Muscles of the hips and thighs

Information

There are three layers of gluteal muscles on the posterior hips, just like there are three layers of muscles in the abdominal trunk. The largest of them is the most superficial muscle, the gluteus maximus. Its origin is on the ilium of the coxal bone, and it inserts part-way down the shaft of the femur. It helps maintain erect posture, abducts the thigh, and rotates the thigh outward.

Below the gluteus maximus is the smaller gluteus medius. The gluteus medius muscle helps abducts the thigh along with the gluteus maximus, but can rotate the thigh inward where the gluteus maximus rotates the thigh outward.

The below the gluteus medius are several muscles, one of which is the gluteus minimus, the smallest of the gluteal muscles. It is a synergist for the gluteus medius.

Figure 9-7. The three layers of gluteal muscles, gluteus maximus, gluteus medius, gluteus minimus.

 

Like the forearm, the upper leg, or thigh, has a dense arrangement of many muscles. On the anterior side, the most prominent of the muscles are the sartorius muscle and the four muscles that make up quadriceps muscle group (the “quads”.)

The quadriceps sounds like it should be just one muscle, akin to the triceps brachii, but it is a group of four muscles, three visible on the surface, and the fourth obscured. The three surface muscles of the quadriceps are the rectus femoris in the center, the vastus medialis on the medial side, and the vastus lateralis on the lateral side. These three muscles are visible in Figure 9-8. Below the rectus femoris and largely hidden by it is the vastus intermedius. This muscle’s position can be seen in Figure 9-9. The four muscle of the quadriceps all extend the lower leg, and the rectus femoris additionally can flex the thigh at the hip.

Figure 9-8. The superficial muscles of the thigh.

 

Figure 9-9. The quadriceps group of four muscles. The view on the left has the rectus femoris cut away to show the vastus intermedius which is below it.

 

The sartorius muscle is a distinctively long and thin muscle that crosses the thigh diagonally. It is visible in Figure 9-8. Sartorius comes from the Latin for tailor, and this is sometimes called the tailor’s muscle, although the reasons for the nickname are obscure. It may be because the shape of the muscle is thin and long, like a tailor’s measuring tape; it may be because it is close to the inseam a tailor measures when tailoring pants, or it may be because it helps bring about the cross-legged position that tailors often adopt when working.

In the posterior thigh the bulk of the musculature is made up of three long muscles that are collectively called the hamstrings. The origin of this nickname is obscure, but it may have to do with the practice of butchers of hanging the thighs of butchered animals such as pig (the “hams”) by the tendons of these three muscles. Move from the medial edge to the lateral edge of the posterior thigh, the hamstring muscles are the semimembranous muscle, the semitendinosus muscle, and the biceps femoris muscle. Notice the upper leg has a “biceps” muscle just like the upper arm does. This is why you have to indicate which biceps you are taking about when discussing one or other of these muscles. On the medial edge of the posterior thigh is the gracilis muscle. It is also visible on the medial edge of the thigh from the anterior.

Figure 9-10. The muscles of the posterior thigh.

 

Figure 9-11. The hamstring group of muscles of the posterior thigh.

 

Lab 9 Exercises 9.4

1. Using the full-scale leg model, locate and identify the muscles of the thigh listed in the table below.

 

2. Write down the muscles of the thigh in the table below and, for each, give the location of that muscle and what effect contracting that muscle has.

Muscle	Location & description	Action(s)
Rectus femoris
Vastus intermedius
Vastus medialis
Vastus lateralis
Sartorius
Gracilis
Semimembranosus
Semitendinosus
Biceps femoris

 

 

Hip Anatomy, Pictures, Function, Problems & Treatment

The hip joint is a ball-and-socket type joint and is formed where the thigh bone (femur) meets the pelvis. The femur has a ball-shaped head on its end that fits into a socket formed in the pelvis, called the acetabulum.  Large ligaments, tendons, and muscles around the hip joint hold the bones (ball and socket) in place and keep it from dislocating.

Hip Anatomy, Function and Common Problems

Front View of the Hip Joint Bones

Normally, a smooth cushion of shiny white hyaline (or articular) cartilage about 1/4 inch thick covers the femoral head and the acetabulum. The articular cartilage is kept slick by fluid made in the synovial membrane (joint lining). Synovial fluid and articular cartilage are a very slippery combination—3 times more slippery than skating on ice and 4 to 10 times more slippery than a metal on plastic hip replacement. Synovial fluid is what allows us to flex our joints under great pressure without wear. Since the cartilage is smooth and slippery, the bones move against each other easily and without pain.

When the cartilage is damaged, whether secondary to osteoarthritis (wear-and-tear type arthritis) or trauma, joint motion can become painful and limited.

The hip joint is one of the largest joints in the body and is a major weight-bearing joint. Weight bearing stresses on the hip during walking can be 5 times a person’s body weight. A healthy hip can support your weight and allow you to move without pain. Changes in the hip from disease or injury will significantly affect your gait and place abnormal stress on joints above and below the hip.

It takes great force to seriously damage the hip because of the strong, large muscles of the thighs that support and move the hip.

Anatomical Terms

Anatomical terms allow us to describe the body and body motions more precisely. Instead of your doctor simply saying that “the patient knee hurts”,  he or she can say that “the patient’s knee hurts anterolaterally”.  Identifying specific areas of pain helps to guide the next steps in treatment or work-up. Below are some anatomic terms doctors use to describe location (applied to the hip):

• Anterior — the abdominal side (front) of the hip
• Posterior — the back side of the hip
• Medial — the side of the hip closest to the spine
• Lateral — the side of the hip farthest from the spine
• Abduction — move away from the body (raising the leg away from midline i. e. towards the side)
• Adduction — move toward the body (lowering the leg toward midline i.e. from the side)
• Proximal — located nearest to the point of attachment or reference, or center of the body
  • example: the knee is proximal to the ankle
• Distal — located farthest from the point of attachment or reference, or center of the body
  • example: the ankle is distal to the knee
• Inferior — located beneath, under or below; under surface

Anatomy of the Hip

Joint capsule of the hip

Like the shoulder, the hip is a ball-and-socket joint, but is much more stable. The stability in the hip begins with a deep socket—the acetabulum. Additional stability is provided by the surrounding muscles, hip capsule and associated ligaments.  If you think of the hip joint in layers, the deepest layer is bone, then ligaments of the joint capsule, then muscles are on top. Various nerves and blood vessels supply the muscles and bones of the hip.

Bony Structures of the Hip

The hip is formed where the thigh bone (femur) meets the three bones that make up the pelvis: the ilium, the pubis (pubic bone) and the ischium.  These three bones converge to form the acetabulum, a deep socket on the outer edge of the pelvis. By adulthood, these three bones are completely fused and the pelvis is effectively a single bone.

The femur is the longest bone in the body. The neck of the femur connects the femoral head with the shaft of the femur.  The neck ends at the greater and lesser trochanters, which are bony prominences of the femur that various muscles attach to. The greater trochanter serves as the site of attachment for the abductor and external rotator muscles which are important stabilizers of the hip joint. This is the prominent part of your hip that you can actually feel on the outer aspect of your thigh. The lesser trochanter serves as the attachment site of the iliopsoas tendon, one of the muscles that allows you to bend your hip.  

It is important to remember that the actual hip joint lies deep in the groin area. This is important, because true hip joint issues are typically associated with groin pain. 

The Hip Joint

The hip joint is a ball and socket type joint.  The femoral head (ball) fits into the acetabulum (socket) of the pelvis. The large round head of the femur rotates and glides within the acetabulum. The depth of the acetabulum is further increased by a fibrocartilagenous labrum that attaches to the outer rim of the acetabulum. It acts to deepen the socket and to add additional stability to the hip joint.  The labrum can become torn and cause symptoms such as pain, weakness, clicking, and instability of the hip. 

Bones of the Hip Joint

There are numerous structures that contribute stability to the hip:

• The ball and socket bony structure
• The labrum
• The capsule and its associated ligaments: e.g. iliofemoral ligament, pubofemoral ligament
• The surrounding muscles including the abductors (gluteus medius and minimus) and external rotators (gemelli muscles, piriformis, the obturators).

 

Hip Ligaments

The iliofemoral ligament in the hip

The stability of the hip is increased by the strong ligaments that encircle the hip (the iliofemoral, pubofemoral, and ischiofemoral ligaments). These ligaments completely encompass the hip joint and form the joint capsule. The iliofemoral ligament is considered by most experts to be the strongest ligament in the body. The ligamentum teres is a small tubular structure that connects the head of the femur to the acetabulum. It contains the  artery of the ligamentum teres. In infants, this serves as a relatively important source of blood supply to the head of the femur.  In adults, the ligamentum teres is thought by most to be more of a vestigial structure that serves little function.

 

The ischiofemoral ligament of the hip

Muscles of the Hip

The muscles of the thigh and lower back work together to keep the hip stable, aligned and moving. It is the muscles of the hip that allow the movements of the hip:

• flexion – bend
• extension – straighten
• abduction – leg move away from midline
• adduction – leg moves back towards midline
• external rotation (allows for the foot to point outwards)
• internal rotation (allows for the foot to point inward)

The hip muscles are divided up into three basic groups based on their location: anterior muscles (front), posterior (back), and medial (inside). The muscles of the anterior thigh consist of the quadriceps (or quads): vastus medialis, intermedius, lateralis and rectus femoris muscles. The quads make up about 70% of the thigh’s muscle mass. The main functions of the quads are flexion (bending) of the hip and extension (straightening) of the knee.

The gluteal and hamstring muscles, as well as the external rotators of the hip are located in the buttocks and posterior thigh. The gluteal muscles consist of the gluteus maximum, gluteus medius, and gluteus minimus. The gluteus maximus is the main hip extensor and helps keep up the normal tone of the fascia lata or iliotibial (IT) band, which is the long, sheet-like tendon on the side of your thigh. It helps with motion of the hip, but perhaps more importantly, acts to help stabilize the knee joint.

Gluteus medius and minimus are the main abductors of the hip —that is, they move the leg away from the midline of the body (using the spine as a midline reference point). They also are the main internal rotators of the hip (i. e. turn the foot inwards). The gluteus medius and minimus are also important stabilizers of the hip joint and help to keep the pelvis level as we walk.

The tensor fascia lata (TFL) is another abductor of the hip, which, along with the gluteus maximus, attaches to the IT band.  The IT band is a common cause of lateral (outside) hip, thigh, and knee pain.

The medial muscles of the hip are involved in the adduction of the leg i.e. bringing the leg back towards the midline. These muscles include the adductors (adductor magnus, adductor longus, adductor brevis, pectineus, gracilis). Obturator externus also helps to adduct the leg.

The external rotator muscles (piriformis, gemelli, obturator internus) of the hip are located in the buttock area and assist in lateral rotation of the hip (out-toeing). Lateral rotation is needed for crossing the legs.

Blood Vessels and Nerves of the Hip

The sciatic nerve is located where it could get injured from a backwards dislocation of the femoral head.

Nerves carry signals from the brain to the muscles to move the hip and carry signals from the muscles back to the brain about pain, pressure and temperature. The main nerves of the hip that supply the muscles in the hip include the femoral, obturator, and sciatic nerves.

The sciatic nerve is the most commonly recognized nerve in the hip and thigh. The sciatic nerve is large—as big around as your thumb—and travels beneath the gluteus maximus down the back of the thigh where it branches to supply the muscles of the leg and foot. Hip dislocations can cause injury to the sciatic nerve.

The blood supply to the hip is extensive and comes from branches of the internal and external iliac arteries: the femoral, obturator, superior and inferior gluteal arteries. The femoral artery is well-known because of its use in cardiac catheterization. You can feel its pulse in your groin area.  It travels from deep within the hip down the thigh and down to the knee. It is the continuation of the external iliac artery which lies within the pelvis. The main blood supply to the femoral head comes from vessels that branch off of the femoral artery:  the lateral and medial femoral circumflex arteries.  Disruption of these arteries can lead to osteonecrosis (bone death) of the femoral head. These arteries can become disrupted with hip fractures and hip dislocations.

Bursae

Bursae are fluid filled sacs lined with a synovial membrane which produce synovial fluid. Bursae are often found near joints. Their function is to lessen the friction between tendon and bone, ligament and bone, tendons and ligaments, and between muscles. There are as many as 20 bursae around the hip. Inflammation or infection of the bursa called bursitis.

The trochanteric bursa is located between the greater trochanter (the bony prominence on the femur) and the muscles and tendons that cross over the greater trochanter. This bursa can get irritated if the IT band is too tight. This bursa is a common cause of lateral thigh (hip) pain. Two other bursa that can get inflamed are the iliopsoas bursa, located under the iliopsoas muscle and the bursa located over the ischial tuberosity (the bone you sit on).

Common Problems of the Hip

Posterior Hip dislocation

Surgery of the Hip

The hip joint is largely responsible for mobility. So any injury, trauma, or disease that affects its function can significantly reduce a person’s independence.

Lastly, there are many conditions in and around the hip and even conditions of the spine, that can cause pain in the hip area.  Therefore, if you suspect that you might be having a problem with your hip(s), don’t hesitate to visit a trusted doctor for further evaluation.

Note that the information in this article is purely informative and should never be used in place of the advice of professionals.

 

Hip & Thigh – Atlas of Anatomy

Atlas of Anatomy

24 Hip & Thigh

Bones of the Lower Limb

Fig. 24.1   Bones of the lower limb
Right limb. The skeleton of the lower limb consists of a limb girdle and an attached free limb. The free limb is divided into the thigh (femur), leg (tibia and fibula), and foot. It is connected to the pelvic girdle by the hip joint.

Fig. 24.2   Line of gravity
Right lateral view. The line of gravity runs vertically from the whole-body center of gravity to the ground with characteristic points of intersection.

Fig. 24.3   Palpable bony prominences in the lower limb
Most skeletal elements of the lower limb have bony prominences, margins, or surfaces (e.g., medial or tibial surfaces) that can be palpated through the skin and soft tissues.

Pelvic Girdle & Hip Bone

Fig. 24.4   Pelvic girdle
Anterior view. Pelvic ring in red.

 Each pelvic girdle consists of a hip bone (coxal bone, innominate bone), which articulates with the head of a femur. Unlike the shoulder girdle, the pelvic girdle is firmly integrated into the axial skeleton: the paired hip bones are connected to each other at the cartilaginous pubic symphysis and to the sacrum via the sacroiliac joints. These attachments create the bony pelvic ring (red), permitting very little motion. This stability is an important prerequisite for the transfer of trunk loads to the lower limb (necessary for normal gait).

Fig. 24.5   Right hip bone

Fig. 24.6   Components of the hip bone
Right hip bone. The three bony elements of the hip bone (ilium, ischium, and pubis) come together at the acetabulum. Definitive fusion of the Y-shaped growth plate (triradiate cartilage) occurs between the 14th and 16th years of life.

Femur

Fig. 24.7   Right femur

 Clinical

Fractures of the femur

Femoral fractures caused by falls in patients with osteoporosis are most frequently located in the neck of the femur. Femoral shaft fractures are less frequent and are usually caused by strong trauma (e. g., a car accident).

Fig. 24.8   Head of femur in the hip joint
Right hip joint, superior view.

Hip Joint: Overview

Fig. 24.9   Right hip joint
The head of the femur articulates with the acetabulum of the pelvis at the hip joint, a special type of spheroidal (ball-and-socket) joint. The roughly spherical femoral head (with an average radius of curvature of approximately 2.5 cm) is largely contained within the acetabulum.

Fig. 24.10   Hip joint: Coronal section
Right hip joint, anterior view.

 Clinical

Diagnosing hip dysplasia and dislocation

Ultrasonography, the most important imaging method for screening the infant hip, is used to identify morphological changes such as hip dysplasia and dislocation. Clinically, hip dislocation presents itself with instability and limited abduction of the hip joint, and leg shortening with asymmetry of the gluteal folds.

Hip Joint: Ligaments & Capsule

 The hip joint has three major ligaments: iliofemoral, pubofemoral, and ischiofemoral. The zona orbicularis (annular ligament) is not visible externally and encircles the femoral neck like a buttonhole.

Fig. 24.11   Hip joint: Lateral view

Fig. 24.12   Hip joint: Anterior view

Fig. 24.13   Hip Joint: Posterior view

Anterior Muscles of the Thigh, Hip & Gluteal Region (I)

Fig. 24.14   Muscles of the hip and thigh: Anterior view (I)
Right limb. Muscle origins (O) are shown in red, insertions (I) in blue.

Anterior Muscles of the Thigh, Hip & Gluteal Region (II)

Fig. 24.15   Muscles of the hip and thigh: Anterior view (II)
Right limb. Muscle origins (O) are shown in red, insertions (I) in blue.

Fig. 24.16   Muscles of the hip, thigh, and gluteal region: Medial view
Midsagittal section.

Posterior Muscles of the Thigh, Hip & Gluteal Region (I)

Fig. 24.17   Muscles of the hip, thigh, and gluteal region: Posterior view (I)
Right limb. Muscle origins (O) are shown in red, insertions (I) in blue.

Posterior Muscles of the Thigh, Hip & Gluteal Region (II)

Fig. 24.18   Muscles of the hip, thigh, and gluteal region: Posterior view (II)
Right limb. Muscle origins (O) are shown in red, insertions (I) in blue.

Fig. 24.19   Muscles of the hip, thigh, and gluteal region: Lateral view
Note: The iliotibial tract (the thickened band of fascia lata) functions as a tension band to reduce the bending loads on the proximal femur.

Muscle Facts (I)

Fig. 24.20   Muscles of the hip
Right side.

Fig. 24.21   Psoas and iliacus muscles
Right side, anterior view.

Fig. 24.22   Superficial muscles of the gluteal region
Right side, posterior view.

Fig. 24.23   Deep muscles of the gluteal region

Muscle Facts (II)

 Functionally, the medial thigh muscles are considered the adductors of the hip.

Fig. 24.24   Medial group: Superficial layer
Right side, anterior view.

Fig. 24.25   Medial group: Deep layer
Right side, anterior view.

Muscle Facts (III)

Fig. 24.26   Anterior thigh muscles
Right side, anterior view.

Fig. 24.27   Posterior thigh muscles
Right side, posterior view.



The Hip Joint – Articulations – Movements

The hip joint is a ball and socket synovial joint, formed by an articulation between the pelvic acetabulum and the head of the femur.

It forms a connection from the lower limb to the pelvic girdle, and thus is designed for stability and weight-bearing – rather than a large range of movement.

In this article, we shall look at the anatomy of the hip joint – its articulating surfaces, ligaments and neurovascular supply.

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Structures of the Hip Joint

Articulating Surfaces

The hip joint consists of an articulation between the head of femur and acetabulum of the pelvis.

The acetabulum is a cup-like depression located on the inferolateral aspect of the pelvis. Its cavity is deepened by the presence of a fibrocartilaginous collar – the acetabular labrum. The head of femur is hemispherical, and fits completely into the concavity of the acetabulum.

Both the acetabulum and head of femur are covered in articular cartilage, which is thicker at the places of weight bearing.

The capsule of the hip joint attaches to the edge of the acetabulum proximally. Distally, it attaches to the intertrochanteric line anteriorly and the femoral neck posteriorly.

Fig 1 – The articulating surfaces of the hip joint – pelvic acetabulum and head of the femur.

Ligaments

The ligaments of the hip joint act to increase stability. They can be divided into two groups – intracapsular and extracapsular:

Intracapsular

The only intracapsular ligament is the ligament of head of femur. It is a relatively small structure, which runs from the acetabular fossa to the fovea of the femur.

It encloses a branch of the obturator artery (artery to head of femur), a minor source of arterial supply to the hip joint.

Extracapsular

There are three main extracapsular ligaments, continuous with the outer surface of the hip joint capsule:

• Iliofemoral ligament – arises from the anterior inferior iliac spine and then bifurcates before inserting into the intertrochanteric line of the femur.
  • It has a ‘Y’ shaped appearance, and prevents hyperextension of the hip joint. It is the strongest of the three ligaments.
• Pubofemoral – spans between the superior pubic rami and the intertrochanteric line of the femur, reinforcing the capsule anteriorly and inferiorly.
  • It has a triangular shape, and prevents excessive abduction and extension.
• Ischiofemoral– spans between the body of the ischium and the greater trochanter of the femur, reinforcing the capsule posteriorly.
  • It has a spiral orientation, and prevents hyperextension and holds the femoral head in the acetabulum.

Neurovascular Supply

The arterial supply to the hip joint is largely via the medial and lateral circumflex femoral arteries – branches of the profunda femoris artery (deep femoral artery). They anastomose at the base of the femoral neck to form a ring, from which smaller arteries arise to supply the hip joint itself.

The medial circumflex femoral artery is responsible for the majority of the arterial supply (the lateral circumflex femoral artery has to penetrate through the thick iliofemoral ligament). Damage to the medial circumflex femoral artery can result in avascular necrosis of the femoral head.

The artery to head of femur and the superior/inferior gluteal arteries provide some additional supply.

The hip joint is innervated primarily by the sciatic, femoral and obturator nerves. These same nerves innervate the knee, which explains why pain can be referred to the knee from the hip and vice versa.

Fig 2 – The medial and lateral circumflex femoral arteries are the major blood supply to the hip joint.

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Stabilising Factors

The primary function of the hip joint is to weight-bear. There are a number of factors that act to increase stability of the joint.

The first structure is the acetabulum. It is deep, and encompasses nearly all of the head of the femur. This decreases the probability of the head slipping out of the acetabulum (dislocation).

There is a horseshoe shaped fibrocartilaginous ring around the acetabulum which increases its depth, known as the acetabular labrum. The increase in depth provides a larger articular surface, further improving the stability of the joint.

The iliofemoral, pubofemoral and ischiofemoral ligaments are very strong, and along with the thickened joint capsule, provide a large degree of stability. These ligaments have a unique spiral orientation; this causes them to become tighter when the joint is extended.

In addition, the muscles and ligaments work in a reciprocal fashion at the hip joint:

• Anteriorly, where the ligaments are strongest, the medial flexors (located anteriorly) are fewer and weaker.
• Posteriorly, where the ligaments are weakest, the medial rotators are greater in number and stronger – they effectively ‘pull’ the head of the femur into the acetabulum.

Fig 3 – The extracapsular ligaments of the hip joint; ileofemoral, pubofemoral and ischiofemoral ligaments.

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Movements and Muscles

The movements that can be carried out at the hip joint are listed below, along with the principle muscles responsible for each action:

• Flexion – iliopsoas, rectus femoris, sartorius, pectineus
• Extension – gluteus maximus; semimembranosus, semitendinosus and biceps femoris (the hamstrings)
• Abduction – gluteus medius, gluteus minimus, piriformis and tensor fascia latae
• Adduction – adductors longus, brevis and magnus, pectineus and gracilis
• Lateral rotation – biceps femoris, gluteus maximus, piriformis, assisted by the obturators, gemilli and quadratus femoris.
• Medial rotation – anterior fibres of gluteus medius and minimus, tensor fascia latae

The degree to which flexion at the hip can occur depends on whether the knee is flexed – this relaxes the hamstring muscles, and increases the range of flexion.

Extension at the hip joint is limited by the joint capsule and the iliofemoral ligament. These structures become taut during extension to limit further movement.

[start-clinical]

Clinical Relevance: Dislocation of the Hip Joint

Congenital Dislocation

Congenital hip dislocation occurs as a result of developmental dysplasia of the hip (DDH). It occurs when the Acetabulum is shallow as a result of failure to develop properly in utero

Common clinical features include:

• Limited abduction at the hip joint
• Limb length discrepancy – the affected limb is shorter
• Asymmetrical gluteal or thigh skin folds

DDH is usually treated with a Pavlik harness. This holds the femoral head in the acetabular fossa and promotes normal development of the hip joint. Surgery is indicated in cases that do not respond to harness treatment.

Acquired Dislocation

Acquired dislocations of the hip joint are relatively uncommon, owing to the strength and stability of the joint. They usually occur as a result of trauma, but it can occur as a complication following Total Hip Replacement or hemiarthroplasty.

There are two main types of acquired hip dislocation; posterior and anterior:

• Posterior dislocation (90%)– the femoral head is forced posteriorly, and tears through the inferior and posterior part of the joint capsule, where it is at its weakest.
  • The affected limb becomes shortened and medially rotated.
  • The sciatic nerve runs posteriorly to the hip joint, and is at risk of injury (occurs in 10-20% of cases). This is often associated with anterior femoral head and posterior wall fractures
• Anterior dislocation(rare) – occurs as a consequence of traumatic extension, abduction and lateral rotation. The femoral head is displaced anteriorly and (usually) inferiorly in relation to the acetabulum.

Fig 4 – Radiograph showing an anterior dislocation of the left hip joint.

[end-clinical]

A Guide to Hip Anatomy: Bones, Muscles, Tendons & Pain Sources

If you are starting to feel hip pain or stiffness, you’ll want to know more about the bones and muscles that make up the hip’s anatomy.

Hip Anatomy: Bones

The hip joint is made up of two bones: the pelvis and the femur (the thighbone). It is the largest ball-and-socket joint in your body. The “ball” is the rounded end of the femur (also called the femoral head). The “socket” is a concave depression in the lower side of the pelvis (also called the acetabulum). The femoral head fits into the acetabulum to form the hip joint. This anatomy allows for a lot of motion within the joint — for instance, walking, running, and climbing.

The femoral head attaches by way of the femoral neck to the rest of the femur. At the top of the femur, next to the femoral neck, there is another bump on the outside of your hip called the greater trochante to which muscles attach. Cartilage helps prevent friction between the femoral head and the acetabulum, but hip pain can occur if your cartilage begins to wear down or is damaged.

“I see a lot of patients who have injuries to the joint, especially to cartilage,” says Brian Parsley, MD, assistant professor in the department of orthopedic surgery at the Baylor College of Medicine in Houston, Texas.

Hip Anatomy: Muscles and Tendons

The motion of the ball-and-socket is controlled by several very powerful muscles which attach to the bones. The muscles you probably know the best are your “glutes” (gluteal muscles), the large, strong muscles that attach to the back of your hip bones and comprise the buttocks.

“The glutes attach to your greater trochanter; those muscles help hold your pelvis and your body up so you don’t fall over and also help you walk,” says Dr. Parsley. “On top of that layer of muscle is the iliotibial band, which starts at the brim of your pelvis outside the hip joint and runs down your leg.”

If the iliotibial band (a long tendon that many muscles in your hip and leg attach to) becomes too tight or overused, this can contribute to hip pain.

Some of the other muscles in the hip are:

• Adductor muscles on the inside of your thigh.
• Iliopsoas muscle, a hip flexor muscle that attaches to the upper thigh bone.
• Rectus femoris muscle, one of the quadriceps muscles on the front of your thigh.

Muscles play an important role in the health and well-being of your hip. All these muscles work together to provide you with range of motion in your hip while keeping your body stable and upright. “The underlying recommendation for preventing hip pain would be to try and maintain flexibility and muscle tone,” Parsley says.

Hip Anatomy: Pain Sources

General causes of hip pain include:

• Muscle strain
• Bone fracture (such as a fracture of the femoral neck)
• Tendinitis
• Arthritis
• Bone spurs or other malformations of your hip

Parsley also sees a lot of patients with bursitis of the hips. This condition is caused when bursae, small fluid-filled sacks that act as cushions in parts of your body where there is friction between muscles, bones, and tendons, become inflamed or damaged from injury or infection.

One of the most common forms of bursitis is trochanteric bursitis (pain on the outside of your hip), but there are bursae in other parts of your hip as well. For example, there is one under the iliopsoas muscle in the front of your hip.

The hip is a complicated mechanism and therefore hip pain can originate in many different parts of the joint. Learning the anatomy of your hip will better enable you to pinpoint your pain and work with your doctor to keep it from limiting your life.

Hip Pain Explained – including structures & anatomy of the hip and pelvis.

The sciatic nerve can sometimes be compressed, irritated or entrapped as it runs through the soft tissues of the buttock. Traditionally, sciatic pain (neuralgia) generated from issues within the buttock has been termed “Piriformis Syndrome” (see Figure 5.7 to view the piriformis muscle and the sciatic nerve).

This was based on a finding that in about 20% of the population, all or part of the sciatic nerve runs through the piriformis muscle. Compression of the nerve within the piriformis muscle was thought to be the problem in all cases of nerve related buttock and leg pain that could not be associated with a problem in the back.

It is now thought that this is the case in only a relatively small number of cases and that this condition has been over-diagnosed. So much so, that some believe it does not exist at all.

The term “Deep Gluteal Syndrome”has been suggested recently as an alternative term to piriformis syndrome. It refers to any irritation of the sciatic nerve in the deep gluteal space, beneath the gluteus maximus muscle.

In this space, the sciatic nerve may be compressed or irritated at the level of the piriformis, as it runs over the deep external rotator muscles or by fibrous bands anywhere along its path through the buttock. The nerve can also be irritated as it leaves the pelvis to head down into the thigh.

Here it runs through a tunnel (ischial tunnel), between the outer side of the sitting bone (ischial tuberosity) and the upper thigh bone (femur) (Figure 5.7).

In this tunnel it may be squeezed between the bones or irritated by unhealthy hamstring tendons (tendinopathy).

Cluneal Nerve Neuralgia

Of the cluneal nerves, the superior and inferior are more likely to be at risk of compression.The superior cluneal nerve branches run from the spine, over the top of the back of the pelvis and down into the buttock.

They usually run through fibrous tunnels as they cross the top edge of the pelvis.This is where the small nerves may become compressed or irritated.

This is usually associated with a fairly localised area of pain in the upper buttock, in the region of its skin supply (Figure 5.8).

The inferior cluneal nerve branches run across the lower buttock, right over the sitting bone (ischial tuberosity). They can be compressed and irritated by a hard fall onto the bottom or sitting for prolonged periods on a hard surface, particularly if you don’t have much gluteal muscle bulk to cushion the bone.

Again, associated symptoms are usually fairly localised to the area of skin supply (Figure 5.8). Sometimes the nearby posterior femoral cutaneous nerve can also be affected. Symptoms may then extend into the back of the thigh (see Figure 5.8 for region of this nerve supply).

Anatomy, Bony Pelvis and Lower Limb, Hip Joint – StatPearls

Introduction

The hip joint is a ball and socket joint that is the point of articulation between the head of the femur and the acetabulum of the pelvis. The joint is a diarthrodial joint with its inherent stability dictated primarily by its osseous components/articulations.  The primary function of the hip joint is to provide dynamic support the weight of the body/trunk while facilitating force and load transmission from the axial skeleton to the lower extremities, allowing mobility.[1][2][3]

Structure and Function

The hip joint connects the lower extremities with the axial skeleton. The hip joint allows for movement in three major axes, all of which are perpendicular to one another. The location of the center of the entire axis is at the femoral head. The transverse axis permits flexion and extension movement. The longitudinal axis, or vertically along the thigh, allows for internal and external rotation. The sagittal axis, or forward to backward, allows for abduction and adduction.[4][5]

In addition to movement, the hip joint facilitates weight-bearing. Hip stability arises from several factors. The shape of the acetabulum. Due to the depth of the acetabulum, it can encompass almost the entire head of the femur. There is an additional fibrocartilaginous collar surrounding the acetabulum, the acetabular labrum, which provides the following functions:

• Load transmission

• Negative pressure maintenance (i.e., the “vacuum seal”) to enhance hip joint stability

• Regulation of synovial fluid hydrodynamic properties

Hip joint capsule and capsular ligaments

In general, the hip joint capsule is tight in extension and more relaxed in flexion.  The capsular ligaments include the iliofemoral ligament (Y ligament of Bigelow), and the pubofemoral and ischiofemoral ligaments.  The iliofemoral ligament is the strongest ligament in the body and attaches the anterior inferior iliac spine (AIIS) to the intertrochanteric crest of the femur.  The pubofemoral ligament prevents excess abduction and extension, ischiofemoral prevents excess extension, and the iliofemoral prevents hyperextension.

The ligamentum teres (ligament of the head of the femur) is located intracapsular and attaches the apex of the cotyloid notch to the fovea of the femoral head. The ligamentum teres serves as a carrier for the foveal artery (posterior division of the obturator artery), which supplies the femoral head in the infant/pediatric population. This relative vascular contribution to the femoral head blood supply is negligible in adults. Injuries to the ligamentum teres can occur in dislocations, which can cause lesions of the foveal artery, resulting in osteonecrosis of the femoral head. 

Embryology

By gestational age weeks 4 to 6, the hip joint begins to develop from mesoderm. By seven weeks gestational age, a cleft forms in the precartilage cells, which are programmed to form the femoral head and acetabulum. By 11 weeks of gestational age, the hip joint has mostly formed. The acetabular cartilage completely encircles the femoral head.

Blood Supply and Lymphatics

There are numerous variations in the blood supply to the hip. The most common variant results in blood supply coming from the medial circumflex and lateral circumflex femoral arteries, each of which is a branch of the profunda femoris (deep artery of the thigh). The profunda femoris is a branch of the femoral artery which travels posteriorly. There is an additional contribution from the foveal artery (artery to the head of the femur), a branch of the posterior division of the obturator artery, which travels in the ligament of the head of the femur. The foveal artery helps avoid avascular necrosis with disruption of the medial and lateral circumflex arteries. There are two significant anastomoses. The cruciate anastomosis supports the upper thigh and the trochanteric anastomosis, which supports the head of the femur.

Lymphatic drainage from the anterior aspect drains to the deep inguinal nodes, while the medial and posterior aspects drain into the internal iliac nodes. 

Nerves

The hip joint receives innervations from the femoral, obturator, superior gluteal nerves.[6]

Muscles

Muscles of the hip joint can be grouped based upon their functions relative to the movements of the hip.[1]

• Flexion: Primarily accomplished via the psoas major and the iliacus, with some assistance from the pectineus, rectus femoris, and the sartorius. 

• Extension: Primarily accomplished via the gluteus maximus as well as the hamstring muscles.

• Medial rotation: Primarily accomplished by the tensor fascia latae and fibers of the gluteus medius and minimus. 

• Lateral rotation: Primarily accomplished by the obturator muscles, the quadratus femoris, and the gemelli with assistance from the gluteus maximus, sartorius, and piriformis.

• Adduction: Primarily accomplished by the adductor longus, brevis, and magnus with assistance from the gracilis and pectineus 

• Abduction: Primarily accomplished by the gluteus medius and minimus with assistance from the tensor fascia latae and sartorius.

Surgical Considerations

Total hip arthroplasty (THA) is an elective procedure for patients with hip pain secondary to degenerative conditions. THA is a highly effective procedure that relieves pain and restores function to improve quality of life. THA is indicated for patients who have failed other conservative methods, including corticosteroid injections, physical therapy, weight reduction, or previous surgical treatments.[7][8]

Approaches

Surgeons can utilize any number of strategies for the THA procedure. The three most common approaches are as follows:

Posterolateral

This is the most common approach for primary and revision THA cases. This dissection does not utilize a true internervous plane. The intermuscular interval involves blunt dissection of the gluteus maximus fibers and sharp incision of the fascia lata distally. The deep dissection involves meticulous dissection of the short external rotators and capsule. Care is necessary to protect these structures as they are later repaired back to the proximal femur via trans-osseous tunnels.

A significant advantage of this approach is the avoidance of the hip abductors. Other benefits include the excellent exposure provided for both the acetabulum and the femur and the optional extensile conversion in the proximal or distal direction. Historically, some studies comparing this approach to the direct anterior (DA) approach have cited higher dislocation rates in the former approach. This data remains inconclusive and controversial as the literature has not established a definitive consensus, especially when comparing the posterior approach technique that utilizes an optimal soft tissue repair at the conclusion of the THA procedure.

Direct Anterior (DA)

The DA approach is becoming increasingly popular among THA surgeons. The internervous interval is between the tensor fascia lata (TFL) and sartorius on the superficial end, and the gluteus medius and rectus femoris (RF) on the deep side. DA THA advocates cite the theoretical decreased hip dislocation rates in the postoperative period and the avoidance of the hip abduction musculature.

The disadvantages include the learning curve associated with the approach, as the literature documents the decreased complication rates after a surgeon surpasses the more than 100-case mark. Other disadvantages include increased wound complications, difficult femoral exposure, the risk of lateral femoral cutaneous nerve (LFCN) paresthesias, and a potentially higher rate of intra-operative femur fractures. Finally, many surgeons need access to a specialized operating table with appropriately trained personnel and surgical technicians to assist in the procedure. Although the latter is not always necessary, learning to do the procedure on a regular operating table also requires a substantial learning curve that one must consider.

Anterolateral

Compared to the other approaches, the anterolateral (AL) approach is the least commonly used approach secondary to its violation of the hip abductor mechanism. The interval exploited includes that of the TFL and gluteus medius musculature; this may lead to a postoperative limp as the tradeoff of a theoretically decreased dislocation rate.

Clinical Significance

Congenital Hip Dislocation/Dysplasia

Also known as developmental dysplasia of the hip, this can arise when there are problems with the development of the hip joint in utero. Risk factors include breech presentation, positive family history, and oligohydramnios. Diagnosis is possible via physical exam with the Barlow and Ortolani maneuvers, which assess joint stability. Additional characteristic findings are leg length asymmetry as well as asymmetric inguinal skin folds.

The ultimate goal of treatment is the open or closed reduction of the femoral head back into the acetabulum. The earlier treatment starts, the better the outcomes. Mild cases can correct spontaneously by two weeks. When subluxation persists for more than two weeks, it indicates the need for treatment. Standard treatment is the use of the Pavlik Harness, which positions the hips into flexion and abduction for six weeks full-time, followed by six weeks part-time.[9]

Traumatic Conditions

Commonly seen in the setting of trauma, posterior dislocation occurs in the setting of high-energy trauma or motor vehicle accidents (MVAs). The femoral head is transmitted posteriorly, injuring the hip joint capsule.  The affected lower extremity presents in a shortened, internally rotated position.  In all traumatic injuries, there is extensive soft tissue injury about the hip joint and capsule, and in the vast majority of presentations, there will be an associated posterior wall (acetabular) fracture and/or femoral head fracture.  The positioning of the hip often determines the associated acetabular injury.

Patients will typically present with significant pain and inability to bear weight. Approximately 10% of cases may have concurrent damage to the sciatic nerve. Treatment consists of both nonoperative and operative measures. In the acute setting, emergent closed reduction is recommended within six hours of the injury.  Following a successful closed reduction, a CT scan can assess and evaluate the extent of associated osseous injuries.  Additionally, the presence of incarcerated fragments in the joint is of utmost importance as appreciably large fragments will not only prevent the complete reduction of the native hip joint but these fragments also potentially can cause further intra-articular damage and chondral injuries secondary to mechanical abrasion and pathologic contact/abutment.

Irreducible dislocations, those with evidence of incarcerated fragments, and delayed presentations are treated via operative open reduction urgently. Open reduction with internal fixation is the recommendation for complex dislocations with evidence of acetabular or femoral fractures.

Osteoarthritis of the Hip

Most commonly presents in adults, greater than 40 years old. Symptoms include pain, disability, ambulatory dysfunction, and stiffness/contracture.  The patient typically feels the pain in the anterior groin, and occasionally involving the buttocks and lateral thigh. Some patients can develop generalized hip referred pain of the knee. It is crucial to consider and/or rule out co-existing lumbar spinous pathology/radiculopathy, and ipsilateral knee conditions. 

The pathogenesis involves wear and tear on the joint cartilage, which over time, leads to decreased protective joint space. As bones begin to rub on one another, they attempt to make up for the lost cartilage and form bone spurs or osteophytes. Nonsurgical treatments involve lifestyle modifications such as weight loss, or minimizing activates that exacerbate pain. Physical therapies, the use of assistive devices, and medications such as NSAIDs, acetaminophen, and corticosteroids also show evidence of effectiveness. For patients whose pain is still irretraceable, surgical intervention may need to be required. Surgical options include osteotomy, hip resurfacing, and total hip replacement.[10]

Continuing Education / Review Questions

Figure

The Hip Joint from behind, Horizontal Fibers, Ischiofemoral Ligament, Spiral fibers. Contributed by Gray’s Anatomy Plates

Figure

Left Hip Joint, Femur, Ischium, Pubis, Ilium, Fovea Capitis, Iliofemoral ligament. Contributed by Gray’s Anatomy Plates

References

1.

Ramage JL, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Sep 17, 2020. Anatomy, Bony Pelvis and Lower Limb, Medial Thigh Muscles. [PubMed: 30521196]

2.

Chang A, Breeland G, Hubbard JB. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 22, 2020. Anatomy, Bony Pelvis and Lower Limb, Femur. [PubMed: 30422577]

3.

Chang C, Jeno SH, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Nov 12, 2020. Anatomy, Bony Pelvis and Lower Limb, Piriformis Muscle. [PubMed: 30137781]

4.

Bordoni B, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 27, 2020. Anatomy, Bony Pelvis and Lower Limb, Thigh Quadriceps Muscle. [PubMed: 30020706]

5.

Glenister R, Sharma S. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 15, 2020. Anatomy, Bony Pelvis and Lower Limb, Hip. [PubMed: 30252275]

6.

Perumal V, Woodley SJ, Nicholson HD. Neurovascular structures of the ligament of the head of femur. J Anat. 2019 Jun;234(6):778-786. [PMC free article: PMC6539739] [PubMed: 30882902]

7.

Arias-de la Torre J, Puigdomenech E, Valderas JM, Evans JP, Martín V, Molina AJ, Rodríguez N, Espallargues M. Availability of specific tools to assess patient reported outcomes in hip arthroplasty in Spain. Identifying the best candidates to incorporate in an arthroplasty register. A systematic review and standardized assessment. PLoS One. 2019;14(4):e0214746. [PMC free article: PMC6443164] [PubMed: 30934024]

8.

Varacallo M, Bordoni B. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Nov 21, 2020. Hip Pointer Injuries. [PubMed: 30855846]

9.

Deak N, Varacallo M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Oct 27, 2020. Hip Precautions. [PubMed: 30725716]

10.

Stirton JB, Maier JC, Nandi S. Total hip arthroplasty for the management of hip fracture: A review of the literature. J Orthop. 2019 Mar-Apr;16(2):141-144. [PMC free article: PMC6403072] [PubMed: 30886461]

90,000 Human thigh muscles anatomy: anterior, posterior, lateral, medial groups

The body is like a puzzle, in which every detail is important for the completeness of the picture. In this article, we will take a closer look at the anatomy of the anterior and posterior muscle groups, as well as the inner and outer parts of the human thigh.

Fabric channels

The femoral triangle is what is placed in the upper region of the limb. It is formed by the adjacent muscles and ligaments.It contains nerves and blood vessels. The connective tissue membrane consists of two plates, between which a channel of the same name is formed, consisting of a pair of holes and three walls.

In this place, catheterization is performed, finger pressing – to stop bleeding.

The thigh muscles are one of the strongest developed in the human body. They hold the torso in an upright position, control the hip and knee joints, are used during various activities, and even at rest.Their correct functioning is extremely important, and any person should know the principle of operation.

For ease of understanding, they are divided into 3 sections. We will analyze each of the points in more detail, and also consider the images.

Front femoral muscles

This group includes mainly the flexor muscles.

Quadruple

Many people know the synonymous name – quadriceps.From the name it is clear that it has 4 “heads”, each of which is considered as an independent link.

Lateral wide

The largest in its section, covers a large anterolateral surface. Goes from the greater trochanter to the patella. Gives a nice roundness to the outer area. Promotes straightening. Most often used when we are doing squats.

Medial broad

Flattened, thick-fiber.It starts from a rough line and ends with a tendon. The beams are directed along an obliquely descending line from the inside to the front. Lunges, jumps, helps to squat, actively works with knee extension.

Direct

The longest presented. Consists of two heads. In the upper part it connects with the pelvic bone, goes down to the knee joint. Takes part in the formation of the circumference of the limb. Works in jumping, pulling to the body.Thanks to her, we can keep our balance.

Intermediate wide

The thinnest, weakest among the rest. Serves as a division of the muscles of the thigh of the lateral group and the medial surface. Lies from the intertrochanteric line going downward. Promotes straightening.

Tailor

The narrowest, longest muscle. It originates from the ilium obliquely. Attaches to the surface of the lower leg. Bends the legs, pulls, turns and presses them to the stomach.

The anterior muscle group plays an extremely important role. It is not so easy to set in motion the most complex bone apparatus. It is a multilevel system that requires coordinated work.

Musculature of the back

Most of the muscles are located here – the flexors.

Double-headed

Thanks to her, we are able to rotate, maintain balance. Presented by two heads:

The first – comes from the ischial tubercle, the second – originates from the lateral zone of the rough line.They are attached to the head of the fibula, located closer to the lateral edge.

Semitendinous

Located in the medial part. It begins in the ischial tuberosity, passes near the knee, attaches to the tuberosity. In the center, it is often interrupted by an oblique tendon bridge. Performs similar actions to the two-headed.

Semi-membranous

The longest and flattest in its class. The initial end is connected to the pelvis, bends around the epicondyle.

It is interesting that it is the muscles of the back surface that are deprived of the proper load. A sedentary lifestyle is inherent in modern people. This leads to less use of them, which leads to an imbalance in development and an increased risk of various injuries, especially the knee. And they are extremely unpleasant, as they restrict movement and take an extremely long time to heal. Re-injury is also possible, which will lead to a longer recovery period.

Inner thigh, muscle names

It is considered the most problematic.The skin here is somewhat thinner, which affects the appearance, especially in the beautiful half of humanity. In addition, sprains and tears often occur here.

Another name is leading. Simply put, the main function is to bring the legs together. Strengthening them is very important, training programs are based on this very action. Let’s consider each in more detail.

Comb

The structure is similar to a quadrangle.Attached to the line of the same name of the femoral region. Located diagonally. Works when running, walking and squatting.

Slim

It is a long bundle located in the pubic area. Crosses the knee and attaches to the tibia. Extends and turns the lower leg. Works in conjunction with other adductors (from the Latin adductor – leading).

Short leading

Flat, small in size, extending from the pubis downward, to a rough line.Flexes and rotates the limb outward. Often injured during sports. It is necessary to warm up so as not to provoke tears and sprains. Healing takes a long time. Pain syndrome is localized in the groin area.

Large adductor

The fibers are deep. Pass from the pubic articulation. Fills the inner space of the femoral area. One of the most difficult to palpate. Its main task is to stabilize the pelvis and align it relative to the lower extremities.This is due to the peculiarities of the fastening. Weakness and underdevelopment leads to hypertonicity and overstrain of neighboring areas.

Long leading

It is flattened and looks like a triangle. Located on the anteromedial side, expands downward. Most convenient for palpation.

Interestingly, adductors are called “guardians of virginity” or “muscles of morality.” Because their increased work and overstrain is associated with dysregulation of sexual activity.This function of “squeezing the legs” leads to the suppression of sexual arousal. It is especially developed in the female sex, as it is a natural defense mechanism.

Outer part

This is the smallest category. But it plays a very important role and makes up the muscles of the thigh of the lateral group.

Fascia Tensioner

Relatively small, flat and slightly elongated. It originates from the pelvic region, goes vertically downward and passes into the ilio-tibial tract.

Participates in flexion, abduction and rotation (rotation). It is actively used when you need to set a stop. Helps in maintaining knee stability. The defeat leads to the onset of pain in the deep parts, which are difficult to differentiate.

Pelvis structure

It is represented by a fairly abundant and varied number of elements that perform many different actions. The muscles of the anterior group of the human thigh work together with the pelvic muscles, their structure and functions:

1. Tube:

• Iliopsoas.Divided into a couple of components. Plays a significant role in the performance of weightlifting exercises, maintains an upright body position, and also works when running, walking. It is an element of the abdominal press. It is one of the most powerful flexors around.

• Pear-shaped. Controls rotation during movement, holds the head of the femur in the acetabulum. The shape and size may vary from individual to individual. It passes through the sciatic foramen, but does not completely fill it, leaving small gaps for blood vessels and nerves.This anatomical structure leads to the possibility of myofascial syndrome, we will talk about it a little later.

• Internal locking. Flattened, fan-shaped bundles forming the channel of the same name. Rotates the limb.

2. Outer layer:

• Large, medium, small gluteus. They are located under each other.Participate in the abduction.

• External locking. Has the shape of an irregular triangle. It is attached next to the muscle of the same name and performs similar functions.

Problems of the femoral muscles

Spasms, pain, discomfort are not uncommon for most of us. Many are faced with this or that problem. There may be one symptom, but there are many reasons. This condition occurs due to injuries, insufficient warm-up and overload.It is important to take sports seriously. Be sure to study the relevant literature or consult trained trainers. The muscles of the anterior and posterior inner thighs, their anatomy and functions are very diverse, as are the problems with them.

DOMS or delayed muscle pain syndrome

Quite common among athletes. Unpleasant sensations arise due to increased physical activity. It usually appears after 8-12 hours.Disturbing at rest and when using overstrained muscles. Another striking sign is a decrease in stamina.

Why does it happen and how dangerous is this condition

For a long time, the pathology was associated with the irritating effect of lactic acid. Anabolic loads promote glucose oxidation and the active release of metabolic products. In trained people, this process is practically not manifested.

However, recent research has led to a new theory that is considered the most reliable.According to her, the reason is a change in the structure of the muscles and the occurrence of inflammation as a result. Muscle fibers are composed of myofibrils. These elements provide the strength and speed of the contraction. It is their deformation that occurs.

At the initial stage of playing sports, such a reaction is understandable and normal. In other cases, overexertion does not benefit the body. To prevent this, you need to thoroughly warm up, objectively assess your training. Conventional anti-inflammatory drugs can help relieve symptoms.

It is important to correctly differentiate this condition.

Myositis

This is inflammation of the muscle tissue. The main symptom is severe pain and weakness, there may be such concomitant manifestations: reddening of the skin, swelling, fever of the whole body. This happens due to: various injuries, hypothermia, vascular disorders or defects of the spine.

If such symptoms are found, you should consult a specialist.Only he will be able to make the correct diagnosis and prescribe treatment. As a possible surgical intervention.

Breaks

The thigh muscles are most susceptible to this action. It is characterized by limited mobility, sharp pain immediately after a blow or excessive exertion. An extremely dangerous condition. Some of its types require surgical intervention.

Stretching

Improper training or falls often provoke deformation.Unpleasant sensations can be accompanied by hematomas or even a “click”, this indicates a strong injury.

First of all, you need to apply a compress for 15–20 minutes. Ice or a cloth soaked in cold water is suitable for this. Then make a fixation bandage, using an elastic bandage or compression stockings. This will reduce swelling. Try to restrict movement. If it does not get better within 24 hours, contact the clinic.

Hypotrophy

This is a condition that occurs as a result of metabolic disorders.The muscles are literally starving. Quite a dangerous disease that can lead to disability.

The main reason is inadequate intake of nutrients. This is due to: burns, hypothermia, intoxication, prolonged shift, and can also be a congenital pathology. Symptoms are as follows: increased pain, weakness, inability to perform the usual action, loss of body weight. Which leads to discomfort. Complex measures are used to solve the problem.Eliminate the primary factor, stimulate trophism, normalize metabolic processes.

At the “I Want to Walk” prosthetics center, we offer rehabilitation and adaptation to children with musculoskeletal disorders, give them the opportunity to join a full and vibrant life in society, show their abilities and talents, and master everyday and professional skills.

Piriformis syndrome

This is a neurological pathological manifestation characterized by a pulling action in the area of ​​the buttocks and lower extremities.This can also lead to numbness, burning, and increased tension in the knee area.

Occurs due to compression of the sciatic nerve. This can be provoked by: hypothermia, physical activity, an incorrectly delivered injection, a defect in the spine or hip joint, muscle strain.

It is extremely difficult to independently determine the correct diagnosis. Better to leave it to a qualified technician. He will palpate, reveal painful foci and flattening.In the absence of serious pathology, a few days of rest will be enough, in some cases, drug treatment, exercise therapy or massage are prescribed. Learn more about how to get rid of a spasm here.

Iliopsoas syndrome

Disease of a tonic nature, the cause is injury to the fiber or adjacent places. However, this effect can affect innervation. Which leads to loss of sensation and motor function.

The clinical picture is very striking: involuntary contractions, weakness on the affected side, especially in the hip girdle. In this case, vigorous activity is impossible.

The pain can be localized in different places. In the intestines, legs, lower back, while in the supine position, it completely disappears.

It is treated with specially designed exercises that should only be performed as directed. They relieve tension, improve the general condition of the patient, promote relaxation, restore tone and blood circulation.And it is also possible to use drug therapy.

Output

Our body is arranged in the most amazing way. Human anatomy is mesmerizing, striking in its thoughtfulness in the smallest detail. Its understanding is most essential for athletes. This allows you to create an effective and safe training plan. Gives an understanding of how to do it correctly, indicates the importance of warm-up, moderate strength loads, so that the exercises do not harm. For ordinary people, this helps to differentiate between symptoms and the occurrence of discomfort.It is important to know the name of the anterior, posterior and internal thigh muscles, and everyone needs to take care of their health. You should not start negative manifestations, delay the visit to the hospital. Early diagnosis can prevent serious complications.

Used literature

• Vasiliev PA – “Atlas of Human Muscles”.

• Boris AI – “Anatomical Atlas. Fundamentals of the structure and physiology of man. “

FUNCTIONAL ANATOMY OF THE MUSCULAR SYSTEM | HIP EXPANSION

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LOWER LIMB MUSCLES – HIP EXTENSORS

Hip extension involves the muscles that cross the hip joint. These muscles go both from the pelvis to the thigh and from the pelvis to the lower leg.

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Hip extension

biceps femoris;

semitendinosus;

semi-membranous;

large leading.

1. The gluteus maximus is located on the back of the hip joint. In humans, this muscle is well developed, since with its tension it keeps the body in an upright position.

Gluteus maximus :

• Extends and supines the thigh.
• With a fixed hip, it extends the pelvis in relation to the hip.

2. The biceps femoris is located on the outside of the back of the thigh.In the muscle, two heads are distinguished – long and short.

Biceps femoris :

• With a fixed pelvis, it extends the thigh.
• With a fixed hip flexes and supines the lower leg.

3. The semitendinosus muscle is located on the back of the thigh from the inside.

Semitendinosus muscle :

• Extends the thigh and flexes the lower leg
• As the lower leg flexes, participates in its pronation.

4. Semi-membranous muscle begins on the ischial tuberosity. Located behind the semitendinosus muscle, it attaches to the medial condyle of the tibia.

Semi-membranous muscle :

• Extends the thigh and flexes the lower leg.
• As the lower leg is flexed, it participates in its pronation
• With the lower leg fixed, the semimembranous muscle tilts the pelvis backward, and also fixes it to the thigh, preventing forward bending.

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• The long head of the biceps femoris, semitendinosus and semimembranous – are bicarticular muscles. They can produce hip extension with the lower leg fixed in the knee joint.
• When the lower leg is bent (for example, when walking), these muscles cannot perform extension of the hip joint, since they hold the lower leg.
• The main muscle that produces extension in the hip joint is the gluteus maximus, especially when climbing a mountain, climbing stairs, getting up from a chair.

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SOURCES:

• Human Anatomy (with the basics of dynamic and sports morphology): Textbook for institutes of physical culture. – Ed. 14th. / Under. ed. B.A. Nikityuk, A.A. Gladysheva, V.F.Sudzilovsky. – M .: Sport, 2018 .– 624 p., Ill.

Posterior thigh muscles. Anatomy and kinesiology of the hip joint extensors. (Lecture 3)

Details

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Category: Scientific Fitness

Created: 15 July 2016

Heading “Kinesiology” .In this article, we will look at the anatomy, innervation, function and kinesiology of the main hip extensors: the biceps femoris, semitendinosus, semimembranosus, gluteus maximus. Biomechanical movements of the lower limb girdle in space.

The main extensors of the hip joint are:

• biceps femoris, semitendinosus and semimembranosus
• gluteus maximus muscle.

Fig.1

Biceps femoris (Fig. 1 and 2) (Latin Musculus biceps femoris), each of the two heads has its own beginning, attaches to the fibula.
Located on the lateral edge of the back of the thigh. In the muscle, two heads are distinguished – long and short. The long head (Latin caput longum) starts from the ischial tuberosity with a small flat tendon; short head (lat.caput breve) – from the lateral lip of the rough line along the lower half of the thigh.
Both heads, joining together, form a powerful abdomen, which, going down, passes into a long, narrow tendon. The latter, having rounded the lateral epicondyle behind, is attached to the head of the fibula. Part of the bundles, going horizontally, is fixed to the edge of the upper articular surface of the fibula, and part, heading slightly down, is woven into the fascia of the leg

Function:

extends the thigh, flexes the lower leg.
With a strengthened lower leg, the trunk is extended together with the gluteus maximus muscle.When the knee is bent, the same muscles rotate the lower leg, contracting separately on one side or the other. The biceps femoris rotates the lower leg outward

Innervation:

long head – from the tibial nerve (Latin n. Tibialis) and n.ischiadicus (SI — SII), short — from n.peroneus communis and n.ischiadicus (LIV — LV; SI))

Fig. 2

Semitendinosus muscle (Fig. 1 and 2) (Latin Musculus semitendinosus) originates from the ischium, attaches to the tibia, and is located closer to the medial edge of the posterior surface of the thigh.Its outer side is bordered by the biceps femoris, the inner side is bordered by the semi-membranous. The proximal muscle is covered by the gluteus maximus muscle.
In the middle, the muscle is often interrupted by an oblique tendon bridge. Starting from the ischial tuberosity, it follows downward, passes into a long tendon, which, having rounded the medial epicondyle of the thigh, follows to the anteromedial surface of the tibia, attaching itself to its tuberosity. Part of the end bundles of the tendon is woven into the fascia of the lower leg.
The tendon of the muscle at the site of its attachment, together with the tendon of the fine and sartorius muscles, forms a triangular tendon extension that connects to the fascia cruris, the so-called superficial crow’s feet (lat.pes anserinus superficialis).

Function:

extends the thigh, flexes the lower leg. Since the muscles of the posterior group of muscles of the thigh are thrown over two joints, then with a fixed pelvis, they, acting together, bend the lower leg at the knee joint, unbend the thigh, and with a strengthened lower leg, they extend the trunk together with the gluteus maximus muscle.When the knee is bent, the same muscles rotate the lower leg, contracting separately on one side or the other. The semitendinosus muscle rotates the lower leg inward

Innervation:

muscle branches of the sciatic nerve (lat. N. Ischiadicus) (LIV-LV; SI)

Fig. 3

Semi-membranous muscle (Fig. 1, 2, 3) (Latin Musculus semimembranosus) originates from the ischium, attaches to the tibia.
Located along the medial edge of the back of the thigh.The outer edge of the muscle is covered with a semitendinosus muscle (Latin Musculus semitendinisus), which leaves an imprint in the form of a longitudinal wide groove. The inner edge is free.
Begins from the ischial tuberosity. Heading downward, it passes into a flat tendon, which then narrows. It goes around the medial epicondyle and goes to the medial surface of the tibia. At this point, the tendon becomes wider and divides into three bundles. The internal bundle, located horizontally, ends on the medial condyle of the tibia, the middle bundle also reaches the medial condyle, passing into the fascia that covers the popliteal muscle; the external bundle, approaching the capsule of the knee joint, passes into the knee ligament

Function:

Extends the thigh, flexes the lower leg.Since the muscles of the posterior group of muscles of the thigh are thrown over two joints, then with a fixed pelvis, they, acting together, bend the lower leg at the knee joint, unbend the thigh, and with a strengthened lower leg, they extend the trunk together with the gluteus maximus muscle. When the knee is bent, the same muscles rotate the lower leg, contracting separately on one side or the other. The semi-membranous muscle rotates the lower leg inward.

Innervation:

muscle branches of the sciatic nerve (lat.n. ischiadicus) (LIV-LV; SI)

The gluteus maximus is also a hip extensor, you can read about it in detail here

Functional Anatomy:

There are two main groups of extensor muscles: the muscles of the first group are attached to the thigh, and the second – in the area of ​​the knee joint (Fig. 4).

In the first group, the most important muscle is the gluteus maximus 1 . This is the most powerful (its capacity is 34 kg, and the contraction length is 15 cm) and the largest (66 cm2 at the cross section) muscle of the body.Accordingly, she is the strongest (her static strength is equivalent to 238 kg). She is helped by the most posterior fibers of the middle 2 and small 3 gluteal muscles. These muscles are also external rotators.
The second muscle group is represented mainly by the ischio-femoral muscles, namely the biceps femoris 4 , semitendinosus 5 and semimembranosus 6 muscles. Their capacity is equivalent to 22 kg, i.e. 66% of the power of the gluteus maximus muscle.They are bicarticular muscles, so their effectiveness on the hip joint depends on the position of the knee joint. Fixation of the knee joint in the extension position enhances their extensor function in the hip joint, which indicates the presence of synergy between the ischio-femoral and quadriceps femoris muscles (especially with the rectus muscle). This group also includes some adductor muscles, especially the large adductor muscle 7 , which is also involved in hip extension.
The extensor muscles of the thigh can also perform other (secondary) functions depending on their position in relation to the anteroposterior axis YY ‘for adduction and abduction:
Muscles extending upward from the YY axis’ provide abduction together with extension, such as with the dance step shown in (Fig. 5). The most posterior fibers of the small 3 and the middle 2 gluteal muscles and the uppermost fibers of the gluteus maximus 1 are involved here.
Muscles running downward from the YY ‘axis provide abduction and extension, as in the movement shown in (Fig.6). These are the ischio-femoral muscles, adductors (those that lie behind the frontal plane) and the largest part of the gluteus maximus 1 .
To provide a “clean” extension (fig. 7), i. E. without combined adduction or abduction, the two muscle groups contract, acting as synergists and antagonists.

The extensor muscles of the thigh play an essential role in stabilizing the pelvis in the anteroposterior direction (Fig. 8):
When the pelvis is tilted posteriorly (Fig. 8 a), i.e. in the direction of extension, it is stabilized only by the tension of the Iliofemoral ligament IF, which limits extension.
There is a position (Fig. 8 b) in which the center of gravity of the C pelvis is located directly above the center of the hip joint. In this case, the flexors and extensors are inactive, and the balance is unstable.

Fig. 8
When the pelvis is tilted anteriorly (Fig. 8c), the center of gravity C is in front of the transverse axis of the hip joints, and the ischio-femoral muscles IJ contract first to straighten the pelvis.
If the inclination of the pelvis increases anteriorly (Fig.8d), then the gluteus maximus F and the ischio-femoral muscles contract, which are more effective the more extension in the knee joint (standing, in the forward tilt position, fingers touch the feet) …

Kinesiology

Concentric contraction of these muscles leads to extension of the hip joint, such as when lifting the legs from a prone position, face down. They are also activated to control eccentric hip flexion (for example, movement during the downward movement of the squat).
During normal walking and other low-intensity movements, the hamstrings are the main activators for hip extension, since there is little activity in the gluteus maximus muscle.With a higher intensity of physical activity (for example, climbing stairs, sprinting, doing exercises on a bicycle ergometer), which requires a greater range of motion of the hip joint and more powerful extension of the hip joint, the gluteus maximus muscle begins to play a major role. When doing step aerobics, the gluteus maximus muscle tends to contract along with the constantly active hamstrings; other types of physical activity, such as jumping rope, “riding” a bicycle indoors, strenuous walking in mountainous terrain, also activate the gluteus maximus muscle.If one of your client’s goals is to have “steel muscles”, be sure to include medium to high intensity exercises that involve hip extension and hyperextension in their training program. When choosing the types of physical activity that cover the gluteus maximus muscles, choose such exercises that would involve the extension of the hip joint by about 90%. These activities are more intense and require full engagement of the gluteus maximus muscles to provide the extra effort needed to help the hamstrings perform their intended purpose.

Source: Applied Anatomy.
“Lower limb. Functional anatomy”
A.I. Kapanji

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Thigh muscles (human anatomy)

content…. 79 80 81 82 83 84 85 86 87 88 89 .. Muscles of the free lower limb (human anatomy) Thigh muscles (human anatomy) On the thigh, three muscle groups are considered: anterior – extensor muscles (see.fig. 4 65), back – flexor muscles (see Fig. 66) and medial – adductor muscles. Fig. 66. External muscles of the pelvis and lower limbs (rear view). one – gluteus maximus muscle; 2 – ilio-tibial tract; 3 – biceps femoris; 4 – semi tendon muscle; 5 – semi-membranous muscle; 6 – gastrocnemius muscle; 7 – tendon of the triceps muscle of the lower leg (Achilles tendon) Anterior group – extensor muscles .1. Quadruple thigh muscle , m. quadriceps femoris, occupies the entire front thigh surface, begins with 4 heads, of which the rectus muscle, m. rectus femoris, is isolated, and the other three are medial, lateral and intermediate, mm. uasti medialis, lateralis, intermedius, not separated between themselves. In the distal thigh, all parts of the quadriceps muscle form a common tendon that encloses the patella and attaching to tuberositas tibiae by means of a tight ligament patella – lig.patellae. Each head has its beginning: straight thigh muscle – from spina iliaca anterior superior, external broad muscle – from the lateral lip of the rough thigh line, inner wide – from the medial lip of the rough thigh line and from the medial intermuscular partitions, intermediate wide – from the front of the thigh. Function: unbends the lower leg; m. rectus femoris flexes the hip. Innervation: L II-III , femoral nerve. 2. Tailor muscle , m. sartorius, the longest, starts from spina iliaca anterior superior, goes obliquely downward and medially, attaches to tuberositas tibiae. Function: flexes the thigh and lower leg, rotates the bent lower leg inward. Innervation: L I-III , femoral nerve. Posterior group – flexor muscles . one. Biceps femoris , m. biceps femoris, occupies a lateral position. Her two heads: long, caput longum, extending from the ischial tuberosity, and short, caput breve, – from the lower parts of the lateral lip of the rough thigh line and lateral intermuscular septum, form a common abdomen, tendon which attaches to the head of the fibula. Function: with a fixed pelvis, flexes the lower leg and extends the thigh. Innervation: L IV-V -S I , sciatic nerve. 2. Semitendinous muscle , m. semitendinosus, starts from the ischial tuberosity, goes down and medially, along its length, it is crossed by a tendon plate, intersectio tendinea, and attaches to tuberositas tibiae, forming together with the tendons of m. sartorius and m. gracilis superficial goose paw, pes anserinus superficialis. Function: with a fixed pelvis, flexes the lower leg and extends the thigh. Innervation: L V -S I-II , sciatic nerve. 3. Semi-membranous muscle , m. semimembranosus, starts from the ischial tuberosity flat, thin long tendon, goes down and somewhat medially; at the level knee joint, her tendon is divided into three bundles, forming a deep crow’s foot, pes anserinus profundus.Largest bundle attached to the medial tibial condyle, the other two go: one to lig. popliteum obliquum of the knee joint, the other – in fascia m. popliteus. Function: with a fixed pelvis, it extends the thigh, flexes the lower leg, the bent lower leg rotates inward. Innervation: L IV -S I , sciatic nerve. Medial group – adductor muscles .The medial group (see Fig. 65) is made up of 5 muscles adducting the thigh: mm. pectineus, adductores longus, brevis et magnus, gracilis. Scallop muscle, m. pectineus, and long adductor muscle, m. adductor longus, start from ramus superior ossis pubis. Thin muscle, m. gracilis, and short adductor muscle, m. adductor brevis, from ramus inferior ossis pubis, adductor muscle, m. adductor magnus, – from ischial tuberosity and the outer surface of the branches of the ischial and pubic bones.All muscles of the medial group attach to the labium mediale linea aspera, except m. gracilis joining tuberositas tibiae. IN tendons m. adductor magnus has a tendon opening, hiatus tendineus, for the passage of the femoral vessels into the popliteal pit. Function: lead and flex the hip; m. gracilis further flexes shin and rotates it inward. Innervation: L II-V , obturator nerve. content .. 79 80 81 82 83 84 85 86 87 88 89 ..

MRI hip: Detailed Anatomy

1, Iliac muscle.2, Rectus abdominis muscle. 3, Ilium. 4, gluteus medius 5, gluteus minimus. 6, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Iliac vessels. 3, Small intestine. 4, Tailor muscle. 5, Piriformis muscle (m. Piriformis) 6, Rectum. 7, Gluteus minimus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Iliac muscle.3, Rectus abdominis muscle. 4, Tailor muscle. 5, Gluteus minimus muscle. 6, Gluteus maximus muscle. 7, Piriformis muscle (m. Piriformis) 8, gluteus medius muscle.

1, Inferior anterior iliac spine. 2, Rectus abdominis muscle. 3, the muscle is the tensioner of the wide fascia of the thigh. 4, gluteus medius muscle. 5, Internal obturator muscles. 6, Gluteus maximus muscle. 7, Gluteus minimus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh.2, Tailor muscle. 3, Iliopsoas muscle. 4, Iliac vessels. 5, Bladder. 6, gluteus medius muscle. 7, Gluteus minimus muscle. 8, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Tailor muscle. 3, Iliac vessels. 4, Bladder. 5, gluteus medius muscle. 6, Gluteus minimus muscle. 7, Rectum. 8, Gluteus maximus muscle.

1, Tailor muscle.2, Iliac vessels. 3, Bladder. 4, Iliopsoas muscle. 5, the muscle is the tensioner of the wide fascia of the thigh. 6, gluteus medius muscle. 7, Sacrum. 8, Gluteus maximus muscle.

1, Right of the femoral head. 2, Femoral blood vessels. 3, Bladder. 4, Iliopsoas muscle. 5, Tailor muscle. 6, muscle is a tensioner of the fascia lata of the thigh 7, Rectum. 8, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh.2, Rectus femoris muscle. 3, Tailor muscle. 4, Bladder. 5, iliopsoas muscle 6, gluteus medius. 7, Internal obturator muscles. 8, Rectum. 9, Gluteus maximus muscle. 10, Femoral head.

1, gluteus medius muscle. 2, Rectus femoris muscle. 3, Bladder. 4, Iliopsoas muscle. 5, Tailor muscle. 6, muscle is a tensioner of the fascia lata of the thigh 7, Gluteus maximus muscle.8, Femoral head.

1, gluteus medius muscle. 2, Rectus femoris muscle. 3, Femoral blood vessels. 4, Bladder. 5, Iliopsoas muscle. 6, Tailor muscle. 7, the muscle is the tensioner of the fascia lata of the thigh. 8, Femoral head. 9, Internal obturator muscles. 10, Gluteus maximus muscle.

1, Tailor muscle. 2, Iliopsoas muscle.3, gluteus medius muscle. 4, Gluteus maximus muscle. 5, Internal obturator muscles. 6, Sciatic-rectal fossa. 7, Right of the femoral head.

1, Rectus femoris muscle. 2, Femoral blood vessels. 3, Bladder. 4, Iliopsoas muscle. 5, Tailor muscle. 6, muscle is a tensioner of the fascia lata of the thigh 7, gluteus medius muscle. 8, Internal obturator muscles. 9, Sciatic-rectal fossa. 10, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Iliopsoas muscle. 3, Bladder. 4, Femoral blood vessels. 5, Tailor muscle. 6, Rectus femoris muscle. 7, gluteus medius muscle. 8, Left femoral head. 9, Internal obturator muscles. 10, Quadrilateral plate. 11, Posterior pillar. 12, Gluteus maximus muscle. 13, Greater skewer.

1, the muscle is the tensioner of the wide fascia of the thigh.2, Rectus femoris muscle. 3, Femoral blood vessels. 4, Bladder. 5, Iliopsoas muscle. 6, Tailor muscle. 7, Femoral neck. 8, Internal obturator muscles. 9, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Rectus femoris muscle. 3, Femoral blood vessels. 4, Tailor muscle. 5, Gluteus maximus muscle. 6, Internal obturator muscles. 7, square femoris muscle.8, Greater skewer.

1, Femoral neck. 2, Femoral blood vessels. 3, Bladder. 4, Tailor muscle. 5, Rectus femoris muscle. 6, muscle is a tensioner of the fascia lata of the thigh 7, Gluteus maximus muscle. 8, Internal obturator muscles.

1, Rectus femoris muscle. 2, Femoral blood vessels. 3, Comb muscle. 4, Tailor muscle. 5, Iliopsoas muscle.6, square femoris muscle. 7, Internal obturator muscles. 8, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Rectus femoris muscle. 3, Tailor muscle. 4, The pubic symphysis. 5, Femoral blood vessels. 6, Iliopsoas muscle. 7, square femoris muscle. 8, Internal obturator muscles. 9, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh.2, Rectus femoris muscle. 3, The pubic symphysis. 4, Iliopsoas muscle. 5, square femoris muscle. 6, External obturator muscle. 7, Internal obturator muscles. 8, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Rectus femoris muscle. 3, The external obturator muscle. 4, The pubic symphysis. 5, Comb muscle. 6, Iliopsoas muscle. 7, square femoris muscle. 8, Internal obturator muscles.9, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Iliopsoas muscle. 3, Femoral blood vessels. 4, Tailor muscle. 5, Rectus femoris muscle. 6, square femoris muscle. 7, External obturator muscle. 8, Ischial tubercle. 9, Semi-membranous muscle. 10, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Iliopsoas muscle.3, Comb muscle. 4, The pubic symphysis. 5, Tailor muscle. 6, Rectus femoris muscle. 7, broad lateral thigh muscle. 8, External obturator muscle. 9, square femoris muscle. 10, Gluteus maximus muscle.

1, the muscle is the tensioner of the wide fascia of the thigh. 2, Rectus femoris muscle. 3, Tailor muscle. 4, Comb muscle. 5, Femoral blood vessels. 6, Iliopsoas muscle. 7, broad lateral thigh muscle.8, Gluteus maximus muscle.

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Hip flexor muscles: anatomy

Muscular system. Flexion of the hip is provided by the muscles

01. Flexion of the hip is provided by muscles:

1 ) square thighs

2) locking

3) iliopsoas

4) gluteal

02. The actual respiratory muscles are:

1) large chest

2 ) intercostal

3) diaphragm

4 ) subclavian

03.Muscles that erect the spine are referred to as muscles:

1) breast

2) belly

3) back

4) pelvis

04. Extension of the foot and toes is provided by the calf muscle group:

1) back

2) medial

3) front

4) lateral

05. The muscle belongs to the back muscle group of the shoulder:

1) double-headed

2) instep support

3) three-headed

4) pronator

06.The masticatory muscles are:

1) chewable

2 ) temporal

3 ) zygomatic

4) pterygoid

07. The muscles lowering the lower jaw are:

1) maxillary-hyoid

2) chewing

3) chin-sublingual

4) temporal

08. The muscles of the chest are:

1) diamond-shaped

2) subclavian

3) front toothed

4) widest

09.The superficial muscles of the neck include:

1) digastric

2) Sternocleidomastoid

3) sternohyoid

4) stylohyoid

10. Adductor thigh muscle group:

1) posterior thigh group

2) gluteal muscles

3) medial thigh group

4) square femoris

11. The white line of the abdomen is formed by:

1) Internal oblique

2) rectus abdominis

3) square muscle of the lower back

4) transverse muscle

12.The deep muscles of the back include:

1) erector spine

2) trapezius muscle

3) internal intercostal muscles

4) lower posterior dentate muscle

13. Find the correspondence of muscles to their groups:

1) trapezoidal a) muscles of the side wall of the abdomen

2) internal oblique muscle of the abdomen b) anterior thigh group

3) sternocleidomastoid c) superficial muscles of the neck

4) quadriceps muscle d) superficial muscles of the back

1d, 2a, 3c, 4b

14.Find the correspondence of a muscle and its function:

1) the gluteus maximus muscle a) tilts the body forward

2) rectus abdominis muscle b) hip extension

3) serratus anterior muscle c) raises the lower jaw

4) chewing muscle d) raises the arm

1b, 2a, 3d, 4c

15. Insert the missing word:

The muscles of inspiration include the external intercostal muscles, short and long muscles, lifting the ribs and __________________________.

(Orifice diaphragm)

16. Insert the missing word:

The diaphragm has holes for the passage of a number of anatomical structures: the aortic, the opening of the inferior vena cava and _______________.

(Oesophageal lead)

17. Find the correspondence of the muscle and its function:

1) the buccal muscle a) lowers the hyoid bone

2) sternohyoid muscle b) brings the cheek closer to the teeth

3) tibialis anterior muscle c) flexes the foot

4) tibialis posterior muscle d) extends the foot

1b, 2a, 3d, 4c

18.Is the saying true:

The muscles of the thigh, surrounding the thigh bone, form the anterior, posterior and lateral groups.

1. Yes 2. No

19. Is the statement true:

The inguinal canal is a paired slit-like space 4-5 cm long in the thickness of the anterior abdominal wall in the groin region, in which the spermatic cord is located in men, and the round ligament of the uterus in women.

1. Yes 2. No

20. Insert the missing word:

Mimic muscles have two features: they start from the bones, and are attached to the skin of the face and do not have ___________________, therefore, when they contract, they move the skin areas, causing facial expressions.

(Hole fascia)

21 Pi contraction of the diaphragm occurs:

1) inhalation

2) exhalation

Hip adduction

Hip abduction

Hip Extension

Hip Flexion

Muscles that produce movements in the hip joint

BIOMECHANICS OF THE LOWER LIMB MUSCLES

The muscles of the lower limb perform movements in the hip, knee, ankle and foot joints.

Correspondingly to the three mutually perpendicular axes of rotation passing through the center of the hip joint, in this joint the thigh with the pelvis fixed, and together with it the whole leg, the following movements can be performed:

1) flexion and extension, i.e. forward and backward movement;

2) abduction and adduction;

3) pronation and supination;

4) circular motion (circumduction).

When securing the thigh or the entire leg, the muscles perform pelvic movements: forward, backward, to the sides and turns to the right and left.

There are six functional muscle groups in the hip joint for these movements.

The muscles that flex the hip in the hip joint are the muscles that cross the transverse axis of this joint and are located in front of it.

Muscles that produce movements in the hip joint

These include:

1) ilio-lumbar;

2) tailor;

3) moushscha-tensioner of the broad fascia,

1) 4) comb;

4) rectus femoris muscle.

Muscles that also cross the transverse axis of the hip joint, but are located behind it, take part in hip extension. These muscles go both from the pelvis to the thigh and from the pelvis to the lower leg. These include:

1) gluteus maximus;

2) biceps femoris;

3) semitendinosus:

4) semi-membranous;

5) large leading

The abductor thigh muscles cross the sagittal axis of the hip joint and are located on its lateral side. They are attached mainly to the greater trochanter.

These muscles include:

1) middle gluteal;

2) small gluteal;

3) pear-shaped;

4) internal locking;

5) twin;

6) muscle-tensor of the wide fascia.

Adduction of the thigh is carried out by the muscles that cross the sagittal axis of the hip joint and are located medially from it. These include:

1) comb;

2) thin;

3) long leading;

4) short leading;

5) large leading.

Muscles supinating the thigh, except for the iliopsoas.

cross the vertical axis of the hip joint obliquely. The iliopsoas muscle supines the thigh due to the special location of the lesser trochanter (not only in front, but also medially).

The muscles that supine the thigh include:

1) ilio-lumbar;

2) square muscle of the thigh;

3) gluteal muscles, of which the middle and small supinate the thigh only with their posterior bundles;

4) tailor;

5) internal obturator and external obturator muscles;

6) pear-shaped;

7) twin.

Shoulder abduction

The muscles abducting the shoulder cross the sagittal axis of rotation in the shoulder joint and are located laterally from it. Shoulder bone abduct muscles:

1) deltoid and

2) supraspinatus.

Deltoid muscle (see Fig. 54) starts from the clavicle (anterior part of the muscle), acromion (middle part) and spine of the scapula (posterior part), and attaches to the deltoid tuberosity of the humerus.

In shape, this muscle is somewhat reminiscent of the inverted Greek letter “delta”, from where it came to the title.

The function of the deltoid muscle is as follows. If the front, then the rear part of it works alternately, then the upper limb moves forward and backward, i.e. flexion and extension.

Productive movements in the girdle of the lower extremities

If the muscle is strained as a whole, then its anterior and posterior parts form a resultant, the control of which coincides with the direction of the fibers of the middle part of the muscle, contributing to the abduction of the shoulder to a horizontal level.

The deltoid muscle has numerous layers of connective tissue, in relation to which individual muscle bundles go at a certain angle, which makes the muscle a multiperis one, increasing its lifting force.

Since the muscle is attached to the deltoid tuberosity, located laterally and in front of the humerus, the muscle can also participate in rotations of this bone around the vertical axis, namely: the anterior part of the muscle not only raises the arm anteriorly (flexes), but also penetrates her, and the posterior part not only unbends, but also supines.

If the front part contracts together with the middle part, then according to the rules of the parallelogram of forces, the muscle flexes and slightly moves the arm to the side. If the middle part contracts together with the back, then the arms are extended and abducted simultaneously.

When hanging on straight arms, the deltoid muscle fixes the belt of the upper limb to the humerus. Attaching to the humerus closer to the point of application of gravity, the muscle is able, due to the longer arm of the lever, to show more force with a smaller arc of motion.It has been established that the middle part of the deltoid muscle, consisting of short muscle bundles, is able to show great strength along small arcs and is adapted mainly for static work; the front and back parts, which are made up of longer fibers, can move with less force, but in larger arcs, i.e. perform dynamic work.

The deltoid muscle strengthens the shoulder joint and determines the shape of this area of ​​the body.

The supraspinatus muscle is located in the supraspinatus fossa of the scapula and has a triangular shape.It starts from this fossa and the fascia covering it, and attaches to the large tubercle of the humerus and partly to the capsule of the shoulder joint.

The function of the muscle is to abduct the shoulder and stretch the articular capsule of the shoulder joint.

Attaching to the humerus close to the axis of rotation, i.e., to the support, and far from the point of application of gravity, the supraspinatus muscle acts on the short arm of the lever, causing various movements along large arcs, but with little force.

In a living person, this muscle is not visible, as it is completely covered by other muscles (trapezius, deltoid).

Correspondingly to the three mutually perpendicular axes of rotation passing through the center of the hip joint, the following movements can be performed in this joint with the hip with the pelvis fixed, and with it the whole leg, the following movements can be performed: flexion and extension, i.e. forward and backward movement; abduction and adduction; pronation and supination; circular movement (circumduction). When fixing the thigh or the entire leg, the muscles produce pelvic movements: forward, backward, to the sides and turns to the right and left.

67. Thigh flexor and extensor muscles

There are six functional muscle groups in the hip joint for these movements.

Hip Flexion. The muscles that flex the hip in the hip joint are the muscles that intersect the transverse axis of this joint and are located in front of it.

These include: 1) ilio-lumbar , 2) tailor , 3) muscle-tensioner of the wide fascia; 4) comb; 5) rectus femoris

Hip extension Hip extension involves muscles that also cross the transverse axis of the hip joint, but are located behind it.

These muscles go both from the pelvis to the thigh and from the pelvis to the lower leg. These include: 1) gluteus maximus; 2) biceps femoris; 3) semitendinosus; 4) semimembranous; 5) large adductor

Hip abduction. The abductor thigh muscles cross the sagittal axis of the hip joint and are located on its lateral side.

They attach mainly to the greater trochanter. These muscles include: 1) gluteus medius; 2) gluteus minimus; 3) pear-shaped; 4) internal obturator; 5) twin;

6) muscle-tensor of the broad fascia

Adduction of the hip Adduction of the hip is carried out by the muscles that cross the sagittal axis of the hip joint and are located medially from it.

These include: 1) comb; 2) thin; 3) long leading; 4) short leading; 5) large leading.

Thigh supination The muscles that supine the thigh, except for the iliopsoas, cross the vertical axis of the hip joint obliquely.

The iliopsoas muscle supines the thigh due to the special location of the lesser trochanter (not only in front, but also medially). The muscles that supinate the thigh include: 1) the iliopsoas; 2) the square muscle of the thigh; 3) the gluteal muscles, of which the middle and small supinate the thigh only with their posterior bundles; 4) the tailor’s; 5) the internal obturator and external obturator muscles; 5) pear-shaped; 6) twin.

Pronation of the thigh The group of muscles-pronators of the thigh is relatively small.

It includes: 1) the muscle-tensor of the wide fascia 2) the anterior bundles of the gluteus medius muscle 3) the anterior bundles of the gluteus maximus muscle 4) semitendinosus, semimembranosus and thin muscles. Circular motion of the thigh In the hip joint, all muscle groups located around it are produced, acting in turn.

Knee joint: structure, shape, movement, blood supply.Muscles that produce movement in a joint.

Formed by the condyles of the femur and articular surfaces of the tibia, the patella. Condylar compound joint. Possible movements: flexion, extension, rotation.

Ligaments – anterior and posterior cruciate, tibial and peroneal collateral ligaments.

It consists of the following formations: 1) bones – femur, tibia and patella, 2) muscles, 3) nerve endings and blood vessels, 4) menisci, 5) cruciate ligaments.

The knee joint consists of the femur and tibia, these tubular bones are interconnected by a system of ligaments and muscles, in addition, in the upper part of the knee there is a rounded bone – the patella or patella.

The femur ends in two spherical formations – the femoral condyles and together with the flat surface of the tibia form a connection – the tibial plateau.

The patella is attached to the main bones by ligaments and is located in front of the patella.

His movements are provided by sliding along special grooves and femoral condyles – a pallofemoral depression. All 3 surfaces are covered with a thick layer of cartilaginous tissue, its thickness reaches 5-6 mm, which provides shock absorption and reduces thorns during movement.

Connecting parts

The main ligaments, together with the bones that make up the device of the knee joint, are cruciate.

In addition to them, the lateral collateral ligaments are located on the sides – medial and lateral.Inside are the most powerful connective tissue formations – the cruciate ligaments. The anterior cruciate ligament connects the femur and the anterior surface of the tibia.

It prevents the tibia from moving forward during movement.

The posterior cruciate ligament does the same, preventing the tibia from moving posteriorly from the femur. Ligaments provide the connection of bones during movement and help to hold it, the rupture of the ligaments leads to the inability to make voluntary movements and lean on the injured leg.

In addition to the ligaments, in the knee joint there are two more connective tissue formations that separate the cartilaginous surfaces of the femur and tibia – menisci, which are very important for its normal functioning. Menisci are often called cartilages, but in their structure they are closer to the ligaments.

Menisci are rounded plates of connective tissue located between the femur and the tibial plateau. They help to correctly distribute the weight of the human body, transferring it to a large surface and, in addition, stabilize the entire knee joint.

Knee muscles

The muscles located around the joint and ensuring its work can be divided into three main groups: 1. anterior muscle group – hip flexors – quadriceps and sartorius muscles, 2. posterior group – extensors – biceps muscle, semimembranosus and semitendinosus muscles, 3. medial (inner) group – the adductor muscles – the thin adductor muscles and the large adductor muscles.

One of the most powerful muscles in the human body is the quadriceps.

It is divided into 4 independent muscles, located on the anterior surface of the femur and attached to the knee pad. There, the tendon of the muscle turns into a ligament and connects to the tibial tuberosity.

The intermediate muscle, one of the branches of the quadriceps muscle, also joins the knee capsule and forms the knee muscle. Contraction of this muscle contributes to the extension of the lower leg and flexion of the hip.

The sartorius muscle is also part of the muscles of the knee joint.It starts from the anterior iliac axis, crosses the surface of the femur and goes along the inner surface to the knee.

There it bends around it from the inside and is attached to the tuberosity of the tibia. This muscle is two-part and due to this it participates in flexion of both the thigh and lower leg, as well as in the movement of the lower leg inward and outward.

Thin muscle – starts from the pubic joint, descends and attaches to the knee joint.

It assists in adduction of the hip and flexion of the lower leg.

In addition to these muscles, the tendons of the biceps femoris, tendonitis, semimembranosus and popliteal muscles pass through the knee joint.

They provide adduction and abduction movements of the lower leg. The popliteal muscle is located directly behind the knee and helps with flexion and inward rotation.

Thigh flexor muscles

Muscles that produce movements in the shoulder joint

All movements of the humerus in the shoulder joint can be reduced to movements in three mutually perpendicular axes of rotation:

• abduction and adduction around the sagittal axis;
• flexion and extension around the frontal axis;
• pronation and supination around the vertical axis;
• circular movements.

Abduction of the humerus is carried out by: deltoid and supraspinatus muscles.

Bringing is carried out by: pectoralis major muscle, broad dorsi muscle, infraspinatus muscle, small round muscle, large round muscle, subscapularis muscle, long head of triceps muscle, corabrachial muscle.

Flexion of the humerus is produced by: pectoralis major muscle, anterior deltoid muscle, beak-brachialis muscle, biceps brachii muscle.

Extension of the shoulder is carried out by the posterior part of the deltoid muscle.

broad muscle of the back, small round and large round muscles.

Pronation of the shoulder is carried out: by the subscapularis, deltoid, large round, pectoralis major, coracobrachial muscles, as well as the broad muscle of the back.

Shoulder supination is performed: infraspinatus, small round muscles, posterior part of the deltoid muscle.

Circular movements of the humerus are carried out alternately by all the aforementioned muscles.

How weak hip muscles can affect knee pain

The knee is a complex multifunctional joint. It carries the load from running, walking, any movement of the body.

Knee pain can be found during warm-up, during exercise, after exercise, or when just hanging out with your family.
If you have a knee pain, pay attention to the work of the hip and the strength of its muscles.
Why? Because the muscles of the thigh, including the gluteus muscles, control the position of the knees with any movement.

Knee pain is a problem that often requires the help of a rehabilitation therapist or physical therapist to treat. It can be caused by arthritis of varying degrees, a fresh injury or the consequences of an old one, as well as repetitive stress (regular stress with insufficient recovery). Pain can only occur while running, but over time it can even limit your ability to walk or climb stairs normally.

Thigh anatomy

To understand the relationship between knee pain and hip muscles, let’s dig a little deeper into basic anatomy.
The hip joint is the ball and socket joint that carries the main joint in the body. Ligaments are located around it, which stabilize the position of the hip.
The next layer is the muscles. Their main task is to control the movement of the joint and the leg in general.

If you have knee pain, look at the thigh muscle group, in particular the gluteus medius, to understand the cause.

The gluteus medius muscle is responsible for abducting the thigh to the side.
It also rotates the hip outward when you are sitting and helps the other muscles to rotate the hip inward when you are standing. When you are standing or walking, the gluteus medius actively supports the pelvis so that it does not bend over.

Thigh muscle weakness

Without proper training and exercise, especially if you are sedentary in office work, you can develop gluteal weakness.Rarely, it can be related to injury. Most often, this happens without any apparent reason or injury.
It is believed that increased tension in the hip flexors (a contracted condition in the front of the thigh) can lead to weakness of the gluteus muscles in the back and lateral thighs. This is sometimes referred to as “cross syndrome” or “gluteal amnesia”.

When the gluteus medius becomes weak, it allows the hip to rotate more freely and twist abnormally inward.This is called the “collapsing kinetic chain”.
This misalignment of the hip can cause undue stress in the knee joint and patella (patella).

The collapsing kinetic chain is often cited as an indirect cause of anterior cruciate ligament (ACL) injury. During physical activity, the athlete runs or jumps, his knee makes an offset and uneven bending (possibly due to weakness in the gluteal muscles), which causes a rupture of the ACL.

Weak thigh muscles may cause:

• patellofemoral syndrome
• iliac friction syndrome
• patellar tendinopathy
• crow’s feet inflammation.

Strengthening the thigh muscles
A careful assessment of your condition, analysis of your gait as well as running dynamics, lower limb strength (including hip strength), flexibility and range of motion will help you choose your recovery path.

If, after analyzing walking or running, weakness in the gluteal region is observed, then you can choose a program of exercises aimed at specific muscles of the thigh, without being sprayed on a multifaceted load.