Practical Class 2: The Gluteal Region and Hip Joint Flashcards
What are the differences between the male and female pelvis?
- The pelvic inlet in women is circular compared with the heart-shaped pelvic inlet in men.
- The angle formed by the two arms of the pubic arch is larger in women (80°–85°) than it is in men (50°–60°).
- The ischial spines generally do not project as far medially into the pelvic cavity in women as they do in men.
- Men have a large acetabulum, women have a smaller acetabulum
What are the functions of the pelvis?
- bear the weight of the upper body when sitting and standing
- transferring that weight from the axial skeleton to the lower appendicular skeleton when standing and walking
- providing attachments for and withstanding the forces of the powerful muscles of locomotion and posture
What movements are possible at the hip joint?
Flexion Extension Abduction Adduction Lateral rotation Medial rotation
Describe the structures that strengthen and stabilise the hip joint.
Intracapsular:
Ligament of head of femur - attaches at one end to the fovea on the head of the femur and at the other to the acetabular fossa, transverse acetabular ligament and margins of the acetabular notch
Extracapsular:
- Iliofemoral: Located anteriorly. It originates from the ilium, immediately inferior to the anterior inferior iliac spine.The ligament attaches to the intertrochanteric line in two places, giving the ligament a Y shaped appearance. It prevents hyperextension of the hip joint.
- Pubofemoral: Located anteriorly and inferiorly. It attaches at the pelvis to the iliopubic eminance and obturator membrane, and then blends with the articular capsule. It prevents excessive abduction and extension.
- Ischiofemoral: Located posteriorly. It originates from the ischium of the pelvis and attaches to the greater trochanter of the femur. It prevents excessive extension of the femur at the hip joint.
Describe the attachments of gluteus maximus.
Proximal attachment - ilium posterior to posterior gluteal line; dorsal surface of sacrum and coccyx; sacrotuberous ligament
Distal attachment - Most fibres end in iliotibial tract, which inserts into lateral condyle of tibia; some fibres insert on gluteal tuberosity.
What are the main functions of gluteus maximus?
Extends thigh (especially from flexed position) and assists in its lateral rotation; steadies thigh and and assists in rising from a sitting position.
Describe the innervation of gluteus maximus.
Inferior gluteal nerve (L5, S1-2)
Describe the attachments of gluteus medius.
Proximal: External surface of ilium between anterior and posterior gluteal lines.
Distal: Lateral surface of greater trochanter of femur
What are the main functions of gluteus medius?
Abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase.
Describe the innervation of gluteus medius.
Superior gluteal nerve (L5, S1)
Describe the attachments of gluteus minimus.
Proximal: External surface of ilium between anterior and inferior gluteal lines.
Distal: Anterior surface of greater trochanter of femur
What are the main actions of gluteus minimus?
Abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase.
Describe the innervation of gluteus minimus.
Superior gluteal nerve (L5, S1)
What is the iliotibial tract?
Also known as the iliotibial band. Lateral continuation of the tensor fasciae latae muscle. Gluteus maximus also inserts onto it.
What is the function of the iliotibial tract?
Extends, abducts, and laterally rotates the hip.
Stabilizes the knee both in extension and in partial flexion, and is therefore used constantly during walking and running
