Muscles of Hip and Thigh Flashcards
What are the regions of the lower limb?
Gluteal
Thigh
Leg
Foot
What is the basis of the regional divisions of the lower limb?
Major joints
Bones
Superficial landmarks
How does the medial rotation of the lower limb during development change its arrangement compared to the upper limb?
Extensors anterior
Great toe medial
What does the position of the extensors in the lower limb favour?
Propulsion
Where is the gluteal region?
Posterolateral, between iliac crests above and gluteal fold below
Where is the thigh?
Between inguinal ligament and knee joint anteriorly
Between gluteal fold and knee joint posteriorly
Where is the leg?
Between knee and ankle
Where is the foot?
Distal to ankle
What makes up the hip bone, and where are they?
Ilium superiorly
Pubis anteriorly
Ischium posteroinferiorly
Where do the three bones of the hip fuse by adulthood?
Acetabulum
What is the upper border of the ilium?
Iliac crest
What is the extent of the iliac crest?
From anterior superior iliac spine to posterior superior iliac spine
Are there any inferior iliac spines?
Yes: anterior and posterior inferior iliac spines
What is the posterior/outer surface of the ilium called?
Gluteal surface
Where do the gluteal muscles attach to the hip bone?
On gluteal surface of ilium
What demarcates the attachment of the different gluteal muscles on the gluteal surface of the ilium?
Gluteal lines
Describe the inner surface of the ilium
Smooth
Has iliac fossa
What muscle does the inner surface of the ilium give rise to?
Iliacus
What does the ischial spine on the ischium demarcate?
Big notch above = greater sciatic notch
Smaller notch below = lesser sciatic notch
What is the shape of the ischial tuberosity?
Wedge
What does the ischial tuberosity do?
Bears weight during sitting
What extends from the ischial tuberosity?
Ischial ramus
Which ramus meets the ischial ramus?
Ramus from pubic bone
Where do the two pubic bones meet?
Pubic symphysis
Where is the body of pubis in relation to the pubic symphysis?
On either side
Where is the pubic crest in relation to the pubic symphysis?
Above
Where is the pubic tubercle in relation to the pubic symphysis?
Lateral extension
What are the two pubic rami?
Superior
Inferior
Where is the pair of pubic rami?
Project above and below obturator foramen
What is the obturator foramen?
Hole in hip bone
What is the long linear ridge on the posterior surface of the femur?
Linear aspera
What does the linear aspera split into distally?
Medial and lateral supracondylar lines
Where do the medial and lateral supracondylar lines end?
Femoral condyles
What is between the greater and lesser trochanters anteriorly?
Intertrochanteric line - rough
What does the intertrochanteric line become posteriorly?
Intertrochanteric crest
What do the intertrochanteric line and crest demarcate?
Neck and shaft of femur
What movements do the muscles of the gluteal region do?
- Extend
- Rotate
- Abduct
Thigh at hip joint (if pelvis fixed)
What do the muscles of the gluteal region during the swing phase of locomotion?
Minimise pelvic tilt
Where do the major flexors of the hip arise from?
Posterior abdominal wall
What are the flexors of the hip?
Psoas major
Iliacus
What separates muscles in the thigh and leg into compartments?
Bone
Fascia
Interosseus membrane
What divides the thigh into its compartments, and how many are there?
Septa divide into 3 compartments
What does the medial compartment of the thigh do?
Adductor compartment
Muscles acting mostly on hip
What does the anterior compartment of the thigh do?
Extensor compartment
Muscles cross both hip and knee
- Extend hip
- Flex knee
What does the posterior compartment of the thigh do?
Flexor compartment
Muscles act on hip and knee - because span both joints
What is the deep fascia of the thigh?
Tensor fascia lata
What is the extent of the tensor fascia lata?
From pelvic girdle above
Becomes continuous beyond knee with leg’s fascia
Goes all the way around thigh
What is the density and strength of tensor fascia lata?
Very dense and strong
What does the tensor fascia lata do?
Limits bulging of muscles outwards > promotes venous return because muscles compressed when they’re working
Where is tensor fascia lata thickened and what is it called?
Thickened laterally = iliotibial tract
What are the attachments of the iliotibial tract?
Iliac crest above
Proximal tibia below
What does the iliotibial tract do?
Stabilises lateral side of extended leg (during standing)
Maintains extension
Stabilises hip joint
Prevents lateral movement of proximal femur
What muscles are like the deltoid of the hip joint?
Gluteus maximus and tensor fascia lata
What part of deltoid is gluteus maximus like?
Posterior fibres
What does gluteus maximus do?
Extend and laterally rotate hip joint
Why isn’t gluteus maximus an adductor of the hip?
Too posterior to axis of joint
What part of deltoid is tensor fascia lata like?
Anterior fibres
What does tensor fascia lata do?
Flex, abduct, and medially rotate hip joint
What is the origin of gluteus maximus?
Gluteal surface of ilium
From part of ilium adjacent to sacrum and dorsum of sacrum
To which of the gluteal lines does gluteus maximus extend to?
Most posterior
In which direction do the fibres of gluteus maximus project?
Inferolaterally at 45 degrees
What is the insertion of gluteus maximus?
From behind into iliotibial tract
Gluteal tuberosity on femur
When does gluteus maximus function the most?
Between flexed and standing position
- Sitting to standing
- Bending to straightening
- Walking uphill or up stairs
What group of muscles is underneath gluteus maximus?
Series of short rotators
Where are gluteus medius and minimus in relation to gluteus maximus?
Underneath
What is the shape of gluteus medius and minimus?
Fan-shaped
What is the extent of gluteus medius and minimus?
From posterolateral part of gluteal surface of ilium
Into greater trochanter, inserting into anterolateral part
Why are gluteus medius and minimus medial rotators of the hip joint?
Pass in front of axis of rotation of hip joint
What do gluteus medius and minimus do?
Medially rotate hip
Abduct hip
Which part of deltoid are gluteus medius and minimus like?
Middle fibres
Which muscles are edge to edge with gluteus medius and minimus inferiorly (from superior to inferior)?
Piriformis
Obturator internus
Quadratus femoris
What is the shape of piriformis?
Triangular
What are the deep muscles of the gluteal region?
Piriformis
Obturator internus
Quadraatus femoris
What is the order of gluteus muscles, from superficial to deep?
Maximus
Medius
Minimus
What is the landmark for the gluteal region?
Piriformis
What is the origin of piriformis and obturator internus?
Side wall of pelvis
What do the deep muscles of the gluteal region do?
Function as rotator cuff
Stabilise hip joint
Lateral rotators
Why are the deep muscles of the gluteal region lateral rotators?
Because behind axis of rotation
How do gluteus medius and minimus work in gait?
When one leg off ground, lose support for pelvis > fall towards that side
Opposite gluteus medius and minimus stabilise pelvis during swing phase > pull pelvis towards supported side
What is the Trendellenberg gait?
Rocking gait because of denervated/weakened gluteus medius and minimus
What descriptively divides the anterior compartment of the thigh?
Sartorius
What is sartorius?
Strap muscle
Moves diagonally across anterior compartment of thigh
Divides muscles into those above and below it
Which muscle is above sartorius?
Iliopsoas
What is iliopsoas?
Converged fibres of iliacus and psoas that insert as conjoined tendon at lesser trochanter
What does iliopsoas do during walking?
Lift thigh at hip
What does iliopsoas do if you fix the thigh?
Flex trunk
What is ilipsoas’ role in posture?
Maintains lumbar lordosis in standing
Which muscle is medial to ilipsoas?
Pectineus
What types of muscles is pectineus a transition muscle between?
Hip flexors and adductors
What are the main actions of sartorius?
Mainly synergistic
Flexing, abducting, and laterally rotating hip
Flexing knee
How much of the femur does qaudriceps cover?
Almost all of anterior aspect and sides
Which muscle makes up the bulk of the anterior compartment of the thigh?
Quadriceps
What is quadriceps’ action on the knee?
Powerful extensor, especially against gravity
What are the insertions of quadriceps?
All four parts insert into tibial tuberosity
What is the name of the insertion of the quadriceps
Quadriceps tendon above patella
Patellar ligament below patella
Where else do vastus medialis and lateralis insert into independently?
Patella via medial and lateral patellar retinacula
What do the medial and lateral patellar retinacula do?
Reinforce knee joint capsule
Keep patella aligned
What does the medial patellar retinaculum oppose?
Lateral pull of rectus femoris on patella
What joints does rectus femoris cross?
Hip
Knee
What is the origin of rectus femoris?
One head - anterior inferior iliac spine
Reflected head - just above acetabulum
Which muscles of quadriceps cross the hip?
Rectus femoris
What does rectus femoris do?
Flexes hip
Extends knee
What is the origin of the rest of qaudriceps?
Femur
Which quadriceps muscles arise from the proximal femur?
Vastus lateralis
Vastus medialis
Which quadriceps muscle is deep?
Vastus intermedius
What is the origin of vastus intermedius?
Anterior aspect of shaft of femur, enclosing front
Which quadriceps muscle is a significant part of the anterior surface’s aponeurosis?
Vastus intermedius
What are the four muscles of quadriceps?
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis
What is the origin of vastus lateralis?
Lateral proximal femoral shaft
What is the origin of vastus medialis?
Medial proximal femoral shaft
What is the action of the medial compartment of the thigh?
Adductors of hip
What are the four muscles of the medial compartment of the thigh?
Gracilis
Adductor longus
Adductor brevis
Adductor magnus
Which muscle forms the medial border of the medial compartment of the thigh?
Gracilis
What is the shape of gracilis?
Long
Slender
What is the order of the “adductor” muscles from superficial to deep in the medial compartment of the thigh?
Longus
Brevis
Magnus
Between which muscles are the adductor muscles?
Quadriceps and sartorius of anterior compartment, and gracilis
Which of the adductor muscles is the biggest, deepest, most powerful, and most posterior?
Adductor magnus
What is the origin of all adductor muscles?
Pubic bone and inferior pubic ramus
What is the insertion of all adductor muscles?
Linea aspera of femur
What is the size of each insertion of the adductors?
Adductor longus = middle sized
Adductor brevis = little
Adductor magnus = big
What is the extent of the insertion of adductor magnus?
Extends through linea aspera all the way down onto medial supracondylar ridge
Which joints do the hamstrings cross?
Hip
Knee
What are the actions of the hamstrings?
Flex knee
Extend hip
What is the origin of the hamstrings?
Ischial tuberosity
Which muscle is a transition muscle between the adductors and the hamstrings?
Adductor magnus
What are the muscles of the hamstrings?
Semimembranosus
Semitendinosus
Biceps femoris
Compare the shapes and spatial relationship of semimembranosus and semitendinosus
Semitendinosus has shorter belly and longer tendon
Semitendinosus overlies semimembranosus
Semimembranosus continues to be fleshy more distally than semitendinosus
On which side of the posterior compartment of the thigh are semimembranosus and semitendinosus?
Medial
What is the insertion of semimembranosus and semitendinosus?
Proximal tibia
On which side of the posterior compartment of the thigh is biceps femoris?
Lateral
Which head of biceps femoris is superficial?
Long head
What is the origin and insertion of biceps femoris?
Origin = ischial tuberosity Insertion = fibula
Which head of biceps femoris is deep?
Short head
Does the short head of biceps femoris cross the hip joint?
No
What is the origin of the short head of biceps femoris?
Posterior aspect of shaft of femur
What is the insertion of the short head of biceps femoris?
Fibula
Which muscles make up the pes anserinus?
Sartorius from anterior compartment
Gracilis from medial compartment
Semitendinosus from posterior compartment
Where does pes anserinus insert>
Medial side of proximal tibia
