Pelvis Flashcards
Ischiofemoral ligament
Reinforces fibrous capsule posteriorly
Resists hyperextension
Iliofemoral ligament
Largest and most important Inverted Y Attaches AIIS and acetabular rim to intertrochanteric line Reinforces fibrous capsule anteriorly Insertion at intertrochanteric line
Lumbar plexus (anterior division)
Subcostal (T12)
Iliohypogstric (T12, L1)
Ilioinguinal (L1)
Genitofemoral (L1, L2)
Lumbar plexus (posterior division)
Lateral femoral cutaneous (L2, L3)
Femoral (L2, L3, L4)
Obturator (L2, L3, L4)
Sacral plexus (Posterior division)
Superior Gluteal (L4, L5, S1) Inferior gluteal (L5, S1, S2) Common Peroneal (L4, L5, S1, S2) Nerve to piriformis (S1, S2)
Sacral plexus (Anterior Division)
Tibial (L4, L5, S1, S2, S3)
Branch to Quadratus femoris & inferior gemellus (L4, L5, S1)
Branch to obturator internus & superior gemellus (L5, S1, S2)
Pudenal (S2, S3, S4)
Where is the lumbar plexus located?
Plexus lies in between the papas major and Quadratus lumborum muscles “psoas compartment”
Quadratus Lumborum
O: iliac crest (posterior inner lip)
I: lower border of12th rib & transverse processes of L2-L5
Fx: lateral flexion,
nn: anterior branches of 12th thoracic nerve and L1-L4 or L5
Iliacus
O: superior 2/3 of iliac fossa, aka of sacrum, and anterior sacroiliac ligaments
I: lesser trochanter, and shaft inferior to it
Fx: flexes thigh and stabilizes hip join
nn: muscular branch of femoral nerve (L1-L3)
Psoas Major & Psoas Minor
O: transverse processes of L1-L5, discs and bodies of T12-L5
I: lesser trochanter
Fx: flexes thigh, can flex vertebral column laterally with superior fibers, used to balance trunk
nn: direct fibers of L1-L3 of lumbar plexus
Gluteus Maximus
O: posterior aspect of ilium posterior to posterior gluteal line, sacrotuberous ligament, and posterior inferior aspect of sacrum and coccyx
I: IT band fascia, gluteal tuberosity
Fx: Major EXtensor of hip assists in lateral rotation, upper and middle 1/3 section are abductors
nn: inferior gluteal nerve (L5, S1, S2)
If there is weakness in the gluteus Maximus muscle, what type of compensation pattern may be present?
Extension of the trunk during gait
Gluteus Medius
O: dorsal ilium inferior to iliac crest
I: lateral and superior surfaces of iliac crest
Fx: Major abductor of thigh, anterior fibers help to rotate hip medially, posterior fibers help to rotate hip laterally
nn: superior gluteal nerve (L4, L5, S1)
Gluteus minimus
O: dorsal ilium between anterior and inferior gluteal line
I: anterior surface of greater trochanter
Fx: abducts and medially rotates the hip joint
nn: Superior gluteal nerve
Piriformis
O: anterior surface of lateral process of sacrum (S2-S4), greater sciatic notch, and gluteal surface of ilium
I: superior border or greater trochanter
Fx: lateral rotator of hip, also helps abduct if hip is flexed
nn: nerve to piriformis (S1-S2)
Superior gemellus
O: ischial spine
I: medial surface of greater trochanter of femur, in common with obturator internus
Fx: Lateral rotator of thigh, also helps abduct when hip flexed
nn: inferior gluteal nerve & nerve to obturator internus and superior gemellus
Inferior gemellus
O: posterior portions of ischial tuberosity and lateral obturator ring
I: medial surface of greater trochanter of femur, in common with obturator internus
Fx: lateral rotator of thigh, also helps abduct when hip flexed
nn: nerve to obturator internus and inferior gemellus, also by superior gluteal nerve
Obturator internus
O: internal surface of obturator membrane and posterior bony margins of obturator foremen
I: medial surface of greater trochanter of femur, in common with inferior gemellus
Fx: lateral rotator of the thigh, also helps abduct when hip is flexed
nn: nerve to obturator internus and superior gemellus & inferior gluteal nerve
Quadratus Femoris
O: lateral margin of obturator ring above ischial tuberosity
I: Quadrate tubercle and adjacent bone of intertrochanteric crest of proximal posterior femur
Fx: lateral rotator of the hip, also abducts when hip is flexed
nn: superior gluteal nerve
Obturator externus
O: external surface of obturator membrane and anterior bony margins of obturator foramen
I: posteromedial surface of greater trochanter
Fx: rotates thigh laterally, helps adduct thigh
nn: obturator
Femoral triangle
“SAIL” = borders = sartorius, adductor longus, inguinal ligament
“NAVEL” = femoral nerve, artery, vein! empty space, lymph nodes - lymph nodes medial to vein
What surgery is performed by entering through the artery located in the femoral triangle?
Coronary angioplasty
Trendelenburg’s Sign
Gluteus Medius weakness
If muscles weak, hip on unsupported side sinks down
Damage to superior gluteal nerve
Results in waddling
