Studying anatomy & physiology grouped by regions of the body.
WORK IN PROGRESS…LAST UPDATE 01.22.2020
Bony Landmarks of the Pelvis/Coxa
| Ilium | Sacroiliac joint |
| Iliac crest | Sacrum: pelvic surface |
| Iliac fossa | Sacrum: lateral part |
| Anterior superior iliac spine (ASIS) | Sacral canal |
| Anterior inferior iliac spine (AIIS) | Posterior sacral foramins |
| Posterior superior iliac spine (PSIS) | Superior articular process |
| Posterior inferior iliac spine (PIIS) | Promontory |
| Anterior sacral foramina | Sacral hiatus |
| Ischium | Median sacral crest |
| Ischial spine | Greater sciatic notch |
| Ischial tuberosity | Lesser sciatic notch |
| Pubis | Obturator foramen |
| Pectin pubis | Acetabulum |
| Public tubercle | Acetabular margin |
| Superior pubic ramus | Coxa |
| Inferior pubic ramus | Coccyx |
| Pubic symphasis |
Bony Landmarks of the Femur
| Femoral head | Intercondyloid fossa |
| Femoral neck | Linea aspera |
| Greater trochanter | Gluteal line |
| Lesser trochanter | Fovea |
| Trochanteric fossa | Adductor tubercle |
| Epiphyseal line | Quadratus tubercle |
| Intertrochanteric line | Intertrochanteric crest |
| Femoral shaft | Pectineal line |
| Lateral epicondyle | Spiral line |
| Medial epicondyle | Medial supracondylar line |
| Lateral condyle | Lateral supracondylar line |
| Medial condyle | Intercondylar line |
| Patellar trochlea | Popliteal surface |
Bone Details
Muscles
Gluteal Region Muscles
| Gluteus maximus | iliac crest, posterior sacrum, coccyx, sacrotuberous ligament. | gluteal tuberosity on posterior femur; iliotibial band. | hip extension and hip lateral rotation; lower fibers ADD; upper fibers ABD. |
| Gluteus medius | right below the line of the iliac crest, upper gluteal surface of ilium. | greater trochanter (mostly lateral, some superior surface). | hip abduction; medial rotation. Assist hip flexion; posterior fibers help hip extension and lateral rotation. |
| Gluteus minimus | lower portion of gluteal surface of ilium. | anterior surface of greater trochanter. | hip abduction; medial rotation. Assist hip flexion. |
| Tensor fascia lata | ASIS, anterior iliac crest. | ITB, lateral tibial condyle. | hip abduction; medial hip rotation. |
Lateral Rotators / Deep Gluteal “Six” Muscles (Deep6)
| Piriformis | anterior sacral surface. | superior border greater trochanter. | lateral rotation and abduction of thigh when thigh is flexed. |
|---|---|---|---|
| Gemellus superior | ischial spine. | trochanteric fossa. | lateral rotation and abduction of thigh when thigh is flexed. |
| Gemellus inferior | ischial tuberosity. | trochanteric fossa. | lateral rotation and abduction of thigh when thigh is flexed. |
| Obturator internus | obturator membrane, surrounding bones. | trochanteric fossa. | lateral rotation and abduction of thigh when thigh is flexed. |
| Quadratus femoris | ischial tuberosity. | intertrochanteric crest. | lateral thigh rotation. |
| Obturator externus | obturator foramen. | trochanteric fossa. | lateral thigh rotation. |
Innervated by: biceps femoris (short & long heads) semitendinosus, semimembranosus by tibial division L5-S3; biceps femoris short head by fibular division L5-S2.
Joints
- Tibiofemoral
- Patellofemoral
Ligaments/Tendons
Sacrotuberous ligament. Connect sacrum to ischium. From ischial spine; to lateral sides of sacrum & coccyx. Triangular/fan shape. Form boundary of greater and lesser sciatic foramen. Another place for g. maximus to insert. Stabilize ilium. Prevent ilium from rotating past the sacrum. Stabilize SI joints 1-3.
Sacrospinous ligament. Connect sacrum to ischium. From lateral margin of inferior sacrum; to ischial spine. Stabilize against excessive external rotational forces. Prevent ilium from rotating past the sacrum.
Vascular Supply
- Internal iliac artery
- External iliac artery
- Superior gluteal artery
- Superior gluteal vein
- Inferior gluteal artery
- Inferior gluteal vein
- Piriformis artery
Innervation
- Lumbar plexus.
- *Sacral plexus = anterior rami, L4-S4.
- Anterior rami of spinal nerves, L1-L4.
- Femoral nerve, L2-4.
- Obturator nerve, L2-4.
- Lateral cutaneous nerve of thigh, L2-3.
- Sciatic nerve, L4-S3.
- Tibial division (of common peroneal), L4-S3.
- Fibular division (of common peroneal), L4-S2.
- Superior gluteal nerve, L5-S1.
- Inferior gluteal nerve, L5-S1/2.
- Piriformis, L5-S1/2.
- Obturator internus, superior gamelli, L5-S1.
- Quadratus femoris, inferior gamelli, L5-S1.
- Cluneal nerves—superior, middle, inferior. Cutaneous/superficial nerves of the buttocks.
Femoral Nerve.
- Supplies: hip flexors; pectineus; knee extensors.
- Cutaneous: anterior thigh nerves; saphenous branch of medial leg and foot.
Obturator Nerve.
- Supplies: hip/thigh adductors; obturator externus.
- Cutaneous: small patch of skin over medial thigh (medial and superior to knee crease).
- Comes out of the pelvis via obturator canal of the obturator foramen.
Cluneal Nerves—Superior, Middle, Inferior.
- Cutaneous/superficial nerves of the buttocks.
Clinical/Pathology
Iliotibial Band Friction Syndrome
Trendelenburg Syndrome
Normally, co-contraction of g. minimus and g. medius on stance leg heps to prevent excessive pelvic tilt & instability on the swing leg side (opposite stance leg). Abnormal g. minimus and g. medius on stance leg side may cause the “drop” on the opposite leg side.
Piriformis Syndrome
Impingement scenarios of sciatic nerve.
Intramuscular Injections
Other Features
- Greater sciatic notch
- Lesser sciatic notch
- Greater sciatic foramen
- Lesser sciatic foramen
- Deep Six
Detailed Studies
Notes
References
Biel, A. (2015). Trail guide to the body: A hands-on guide to locating muscles, bones and more.
Cedars-Sinai. (2018). Vertebrae of the spine. Retrieved from https://www.cedars-sinai.org/health-library/diseases-and-conditions/v/vertebrae-of-the-spine.html
Jenkins, G., & Tortora, G. J. (2012). Anatomy and Physiology: From Science to Life, 3rd Edition International Stu. John Wiley & Sons.
Muscolino, J. E. (2017). The muscular system manual: The skeletal muscles of the human body.
