Appendicular Skeleton: Pelvis (OS Coxa) and Associated Muscles

Module: Skeletal Topic: Pelvis View: Superior

Ala of Sacrum:

Location:

  • sacrum (base)

Description:

  • paired, wing-like, laterally projecting masses

  • modification of the S1 vertebral transverse process

Comments:

  • the base of the sacrum is the superior surface of the S1 vertebra

Anterior Inferior Iliac Spine:

Location:

  • ilium (anterior)

  • at the upper margin of the acetabulum

Description:

  • roughened projection

Comments:

  • provides attachment for the rectus femoris muscle

Anterior Superior Iliac Spine:

Location:

  • ilium (anterior end of iliac crest)

Description:

  • a small, rounded, bony projection

Comments:

  • provides attachment for the lateral end of the inguinal ligament and for the sartorius and the tensor fasciae latae muscle

Coccyx:

Location:

  • posterior pelvic wall

  • lower back, inferior to the S5 vertebra

Description:

  • a small, triangular bone

  • consists of 3 to 5, variably fused, poorly developed vertebrae

Comments:

  • know as the “tailbone”

  • rudiment of the tail in the other vertebrates

Iliac Crest:

Location:

  • ilium

Description:

  • a prominent ridge on the superior margin

Comments:

  • provides attachment for muscles of the back, the thigh, and the abdominal wall

  • landmark for the intramuscular injections

Iliac Fossa:

Location:

  • ilium (pelvic surface)

Description:

  • a broad, shallow concavity

  • forms the posterolateral wall of the greater pelvis

Comments:

  • the right iliac fossa contains cecum, vermiform appendix, and terminal ileum

  • the left iliac fossa contains the terminal descending colon

Ilium:

Location:

  • pelvis

Description:

  • the largest of 3 coxal (hip) bones

  • has a large, wing-like superior extension (ala); the law form the bony walls of the greater (false) pelvis

  • contributes to the acetabulum (hip joint socket) and wall of the lesser (true) pelvis

  • articulates with the sacrum at the sacroiliac joint

Comments:

  • fused with the ischium and the pubis in an adult to form the coxal (hip) bone

  • bony pelvis is formed by paired hip bones and the sacrum

Intervertebral Disc:

Location:

  • between the vertebral bodies (C2 to S1)

Description:

  • outer part: annulus fibrosis consisting of a fibrocartilage ring

  • inner part: nucleus pulposus composed of mucoid material

Comments:

  • no disk between the atlas (C1 vertebra) and axis (C2 vertebra)

Ischial Spine:

Location:

  • ischium

Description:

  • a pointed projection

Comments:

  • provides attachment for the pelvic diaphragm (coccygeus muscle) and the sacrospinous ligament

  • landmark for administering anesthetic during childbirth (“pudendal block”)

Ischium:

Location:

  • pelvis

Description:

  • 1 of 3 coxal (hip) bones

  • characteristic features include a tuberosity and the spine

  • contributes to the acetabulum (hip joint socket), the obturator foramen, and the wall of the lesser (true) pelvis

Comments:

  • fused with ilium and pubis in adults to form coxal (hip) bone

  • obturator foramen formed by rami of pubis and ischium

Lumbar Vertebra:

Location:

  • lower back

  • between T12 and S1 vertebrae

Description:

  • 5 individual vertebrae

  • characteristic features include a large size, kidney bean-shaped body, and a thick, blunt spinous process

Comments:

  • bodies are arranged to form the prominent anterior convexity (limbar curvature; also known as lumbar lordosis, which can be accentuated pathologically)

  • intervertebral discs between the lumbar vertebrae most commonly herniate (“slipped disk”)

Pelvic Inlet:

Location:

  • pelvis

Description:

  • a ridge of bone marking the junction of the false (greater) pelvis and true (lesser) pelvis

  • sacrum, ilium, and pubis contribute to the inlet

  • sacral promontory and alae; arcuate line of the ilium; pectineal line of the superior pubic ramus; and the pubic crest on the body of the pubis form the pelvic intel

Comments:

  • known as the “pelvic brim”

  • wide and oval-shaped in females

  • heart-shaped in males

Pubic Crest:

Location:

  • pubis (body)

Description:

  • rounded, upper border of the body

  • ends laterally as a pubic tubercle

Pubic Symphysis:

Location:

  • pelvis (anterior midline)

Description:

  • the joint is formed by 2 pubic bones and an intervening fibrocartilage disc

Comments:

  • in females, the fibrocartilage softens in late pregnancy to allow slight separation of the pubic bones

Pubic Tubercle:

Location:

  • pubis (body)

Description:

  • a small projection lateral to the pubis symphysis

Comments:

  • provides attachment for the medial end of the inguinal ligament

Pubis:

Location:

  • pelvis

Description:

  • 1 of 3 coxal (hip) bones

  • characteristic features include the body and the rami (superior and inferior)

  • midline junction of the pubic bones forms the pubic symphysis

  • contributes to the acetabulum (hip joint socket), obturator foramen, and the wall of the lesser (true) pelvis

Comments:

  • fused with ilium and ischium in an adult to form coxal (hip) bone

Sacro-iliac Joint:

Location:

  • pelvis

Description:

  • synovial joint between the sacrum and ilium

  • limited movement due to rough, irregular articular surfaces

Comments:

  • a major point of force (weight) transforms from the trunk to the lower limb

Sacrum:

Location:

  • lower back

  • between L5 and Co1 vertebrae

  • posterior wall of the pelvis

Description:

  • 5 fused vertebrae

  • a triangular bone wedged between hip bones

Comments:

  • sacra; promontory 9the prominent, projecting edge of the base of the sacrum formed by the superior border of the S1 vertebral body) is a landmark for establishing female pelvic dimensions

Module: Muscular Topic: Abdomen View: Anterior

Rectus Abdominis m :

Action:

  • flexion of the trunk (sit-ups)

  • compression of the anterior abdominal wall

Origin:

  • pubis (crest and symphysis)

Insertion:

  • sternum (xiphoid process)

  • costal cartilages 5-7

Innervation:

  • ventral rami of the T7-12 spinal nerves

Comment:

  • 3 or 4bellies, separated by tendinous intersections

  • encased in fibrous (rectus) sheath

  • important in "straining" (e.g., lifting, defecation, urination, child-birth)

  • functions in respiration ("abdominal breathing"

Module: Muscular Topic: Hip & Thigh View: Posterior

Gluteus Maximus m. :

Action:

  • extension of the thigh

  • lateral rotation of the thigh

  • abduction of the thigh

Origin:

  • ilium (ala)

  • sacrum

  • coccyx

Insertion:

  • iliotibial tract

  • femur (gluteal tuberosity)

Innervation:

  • inferior gluteal nerve

Comments:

  • important for powerful extension of the femur (running, climbing stairs, rising a from seated position)

  • NOT important in walking

Gluteus Medius m. :

Action:

  • abduction of the thigh (non-weight-bearing)

  • lowers pelvis on the weight-bearing side

Origin:

  • ilium (ala)

Insertion:

  • femur (greater trochanter)

Innervation:

  • superior gluteal nerve

Comments:

  • lowering (“tilting” downward) the pelvis on the weight-bearing side allows non-weight-bearing limbs to swing forward during walking

  • acts with the gluteus minimus

Module: Muscular Topic: Back View: Posterior

Erector Spine m. :

Action:

  • unilateral: lateral flexion and rotation of vertebral column and head

  • bilateral: extension of vertebral column and head

Origin:

  • iliocostalis: common origin and ribs

  • longissimus: common origin

  • spinalis: spinous processes and nuchal ligament

Insertion:

  • iliocostalis: ribs (1-12) and transverse processes (cervical)

  • longissimus: transverse processes (cervical and thoracic), ribs, and mastoid process

  • spinalis: spinous processes (cervical and thoracic) and occipital bone

Innervation:

  • dorsal rami of the spinal nerves

Comments:

  • “antigravity" muscles

  • composed of 3 muscular columns (lateral to medial): iliocostalis, longissimus, and spinalis

  • common origin of the erector spinae: dorsal sacrum, iliac crest, and spinous processes

Latissimus Dorsi m. :

Action:

  • adduction of the arm

  • extension of the arm

  • medial rotation of the arm

Origin:

  • sacral and lumbar spines via thoracolumbar fascia

  • ilium (iliac crest) via thoracolumbar fascia

  • ribs (lower four)

  • spinous processes of T6-12 vertebrae

  • scapula (inferior angle)

Insertion:

  • humerus (floor of intertubercular sulcus)

Innervation:

  • thoracodorsal nerve