Basic Science. Anatomy of Lower Limbs (Part 1). 9/15.

Ilium, sacrum, coccyx

Gluteus maximus attachments? (3)

Inferior gluteal nerve (L5-S2 roots)

Gluteus maximus innervation

Hip

Lateral

Pelvis

The gluteus maximus actions: extends ____, assists ____ rotation, stablizes ____

Gluteus maximus

What hip extensor is the most powerful and active during climbing and rising?

Gluteus medius

Anatomy

External ilium and greater trochanter of femur

Gluteus medius attachments (origin and insertion)

Superior gluteal nerve (L4-S1)

Gluteus medius, gluteus minus, and tensor fasciae latae innervation

greater trochanter

Femur anatomy

lesser trochanter

Femur anatomy

Linea aspera

Anatomy

Abducts hip, stabilizes pelvis during walking

Action of gluteus medius

Trendelenburg gait

Weakness of the gluteus medius produces a hip drop, called?

External ilium and greater trochanter

Gluteus minimus attachment (origin and insertion)

Unsteady, waddling

Injury to the gluteus minimus causes what type of gait pattern?

Tensor fasciae latae (TFL)

Anatomy

Anterior iliac crest and iliotibial tract

Tensor fasciae latae attachments (origin and insertion)

Medially rotates

Tensor fasciae latae (TFL) flexes, abducts, and ___ the hip

the knee in extension

Tensor fasciae latae tightens the IT band, which stabilizes what?

Piriformis, obturator internus, gemelli, quadratus femoris

4 muscles of the deep hip rotators?

Sacral plexus branches (L4-S2 roots )

Innervation of the deep hip rotators

Hip stability in standing

Deep hip rotators laterally rotate and stabilize femoral head which is important for hip ____

Piriformis

This muscle of the deep hip rotators lies close to the sciatic nerve

Sciatic nerve, causing pain

Piriformis syndrome compresses what nerve?

Ball and socket

What type of join is the hip joint?

Acetabulum / acetabular labrum

Anatomy shown + femoral head of the femur = ball and socket joint of the hip

Walking, running, climbing; stability with a wide range of motion

The ball-and-socket hip joint supports which activities?

True, since it is weight bearing

T/F: the hip joint is stronger than the shoulder joint

Joint capsule

What attaches around the acetabulum and femoral neck?

Ligament of the head of the femur

Anatomy which carries blood supply to the femoral head

Synovial membrane

Lines the capsule and secretes fluid

Iliofemoral ligament

Strongest hip ligament which prevents hyperextension of the hip (A)

Pubofemoral ligament

Hip ligament which limits excessive abduction (2)

Ischiofemoral ligament

Hip ligament which spirals posteriorly, limits internal rotation (only seen on posterior view)

Trochanteric bursa

Bursae (fluid sacs around joints) located between gluteus maximus and greater trochanter

Ischial tuberosity

Anatomy

Ischial bursa/ischiogluteal bursa

Bursae (fluid sacs around joints) located between gluteus maximus and ischial tuberosity

Iliopectinal bursa/iliopsoas bursa

Anatomy which is near the iliosposas tendon and hip joint

Bursitis syndromes

Common in runners and older adults

Inflammation of bursae (fluid sacs around joints) results in ____ which is common in?

Posterior

Which part of the hip is most commonly dislocated?

Avascular necrosis (loss of blood supply to bone)

Femoral neck fractures are common in elderly, increasing risk of?

Abnormal gait

Developmental dysplasia of the hip leads to?

Femur

Longest, strongest bone in the body

Medial epicondyle (knee joint)

Anatomy

Knee joint

The femur, tibia, and patella are connect by the?

Femoral nerve

Which nerve innervates the anterior thigh muscles?

Sartorius

Anterior thigh anatomy

Tailor's muscle

The sartorius is also know as the ___ muscle for cross-legged sitting

Anterior superior iliac spine

Medial tibia (pes anserinus)

Sartorius attachments (origin and insertion)

Flexes hip, flexes knee, laterally rotates thigh

Action of sartorius muscles (3)

Rectus femoris

Anterior thigh anatomy (between the pink and green muscles)

Anterior inferior iliac spine

Tibial tuberosity (shown in photo)

Rectus femoris attachments (origin and insertion (photo))

Knee joint (kicking)

Rectus femoris is responsible for hip flexion and extension of?

vastus lateralis

Anterior thigh anatomy (green)

Greater trochanter

Tibial tuberosity

Vastus lateralis attachments (origin and insertion)

Patella

Vastus lateralis extends knee and stabilizes ___ laterally?

Vastus lateralis

Which quadricep muscle is largest?

vasus medialis

Anterior thigh anatomy (pink)

Linea aspera

Tibial tuberosity

Vastus medialis attachments (origin and insertion)

Medially

Action of the vastus medialis includes knee extension and stabilizing the patella ___

Patellofemoral pain syndrome

Weakness of the vastus medialis causes ___ syndrome

Vastus lateralis

IM injection for infants

Obturator nerve

Femoral nerve

The medial thigh (except pectineus) is innervated by which nerve? What is the pectineus muscle innervated by?

Pectineus muscle

Adducts and flexes thigh at hip joint

Superior pubic ramus (photo)

Pectineal line of femur

Pectineus muscle attachments (origin (photo) and insertion)

Adductor longus

Adducts thigh, assists with medial rotation (green)

Pubic body

Linea aspera of femus

Adductor longus attachments (origin and insertion)

Adductor longus

Thigh muscle commonly strained in sports

Adductor brevis

Adducts thigh, assists flexion at the hip (light blue)

Inferior pubic ramus

Linea aspera of femur

Adductor brevis attachments (origin and insertion)

Groin strain

Injury to the adductor brevis can mimic?

Adductor magnus

Powerful adductor, hamstring portion extends thigh (yellow)

Pubic ramus and ischial tuberosity

Linea aspera

Adductor magnus attachments (origin (2) and insertion)

Adductor hiatus

Adductor magnus is a landmark for?

Gracilis muscle

Adducts thigh, flexes knee, assists medial rotation

Inferior pubic ramus

Medial tibia

Gracilis attachments (origin and insertion)

Obturator externus

Laterally rotates thigh, stabilizes femoral head

External obturator membrane

Trochanteric fossa of femur (photo)

Obturator externus attachments (origin and insertion (photo))

Hamstrings

Another name for posterior thigh muscles

Tibial branch of sciatic nerve

Innervation of the posterior thigh/hamstrings

Hip extension and knee flexion

2 Main functions of the posterior thigh/hamstrings pertaining to the hip and knee

False, very common

T/F: hamstring strains are uncommon in athletes

Biceps femoris

Anatomy

Long head: ischial tuberosity and fibular head

Short head: linea aspera and fibular head

Long head vs. short head of the biceps femoris attachments (origin and insertion)

Knee

Hip

Leg

Biceps femoris flexes ___, extends ___, laterally rotates ___

Tibial nerve

Fibular nerve

Biceps femoris long head vs. short head innervation

Semitendinosus hamstring muscle

Hamstring muscle that extends hip, flexes knee, medially rotates leg

Semimenbranosus

Injury may mimic medial meniscus pathology

Ischial tuberosity and posterior medial tibial condyle

Attachments (origin and insertion) of semimembranosus

inguinal ligament, satorius (lateral), adductor longus (medial)

3 borders of the femoral triangle (superior, lateral, medial)

Femoral nerve, artery, vein, lymphatics

The femoral triangle contains which nerve, artery, vein?

Women

Femoral hernias protrude through the femoral triangle, which is more common in (men, women)