Category "Kinesiology" In this article we will look at the anatomy, function and kinesiology of the lower extremity girdle (pelvis) in particular: iliopsoas, psoas major, psoas minor, piriformis, obturator internus and externus, gemellus superior and inferior, tensor fascia lata, quadratus femoris , coccygeus muscle. Hip flexors. Biomechanical movements of the lower limb belt in space. Exercise technique.
The legs have a more massive skeleton than the arms. Their muscles have great strength, but with less variety and a limited range of movements. The muscles located in the area of the lower extremities drive the movement of the leg in the hip joint, as well as the spinal column.
Rice. 1. Muscles of the anterior wall of the abdomen and pelvis
The muscles of the lower limb girdle - the pelvis - surround the hip joint. They start from the sacrum, pelvic bones and spine, and are attached to the proximal end of the femur. Topographically, they are divided into two groups: internal and external pelvic muscles.
Let's look at the pelvic muscles from an anatomical point of view.
Rice. 2. Muscles of the pelvis and thigh (front view)
Where: 1 - psoas minor muscle; 2 - iliacus muscle; 3 - psoas major muscle; 4 - piriformis muscle;
5 - iliopsoas muscle; 6 - vascular lacuna; 7 - muscle that stretches the lata fascia of the thigh;
8 - pectineus muscle; 9 - long adductor muscle; 10 - sartorius muscle; 11 - thin muscle;
2 - the longest rectus femoris muscle; 13 - adductor magnus; 14 - iliotibial tract;
15 - vastus lateralis muscle; 16 - vastus medialis;
17 - tendon of the longest rectus femoris muscle; 18 - sartorius tendon
- Greater lumbar (lat. psoas major), originating from the XII thoracic and I-II lumbar vertebrae. Both muscles join together, pass under the inguinal ligament in the muscle lacuna and attach to the lesser trochanter of the femur. (Number 3)
Function:
flexes the hip and rotates it outward.
Innervation:
lumbar plexus, LI-SII.
- Psoas minor muscle (lat. psoas minor) is unstable, has a fusiform shape and is located on the anterior surface of the psoas major muscle. Its point of origin is on the lateral surface of the bodies of the 1st lumbar and 12th thoracic vertebrae, and its attachment point is on the iliac fascia and the crest of the pubic bone. (Number 1)
Function:
stretches the fascia iliaca.
Innervation:
lumbar plexus, LI-LII.
- Piriformis muscle (lat. piriformis) rotates the thigh outward and takes part in its abduction. The muscle has the shape of a flat isosceles triangle. It starts from the anterior (pelvic) surface of the sacrum, exits the pelvic cavity through the greater sciatic foramen and attaches to the top of the greater trochanter of the pelvic bone. At the site of muscle attachment there is a mucous bursa of the piriformis muscle (bursa m. piriformis). The muscle completely fills the large sciatic foramen, forming supragiriform spaces on top and infrapiriform spaces below, through which vessels and nerves pass. (Number 4)
Function:
externally rotates the hip.
Innervation:
sacral plexus, SI-SII.
Rice. 3. Pelvic muscles (back view)
- Internal obturator muscle (lat. obturatorius internus) rotates the hip outward. This is a flat muscle with fan-shaped bundles. Its starting point is located on the inner surface of the pelvic bone in the circumference of the locking membrane. The muscle exits the pelvic cavity through the lesser sciatic foramen and attaches to the vertical fossa of the femur. Between the muscle and the locking groove of the pubic bone, a small gap is formed - the locking canal (canalis obturatorius), through which the vessels and nerve pass. (Fig.3)
Function:
externally rotates the hip.
Innervation:
sacral plexus, LI-SII.
- Superior and inferior gemellus muscles (lat. gemellus superior et inferior) begin from the ischial spine (upper) and the ischial tuberosity (lower); are attached in the trochanteric fossa. (Fig.3)
Function:
rotate the hip outward.
Innervation:
sacral plexus, LIV-SII
- Coccygeus muscle (lat. coccygeus), contracting, takes part in strengthening the walls of the pelvis. The muscle is rudimentary, it is a thin plate with a small number of muscle bundles. Its point of origin is located on the ischial spine, and its attachment point is on the outer surface of the two lower sacral and two or three upper coccygeal vertebrae.
Basic hip flexors
- iliopsoas,
- rectus femoris muscle,
- sartorius muscle and
- tensor fascia lata.
Acting synergistically, these muscles cause flexion of the hip joint, such as when raising a straight leg and knee. They also contract eccentrically to control hip extension, such as during the downward phase of a straight leg or knee raise. Let's look at each one separately.
Rice. 4. Muscles of the pelvis and thigh (front view)
Iliopsoas muscle(Fig.4) flexes the thigh at the hip joint, rotating it outward. When the hip is in a fixed position, it bends the lumbar region and pelvis, tilting the torso forward. Received its name from the site of its origin on the inner surface of the ilium; it is attached to the lesser trochanter of the femur.
The muscle is formed as a result of the connection of the psoas major muscle ( lat. psoas major) and iliacus muscle ( lat. iliacus).
The psoas major muscle is a long, fusiform muscle, starting from the lateral surface of the bodies of the I-IV lumbar vertebrae and the XII thoracic vertebra. The iliacus muscle has the shape of a triangle and fills the iliac fossa, on the walls of which is the point of origin of the muscle. Both muscles connect at the attachment point, which is located on the lesser trochanter of the femur. Between the joint capsule and the muscle tendon is the iliopectineal bursa (bursa iliopectinea). Essentially, it consists of three muscles: the round major and minor (absent in about 10% of the population) psoas and iliacus, which function as a single unit.
Kinesiology: The psoas muscle must exert considerable force to raise and lower the mass of the straightened leg. In most people, the abdominal muscles are not strong enough and cannot balance the force generated by the psoas to keep the spine in a neutral position when lifting the straight leg. This is one of the reasons why it is not recommended to lift the body from a lying position without the help of arms and legs with straight legs. Because the psoas muscle originates in the lumbar spine, stiffness or hypertrophy can result in passive hyperextension of the lumbar spine.
Stiffness of the iliopsoas muscle can be explained by insufficient stretching exercises, as well as incorrect posture while standing or sitting. To stretch the iliopsoas muscle, the client should stand in a lunge forward with one leg bent at the knee and the heel of the other leg without touching the floor. Then, contracting the abdominal muscles, he must bend the lumbar spine and fix this position for at least 10 seconds. You should carefully monitor how the client performs this exercise, as there is a tendency to hyperextend the lumbar spine, which is accompanied by unnecessary stress on it.
To strengthen the iliopsoas muscle, from a lying position on your back, use your abdominal muscles to lift your pelvis up to stabilize your lower back and then alternately lift one straight leg and then the other leg up.
Rice. 5. Thigh. (Front view)
- Rectus femoris muscle(Fig. 5)
Quadriceps femoris (lat. quadriceps femoris) is located on the front surface of the thigh and consists of 4 heads - muscles. Since one of the heads of the four main muscles, the rectus bera muscle, is involved to a greater extent in flexing the pelvis, let’s look at it in more detail.
Rectus femoris muscle(lat. musculus rectus femoris) is the longest of all muscle heads. Occupies the anterior surface of the thigh. It begins with a thin tendon from the lower anterior spine, the supraacetabular groove. At the very beginning m is covered. tensor fasciae latae and sartorius muscle. It goes down and passes into a narrow tendon, which is part of the common tendon of the quadriceps muscle. Having reached the tibia, the tendon attaches to the tibial tuberosity. Below the patella it is called the patellar ligament (lat. ligamentum patellae).
The only one of the four muscles of the quadriceps group that crosses the hip joint. Concentric contraction of this muscle results in hip flexion, knee extension, or both. The best exercise to strengthen this muscle is the straight leg raise from a standing position. To stretch the rectus femoris, perform an iliopsoas stretch and then lower your torso until the knee of your back leg is bent.
- Sartorius(Fig. 5)
Sartorius (lat. sartorius) the longest muscle in the human body, starting from the superior anterior iliac spine; attaches to the medial surface of the tibial tuberosity.
Function:
bends the thigh and lower leg, rotates the limb bent at the knee joint inward.
Innervation:
femoral nerve, LI-LII.
This multi-joint muscle flexes, abducts and externally rotates the hip joint and at the same time flexes and internally rotates the knee joint. Lateral to the sartorius muscle is the tensor fascia lata, a short muscle with a very long tendon that connects to the lower fibers of the gluteus maximus muscle. The tensor fasciae lata originates on the anterior superior ilium and inserts on the lateral aspect of the tibia below the knee.
- (Fig. 5)
Tensor fascia lata (lat. Musculus tensor fasciae latae)
A flat, slightly elongated muscle that lies on the anterolateral surface of the pelvis. With its distal end it is woven into the fascia lata of the thigh. The muscle begins on the outer lip of the iliac crest, closer to the superior anterior iliac spine. The muscle bundles are directed vertically downward, passing into the iliotibial tract of the fascia lata of the thigh.
Functions: Stretches the fascia lata and the iliotibial band. Through it it acts on the knee joint and flexes the hip. Through their connection to the tensor fascia lata, the gluteus maximus and gluteus medius muscles promote motion at the knee joint. This muscle is not only a hip flexor, but also a pronator. In addition, it abducts the hip. When the hip is fixed, it participates in the rotation of the pelvis.
They affect the hip joints. As for their location, they are divided according to this criterion into two divisions. These will be external and internal divisions. The external ones include the gluteus maximus, both gluteal muscles, the quadratus muscle, the muscle responsible for stretching the wide connective tissue membrane of the thigh, including both gemini muscles and the external locking muscle. The internal pelvic muscles include the obturator internus, piriformis, and iliopsoas muscles.
All pelvic muscles belonging to the group of external ones are located in the buttocks area and on the lateral area of the pelvis. Most of their surface is located on the bones of the pelvic girdle, where, in fact, they begin. Many of these muscles reach the attachment point, which is located on the femur. This muscle group has three layers. Namely superficial, deep and medium. The surface layer is represented in the form of a large muscle of the buttocks, another muscle capable of straining the connective tissue membrane of the thigh. The deep layer refers to the gluteus minimus and obturator externus muscles. But the middle layer includes the largest number of muscles. To be more precise, the gluteus medius, quadratus femoris, those parts of the piriformis and obturator muscles that are located outside the pelvis, and both gemini muscles.
The gluteus maximus is considered a muscle of average strength. Its structure was called large-beam. It stands out in relief due to the large mass in the buttock area. The large buttock muscle is developed much better in humans than in anyone else, and all thanks to our upright posture. Its origin is located in several places, namely on the ilium, the first zone of the muscle responsible for straightening the spine, on the dorsal region of the sacrum and coccyx, and the sacrotuberous ligament.
The gluteus medius muscle developed on the gluteal portion of the ilium, but some of it developed on the connective tissue sheath. Then it passes down, gradually turning into a thick tendon, which in turn joins the upper region of the outer zone of the greater trochanter.
The gluteus minimus is present below the gluteus medius. Its origin is located on the edge of the greater sciatic notch, still on the outer part of the wing of the ilium, approximately in the area of the two lines of the buttocks. This muscle is attached to the anterolateral part of the greater femoral trochanter. Some bundles of the minor muscle are connected to the capsule of the hip joint. The trochanteric bursa, which belongs to the minor muscle of the buttocks, lies in the area of the greater trochanter and directly the tendon of this pelvic muscle.
The muscle responsible for tensioning the lata of the thigh begins at the highest point of the frontal iliac spine, located next to the iliac crest zone. Among other things, it is located in the area between the plates of the wide connective tissue membrane, that is, between the superficial and deep. Then, having reached the limit of the upper and middle zones of the thigh, it turns into the iliotibial tract of the lata. Then it descends even lower and is attached to the lateral condyle of the tibia bone.
A flat, quadrangle-like muscle is considered to be the quadratus femoris muscle. It lies in the zone formed by the gemminis muscle and the superior point of the adductor magnus muscle. Moreover, in one case it goes along the top, and in the other - along the bottom. At the peak of the outer part of the ischial tuberosity, the quadratus muscle is formed. Its attachment occurs in the area of the upper point of the intertrochanteric ridge. The synovial bursa is located in the area between the frontal part of the quadratus muscle and the greater trochanter.
Another triangular muscle is the obturator externus muscle. Its origin lies at the outer zone of the pubic bone, including on one of the branches of the ischium, and on the middle two of the three parts of the obturator membrane. Its associations go backwards, then go sideways, and only after that go up. The obturator externus tendons run behind the hip joint and ultimately attach to the trochanteric fossa and joint capsule.
The internal pelvic muscles include the obturator internus, iliopsoas and piriformis muscles. In turn, the iliopsoas is divided into two muscles - the psoas major and the iliacus. They originate from different places, that is, from the lumbar vertebrae and the ilium, respectively. But they still come together at a certain point. This creates a muscle that attaches to the lesser trochanter of the femur. Two parts of this muscle are actively involved in creating the posterior wall of the peritoneum.
At the obturator entrance area, another muscle begins, which received two words in its name - internal and obturator. Its origin lies on that part of the obturator membrane that is located inside, the pelvic surface of the ilium and on the obturator connective tissue membrane. From the pelvic area it passes through the lesser sciatic foramen, then at an acute angle passes through the area of the lesser sciatic notch.
The piriformis muscle placed its initial part in the area of the pelvic sacrum, or rather slightly to the side of the holes of the same name. It passes through the interior of the pelvis and then arises from the greater sciatic outlet. In the area of the posterior surface of the femoral neck it transforms into a round tendon, attached at the highest point of the greater trochanter. A small space under it is occupied by the synovial bursa of the piriformis muscle.
Pelvic muscles go from the pelvic girdle to the femur and produce movement in the hip joint around all its 3 axes. Therefore, they are located on all sides and perform all types of movements. Based on their attachment points on the thigh, as well as their functions, they are divided into 2 groups: internal and external. The muscles are supplied with blood by the parietal branches of the internal iliac artery, and are innervated by the branches of the lumbar and sacral plexus.
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Muscle name |
Attachment |
Muscle function |
Blood supply to muscles |
Innervation |
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Internal pelvic muscle group: |
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1. The iliopsoas muscle (m.iliopsoas) consists of two muscles: Iliacus muscle (m. iliacus); Psoas major muscle (m.psoasmajor) |
iliac fossa of the ilium transverse processes of 1-5 lumbar vertebrae |
lesser trochanter of the femur lesser trochanter of the femur |
bends the thigh at the hip joint, rotating it outward, and with the lower limb fixed, tilts the torso forward |
iliopsoas artery |
muscular branches of the lumbar plexus |
|
2. Piriformis muscle (m.piriformis) |
pelvic surface of the sacrum lateral to the anterior sacral foramina |
superior portion of the greater trochanter |
rotates the hip outward and abducts it |
lateral sacral artery, gluteal arteries, |
muscular branches of the sacral plexus |
|
3. Internal obturator muscle (m. obturatoriusinternus) |
edges of the obturator foramen, obturator membrane |
medial surface of the greater trochanter |
rotates the hip outward |
superior gluteal artery, obturator artery |
obturator nerve |
External pelvic muscle group: |
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1. External obturator muscle (mobturatorius. externus) |
outer surfaces of the pubis and ischium near the obturator foramen |
trochanteric fossa of the femur |
obturator artery |
obturator nerve (lumbar plexus) |
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2. Gluteus maximus (m. gluteusmaximus) |
Dorsal surfaces of the sacrum and coccyx |
gluteal tuberosity of the femur |
extends the thigh, rotating it slightly outward; with a strengthened thigh, straightens the torso |
inferior gluteal artery |
inferior gluteal nerve |
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3. Gluteus medius muscle (m. gluteusmedius) |
gluteal surface of the ilium |
large skewer |
superior gluteal artery |
superior gluteal nerve |
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4. Gluteus minimus (m. gluteusminimus) |
gluteal surface of the ilium |
large skewer |
abducts the thigh, the anterior bundles rotate the thigh inward, the posterior bundles turn the thigh outward |
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The pelvic muscles are divided into internal and external groups.
Internal pelvic muscle group
- Psoas major muscle, m.psoas major.
- Psoas minor muscle, m. psoas minor.
- Iliacus muscle, m. iliacus.
- Iliopsoas muscle, m. iliopsoas.
- Obturator internus muscle, m. obturatorius interims.
- Piriformis muscle, m. piriformis.
- Coccygeus muscle, m. coccygeus.
External pelvic muscle group
- Gluteus maximus muscle, m. gluteus maximus.
- Gluteus medius muscle, m. gluteus medius.
- Gluteus minimus, m. gluteus minim
Internal pelvic muscle group
- Psoas major muscle, m. psoas major, long, fusiform, begins with 5 teeth from the lateral surface of the bodies of the XII thoracic, four upper lumbar vertebrae and the corresponding intervertebral cartilages. The deeper muscle bundles originate from the transverse processes of all lumbar vertebrae. Tapering somewhat, the muscle is directed downward and slightly outward and, connecting with the bundles of the iliacus muscle, m. iliacus, forms the common iliopsoas muscle, m. ilio
.Action: flexes the thigh at the hip joint, rotating it outward. When the hip is fixed, it tilts (bends) the torso forward. Innervation: rr. musculares plexus lumbalis (L1 -L2). Blood supply: aa. iliolumbalis, circumflexa ilium profunda.
i a and from its inner surface. A small gap between the muscle bundles and the sulcus obturatorius of the pubic bone turns into the obturator canal, canalis obturatorius. through which blood vessels and nerves pass. Then the muscle bundles, converging, are directed outward and, bending almost at a right angle through the lesser sciatic notch, leave the pelvic cavity through the foramen ischiadicum minus, attaching with a short, powerful tendon in the fossa trochanterica area. At the point of inflection over the edge of the lesser sciatic notch there is an ischial bursa of the obturator internus muscle, bursa ischiadica m. obluratorii interni. Topographically, the obturator internus muscle is divided into two parts: the larger one, before exiting the pelvic cavity, the intrapelvic muscle, and the smaller, tendinous muscle, which lies under the gluteus maximus muscle, the extrapelvic muscle. Action: supinates the thigh. Innervation: rr. musculares plexus sacralis. Blood supply: aa.glutea inferior, obturatoria, pudenda intema.
Innervation: rr. musculares nervi pudendi.Blood supply: rr. musculares a. pudendae intemae.
External pelvic muscle group
- Gluteus maximus muscle, m. gluteus maximus, approximates a rhombus in shape. The muscle is large-fiber, powerful, flat and reaches a thickness of 2-3 cm. In its course, the muscle overlaps the greater trochanter, as well as the rest of the muscles of this group. It starts from the posterior part of the outer surface of the ilium, posterior to
linea glutea posterior, from the lateral edge of the sacrum and coccyx and from the lig. sacrotu-berale. The muscle bundles stretch obliquely downwards and laterally and are attached with their upper bundles to the fascia lata, which passes into the tractus iliotibialis, and with their lower bundles to the tuberositas glutea f emoris; here between the greater trochanter and the muscle there is a trochanteric bursa of the gluteus maximus muscle, bursa trochanterica m.glutei maximi. Action: straightens the torso bent forward, straightens the hip, and also stretches the lata fascia of the thigh. Innervation: n. gluteus inferior (plexus sacralis) (L5 S1 -S2). Blood supply: aa. gluteae superior et inferior, circumflexa femoris medialis, profunda femoris (perforans I).
t ea anterior, above - crista iliaca and below - linea glutea posterior. Then all muscle bundles converge into a common powerful tendon, attached to the top of the trochanter major, where there is a trochanteric bursa of the gluteus medius muscle, bursa trochanterica m. glute i medii.Action: abducts the thigh, with the anterior bundles rotating the thigh inward, and the posterior bundles rotating outward; takes part in straightening the body bent forward. Innervation: n. gluteus superior (plexus sacralis) (L1 -L5, S1). Blood supply: aa. glutea superior et circumflexa femoris lateralis.
5)].Blood supply: aa. obturatoria, circumflexa femoris lateralis.
The gas muscles include those muscles that begin on the pelvic bones and attach to the femur, i.e., they act on the hip joints.
Anterior pelvic muscles
The iliac muscle (m. iliacus) (Fig. 196) begins on the entire area of the fossa iliaca of the ilium, then under the inguinal ligament in the lacuna musculorum in the place with m. psoas major passes in front of the femoral head. Attaches to the lesser trochanter of the femur. Between the joint capsule and the deep layer of muscle fascia there is a mucous bursa, which in some cases communicates with the joint cavity.
196. Muscles of the pelvis and thigh, front.
1 - m. psoas major; 2 - m. piriformis; 3 - lig. inguinal; 4 - lacuna vasorum; 5 - m. pectineus; 6 - m. adductor longus; 7 - m. gracilis; 8 - m. vastus medialis; 9 - lig. patellae; 10 - tendo m. recti femoris; 11 - tractus iliotibialis; 12 - m. vastus lateralis; 13 - m. tensor fasciae latae; 14 - m. sartorius; 15 - m. iliacus.
Innervation: branches of plexus lumbalis and n. femoralis LII-IV.
Function. When the lower limb is free, the muscle flexes the thigh at the hip joint. When standing, the torso tilts forward. Functionally combined with m. psoas major.
Posterior pelvic muscles
The gluteus maximus muscle (m. gluteus maximus) is well developed, massive, irregularly quadrangular in shape. Starts from the posterior 2/3 of the iliac crest, f. lumbodorsalis, lateral parts of the sacrum, coccyx and pelvic ligaments. Large muscle bundles, separated by layers of connective tissue, are directed laterally and downward. The anterior muscle bundles form a flat tendon covering the front of the greater trochanter of the femur, and then pass into the tendon tract of the thigh. The posterior bundles are attached to the tuberositas glutea of the femur. Between the tendon and the greater trochanter there is a mucous bursa.
Innervation: n. gluteus inferior (LV-SI).
Function. With a free lower limb, the femur extends at the hip joint. When standing, the torso extends.
Gluteus medius muscle (m. gluteus medius) (); its posterior part is covered by the previous muscle, and its anterior part is covered with thick fascia. It starts from the ilium between the linea glutea anterior et posterior below, the iliac crest behind and above. Its anterior bundles begin from the fascia lata. Attached by a broad tendon to the apex and outer surface of the greater trochanter. At the site of muscle attachment there is a mucous bursa.
Innervation: n. gluteus superior (LIV-SI).
Function. When the muscle contracts, the free part of the lower limb is abducted; when the anterior bundles contract, the thigh rotates inward (pronation), and the posterior bundles rotate outward (supination). When the lower limbs are fixed (standing), the torso tilts in the direction of muscle contraction.
The gluteus minimus muscle (m. gluteus minimus) is covered by the previous muscle, somewhat smaller in size. It begins in a fan-shaped manner from the outer surface of the wing of the ilium between the anterior and lower gluteal lines. Attached to the anterior part of the greater trochanter, i.e., in front of the attachment of m. gluteus medius, where there is a mucous bursa.
Innervation: n. gluteus superior (LIV-V-SI).
Piriformis muscle (m. piriformis); its initial part is located in the pelvic cavity. It starts from the anterior surface of the II-IV sacral vertebrae near the anterior sacral foramina, moving laterally through the greater sciatic foramen, leaving the pelvic cavity and emerging on its posterior surface. Attached to the anterior edge of the greater trochanter of the femur. Above and below the piriformis muscle in the sciatic foramen there are forr. supra- et infrapiriformis.
Innervation: n. gluteus superior (SI-II).
Function. Abducts the hip with the free leg. When standing, tilts the torso in the direction of contraction.
The internal obturator muscle (m. obturatorius internus) begins on the inner surface of the small pelvis in the area of the obturator membrane and the bones surrounding it. The muscle is directed backward and, bending around the sciatic notch in the area of the lesser sciatic foramen, exits at a right angle to the posterior surface of the pelvis below m. piriformis. Attached to the fossa of the greater trochanter of the femur.
Innervation: r. muscularis plexus sacralis (LIV-SII).
Function. Abducts the hip and supinates with the lower limb free.
The superior and inferior twin muscles (mm. gemelli superior et inferior) begin from the spina ischiadica and tuber ischii, respectively, and are attached to the fossa of the greater trochanter. Both muscles are fused with the obturator internus muscle.
Innervation: rr. musculares plexus sacralis (LIV-SI).
Function. Participates in hip abduction.
Quadratus femoris muscle (m. quadratus femoris); its shape fully corresponds to its name. It starts from the ischial tuberosity and is located in the horizontal plane. Attached to the posterior part of the greater trochanter and to the crista intertrochanterica.
Innervation: rr. musculares plexus sacralis (LIV-V-SI).
Function. Due to the significant torque, it develops great force. With a free leg, the hip supinates. When standing, the pelvis tilts back.
Lateral pelvic muscles
The tensor fasciae latae is located behind the beginning of the sartorius muscle of the thigh. Its thin muscle belly is enclosed in a dense fascia of the thigh. It starts from the iliac crest behind the spina iliaca anterior superior and, going down to the thigh, continues into the tendon aponeurosis in the form of tr. iliotibialis f. latae, which ends on the lateral condyle of the tibia.
Innervation: n. gluteus superior (LIV-V).
Function. With a free limb, it promotes flexion of the thigh at the hip joint. When standing, it tightens the fascia of the thigh.
Medial pelvic muscles
The pectineus muscle (m. pectineus) starts from the upper branch and crest of the pubic bone, and is attached to the initial part of the linea aspera femoris (Fig. 196). Its lateral edge borders m. iliacus and m. psoas major, forming with them fossa iliopectinea.
Innervation: n. obturatorius, n. femoralis (LII-III).
Function. Since the frontal axis of the hip joint is behind the point of passage of the muscle, it can not only adduct the hip, but also internally rotate and flex the hip joint. When standing, tilts the pelvis forward.
The external obturator muscle (m. obturatorius externus) is located under the m. pectineus. It can also be seen after removing m. quadratus femoris. It starts from the membrana obturatoria and the bones that form the obturator foramen. It is directed laterally and upward, bending around the back of the femoral neck. Attached to the fossa of the greater trochanter.
Innervation: n. obturatorius (LIII-IV).
Function. The free lower limb is rotated outward.
The long adductor muscle (m. adductor longus) is located below the m. pectineus, separated by an intermuscular layer of connective tissue. It starts from the pubic bone between the symphysis and the pubic tubercle. Attaches to the medial lip of the middle linea aspera femoris.
Function. Adducts the femur at the hip joint.
The short adductor muscle (m. adductor brevis) is covered in front by the m. pectineus and m. adductor longus, behind - m. adductor magnus. It starts from the lower branch of the pubic bone, then diverges downwards and laterally, attaching to the upper third of the medial lip linea aspera femoris.
Between m. pectineus and m. The adductor brevis on the thigh opens to the canalis obturatorius.
Innervation: n. obturatorius (LII-III).
Function. The same as the previous muscle.
The adductor magnus (m. adductor magnus) (Fig. 195) lives up to its name. It is covered by all the previous muscles and upon examination only its medial edge is visible. It starts from the ischial tuberosity, a branch of the ischium, then attaches along the entire length of the medial lip linea aspera femoris and to the medial epicondyle of the femur. The part of the tendon that attaches to the medial epicondyle is thickened and can be easily felt on the thigh. Lateral to this tendon, i.e. closer to the midline of the thigh, at the level of its lower third there is a hole - hiatus tendineus, the edges of which contain tendon fibers that prevent the hole from changing its shape during muscle contraction. The femoral artery and vein pass through the hole into the popliteal fossa.
Innervation: n. obturatorius and branches n. ischiadicus (LII-V).
Function. Adducts the hip. Since the origin of the muscle is behind the frontal axis of the hip joint, extension is possible.
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