the hip buttock and thigh Flashcards
describe the twisting of the knee joint during development *
there is permenant pronatoion mid thigh
everything below is back to front
nerve supply is what it would be if the posterior compartment was the anterior compartment ie before rotation
it means flexion and extension are differnt
what are the 2 major compartments of the lower limb *
gluteal regon - part of trunk
free lowr limb = thigh, leg and foot
which direction and what roots is extension and flexion of the hip *
flexion forward - l2, 3
extension l4 5 backward
what roots control lateral and medial rotation of the hip *
medial - l1 2 3
lateral = l1 5
what are the bones of the hip, buttock and thigh *
pelvis - hip bone (ishium, ilium, pubis)
the femer
what is the leg
region between knee and ankle
describe the hip bone *
ileum is the flat bone - ala of ileum is the posterior part, iliac fossa is the anterior part
pubis is anterior - body is in the midline, and have superiuor and nerior ramus
ishium is posterior
ishium has ishial spine an dischial tuberosity for attachment of the bony ligaments - boundary between anterior and posterior pelvsi
acetabulum is the hip joint, made of all 3 bones - articulation with the femer - fossa in middle not part of teh artiiculation
ileum has articulation for the sacrum - sacroiliac joint
identify: ASIS, AIIS, PISI, PIIS, iliac crest, iliac fossa, iliac part of acetabulum, body of ishium, ishial tuberosity, ramus of ishium, obturator foramen, greater sciatic notch, lesser sciatic notch, ischial spine, ischial part of acetabulum, superior pubic ramus, inferior pubic ramus, pubic crest, pubic tubercle, pubic portion of acetabulum, acetabular notch, acetabular fossa, lunate fossa
how can you tell which part of the bone ossificated separately
the cartilage during development
describe the femer bone *
long straight shaft
head is hemisherical covered in hyaline cartilage - articulates with acetabulum
greater and lesser trochanter (proterbances) and intertrochanteric line anteriorly, and intertrochanteric crest posteriorly
on back of shaft is linea aspera formed from the ridges of the epicondyles
anterior surface is smooth and concave
patella articulates the intercondylar region - is a sesamoid bone - formed within tendon where muscle is going to move over the surface of the bone to minimise friction
medial and lateral epicondyles
medal and lateral conduyles that articulate with the tibia plateau - hagve intercondylar fossa
common places for head of femer fracture *
most common at femoral neck
intertrochanteric fracture
(fractures becoming more important with aging population )
describe the ligamentous anatomy of the pelvis *
sacrotuberous ligament goes from sacrum to ishial tuberosity - forms the greater sciatic foramen
sacrospinous ligament goes from the the sacrum to ischia spine - forms lesser sciatic foramen
the foramen formed allow structures to pass between anterior and posterior
describe the fascia of the buttock, thigh *
there are 2 layers
- superficial - subcut tissue
- deep - called fascia lata (holds all the muscle compartments in it)
the fascia lata has a thickened area called the ilio-tibial tract - this merges with fascia across the knee
fibres from glut max merge with the fascia lata
distal attachement of tensor fascia latea os fascia lata
what are the muscular compartments of the hip, buttock and thigh *
gluteal compartment
anterior compartment of the thigh
medial ‘’
posterior ‘’
what are the muscles of the gluteal region and what are their overall functions *
func - extensors, abductors, external rotators of the hip
gluteal muscles
- gluteus maximus
- gluteus medius
- gluteus minimus
- (tensor fascia lata) - neurologically gluteal, but function more anterior
short lateral rotators of the hip - hold head of femer into acetabulum to stabalise joint (also lateral rotation)
- piriformis
- obturator internus
- the gemelli (superior and inferior)
- quadratus formis
describe gluteus maximus *
biggest muscle in body
course fibres - not involved in fine movement
most superficial muscle in the gluteal region
origin - fascia covering gluteus medius, ileum behind posterior gluteal line, fascia of erector spinae, dorsal surface of lower sacrum, coccyx and sacrotuberous ligament
superficial 3/4 attachs to ilio-tibial tract
deep distal 1/4 attaches to gluetal tuberosity of femer
extensor of hip joint, laterally rotates thigh, adductor of thigh
fibres of the iliotibial tract stabalise a fully extended knee
blood - unferior and superior gluteal artery
nerve - inferior gluteal nerve - L5 s1 2
describe teh tesnor fasciae latae *
tense fascia
stabalise knee as it acts across it
origin - lateral aspect of crest of ileum between ASIS and tubercle of crest
insertion - iliotibial tract below greater trochanteur
action - hip flexion, medial rotate and abduct a flexed thigh, tense iliotibial tract to support femer on tibia in standing
blood - superior gluteal a, lateral femoral circumflex a
nerve - superior gluteal l4 5 s1
describe the gluteus medius and minimus *
originate from ileum and gluteal aponeurosis, the fibres cross laterally and attach at the greater trochanter of the humerus (minimis also attaches to anterior capsule of hip joint)
abduct - important in stabalising gait
adduct and medially rotate the thigh, posterior fibres may laterally rotate the thigh
blood - superior gluteal artery
nerve - superior gluteal nerve l4 5 s1
describe the piriformis *
comes off the anterior surface of sacrum
attaches to the medial side of the superior greater trochanter
lateral rotation of extended thigh, abducts a flexed thigh
blood - superior and inferior gluteal a
nerve - nerve to piriformis
describe the lateral rotators of the hip *
attacg around the hip joint
lateral rotation
describe obturator internus (lateral rotator) *
comes form the obturator foramen and membrane then moves at an angle
attach to medial side greater trochanter through lesser sciatic foramen
laterally rotates femer, abducts thigh when flexed
blood - inf gluteal a
nerve - nerve to obturator internus l5l s1 2
image of superficial gluteal muscles *
image of deep gluteal muscles *
what are the muscles of the anterior compartment of the thigh and their generic function *
hip flexors and knee extensors
pectineus
ilio-psoas
(tensor fasciae latae)
sartorius
guadiceps femoris
- rectus femoris
- vastus medialis
- vastus intermedius
- vastus lateralis
describe pectineus *
muscle of the groin
attach to superior ramus of pubic bone and superior part of pectineal line fo femer
flexor and adduction
describe iliopsoas *
muscle from pelvis
psoas major which attachs to lumbar spine from T12-L5, and iliacus which attaches to iliac fossa come together, pass under inguinal ligament and attach to lesser trochanter as the iliopsoas tendon
they are flexors - hip flexion and lateral rotation
blood - muscular branch of medial femoral circumflex artery
nerve - femoral - psoas major - L1 2 3, iliacus - l3 4
describe sartorius *
flex knee and abduct thigh
go from ASIS to medial side of knee - attach below knee at shaft of the tibia inferomedial to the tibial tuberosity
course is anterior and medial
describe the quadriceps femoris *
extensors of knee,
rectus femoris can flex hip
rectus femorus attaches across hip joint
vastus lateralis can abnormally displace patella
vastus stay within the thigh
at knee the fibres converge and attach at the patella (patella embedded in ligament that they form) - ligement continues to tibial tuberosity as the patella ligament attach at the tibial tuberosity
identify muscles on a cross sectoion through the thigh
describe the bursas of the knee joint *
little sacs
some continuous wit the joint cavity nd others are separate
what are the muscles and their functoion fo the medial compartment of the thigh *
hip adductors
adductor longus
adductor brevis
adductor magnus
gracilis
obturator externus
describe the attachments of the medial compartment of the thigh *
attach around the pubiuc bone
distal attachment on posterior shaft of femer - to linea aspera
adductor longus - comes of crest of pubis to femur
gracilis - strap muscle from inferior ramus of pubis, external surface of body of pubis and ramus of ishium; and attaches to medial surface of shaft of the tibia across the knee
adductor magnus has 2 compartments - medial is an adductor, posterior is a hamstring
- adductor attaches to ischiopubic ramus to posterior surface of the prox femer, linea aspera and medial supracondylar line
- hamstring - ischial tuberosity to adductor tubercle and supracondylar line
adductor magnus has a broad attachment on femer’s linea aspera, then there is a gap called the adductor hiatus, then small attachment at adductor tubercle
adductor brevis - external surface of body of pubis and inferior pubic ramus to posterior surface of femur and linea aspera
obturator externus - external surface of obturator foramen and membrane to greater trochanter(trochanteric fossa)
what is teh importance of teh addductor hiatus *
for structures to pas through
what are the muscles of the posterior compartment of the thigh, and what is the function *
knee flexors and hip extensors
the hamstrings:
semimembranosus
semitendinosus
biceps femoris
describe the attachment of teh posterior thigh muscles *
from ishial tuberosity
except short head of biceps - comes off posterior of femer (linea aspera)
semitendinosis and semimembrinosis stay medial - course is across knee - attach to medial epicondylar region of the tibia, semimembranous attach to medial condyle
long head of the biceps femoris - runs laterally and is joined by fibres from the short head coming from the inferior linea aspera and supracondylar ridge of femer - they form a common tendon that cross knee joint to insert into head of fibula
biceps femoris attaches to head of fibula
how can you tell the difference between the semimembranosus and semitendinosus
tendonosus has a rope like tendon
membranosus - strap
what is the outline of the femoral triangle *
superior - inguinal ligament
medial - lateral edge of teh adductor longus
laterally - medial edge of sartorius
(covered by the fascia lata)
what does the femoral triangle contain *
femoral nerve
femroal artery
femoral vein
important lymph nodes
(order is NAVY Y being y fronts)
(the femoral sheath encloses teh femoral artery and vein - a portion of it medially forms the femoral canal
what is the saphenous opening *
where the long saphenous vein pierces the fascia lata nad drains into the femoral vein
alternative names for the adductor canal
hunter’s canal
subsartorial canal
where does the adductor canal run and what is it lined by *
extends along the medial aspect of the thigh from apex of femoral triangle and at adducter hiatus
formed by:
- vastus medialis anteriorly
- adductor longus nd adductor magnus posteriorly
- sartorius medially
what does the adductor canal contain *
the femoral artery
femoral vein
saphenus nerve (this is a terminal branch of the femoral nerve which gives off branches, not long after entering the femoral triangle)
they run under satorius
they pass through the adducter meatus and enter the politeal fossa
what are the features of the gluteal region *
greater and lesser sciatic notches (parts of the ishial bone)
greater foramen and lesser sciatic foramen
sacrotuberus ligament
sacrospinous ligament
purpose of the greater and lesser sciatic foramen *
greator - structures pass from pelvis to thigh
lesser - from pelvis to perineum
describe the path of the sciatic nerve *
pass from pelvis to buttock through the greater sciatic notch/foramen
usually enters gluteal region inferiorly to the piriformis muscle but can be supperior/pierce the muscle
in buttock lies in inferior and medial quadrant
pass along posterior aspect of thigh
divides into tibial and common perineal nerve (this is at an inconsistant level)
what does the sciatic nerve supply *
hamstring muscles
its divisions supply all muscles below the level of the knee
what goes superior ro the pirmormis when entering the gluteal region *
superior gluteal nerves and vessles
describe the safe area for IM injections*
to avoid hitting the sciatic nerve (and superior gluteal nerve and vessels) during IM injection
inject into upper lateral quadrant of buttox - into the gluteus mediaus muscle
describe the trendelenburg test *
the abductors of the thigh prevent the tilting of the pelvis when a limb is raised so you dont fall
when there is paralysis of a thigh abductor - the pelvis tilts and pt waddles
subject asked to stand on both legs - R and L pelvis should remain at the same level w/o any tilt - examiner should stand behind and feel pelvis
then pt should raise 1 leg - pelvis should remain horizontal
if pelvis on raised leg drops down - the test is positive - shows weakness of motor fuction of abductor muscles - glut max and med in leg standing on
describe the hip joint *
it is a synovial ball and scoket joint
between head of femer and acetabulum
all 3 bones of pelvis contribute
the acetabular labrum is a im of cartilage that deepens the socket
the deficiency in bone of the acetabulum is made up for by the transverse acetabular ligament - it is continuous with the acetabular labrum and attaches to the head of the femer
the ligament of the head of the femer attaches to the head of the femur at the fovea
teh acetabular fossa is full of fibro-fatty tissue - not actually involved in the joint
describe the capsule of the hip joint *
extends down the neck of the femur it extends further anteriorly than posteriorly
within the capsule runs the blood supply of the femer head
classification of hip fractures *
intracapslar
extracapsular
what are the ligaments of the hip joint *
ilio-femoral ligament - coming off the ileum and fans to attach to the intertrochanteric line
pubo-femoral ligament off pubis then attach to intertrochanteric line
ischio-femoral ligament - from ischium to intertrochanteric line
the ligament of the head of the femer - not most important for the stabalisation of the joint
the ligaments are arranged spirally - when extend the hip the ligaments tightn up spiral and bring the 2 parts together - pull hip into the pelvis and stabalise the hip
what is the blood supply for the head of the femer *
medial and lateral circumflex arteries tehy come distally to supply the head
the artery of the head pof the femer - more important in children
obturator artery is a branch through ligament to head of femur - small supply
what is the consequence pof intracapsular fractures *
because main blood supply is coming distally - when fracture only get blood supply form the obturator artery = avascular necrosis of teh femoral head
what are the hip-flexors *
–Ilio-psoas
–Sartorius
–Tensor fascia lata
–Rectus femoris
–Adductor longus
–Adductor brevis
–Adductor portion of adductor magnus
–gracilis
what are the hip adductors *
–Adductor longus
–Adductor brevis
–Adductor magnus
–Gracilis
–Pectineus
Obturator externus
what are the hip extensors *
–The hamstrings – semimembranosus, semitendinosus, biceps femoris
–Posterior part of adductor magnus
–Gluteus maximus
what are the hip abductors *
–Gluteus medius
–Gluteus minimus
–Tensor fascia lata
what are teh external hip rotators *
–Obturator internus and obturator externus
–The Gemelli
–Piriformis
–Quadratus femoris
Gluteus maximus
what are the hip internal rotators *
–Anterior portion of gluteus medius
–Anterior portion of gluteus minimus
–Tensor fascia lata
what are the blood vessels of the buttock, hip and thigh *
external iliac
femoral - at midinguinal point
(femoral artery lies between femoral nerve which is medial and vein)
profunda femoris artery
circumflex vessles
femoral artery continues as superficial femoral artery and then popliteal artery
describe the path of the arteries *
abdominal aorta divides into internal and external iliac
external iliac pasess under inguinal ligamnent and becomes femoral - at inguial ligament it is at the mid-inguinal point, ie half way between the ASIS and pubic symphisis
internal iliac branches into obturator artery - supplies some of buttock and medial thigh
femoral gives off profunda femoris artey - deep branch of thigh
both femoral and profunda give off circumflex arteries that supply the hip joint
femoral artey continus behind knee to become the popliteal artery
how do the femoral artey and vein pass from the anterior to posterior compartment *
through the hiatus of the adductor magnus muscle
what are the superficial veins *
long saphrenous - runs from the medial border fo the foot - pass up posterior and medial at knee, mediual side of thigh then anterior
joins teh femoral vein at sapheno-femoral junction in saphenous opening of fascia lata in the femoral triangle
there is a valve at the sapheno-femoral junction that prevents blood passing from the deep to superficial system - this valve can be faulty or incompetent in varicose veins
what are the deep veins *
popliteal
femoral
external iliac
spheno-femoral junction
vanae comitantes of the profunda femoris artery
descrieb teh lymph drainage of the region *
lymph flows woith the superficial veins
there are superficial inguinal and knee nodes they drain into the deep inguinal lymph nodes and the external iliac nodes
the deep system of lymphatic drainage drains alongside the deep veins to the deep inguinal nodes - these drain into the external iliac nodes
important because they drain the iliac region
what is motor nerve supply of anterior compartment of thigh *
femoral nerve which is derived from the posterior divisions of lumbar plexus l2 3 4
what is the motor nerve supply of the median compartment of thigh *
obturator nerve through obturator foramenwhich is derived from the
anterior divisoon of lumbar plexus l2 3 4
what supplies posterior thigh, anterior and posterior leg and foot motor*
sciatic/ its branchs ie tibial or common perineal which is derived from the lumbo-sacral plexus l3 4 5 s1 2
also supply a lot of superficial cutaneous supply in foot and leg
what roots are knee extensors
l3 4
what root are knee flexors
l5 s1
what is the motor nerve supply of the gluteal compartment of the thigh *
superior gluteal nerve l4 5 s1 - gluteus mediuus and minimus
inferior gluteal nerve l5 s1 2 - gluteus maximus
describe teh sensory segmental supply of the region *
front of thigh t12 l1 2 3
back of thigh s1 2 3
buttock s2 3 4
map the dermatomes of the leg *
l3 to knee
l4 to floor
s1 and 2 are posterior
ewhat are the nerves for the sensory peripheral supply *
- Subcostal nerve (T12)
- Ilio-hypogastric nerve (L1)
- Ilio-inguinal nerve (L1)
- Genito-femoral nerve (L12)
- Lateral cutaneous nerve of the thigh (L23)
- Sensory branches of the femoral nerve (L234)
- Sensory branches of the obturator nerve (L234)
- Posterior cutaneous nerve of the thigh (S23)
- Saphenous nerve (L234)
- Buttock nerves from the scaral plexus (L1-S3)
describe the path of the deep veins *
flow into the popliteal vein at the level of the knee
popliteal vein runs along the popliteal and femoral arteries to form the femoral vein
the femoral vein lies medial to femoral artery in groin and then passes beneath the inguinal ligament to form external iliac vein
the femoral vein recieve sthe long saphrenous vein at the sapheno-femoral junction in the groin
proximal to this is recieves the venae comitantes of the profunda femoris artery
attachments of gluteus medius *
origin - external surface of ileum between anterior and posterior gluteal lines
insertion - lateral surface of greater trochanter
attachments of the gamellus superior *
external surface of ishial spine
along length of obturator internus tendon and into medial side of greater trochanter with obturator internus tendon
attachments of gamellus inferior *
ischial tuberosity
along length of obturatir internus tendon and medial side of greater trochanter
attachments of quadratus femoris *
ishium - anterior to ischila tuberosity
intertrochanteric crest of prox femer
attachments of vastus medialis *
femur - medial part of intertrochanteric line, pectinal line, linea aspera, medial supracondylar line
quadriceps femoris tendon and medial border of patella
profunda femoris artery, genicular artery
attachments of vastas intermedius *
femur anterior and lateral surfaces
quadriceps femoris tendon and lateral margin of patella and lateral condyle of tibia
femoral circumflex artery
attachments of vastus lateralis *
femur - interotrocahnteric line, greater trochanter, gluteal tuberosity, linea aspera, intermuscular septum
quadriceps femoris tendon and lateral margin of patella
femoral circumflex a
attachments of rectus femoris *
straight head from ASIS, reflected head from ileum superior to acetabulum
quadriceps femoris tendon into patella - tibial tuberosity via the patella tendon
blood femoral circumflex
what can be affected in a fracture of the head of the femur *
because of the force needed to break the bone it causes damage to the soft tissue ie the musclular compartments and the structures they contain
what provides stability for the hip joint *
the ligaments of the hip joint
teh acetabulum encompasses the hemi-spherical head of the femer and contributes substantially to stability
the rim of the acetabulum is raised by a fibro-cartilaginous collar - the acetabular labrum
the fibrous membrane that encloses the the hip joint is strong and thick
identify the major ligaments of the hip and buttock *
pic from dissection
where are the superior and inferior gluteal nerves and vessels *
pass between the pelvis and buttock
superior - above the piriformis
inferior - below the piriformis
where does the posterior cutaneous nerve of the thigh run *
on top of the sciatic nerve
describe anteversion of the femoral neck *
it is teh angular difference between the axis of the femoral neck and the transcondylar axis of the knee
in adults it is 12degrees
at birth it is around 30-40 degrees
it reduces a degree a year until age 20
a high angle = intoed feet - normal in young children
palpate the iliac crest
where place hands on top of hips
l4 5
palpate ASIS
-
palpate femoral head
at midpoint between ASIS and pubic symphisis/site of femoral artery palpation
what level is the iliac tubercle
l5
palpate PSIS
indicated by skin dimple at S2
palpate the greater trochanter of the femer
bony prominence on the lateral side of the upper thigh about 10cm below iliac crest
palpate body of pubis
a hands width below umbilicus
palpate pubic symphisis and superior pubic ramus
-
palpate pubic tubercle
2cm lateral to pubic symphysis
palpate ischial tuberosity
on inferior part of buttock when thigh is flexed
palpate inferior pubic ramus
follow body of pubis inferiorly then continue infero-laterally
surface mark the inguinal ligamentr
between ASIS and pubic tubercle
palpate femoral artery
mid inguinal point - between ASIS and pubic symphysis
surface mark femoral vein
on medial side of femoral artery
surface mark femoral nerve
on lateral side of femoral artery
palpate the gluteal fold
the inferior border of the gluteus maximus
extend thigh at hip joint and feel muscle contracting and producing rounded contour of buttock
surface mark the gluteal sulcus
the visible skin crease separating the buttock and thigh which crosses the true gluteal fold obliquely
test the gluteus maximus
inferior gluteal nerve - l5 s1 s2
subject lies prone (on front) with knee flexed
ask subject to extend their thigh at hip joint while applying resistance at distal end of thigh
examiner palpates rounded countour of buttock for muscle contraction
test the gluteus medius and minimus
superior gluteal nerve l5 s1
subject lies on side with lower limb fully extended
ask subject to abduct limb at hip joint while applying resistance at distal end of thigh
examiner palpates contraction of the gluteus medius inferior to the iliac crest
test the tensor fascia lata
superior gluteal nerve l5 s1
subject lies on side - slightly towards supine
pts legs are extended
ask to abduct and place finger tip on tensor fascia lata muscle and ilio-tibial band
test the hamstrings
nerve - tibial division of sciatic l5 s1 s2 except for biceps which is common fibular division - l5 s1 s2
subject lies prone with knee flexed to 30degrees
examiner places opposing force just above posterior side of ankle while subject attempts to flex knee further
hamstring tendons will be visible around the popliteal region and muscle contraction is palpable on posterior side of midthigh
test the quadriceps
femoral nerve l2 3 4
subject sits on couch with knees bent to 90degrees over the edge
the examiner applies pressure over distal part of the leg while subject attempts to extend it
the contracting quadriceps can be palpated on anterior thigh
draw the course of the sciatic nerve
the nerve leaves teh greater sciatic notch and enters the gluteal region at midpoint between PSIS and ischial tuberosity
it forms a downward curve to pass under the thigh around the midpoint between the greater trochanter and ischial tuberosity before reaching the popliteal fossa
identify the safe area for intragluteal injections
place index finger on ASIS and middle finger on iliac tubercle - safe area is the area in between
joints that do flexion (or plantar flexion(
hip
knee
ankle
toes - MCP and IP
joints that do extension (dorsi flexion)
hip
knee
ankle
toes - MTP and IP
joints that do abduction
hip
toes - MTP (midline is 2nd toe)
joinst that do adduction
hip
toes
joints that do rotaion
hip
in knee there is some passive medial rotation - 5 degrees of the femer on tibia during full extension and active lateral rotation of 5degrees during flexion from a fully extended position
joints that do circumduction
hip
things that can do eversion and inversion
foot at subatlar and transverse tarsal joints
eversion - move foot away from median plane - face laterally
inversion - moving sole of foot towards median plane - ie face medially
what is true leg length
measure the distance between the medial malleolus of ankle and bony fixed part of pelvis eg ASIS on both legs
if discrepancy >1.5cm = discrepancy in true leg length
eg by fractures, congenital, injury
how do you measure apparent leg length
measure distance between the medial malleolus of ankle and non-fixed landmark eg xiphisternum
measure length on both sides
if difference >1.5cm - discrepancy in apparent (functional)
can be caused by pelvic tilt/rotation, hip joint or sacroiliac abnormalities
describe the lunate surface of the acetabulum
half moon shape
articulates surface for head of femer
covered in hyaline cartilage
significance of the ishial spine
pudendal nerve passes over it
what type of joint is the pubic symphisis
seconadary cartilaginous - there is a fibrocartilage disk
what type of joint is the sacro-iliac joint
synovial - but doesnt move
what is the false and true pelvis
above and below the pelvic inlet respectively
describe the femoral canal
in femoral triangle the artery, vein and lymphatics afre in the femoral sheath
each of the structures surrounded by the sheath is contained in a separate fascial compartment
the medial most is the femoral canal and contains the lymphatics
the opening is weak and is a site for hernias
effect of disslocation of the hip joint *
damage trhe structures around - labrum, ligaments, muscles, soft tissue, nerves and bv can be damaged
damage to bv = avascular necrosis - can lead to arthritis
patients are unable to move leg and if there is nerve damage - wont have sensation
damage sciatic nerve - loss of mobility of leg and sensation of back of leg
attachments of gluteal minimus *
external surface of ileum between inferior and posterior gluteal lines
greater trochanter
attachments of teh gluteus minimis *
external surface of the ileum between inferior and anterior gluteal lines
anterolateral aspect of greater trochanter
attachments of the tensor fascia latae *
lateral aspect of crest of ileum between ASIS and crest
iliotibial tract
attachment of vastus intermedius *
femer - anterior and lateral surfaces
quadriceps femoris tendon, lateral margin of patella, lateral condyle of tibia
innervation of the posterior compartment of the thigh *
sciatic nerve
l5 s1 2
what are the nerves for the rotator muscles of the hip joint *
nerve to piriformis, nerve to obturator internus, nerve to quadratus femoris
innervation of the medial compartment of thigh *
obturator nerve
(except pectineus - femoral, and part of adductor magnus - sciatic [tibial])
blood supply to the thigh *
mainly the profunda femoris artery
describe the adductor longus *
origin - anterior surface of pubis insert to medial lip of linea aspera on middle half of femur
adducts thigh, flexes thigh, may laterally rotate thigh at hip
blood - muscular branches of femoral a
nerve- obturator L2 3 4
action and blood supply of the adductor magnus *
adducts thigh, posterior fibres adduct and laterally rotate the thigh
blood - profunda femoris
action and blood of adductor brevis *
action - adducts thigh, aids in flexion of thigh, may laterally rotate at hip
femoral artery
describe the superior gemellus *
origin - ischial spine
insertion - medial asoect of greater trochanteur via upper tendon of obturator internus
action - laterally rotates the femer, abducts thigh when flexed
blood - inferior glut a
nerve - nerve to obturator internus l5 s1 2
function and blood of obturator externus *
laterally rotates thigh, assists in flexion of hip joint
obturator a
describe the inferior gemellus *
origin - ischial tuberosity
insertion - medial aspect of greater trochanteur via lower tendon of obturator internus
action - laterally rotates femer
inferior glut a
nerve to quadratus femoris - l4 5 s1
describe the quadratus femorus *
origin - lateral aspect of the ischial tuberosity
insertion - quadrate line - along posterior aspect of femur and interotrochanteuric crest
laterally rotates femer
inferior gluteal a
nerve to quadratus l4 5 s1
action and blood of biceps femoris *
flexor at knee, laterally rotates thigh if flexed at knee, extends hip
profunda femoris, inferior gluteal a
action and blood of semimembrinosis *
flex knee, extends hip, medially rotates tibia, pulls medial meniscus posterior during flexion
profunda femoris and inferior gluteal a
action and blood of semitendinosis *
extends hip, flexes knee, medial rotates tibia
profunda femoris, inferior gluteal a
