Hip and Thigh Muscles Osteology of the Femur - Distal Medial Epicondyle Patellar surface: where patella articulates Lateral Epicondyle Lateral Condyle Medial Condyle Adductor Tubercle Medial supracondylar line Lateral supracondylar line Linea Aspera Pectineal line Popliteal groove Condyles cannot be palpated; Epicondyles serve as muscle attachments Pectineus Origin: pectineal line (pubis) and adjacent bone Insertion: Posterior proximal femur (from base of lesser trochanter to linea aspera) – pectineal line of femur Action: Hip adduction and flexion Innervation: Femoral nerve Adductor Hiatus: Allows the passage of vessels from the anterior to the posterior aspect Adductor Longus Origin: Superior ramus of pubis Insertion: Linea aspera on 1/3 of femur Action: Hip adduction Innervation: Obturator Nerve Adductor Brevis Origin: Lateral to pubic symphysis on pubis and inferior ramus on pubis Insertion: Posterior proximal femur and proximal 1/3 linea aspera Action: Hip adduction Innervation: Obturator nerve Adductor brevis is deep to adductor longus; Brevis means ‘short’ Adductor Magnus (2 parts) Adductor part Origin: ischial ramus of inferior pubic ramus Insertion: Posterior proximal femur, linea aspera, medial supracondylar line Action: Hip adduction and flexion Innervation: Obturator nerve Hamstring part Origin: Ischial tuberosity Insertion: Adductor tubercle and medial supracondylar line Action: Hip adduction and extension Innervation: Sciatic nerve Adductor magnus is deep to adductor brevis Perforations for branches of Deep Artery of thigh Gracilis Origin: Lateral to pubic symphysis on pubis Insertion: Medial surface of proximal shaft of tibia Action: Hip adduction and knee flexion Innervation: Obturator nerve Clinical – Groin Strain Iliacus and psoas muscles: True groin muscles (learn in Thorax and Abdomen unit) Hyperextension Adductor muscle group: Common groin muscles Overstretching Posterior Thigh Muscles (Hamstrings) Biceps Femoris Origin: Long head – upper ischial tuberosity; Short head – lateral edge of linea aspera Insertion: Head of fibula Action: Knee flexion, hip extension (long head only) Innervation: Sciatic Nerve Semitendinosus Origin: Upper ischial tuberosity Insertion: Medial surface of proximal tibia Action: knee flexion and internal rotation, hip extension and internal rotation Innervation: Sciatic Nerve Semimembranosus Origin: Ischial tuberosity Insertion: Medial and posterior medial condyle of tibia Action: Knee flexion and internal rotation, hip extension and internal rotation Innervation: Sciatic Nerve Semimembranosus is deep to semitendinosus Clinical - Hamstring Strain Hip or knee hyperextension Combo of hip flexion or knee extension Muscles of the Gluteal Region Tensor Fasciae Latae Origin: Anterior superior iliac spine; anterior iliac crest Insertion: Iliotibial tract, which attaches to lateral condyle of tibia (Gerdy’s tubercle) Action: Flexes hip joint, some hip abduction, internal hip rotation; stabilizes the extended knee Innervation: Superior gluteal nerve Iliotibial Band Formed by the tensor fasciae latae and gluteus maximus Originates on the posterior iliac crest Inserts on Gerdy’s tubercle on the lateral tibia More on the iliotibial band later (knee topic). Anterior Thigh Muscles Sartorius Origin: ASIS Insertion: Medial surface of tibia just below tibial tuberosity Action: Hip and knee flexion Innervation: Femoral nerve FUN FACT: Sartorius is the longest muscle in the human body Rectus Femoris Origin: AIIS and ilium superior to acetabulum Insertion: Quadriceps tendon Action: Hip flexion, knee extension Innervation: Femoral Nerve Vastus Intermedius Origin: Upper 2/3 of anterior and lateral surfaces of femur Insertion: Quadriceps tendon Action: Knee extension Innervation: Femoral nerve Origin: Femur – intertrochanteric line, pectineal line, medial linea aspera, medial supracondylar line Insertion: Quadriceps tendon Action: Knee extension Innervation: Femoral Nerve Vastus Lateralis Origin: Femur – intertrochanteric line, greater trochanter, gluteal tuberosity, lateral linea aspera Insertion: Quadriceps tendon Action: Knee extension Innervation: Femoral Nerve Tensor of the Vastus Intermedius NEW MUSCLE! Is it possible instead of QUADriceps femoris we have PENTcepts femoris? The tensor of the vastus intermedius has been identified between vastus lateralis and vastus intermedius. Quadriceps Tendon, Patella, Patellar Ligament Best defined as one continuous structure Patellar ligament is the continuation of the quadriceps tendon below the patella Femoral Triangle Important landmark for clinicians inserting a venous catheter Tight pants – impingement of the lateral cutaneous nerve Contents: Femoral nerve, artery, and vein BoundariesInguinal ligament Sartorius Adductor longus Floor: pectineus, adductor longus, and iliopsoas (iliacus and psoas major) Be aware of the femoral triangle and it’s importance Popliteal Fossa Posterior knee, Diamond-shaped space Important vessels/nerves travel from the thigh to leg through this fossa Boundaries:Superior-laterally: biceps femoris Superior-medially: semimembranosus Inferior-laterally AND interior-medially: lateral and medial heads of gastrocnemius, respectively Roof: skin and popliteal fascia Floor: femur, posterior capsule of knee joint, popliteal fascia covering the popliteus muscle Contents: small saphenous vein termination, popliteal artery and vein (+ branches), tibial and common fibular nerves, posterior cutaneous nerve of the thigh, popliteal lymph nodes and lymphatic vessels, fat Be aware of the popliteal fossa Knowt Play Call Kai