Hip, Thigh and Buttocks

Question 1

Psoas major - attachments

Answer 1

Proximal: Arises from transverse processes of all 5 lumbar vertebrae and from sides of T12-L5 vertebrae and the intervertebral discs between them

Distal: Tapers inferiorly crossing in front of the sacrum and sacro-iliac joint to join with the iliac muscle and to insert onto the lesser trochanter of the femur

Question 2

Iliacus - attachments

Answer 2

Proximal: Arises from inner surface of iliac fossa

Distal: Blend with fibres of psoas major and inserts onto lesser trochanter of femur

Question 3

Tensor fascia latae - attachments

Answer 3

Proximal: ASIS and anterior portion of iliac crest

Distal: Inserts into iliotibiial tract which inserts onto lateral condyle of the tibia

Question 4

Rectus femoris - attachments

Answer 4

Proximal: Arises by 2 separate heads (straight head from AIIS and reflected head from ilium just superior to acetabulum)

Distal: Tendons form fusiform muscle belly which inserts into quadriceps tendon which inserts into base of patella tendon

Question 5

Vastus lateralis - attachments

Answer 5

Proximal: Arises from posterior aspect of femur, beginning at greater trochanter and continuing inferiorly along the lateral lip of the linea aspera of the femur

Distal: Inserts into lateral patella and tendon of rectus femoris to form quadriceps tendon

Question 6

Vastus intermedius - attachments

Answer 6

Proximal: Arises from anterior and lateral aspects of femoral shaft and lateral intermuscular septum

Distal: Inserts into posterior surface of the upper border of the patella and forms part of the quadriceps tendon

Question 7

Vastus medialis - attachments

Answer 7

Proximal: Arises from the intertrochanteric line and medial lip of line aspera of femur and from the medial inter muscular septum

Distal: Inserts into medial border of the quadriceps tendon, but some of inferior fibres insert directly into the medial side of the patella

Question 8

Pectineus - attachments

Answer 8

Proximal: Arises from pecten pubis

Distal: Inserts on pectineal line of the shaft of the femur just inferior to lesser trochanter

Question 9

Adductor longus - attachments

Answer 9

Proximal: Arises from the body of the pubic bone, just beneath the pubic tubercle

Distal: Inserts onto the linea aspera of the femur

Question 10

Adductor brevis - attachments

Answer 10

Proximal: Arises from the body and inferior ramus of the pubis

Distal: Inserts into the pectineal line and proximal portion of the linea aspera of the femur

Question 11

Obturator externus - attachments

Answer 11

Proximal: Arises from margins of the obturator foramen and obturator membrane

Distal: Fibres converge and course behind the neck of femur to insert on the intertrochanteric fossa

Question 12

Adductor magnus - attachments

Answer 12

Proximal: Inferior ramus of pubis, ramus of ischium and ischial tuberosity

Distal: Gluteal tuberosity, linea aspera, medial supracondylar line, adductor tubercle of femur.

NOTE: Portion inserting on SC line = adductor portion
Portion inserting on AT = hamstring portion

Question 13

Gracilis muscle - attachments

Answer 13

Proximal: Body and inferior ramus of pubis

Distal: Medial aspect of upper portion of tibia, just below medial condyle

Question 14

Psoas major - function

Answer 14

Flexion of the thigh at hip alongside iliacus

Question 15

Iliacus - function

Answer 15

Flexion of thigh at hip alongside iliacus

Question 16

Tensor fascia latea - function

Answer 16

Flexion, abduction and medial rotation of hip

Question 17

Psoas major innervation

Answer 17

Ventral rami of L1-3

Question 18

Iliacus innervation

Answer 18

Femoral nerve (L2,3,4)

Question 19

Tensor fascia latae innervation

Answer 19

Superior gluteal nerve (L4 + 5)

Question 20

Sartorius - attachments

Answer 20

Proximal: ASIS

Distal: Superior part of medial surface of tibial shaft

Question 21

Sartorius - function

Answer 21

Flexion, abduction and lateral rotation of the thigh at hip joint

Question 22

Sartorius - innervation

Answer 22

Femoral nerve (L2 L3)

Question 23

Rectus femoris - function

Answer 23

Extension of leg at knee joint

Flexion of thigh (helps iliopsoas)

Question 24

Rectus femoris - innervation

Answer 24

Femoral nerve (L2, L3, L4)

Question 25

Vastus lateralis - function

Answer 25

Extension of leg at knee joint

Question 26

Vastus lateralis - innervation

Answer 26

Femoral nerve (L2, L3, L4)

Question 27

Vastus intermedius - function

Answer 27

Extension of leg at knee joint

Question 28

Vastus intermedius - innervation

Answer 28

Femoral nerve (L2, L3, L4)

Question 29

Vastus medialis - function

Answer 29

Extension of leg at knee joint

Question 30

Vastus medialis - innervation

Answer 30

Femoral nerve (L2, L3, L4)

Question 31

Pectineus - function

Answer 31

Adduction and flexion of thigh at hip joint | Assists with medial rotation of the thigh

Question 32

Pectineus - innervation

Answer 32

Femoral nerve (L2, L3) and occasionally branch from obturator nerve

Question 33

Adductor longus - function

Answer 33

Adduction, flexion and medial rotation of thigh

Question 34

Adductor longus - innervation

Answer 34

Obturator nerve via anterior branch (L2, L3, L4)

Question 35

Adductor brevis - function

Answer 35

Adduction, flexion and medial rotation of thigh

Question 36

Adductor brevis - innervation

Answer 36

Obturator nerve (L2, L3, L4)

Question 37

Obturator externus - function

Answer 37

Lateral rotation of thigh at hip and steadies head of femur in acetabulum

Question 38

Obturator externus - innervation

Answer 38

Obturator nerve (L3, L4)

Question 39

Adductor magnus - function

Answer 39

Adduction of thigh at hip Weak flexion and medial rotation of thigh (superior) Extension and lateral rotation of thigh (lower)

Question 40

Adductor magnus - innervation

Answer 40

Obturator nerve (L2, L3, L4)

Question 41

Gracilis - function

Answer 41

Adduction of thigh Flexion of leg at knee Medial rotation when knee is flexed

Question 42

Gracilis - innervation

Answer 42

Obturator nerve (L2, L3)

Question 43

Gluteus maximus - attachments

Answer 43

Proximal: Posterior gluteal line of ilium, dorsal surfaces of sacrum and coccyx and sacrotuberous ligament Distal: Iliotibial tract (+some fibres from lower half attach to gluteal tuberosity of femur)

Question 44

Gluteus maximus - function

Answer 44

Extension and lateral rotation of thigh at hip joint Abduction of thigh - upper fibres Adduction of thigh - lower fibres

Question 45

Gluteus maximus - innervation

Answer 45

Inferior gluteal nerve (L5, S1, S2)

Question 46

Gluteus medius - attachments

Answer 46

Proximal: External surface of ilium between anterior and posterior gluteal lines Distal: Greater trochanter of femur

Question 47

Gluteus medius - function

Answer 47

Abduction and medial rotation of thigh at hip joint | Steadies pelvis on leg when opposite leg is raised off ground

Question 48

Gluteus medius - innervation

Answer 48

Superior gluteal nerve (L5, S1)

Question 49

Gluteus minimus - attachments

Answer 49

Proximal: External surface of ilium between anterior and inferior gluteal lines Distal: Greater trochanter of femur

Question 50

Gluteus minimus - function

Answer 50

Abduction and medial rotation of thigh at hip | Steadies pelvis on leg when opposite leg raised off ground (with gluteus medius)

Question 51

Gluteus minimus - innervation

Answer 51

Superior gluteal nerve (L5, S1)

Question 52

Piriformis - attachments

Answer 52

Proximal: Anterior surface of sacral segments and sacrotuberous ligament Distal: Round tendon inserts into greater trochanter of femur

Question 53

Piriformis - function

Answer 53

Abduction of flexed thigh at hip Stabilisation of hip joint Lateral rotation of extended thigh

Question 54

Piriformis - innervation

Answer 54

Ventral rami of S1 and S2

Question 55

Gemellus : superior and inferior - attachments

Answer 55

Proximal: Superior arises from spine of ischium Inferior arises from ischial tuberosity Distal: both tendons blend with tendon of obturator internus to insert on medial aspect of greater trochanter of femur

Question 56

Gemellus : superior and inferior - function

Answer 56

Lateral rotation of extended thigh Abduction of flexed thigh at hip Steady femoral head in acetabulum

Question 57

Gemellus : superior and inferior - innervation

Answer 57

Superior - obturator internus (L5, S1) | Inferior - branch of nerve to quadratus femoris (L5, S1)