Pelvis,
Hip Joint and the Thigh
11
February 2010
Osteology
of the Pelvis
The
bony pelvis is composed of the sacrum and two coxal
bones
Each coxa is composed of three bones
-
-Pubis
-Ischium
Each
bone contributes to the acetabulum
The
space between the ischium & pubis is the obturator
foramen.
Netter, 2003 pl. 342; Netter, 2006
pl. 354
Bony
landmarks of the pelvis
·
Iliac
crest
·
Post.
superior iliac spine
·
Post.
inferior iliac spine
·
·
·
Pubic
tubercle
·
Pectin
pubis
·
Sacral
articular surface
·
Acetabular
notch
·
Ischial
spine
·
Ischial
tuberosity
Clemente, 1997; Fig. 376;
Netter, 2003, Pl. 340, 342; see
Netter, 2006 pl. 352, 354
Coxal
bone - Medial view
·
Post.
superior iliac sp.
·
Post.
inferior iliac sp.
·
Sacral
articular surface
·
Pubic
tubercle
·
Pectin
pubis
·
Ischial
spine
·
Ischial
tuberosity
·
Symphyseal
surface
Clemente, 1997; Fig. 378
see Netter, 2003 pl. 340; Netter,
2006 pl. 352
Development
of the Pelvis
·
·
Pubis
·
Ishium
All
contribute to the acetabulum
Clemente, 1997; Fig. 377
see Netter, 2003 pl. 468; Netter,
2006 pl. 486
Ligaments
of the Pelvis
·
The
coxae are attached to the sacrum with ligaments
Sacroilial ligament spans joint
anteriorly and posteriorly
·
Sacrospinous and sacrotuberous ligs.
span between the sacrum and ischium posteriorly
They attach to the ischial spine &
tubersoity
·
The
left & right pubic bones articulate at the symphysis pubis
Netter, 2003, pl. 340, 341; Netter,
2006, pl.352, 353
Foramina
of the Pelvis
·
The
sacrospinous & sacrotuberous
ligaments define the lesser & greater sciatic foramina
·
The
obturator foramen is between the pubis and ischium
It is covered by the obturator
membrane except for a small passage,the obturator canal
·
The
inguinal ligament spans from the anterior superior iliac spine to the pubic
tubercle
It defines the lacuna vasorum and
lacuna musculorum
Inguinal
Ligament
·
Lacuna
musculorum
·
Iliopectineal arch
·
Lacuna
vasorum
·
Lacunar
ligament
·
Structures
that pass through the lacuna vasorum:
"NAVEL"
Movements
of the Lower Limb
·
Note
Dorsi flexion and plantar flexion, and inversion and eversion of the foot
Netter, 2003 pl. 525;
Netter, 2006 pl. 543
Lower Limb Development - images
from Netter's Interactive Atlas of Human Anatomy (CD)
Innervation
of the Lower Limb
Nerves of the lower limb are derived from the lumbar and sacral spinal nerves
Three
major nerves and several small branches
Sciatic (tibial & fibular)
Femoral
Obturator
Branches directly from lumbosacral
plexus to buttocks
Netter, 2003, pl. 478, 480, 481;
Netter, 2006 pl. 496, 498, 499
Lumbosacral plexus
Lumbar branches to lower limb
Lateral femoral cutaneous
Femoral n.
Obturator
n.
Sacral branches to lower limb
L4 & L5
S1-S5
Netter, 2003 pl. 480, 481; Netter,
2006 pl. 498, 499
The
Back & the Thighs
·
Quadratus
lumborum
·
-T12-L4
·
Psoas
-L2-L4
·
Iliacus
-Femoral n.
Netter, 2003 pl. 478; Netter, 2006
pl. 496
Nerves
of the Lower Limb
Sciatic
n.
Tibial n.
(anterior)
Common Peroneal n.
(posterior)
Posterior
Femoral Cutaneous n.
Netter, 2003 pl. 522; Netter, 2006,
pl. 540
Femoral
n.
Anterior
muscular compartment of thigh
·
Quadriceps
femoris
·
Sartorius
·
Pectineus
Netter, 2003 pl. 520; Netter, 2006 pl. 538
Obturator
n.
Medial
or adductor compartment of thigh
·
Adductor
brevis
·
Adductor
longus
·
Adductor
magnus (in part )
·
Gracilis
Netter, 2003 pl. 521; Netter, 2006 pl. 539
Blood
Supply to the Lower Limb
·
Gluteal
region supplied by superior & inferior gluteal aa.
·
Obturator
a. supplies small part of medial area
·
Majority
of Lower Limb from femoral a.
Circumflex femoral aa.
Deep femoral a. (passes through adductor hiatus)
·
Popliteal
a.
·
Anterior
tibial, posterior tibial
·
Fibular
(peroneal) a.
Netter, 2003 pl. 494; Netter, 2006
pl. 512
Muscle
Groups
·
Anterior
Femoral
n.
· Medial (Adductor)
Obturator
n.
·
Posterior (Hamstring)
Tibial
n.
· Gluteal
Superior
& inferior gluteal nn.
(and others)
Muscles
of the back & thighs that originate in the back
Quadratus lumborum (T12-L4)
Psoas (L2-L4)
Iliacus
(Femoral n.)
Clemente, 1997; Fig. 493, 497, 499
see Netter, 1997; Plate 462; 2003, Pl. 474
Anterior
Compartment
·
(Tensor
fasciae latae)
·
Sartorius
·
Rectus
femoris
·
Vastus
group
Adductor
Compartment
·
Pectineus
·
Adductor
longus
·
Gracilis
Clemente, 1997; Plate 497
see Netter, 2003, Pl. 474; Netter,
2006 pl. 492
Adductor
compartment (deep dissection)
·
Pectineus
(cut & reflected)
·
Adductor
longus (cut & reflected)
·
Adductor
brevis (cut)
·
Adductor
magnus
Adductor hiatus
Netter, 2003 pl. 475; Netter, 2006 pl. 493
Medial (Adductor)
compartment
Pectineus
Adductor
brevis
Adductor
longus
Adductor
magnus
Gracilis
Clemente, 1997; Fig. 493
see Netter, 2003 pl. 474; Netter,
2006 pl. 492
Reference:
Clemente,
C. 1997. Anatomy: A regional atlas of the human body. 4th Ed. Williams &
Wilkins