Anatomy Block 5 Lecture

Lower Limb

Iliofemoral

Ligament of the hip

Ischiofemoral

Ligament of the hip

Pubofemoral

Ligament of the hip

Capsular

Ligament of the hip

Labrum

Ligament of the hip

Transverse acetabular

Ligament of the hip

Ligament of head of femur/Ligamentum teres

Ligament of the hip

Hip ligaments importance

Prevents dislocations and excessive movement, ensuring the femoral head remains securely within the acetabulum.

How many hip ligaments are there?

7

Lumbar Plexus

L1-L4

Iliohypogastric nerve

L1

Ilioinguinal nerve

L1

Genitofemoral nerve

L1-L2

Lateral femoral cutaneous nerve

L2-L3

Obturator nerve

L2-L4

Femoral nerve

L2-L4

Sacral Plexus

L4-S4

Superior gluteal nerve

L4-S1

Inferior gluteal nerve

L5-S2

Posterior femoral cutaneous nerve

S1-S3

Sciatic nerve

L4-S3

Common fibular nerve

L4-S2

Tibial nerve

L4-S3

Sciatic nerve contains

Common fibular nerve (L4-S2) and Tibial nerve (L4-S3)

Pudendal nerve

S2-S4

Lumbosacral Trunk

L4-L5

Origin of psoas major

• Superficial: T12-L4 and associated intervertebral disks.

• Deep: L1-L5

Insertion of psoas major

Lesser trochanter

Innervation of psoas major

Direct branches from the lumbar plexus

Function of psoas major

Hip joint:

• Flexion

• External rotation

Lumbar spine:

• Unilateral contraction bends the trunk laterally the same side.

• Bilateral contraction: raises the trunk from the supine position

Origin of iliacus

Iliac fossa

Insertion of iliacus

Lesser trochanter

Innervation iliacus

Femoral nerve

Function of iliacus

Same as psoas major

Origin of gluteus maximus

Sacrum (dorsal surface, lateral part), ilium (gluteal surface, posterior part), thoracolumbar fascia, sacrotuberous ligament

Insertion of gluteus maximus

• Upper fibers: iliotibial tract

• Lower fibers: gluteal tuberosity

Innervation of gluteus maximus

Inferior gluteal nerve

Function of gluteus maximus

Entire muscle: Extends and externally rotates the hip in sagittal and coronal planes

Upper fibers: Abduction

Lower fibers: Adduction

Piriformis: Origin

Pelvic surface of the sacrum

Piriformis: Insertion

Apex of the greater trochanter of the femur

Piriformis: Innervation

Direct branches from the sacral plexus

Piriformis: Function

Hip joint: - External rotation - Abduction - Extension - Stabilizes the hip joint

Obturator internus: Origin

Inner surface of the obturator membrane and its bony boundaries

Obturator internus: Insertion

Medial surface of the greater trochanter

Obturator internus: Innervation

Direct branches from the sacral plexus

Obturator internus: Function

• External rotation - Abduction - Extension of the hip joint

Superior gemellus: Origin

Ischial spine

Superior gemellus: Insertion

Jointly with obturator internus tendon

Superior gemellus: Innervation

Direct branches from the sacral plexus

Superior gemellus: Function

• External rotation - Adduction - Extension of the hip joint

Inferior gemellus: Origin

Ischial tuberosity

Inferior gemellus: Insertion

Jointly with obturator internus tendon

Inferior gemellus: Innervation

Direct branches from the sacral plexus

Inferior gemellus: Function

• External rotation - Adduction - Extension of the hip joint

Quadratus femoris: Origin

Lateral border of the ischial tuberosity

Quadratus femoris: Insertion

Intertrochanteric crest of the femur

Quadratus femoris: Innervation

Direct branches from the sacral plexus

Quadratus femoris: Function

• External rotation - Adduction of the hip joint

Sartorius: Origin

Anterior superior iliac spine

Sartorius: Insertion

Medial to the tibial tuberosity

Sartorius: Innervation

Femoral n.

Sartorius: Function

Hip joint: - Flexion - Abduction - External rotation; Knee joint: - Flexion - Internal rotation

Rectus femoris: Origin

Anterior inferior iliac spine, acetabular roof of hip joint

Rectus femoris: Insertion

Tibial tuberosity

Rectus femoris: Innervation

Femoral n.

Rectus femoris: Function

Hip joint: - Flexion; Knee joint: - Extension

Vastus medialis: Origin

Linea aspera (medial lip), intertrochanteric line (distal part)

Vastus medialis: Insertion

Both sides of tuberosity on the medial and lateral condyles

Vastus medialis: Innervation

Femoral n.

Vastus medialis: Function

Knee joint: - Extension

Vastus lateralis: Origin

Linea aspera (lateral lip), greater trochanter (lateral surface)

Vastus lateralis: Insertion

Both sides of tuberosity on the medial and lateral condyles

Vastus lateralis: Innervation

Femoral n.

Vastus lateralis: Function

Knee joint: - Extension

Vastus intermedius: Origin

Femoral shaft (anterior side)

Vastus intermedius: Insertion

Tibial tuberosity

Vastus intermedius: Innervation

Femoral n.

Vastus intermedius: Function

Knee joint: - Extension

Pectineus: Origin

Pecten pubis

Pectineus: Insertion

Femur (pectineal line and proximal linea aspera)

Pectineus: Innervation

Femoral n.

Pectineus: Function

Hip joint: - Adduction - External rotation - Slight flexion; Stabilizes the pelvis in the coronal and sagittal planes

Adductor longus: Origin

Superior pubic ramus and anterior side of the symphysis

Adductor longus: Insertion

Femur (linea aspera, medial lip in the middle third of the femur)

Adductor longus: Innervation

Obturator n.

Adductor longus: Function

Hip joint: - Adduction - Flexion up to 70° - Extension past 80°; Stabilizes the pelvis in the coronal and sagittal planes

Adductor brevis: Origin

Inferior pubic ramus below the symphysis

Adductor brevis: Insertion

Femur (linea aspera, medial lip in the middle third of the femur)

Adductor brevis: Innervation

Obturator n.

Adductor brevis: Function

Same as adductor longus

Gracilis: Origin

Inferior pubic ramus below the symphysis

Gracilis: Insertion

Tibia (medial border of the tuberosity, along with the tendons of sartorius and semitendinosus)

Gracilis: Innervation

Obturator n.

Gracilis: Function

Hip joint: - Adduction - Flexion; Knee joint: - Flexion - Internal rotation

Obturator externus: Origin

Outer surface of the obturator membrane and its bony boundaries

Obturator externus: Insertion

Trochanteric fossa of the femur

Obturator externus: Innervation

Obturator n.

Obturator externus: Function

Hip joint: - Adduction - External rotation; Stabilizes the pelvis

Adductor minimus: Origin

Inferior pubic ramus