Hip joint, deep back, suboccipital, gluteal regions Flashcards by Talia Casarella

Pelvic Bones

Illium
ischium
pubis

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Landmarks in the pelvic

look over

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Serratus Posteior Superior

Origin:
1. C7-T3 SP
Insertion:
1. Ribs 2-5 (Run out laterally)
Action:
1. elevates the ribs
Innervation:
1. ventral rami of the thoracic nerves

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Serrratus posterior inferior

Origin:
1. T11-L3 SP

Insertion:
1. Ribs 9-12

Action:
1. depress the ribs

Innervation:
1. ventral rami of thoracic nerves

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Splenius Capitis

Origin:
1. spinous processes of C7-T4

Insertion:
1. mastoid process
2. lateral 1/3 of superior nuchal line

Action:
1. bilateral: extend neck
2. Unilateral: ipsilateral neck rotation

Innervation:
1. dorsal rami of cervical nerves

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Splenius Cervicis

Origin:
1. Spinous processes of T3-T6
Insertion:
1. Transverse processes of C1-C3

Action:
1. Bilateral: Extend neck
2. Unilateral: Ipsilateral neck rotation

Innervation:
1. Dorsal rami of cervical nerves

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iliocastalis (errector spinae)

Lateral column
divisions:
- Lumborum
- Thoracis
- Cervicis

Origin:
1. Sacrum
2. lumbar spinous process
3. iliac crest

Insertion:
1. Angles of ribs
2. cervical transverse processes

Action:
1. bilateral: trunk extension
2. unilateral: ipsilateral trunk lateral flexion and rotation

Innervation:
1. dorsal rami

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Longissimus

Middle column (erector spinae)
Divisions:
-thoracis
-cervicis
-capitis

Origin:
1. Thoracic and cervical TP

Insertion:
1. Thoracic and cervical TP
2. mastoid process

Action:
bilateral: trunk extension
unilateral: ipsilateral trunk lateral flexion

Innervation:
dorsal rami

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Spinalis

Medial column (erector spinae)
Divisions:
- thoracis
- cervicis
- capitis

Origin:
1. thoracic and cervical spinous process

Insertion:
1. thoracic and cervical spinous process
2. blends with semispinalis capitis

Action:
1. bilateral: trunk extension
2. unilateral: ipsilateral trunk lateral flexion

Innervation:
1. dorsal rami

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Tranversospinales

Origin:
1. transverse process
Insertion:
2. spinous process
-Semispinalis: spans 4-6 vertebrae (Occiput-thoracic)
-multifidus: spans 2-4 vertebrae (deep to semispinalis)
-rotatores: spans 1-2 vertebrae (deep to semispinalis thoracic)

Action:
1. Bilateral: extend trunk
2. unilateral: contralateral trunk rotation

Innervation:
1. dorsal rami

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Segmental Muscles: levatores costrum

Origin:
1. Thoracic TP

Insertion:
1. Rib below

Action:
1. stabilize vertebral column

Innervation:
1. dorsal rami

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Segmental Muscules: interspinales

Origin:
1. SP

Insertion:
1. SP below

Action:
1. stabilize vertebral column

Innervation:
1. dorsal rami

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Segmental muscules: intetransversarrii

Origin:
1. TP

Insertion:
1. TP below

Action:
1. stabilize the vertebral column

Innervation:
1. Dorsal rami

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Scalene

Anterior scalene
middle scalene
posterior scalene

Origin:
1. cervical TP
Insertion:
1. rib 1 or rib 2

Action:
1. elevation of rib 1 or 2

Innervation:
1. cervical ventral rami

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Rectus Capitis Posterior minor

Origin:
1. C1 SP

Insertion:
1. medial occipital bone

Action:
1. Stabilize the head

Innervation:
1. suboccipital nerve (C1)

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Rectus Capitis posterior major

Origin:
1. C2 SP

Insertion:
1. lateral occipital bone

Action
1. stabilize head and neck

Innervation:
1. suboccipital nerve (C1)

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Obliquus Capitis Supeiror

Origin:
1. C1 TP

Insertion:
1. occiput

Action:
1. stabilize Head and neck

Innervation:

suboccipital nerve C1

obliquus capitis inferior

Origin:
1. C2 SP

Insertion:
1. C1 TP

Action:
1. stabilize head and neck

Innervation:
1. suboccipital nerve C1

Gluteus Minimus

Origin:
1. ilium
2. between inferior and anterior gluteal lines

Insertion:
1. Greater trochanter

Action:
1. Hip abduction

Innveration:
1. Superior gluteal nerve L4-S1

Gluteus Medius

Origin:
1. ilium
2. between anterior and posterior gluteal lines

Insertion:
1. greater trochanter of the femur

Action:
1. Hip abduction

Innveration:
1. Superior gluteal nerve L4-S1

Gluteus Maximus

Origin:
1. ilium (posterior to gluteal line)
2. sacrum
3. coccyx
4. sacrotuberous ligament

Insertion:
1. iliotibial tract
2. Gluteal tuberosity of the femur

Action:
1. extends the thigh
2. laterally rotates the thigh
3. abducts the thigh

Innervation:
1. inferior gluteal L5-S2

Tensor fascia Latte

Origin:
1. anterior iliac crest

Insertion:
1. Anterior aspect of iliotibial tract

Action:
1. Flexes hip
2. abducts the hip
3. IR hip
4. Stabilizes knee in extension

Innervation:
1. superior gluteal L4-S1

Piriformis

Origin:
1. anterior sacrum

Insertion:
1. Greater trochanter

Action:
1. lateral hip rotation

Innervation:
1. S1, S2

Gemellus Superior

Origin:
1. Ischial spine

Insertion:
1. Greater trochanter

Action:
1. lateral hip rotation

Innervation:
1. Nerve to obturator interns L5-S2

Obturator Internus

Origin: 1. Medial surface of obturator membrane Insertion: 1. Greater trochanter Action: 1. lateral hip rotation Innervation: 1. Nerve to obturator interns L5-S2

Gemellus Inferior

Origin: 1. ischial tuberosity Insertion: 1. Greater Trochanter Action: 1. lateral hip rotation Innervation: 1. Nerve to quadrates femoris L4-S1

Quadratus Femoris

Origin: 1. ischium Insertion: 1. intertrochanteric crest of the femur Action: 1. lateral hip rotation Innervation: 1. Nerve to quadrates femoris L4-S1

Blood Supply in this region

- Common iliac artery - internal iliac artery and external iliac artery - femoral artery

What supplies the femoral head

- lateral circumflex artery medial cicumflex femoral artery - obturator artery

Deep back ligaments

- ligamentum flavum: between the lamina - posterior longitudinal: vertebral bodies - anterior longitudinal: vertebral bodies - interspinous ligament: between Spinous process - supraspinous: above spinous process

Suboccipital triangle anatomy

- rectus capitis posteriror major - rectus capitis posterior minor - obliquus capitis superior - obliquus capitis inferior Contents: - vertebral artery - suboccipital nerve C1 Runs over top - greater occiptial nerve C2

Subocciptial Ligaments

nuchal ligaments alar ligaments transverse ligament

Gluteal Region nerves that enter through the greater sciatic forearm

- superior gluteal nerve L4-S1 - inferior gluteal nerve (L5-S2) - sciatic nerve (L4-S3) - Nerve to quadratus Femoris (L4-S1) - Posterior cutaneous nerve of thigh

Gluteal region that enter through the lesser sciatic foramen

- Nerve to obturator internus (L5-S2) - Pudendal Nerve S2-S4

Suboccipital Nerves

Suboccipital nerve C1 (motor and goes through triangle) Greater occipital nerve C2 (sensory and goes under oblique capitus inferior

Sciatic nerve entrapment/piriformis syndrome | Causes

- muscle spasm in the piriformis muscle - irritation in the muscule - irritation in nearby structures such as the sacroiliac joint or hip - tightening of the piriformis in response to injury or spasms - swelling of the piriformis muscle - sciatic nerve piercing the piriformis - sciatic nerve passing superior to the piriformis

Piriformis syndrome

- Pain in the buttocks and down the leg - chronic pain in the buttock and hip area - pain when getting out of bed - inability to sit for a prolonged time - pain in the buttocks that is worsened by hip movements

Common referral pattern | sciatica

- characteristic pain in the buttocks that run down the leg - shooting - burning - aching down - numbness - tingling - occurs with movement or in sitting - can extend lower over the proximal two thirds of the posterior thigh - can be mistaken for superior hamstring or medial hamstring pain

Hip OA

- gradual erosion of cartilage which causes joint pain stiffness - most common cause of hip pain in older adults - diagnosis: moderate anterior/lateral pain in weight bearing, morning stiffness less than 1 hour after waking up hip internal rotation <24º and or flexion <15º - physical examination: leg length discrpenancy, antalgic gait and trendelenburg gait

Forward head posture

- shortening of posterior cerivcal extensor muscles and tightening of anterior cervical muscles - the weight of the head is maintained in fron of the line of gravity which then increases the flexion moment on spine