swing phase of locomotion

Question 9

Where do major flexors of the hip arise from?

Answer 9

Posterior abdominal wall

Question 10

What creates the muscle compartments in the thigh and leg?

Answer 10

Bone, fascia and interosseous membrane

Question 11

Which muscle compartments are present in the thigh?

What are their actions?

Answer 11

Medial: adductor

Anterior: extensor (extend knee, flex hip)

Posterior: flexor

Question 12

Which muscle compartments are present in the leg?

What are their actions?

Answer 12

Anterior: dorsiflex and extend toes

Posterior: plantarflex foot and flex toes

Lateral: evert foot

Question 13

What is the fascia lata?

What is its function?

Answer 13

Deep fascia encircling the thigh muscles

Limits outward bulging of muscles and promotes venous return

Question 14

What is the iliotibial tract?

Answer 14

Thickening in lateral part of fascia lata

Question 15

Which muscles are related to the iliotibial tract?

Answer 15

Shared aponeurotic tendon of gluteus maximus and tensor fascia lata

Question 16

Describe the actions of tensor fascia lata?

Answer 16

Flexes, abducts and medially rotates

Question 17

Describe the attachments of the gluteus maximus?

Answer 17

From gluteal surface of ilium, posterior to the posterior gluteal line and dorsum of sacrum

(from back of sacrum and adjacent part of ilium)

Inserts into iliotibial tract, with some deep fibres passing into the gluteal tuberosity

Question 18

Describe the actions of the gluteus maximus?

Answer 18

Extension and lateral rotation

(standing up from sitting, bending over, walking up stairs)

Question 19

Describe the muscles that lie posteriorly to the hip joint, below gluteus maximus?

Answer 19

Gluteus medius

Gluteus minimus

Piriformis

Gemellus superior

Obturator internus

Gemellus inferior

Quadratus femoris

Question 20

Describe the structure and insertions of gluteus medius and gluteus minimus?

Answer 20

Fan shaped

Insert into lesser trochanter

Question 21

Describe the functions of gluteus medius and gluteus minimus?

Answer 21

Abduct hip

Medially rotate

Function in locomotion

Question 22

Describe the structure and pathway of piriformis?

What is the significance of this muscle?

Answer 22

Triangular

Arises within pelvis from anterior sacrum > exits pelvis through sciatic notch and inserts into gluteal region

Key to organising neurovascular structures in lower limb

Question 23

Where does obturator internus arise from?

Answer 23

Lateral wall of pelvis

Question 24

Which larger muscle are the gemelli associated with/helpers of?

Answer 24

Obturator internus

Question 25

Which landmarks lie either side of quadratus femoris?

Answer 25

Ischeal tuberosity to medial side Greater trochanter to lateral side

Question 26

List the muscles in the anterior compartment of the thigh?

Answer 26

Iliopsoas Pectineus Sartorius Rectus femoris Vastus lateralis Vastus intermedius (deep) Vastus medialis

Question 27

Which muscle organises the anterior compartment of the thigh?

Answer 27

Sartorius Hip flexors lie above it Quadriceps lie below it

Question 28

Describe the functions of iliopsoas?

Answer 28

Flexes trunk on thigh Lifts thigh at hip Important postural muscle during standing - maintains lumbar lordosis

Question 29

Describe the actions of pectineus? Explain?

Answer 29

Flexion at hip Adduction at hip Transition between anterior extensor compartment and medial adductor compartment

Question 30

Describe the action of sartorius?

Answer 30

Sitting cross-legged Mainly a synergist

Question 31

Describe the actions of the quadriceps muscles?

Answer 31

Extend knee Rising from sitting, walking up stairs

Question 32

Describe the insertion of the quadriceps muscles?

Answer 32

Four components \> quadrcieps tendon \> patellar ligament \> inserts into tibial tuberosity

Question 33

Describe the vastus intermedius?

Answer 33

Deep component of quadriceps muscles Anterior surface has aponeurosis over top \> blends with quadriceps tendon

Question 34

List the muscles of the medial compartment of the thigh?

Answer 34

Gracillis Adductor longus Adductor brevis Adductor magnus

Question 35

How are the adductor muscles arranged in relation to each other?

Answer 35

Superficial to deep: longus, brevis, magnus

Question 36

Which is the deepest muscle of the medial compartment of the thigh?

Answer 36

Adducotr magnus

Question 37

Which muscle of the medial compartment of the thigh is very extensive? Describe its insertion?

Answer 37

Adductor magnus Inserts along whole of linea aspera, right down to adductor tubercle

Question 38

List the muscles present in the posterior compartment of the thigh?

Answer 38

Semitendinosus Semimembranosus Biceps femoris (long and short head)

Question 39

How does the biceps femoris differ from the other quadriceps muscles?

Answer 39

Origin on hip bone Crosses knee and hip joint \> knee extension and hip flexion Also has two heads

Question 40

How does gracilis differ from the other muscles of the medial compartment of the thigh?

Answer 40

Crosses both hip and knee joint (inserts into proximal tibia)

Question 41

What is the adductor hiatus?

Answer 41

Gap in adductor magnus Gap in its insertion between linea aspera/supracondylar ridge and adductor tubercle Passage for main vessels of lower limb

Question 42

Describe the origin of the hamstring muscles?

Answer 42

Superificial three: ischeal tuberosity Short head of biceps: shaft of femur

Question 43

Describe the actions of the hamstring muscles?

Answer 43

Hip extensors (not short head of biceps) Knee flexors

Question 44

Describe the arrangement of the muscles of the posterior compartment of the thigh?

Answer 44

MEDIAL Semimembranosus Semitendinosus (overlies semimebranosus) LATERAL Biceps femoris long head (superifical) Biceps femoris short head (deep)

Question 45

How does the semitendinosus differ from the semimembranosus?

Answer 45

Semitendinosus is more superficial Has more tendon (belly stops earlier)

Question 46

Describe the insertions of the hamstring muscles?

Answer 46

Biceps femoris: fibula (lateral) Semimembranosus: posterior of medial condyle of tibia Semitendinosus: pes anserinus (proximal tibia)

Question 47

Describe the pes anserinus?

Answer 47

Common insertion of three muscles, one from each compartment of thigh Sartorius Gracilis (bursa) Semintendinosus (SAY GRACE BEFORE TEA)