HIP MYOLOGY

Question 1

Movements occurring at hip by muscle groups

Answer 1

Flexors
Extensors
Abductors
Adductors
Medial rotators
Lateral rotators

Question 2

Flexors of the hip

Answer 2

Psoas major: palpable (tendon
only)

Illiacus: palpable (tendon only)

Sartorius: palpable

Pectineus: x palpable (too deep)

Question 3

Psoas major 🐶

Answer 3

Shape: large and powerful

Origin: bodies and discs of vertebrae T12 – L5
Anterior aspect of all lumber transverse processes (TPs)

Insertion: lesser trochanter or Femur (with iliacus)

Direction: inferiorly

Actions: flexes hip, working bi-laterally laterally flexes is the lumbar spine

Function: sitting up from a lying position

Nerve supply: anterior rami L1,2,3,4

Question 4

Sartorius 🐍

Answer 4

Shape: Strape like thin longest muscle in body

Origin: Anterior Superior iliac spine

Insertion: upper medial shaft of tibia

Direction: inferiorly medially

Action: Flexes and laterally rotates the hip flexes the knee

Function: sitting cross-legged

Nerve supply: femoral nerve L2,3

Question 5

Illiacus 🍗

Answer 5

Shape: flat fan shaped

Origin: upper and posterior 2/3 iliac fossa of sacrum and anterior Sacroiliac ligament

Insertion: lesser trochanter of femur with psoas major

Direction: inferiorly anteriorly

Actions: flexes the hip

Function: sitting up from a lying position

Nerve supply: femoral nerve L2, 3

Question 6

Pectineus🤚

Answer 6

Shape: small rectangular

Origin: superior ramus of pubis iliopubic eminence and pubic tubercle

Insertion: pectineal line on upper posterior femur

Direction: inferiorly laterally

Actions: flexes and adducts the hip

Function: sitting up from a line position

Nerve supply: femoral nerve L2, 3

Question 7

Extensors

Answer 7

Gluteus maximus – palpable

Hamstrings – palpable

Question 8

Gluteus maximus 🥩

Answer 8

Shape: very powerful larges of the gluteal muscles most superficial gluteal muscle quadrilateral shaped

Origin: gluteal surface of ilium, iliac crest, posterior sacrum and coccyx Sarcotuberous ligament and fascia covering erector spinae

Insertion: deep part to the gluteal tuberosity of fumur superficial 3/4 to the iliotibial tract

Direction: inferiorly latterly

Actions: extends laterally rotates and abducts the hip

Function: running walking climbing keeping us up right

Nerve supply: inferior gluteal nerve L5 S1,2

Question 9

Adductors

Answer 9

Adductor longus – palpable

Adductor Magnus – palpable

Adductor brevis - x palpable

Gracilis – x palpable

Question 10

Adductor longus /

Answer 10

Shape: triangular

Origin: anterior aspect body of pubis

Insertion: upper half linea aspara of femur

Direction: inferiorly laterally

Actions: adducts hip

Function: weight transference during walking, horse riding

Nerve supply: obturator nerve L2, 3,4

Question 11

Adductor Magnus 🌲

Answer 11

Shape: largest adductor muscle two components adductor part and hamstring part. Triangular

Origin: ischiopubic ramus inferior surface of ischial tuberosity

Insertion: adductor part- into the whole length of the linea aspara of Femur

hamstring part- into the middle supracondylar ridge and adductor tubercle of femur

Direction: inferiorly laterally

Actions: adducts and extend the hip

Function: weight transference during walking, horseriding

Nerve supply: adductor- obturator nerve L2,3
Hamstring part: sciatic nerve L4

Question 12

Adductor brevis 🌱

Answer 12

Shape:‘s smallest adductor muscle triangular

Origin: body and inferior ramus of pubis

Insertion: upper half of linea aspera of femur

Direction: inferiorly laterally

Actions adducts hip

Function: weight transference during walking, horseriding

Nerve supply: obturator nerve L2,3,4

Question 13

Gracilis ( I )

Answer 13

Shape: long thin muscle

Origin: body and inferior ramus of pubis

Insertion: medial surface shaft of tibia between sartorius and semitendinous

Direction: inferiorly

Actions: adducts hip and flexs the knee

Function: weight transference train walking, horseriding

Nerve supply: obturator nerve L2, 3

Question 14

Abductors

Answer 14

Gluteus medius – palpable

Gluteus minimus – X palpable

Tensor fascia lata – palpable

Sartorius - palpable

Question 15

Gluteus medius 🥩

Answer 15

Shape: second largest gluteal muscle lies under gluteus maximus triangular

Origin: gluteal surface of ilium and covering fascia

Insertion: superolateral surface of greater trochanter a femur

Direction: inferiorly laterally

Actions: abducts and medially rotates hip

Function: keeps the pelvis level during walking

Nerve supply: superior gluteal nerve L4, 5,S1

Question 16

Gluteus minimus 🥩

Answer 16

Shape: smallest and deepest gluteal muscle lies under gluteus medius triangular

Origin: gluteal surface of ilium deep to gluteus medius

Insertion: anterior superior surface of greater trochanter of femur

Direction: inferiorly latterly

Actions: abducts and medially rotates hip

Function: stability and control of pelvic movements

Nerve supply: superior gluteal nerve L4, 5, S1

Question 17

Tensor fascia lata ❗️

Answer 17

Shape: smallish and triangular

Origin: ASIS and adjacent iliac crest

Insertion: plants between the two layers of the iliotibial tract and onto the lateral tibial condyle

Direction: inferiorly posteriorly

Actions: abducts medially rotate tape assists in the extension

Function: Keeps the pelvis level during walking

Nerve supply: superior gluteal nerve L4, 5

Question 18

Medial rotators

Answer 18

Gluteus medius – palpable

Gluteus minimus – x palpable

Tensor fascia lata – palpable

Question 19

Lateral rotators (deep)

Answer 19

Piriformis – X palpable

Quadratus femoris – X palpable

Obturator internus/externus – X palpable

Gemellus superior/inferior – X
palpable

Gluteus maximus – palpable

Sartorius – palpable

Question 20

What is the fascia

Answer 20

Any collection of connective-tissue large enough to be visible to the naked eye

Two types: superficial, deep

Question 21

Superficial fascia of the thigh

Answer 21

Sits just below the skin like a sleeve around the thigh

Allows the passage of nerves and lymphatics to the skin

Question 22

Deep fascia of the thigh

Answer 22

Also known as the fascia lata and it ensheaths the muscles

Encloses glutes and tensor fascia lata

Deepest part has elongations called intermuscular septa that anchors the fascia to the femur And divide the thigh muscles into fascial compartments

Thickening of the deep fascia on the lateral aspect of the thigh forms the iliotibial tract which extends from the iliac crest on the pelvis to the lateral aspect of the lateral tibial condyle

Question 23

Why is the iliotibial tract important

Answer 23

important structure: provides a large surface area for other muscles to attach

Question 24

Origin

Answer 24

Proximal attachment

Fixed bone

Question 25

Insertion

Answer 25

Distal attachment | Moveable bone

Question 26

Iliotibial tract Position and Attachments

Answer 26

Iliotibial tract is a vertical band of thickened fascia Position: found in the lateral part of the fascia lata Attachments: Proximal: superiorly to the outer lip of the iliac crest behind the iliac tubercle Distal: Inferiorly to a tubercle on the anterior aspect of the lateral tibial condyle(gerdy’s tubercle) Thickest below the level of the greater trochanter

Question 27

Piriformus

Answer 27

Shape: triangular Origin: 2nd 3rd 4th sacral segments lateral to anterior sacral foramina Insertion: superior body of greater trochanter Direction: laterally anteriorly Action: lateral rotation abduction Function: stabilises hip Nerve supply: lumbosacral plexus L5 S1,2

Question 28

Quadratus femoris

Answer 28

Shape: flat quadraleteral muscle Origin: ischial tuberosity Insertion: superior to mid portion of intertrichanteric crest on posterior of femur Action: laterally rotates Function: stabilizes hip Nerve supply: quadratus femoris L4,5 S1

Question 29

Obturator internus

Answer 29

Shape: triangular shape posterior to hip Origin: inner surface of obturator foramen pubis and ischium Insertion: medial surface of greater trochanter if femur Direction: laterally posteriorly Action:laterally rotates abduction Function: moving sideways lower limb swinging crawling Nerve supply: obturator internus L5 S1,2

Question 30

Obturator externus

Answer 30

Shape: triangular Origin: outer surface of obturator membrane Insertion: trochanteric fossa Direction: below Acetabulum across the back of the femoral neck to attach to the trochanteric fossa Action: laterally rotates abduction Function: controlling pelvis forward swinging phase controlling movement when pelvis is flexed Nerve supply: obturator nerve L3,4

Question 31

Gemellus superior

Answer 31

Shape:triangular Origin: Ischial spine Insertion: medial surface of greater trochanter if femur Direction: laterally inferiorly Action: laterally rotates abducts Function:stabilise hip Nerve supply: obturator internus L5 S1,2

Question 32

Gemellus inferior

Answer 32

Shape: triangular Origin: ischial tuberosity Insertion: medial surface of greater trochanter of femur Direction: laterally superiorly Action: laterally rotates abducts Function: stabilise hip Nerve supply: quadratus femoris L4,5 S1

Question 33

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Answer 33

Piriformis Gemellus superior Obturator internus Gemellus inferior Quadratus femoris Obturator externus