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Lower Limb > Muscles of the Iliac and Gluteal Region > Flashcards

Muscles of the Iliac and Gluteal Region Flashcards

1
Q

Muscles of the iliac region

A

ALL take origin in the iliac region and insert onto the femur

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2
Q

Three muscles of the iliac region

A
  • Psoas major and minor

- Iliacus

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3
Q

Muscles of the gluteal region

A 
o	Gluteus maximus
o	Gluteus medius
o	Gluteus minimus 
o	Tensor fasciae latae 
o	Piriformis
o	Obturator internus 
o	Superior gemellus
o	Inferior gemellus
o	Quadratus femoris 
o	Obturator externus
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4
Q

Psoas major origin

A
  • Ventral surfaces of caudal borders and bases of the transverse processes of all lumbar vertebrae
  • Lateral surfaces of intervertebral discs of the last thoracic vertebrae
  • Tendinous arches which allow the passage of lumbar arteries, veins
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5
Q

Psoas major insertion

A

Muscle passes distally across the brim of the true pelvis and deep to the inguinal ligament to insert into
- Apex of lesser trochanter of the femur (medial to insertion of iliacus)
NOTE: bursa separates the tendon from the pubis and hip joint capsule

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6
Q

Psoas major nerve supply

A

Branches of the lumbar plexus containing fibers from L2 and L3

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7
Q

Psoas major function

A

Flexor at the hip and flexor of the lumbar spine

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8
Q

Psoas minor notes

A

The psoas minor is an inconstant muscle found on anterior surface of psoas major

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9
Q

Psoas minor origin

A

12th thoracic and 1st lumbar vertebrae and intervertebral disc between them

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10
Q

Psoas minor insertion

A

Via a long, thin tendon, psoas minor inserts into the iliopectineal eminence and iliac fascia

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11
Q

Psoas minor nerve supply

A

1st lumbar nerve

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12
Q

Psoas minor function

A

Flexion of lumbar spine

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13
Q

Iliacus notes

A

Iliacus muscle fills the iliac fossa

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14
Q

Iliacus origin

A
  • Upper 2/3 of iliac fossa
  • Iliac crest reaching the ASIS and AIIS
  • Superolateral portion (ala) of the sacrum
  • Anterior sacroiliac and iliolumbar ligaments
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15
Q

Iliacus insertion

A

The muscle becomes a tendon on the lateral side of the psoas major muscle and inserts into the base of the lesser trochanter of the femur

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16
Q

Iliacus nerve supply

A

Femoral nerve

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17
Q

Iliacus function

A

Flexion at the hip

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18
Q

Iliacus minor is occasionally present

A

o A small muscle (sometimes considered to be a detached part of the iliacus) is occasionally present
o Arises from the anterior inferior iliac spine
o Inserts on the intertrochanteric line of the femur or into the iliofemoral ligament

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19
Q

Fascia of the gluteal region

A
  • Subcutaneous fascia of gluteal region is continuous with fascia of the thigh and back
  • Made up of a superficial fatty layer and a deep membranous layer
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20
Q

Deep layer of fasica of gluteal region

A

o Continuous with fascia lata of the thigh
o As fascia lata passes upward toward gluteal region, it surrounds gluteus maximus
o Tendon of gluteus maximus ends in the iliotibial tract, which is a strong tendon embedded in the fascia lata

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21
Q

Gluteal aponeurosis

A

o Composed of vertical fibers which are present between the iliac crest and superior border of the gluteus maximus

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22
Q

Muscles of gluteal region

A 
o	Gluteus maximus
o	Gluteus medius
o	Gluteus minimus 
o	Tensor fasciae latae 
o	Piriformis
o	Obturator internus 
o	Superior gemellus
o	Inferior gemellus
o	Quadratus femoris 
o	Obturator externus
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23
Q

Notes on gluteus maximus

A

Large thick muscle, composed of remarkably coarse parallel fibers and lies superficially on the buttock

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24
Q

Origin of gluteus maximus

A
  • Posterior gluteal line of the ilium (and bone superior and posterior to it)
  • Posterior surface of the sacrum and coccyx
  • Aponeurosis of the sacrospinalis muscle
  • Sacrotuberous ligament
  • Gluteal aponeurosis covering gluteus medius
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25
Q

Insertion of gluteus maximus

A

Proximal and superficial fibers of distal muscle
- Iliotibial band

Deep fibers of distal portion
- Gluteal tuberosity

Bursae

  • Generally, there are 3 bursae associated with gluteus maximus, which are all found on its deep surface
  • 1st largest bursae - over the greater trochanter
  • 2nd largest bursae - over the ischial tuberosity (most commonly missing)
  • 3rd largest bursae - between tendon of gluteus maximus and tendon of vastus lateralis
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26
Q

Nerve supply of gluteus maximus

A

Inferior gluteal nerve

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27
Q

Function of gluteus maximus

A

Extend, laterally rotate and abduct the thigh at the hip

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28
Q

Gluteus medius notes

A

Located on the outer surface of the pelvis, with its posterior ½ being covered by the gluteus maximus and its anterior ½ being covered by the gluteal aponeurosis

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29
Q

Gluteus medius origin

A
  • Outer surface of the ilium between the iliac crest and posterior gluteal line (posteriorly)
  • Anterior gluteal line (anteriorly)
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30
Q

Gluteus medius insertion

A

Oblique bony ridge on the lateral surface of the greater trochanter

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31
Q

Gluteus medius nerve supply

A

Superior gluteal nerve

32
Q

Gluteus medius function

A

Abduction of the hip and medial rotation of an extended hip

  • Anterior fibers  flex and medially rotate at the hip
  • Posterior fibers  laterally rotates at the hip
  • **Most important = stabilization of the pelvis during locomotion
33
Q

Gluteus minimus notes

A

Third and smallest of the gluteal muscles

  • Lies deep to gluteus medius
  • Between medius and minimus is the superior gluteal nerve and the deep branches of the superior gluteal artery and vein
34
Q

Gluteus minimus origin

A
  • Outer surface of the ilium between the anterior and inferior gluteal lines
  • Edge of the greater sciatic notch
35
Q

Gluteus minimus insertion

A

Anterior border of greater trochanter

- NOTE: a bursa is frequently found between its tendon and the greater trochanter

36
Q

Gluteus minimus nerve supply

A

Superior gluteal nerve

37
Q

Gluteus minimus function

A

Abduction of the hip, medial rotation of an extended hip, weak hip flexor
- Like gluteus medius, it stabilizes the pelvis during locomotion

38
Q

Tensor fasciae latae notes

A

Entirely enclosed in the upper fibers of the iliotibial band

39
Q

Tensor fasciae latae origin

A
  • Anterior end of iliac crest near anterior superior iliac spine
40
Q

Tensor fasciae latae insertion

A

This short, bulky muscle has fibers which pass inferiorly to insert into the iliotibial tract, usually slightly distal to the level of the greater trochanter
- The iliotibial tract attaches inferiorly on the lateral tibial condyle and also forms part of the capsule of the knee joint

41
Q

Tensor fasciae latae nerve supply

A

Superior gluteal nerve

42
Q

Tensor fasciae latae function

A

Hip flexor and medial rotator

43
Q

Piriformis origin

A

Within the pelvis - anterior surface of the sacrum between the 1st, 2nd, 3rd and 4th sacral foramina

44
Q

Piriformis insertion

A

The muscle passes through the greater sciatic foramen to be inserted on the
- Superior border of the greater trochanter posterior to the common tendon of the obturator internus and gemelli

45
Q

Piriformis nerve supply

A

2nd sacral nerve (or 1st and 2nd)

46
Q

Piriformis function

A

Lateral rotation, abduction of a flexed hip and extension of the hip

47
Q

Obturator internus origin

A
  • Inside surface of the superior and inferior pubic rami
  • Inside surface of ischial ramus
  • Ilial and ischial contributions to the wall of the true pelvis
  • Obturator membrane
48
Q

Obturator internus insertion

A

Fibers of the obturator internus are directed toward the lesser sciatic foramen where they pass at a right angle over the bone between the spine and tuberosity of the ischium – the tendon receives fibers fo the gemelli muscle and is then inserted into:
- Medial surface of greater trochanter, anterior to trochanteric fossa
NOTE: a bursa is found as the tendon passes through the lesser sciatic foramen, another is found between the tendon and the hip joint capsule

49
Q

Obturator internus nerve supply

A

Nerve to obturator internus (L5-S1, 2)

50
Q

Obturator internus function

A

Lateral rotation of the hip, extension of the hip, abduction of a flexed hip

51
Q

Superior gemelli notes

A

The superior and inferior gemelli are the two muscles that lie on either side of the tendon of the obturator internus

52
Q

Superior gemelli origin

A

Outer surface of ischial spine

53
Q

Superior gemelli insertion

A

After partial fusion with the tendon of the obturator internus, it inserts into
- Medial surface of the greater trochanter

54
Q

Superior gemelli nerve supply

A

Nerve to obturator internus

55
Q

Superior gemelli function

A

Lateral rotation of the hip

56
Q

Inferior gemelli notes

A

Larger of the two gemelli muscles

57
Q

Inferior gemelli origin

A

Upper (superomedial) part of the ischial tuberosity

58
Q

Inferior gemelli insertion

A

After partial fusion with the tendon of the obturator internus, it inserts into
- Medial surface of the greater trochanter

59
Q

Inferior gemelli nerve supply

A

Nerve to quadratus femoris

60
Q

Inferior gemelli function

A

Lateral rotator at the hip

61
Q

Quadratus femoris notes

A

Quadratus femoris is a muscle found between the inferior gemellus and the upper fibers of the adductor magnus

62
Q

Quadratus femoris origin

A

External margin (lateral edge) of the ischial tuberosity

63
Q

Quadratus femoris insertion

A

Linea quadrata and quadrate tubercle of the femur

64
Q

Quadratus femoris nerve supply

A

Nerve to quadratus femoris (L4, L5, S1)

65
Q

Quadratus femoris function

A

Abduction and lateral rotation of the hip

66
Q

Obturator externus notes

A

Obturator externus covers the outer surface of the anterior pelvic wall

67
Q

Obturator externus origin

A
  • Those portions of the ischium and pubis which surround the medial margin of the obturator foramen
  • Obturator membrane
68
Q

Obturator externus insertion

A

Its tendon passes laterally to be inserted into the

- Trochanteric fossa of the femur

69
Q

Obturator externus nerve supply

A

Posterior division of the obturator nerve

70
Q

Obturator externus function

A

Adduction and lateral rotation of the hip

71
Q

Muscle in the gluteal region that can vary

A
  • Piriformis
  • Superior gemellus
  • Inferior gemellus
  • Quadratus femoris
72
Q

Piriformis variation

A

o May be divided into 2 parts by the passage of the fibular portion of sciatic nerve
o May be fused with gluteus medius
o May also receive fibers from superior gemellus
o May be absent

73
Q

Superior gemellus variation

A

o May be absent

74
Q

Inferior gemellus variation

A

o May be fused with quadratus femoris or obturator internus

75
Q

Quadratus femoris variation

A

o May be absent
o May be fused with adductor magnus or inferior gemellus
o May have 2 separate tendons of insertion, with the anterior tendon attaching to the intertrochanteric crest of the femur

Lower Limb (24 decks)

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