Luke Vetti – NBPME Part 1 – LEA – Anterior Hip + Gluteal Muscles 1

Anterior Hip Muscles

 provide stability @ hip joint anteriorly
 iliopectineal bursa  separates muscles from capsule Gluteal Muscles
 iliopsoas  tensor fasciae latae
o action  lateral rotation of leg
o origin
o insertion (iliacus + psoas major)
 lesser trochanter (femur)  iliac crest (anterior ¼ of lateral lip)
 femoral shaft (distal to lesser trochanter)  ASIS (lateral)
 iliacus  interspinous fossa
o origin  fascia lata/gluteal fascia
 iliac fossa o insertion
 iliac crest (internal lip)  IT band
 pelvic surface of sacrum (lateral)  (travels between 2 layers of fascia lata)
 ventro sacroiliac ligament o innervation
 iliolumbar ligament
o innervation  superior gluteal (L4)
 L2 ventral rami (dorsal divisions) o blood supply: lateral femoral circumflex and superior gluteal
 L3 ventral rami
 L4 ventral rami o actions
o blood supply: common, internal, and external iliac (same for psoas major)  flexes/abducts the thigh
o action  tenses fascia lata
 hip flexor (major)  gluteus maximus
 others… o origin
 psoas major
o origin
 ilium (posterior to posterior gluteal line)
 ventral fibers  distal 2 sacral segments (dorsal)
 IV disks  coccyx
 vertebral bodies of T12-L5  aponeurosis of erector spinae
 dorsal fibers  dorsal sacroiliac ligament
 transverse processes of L1-L5 (inf. edge)  sacrotuberous ligament
o innervation  fascia lata
 L2 ventral rami (dorsal divisions) o insertion
 L3 ventral rami  superior/superficial fibers  IT tract
 L4 ventral rami  deep fibers  gluteal tuberosity
o action
o blood supply
 flexion of hip
 flexion of trunk  superior gluteal (superficial)
 others…  inferior gluteal
 psoas minor o innervation
o anterior to psoas major  inferior gluteal nerve
o origin o actions
 T12, L1 vertebral bodies  extension + lateral rotation of hip
 T12, L1 IV disks  superior fibers  ABD hip
o insertion  other fibers  ADD hip
 iliopubic eminence o bursae
o innervation
 L1 ventral rami
 ischial  gluteus maximus + ischial tuberosity
o action  trochanteric  gluteus maximus + greater trochanter (lateral)
 flexion of trunk (weak)  gluteofemoral  gluteus maximus + origin of VL
 NO action @ hip o gluteus maximus gait
 Luke Vetti – NBPME Part 1 – LEA – Anterior Hip + Gluteal Muscles 2
 issue w/inferior gluteal nerve
Gluteal Muscles (cont’d)
 gluteus medius
o origin
 ilium (posterior + anterior gluteal lines)
 gluteal fascia  obturator externus
o insertion o origin
 greater trochanter (diagonal ridge @ lateral surface)  obturator foramen (external margin, but not ilium)
 obturator membrane (external)
o blood supply
o insertion
 superior gluteal (deep branch)
 trochanteric fossa (medial surface of greater trochanter)
o innervation o blood supply
 superior gluteal  inferior gluteal
o actions o innervation
 ABD/lat rotation of the hip (stabilization of pelvis)  obturator nerve
 anterior fibers  flexion + medial rotation @ hip o action
 posterior fibers  extension + lateral rotation @ hip  laterally rotates hip
 gluteus minimus  weak adductor (?)
o origin  obturator internus + gemelli
 ilium (anterior + inferior gluteal lines) o origins
o insertion  obturator internus
 greater trochanter (depression @ anterior surface)  obturator foramen (internal margin)
o blood supply  obturator membrane (internal)
 superior gluteal (deep branch)  superior gemellus
 ischial spine
o innervation
 superior edge of the lesser sciatic notch
 superior gluteal  inferior gemellus
o actions  ischial tuberosity
 ABD of hip (pelvic stabilization)  inferior margin of the lesser sciatic notch
 flexion + medial rotation of hip o insertion
 piriformis  all combine to common tendon
o origin  greater trochanter (medial side  ant. + sup. to trochanteric fossa)
 pelvic surface of sacrum (lateral part of S2-S4) o blood supply
 ventral sacroiliac ligament  inferior gluteal
 sacrotuberous ligament o innervation
o insertion  obturator internus/superior gemellus
 greater trochanter (“tip”  posterior + superior borders meet)  nerve to obturator internus
o blood supply  inferior gemellus/quadratus femoris
 inferior gluteal  nerve to quadratus femoris + inferior gemellus
o innervation o action
 dorsal division of ventral rami of S1 + S2 (nerve to  laterally rotate hip
piriformis)  ABD thigh when hip is flexed
 quadratus femoris
o actions o origin
 lateral rotation of hip  ischial tuberosity (lateral border)
 abductor of thigh w/ hip flexed (sitting crossed legged)  body of ischium (descending part)
o insertion
 Luke Vetti – NBPME Part 1 – LEA – Anterior Hip + Gluteal Muscles 3
 quadrate tubercle (and adjacent bone)
o blood supply
 inferior gluteal
o innervation
 nerve to quadratus femoris + inferior gemellus
o action
 laterally rotates hip
 weak adductor (?)