Studying anatomy & physiology grouped by regions of the body.
WORK IN PROGRESS…LAST UPDATE 01.20.2020
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
Anterior Thigh Compartment: Quadriceps Group, Knee Extensors
| Rectus femoris | AIIS. | Via patellar ligament to tibial tuberosity. | Knee extension; hip flexion. |
| Vastus lateralis | Lateral lip of linea aspera, gluteal tuberosity, greater trochanter. | Via patellar ligament to tibial tuberosity. | Knee extension. |
| Vastus medialis | Medial lip of linea aspera. | Via patellar ligament to tibial tuberosity. | Knee extension. |
| Vastus intermedius | Anterior & lateral shaft of femur. | Via patellar ligament to tibial tuberosity. | Knee extension. |
Innervated by femoral nerve (ventral rami L2-4).
Anterior Thigh Compartment: Hip Flexors
| Pectineus | Superior ramus of pubis. | Pectineal line of femur. | Adduct & flex thigh at hip joint. |
| Psoas major | T12-L5 vertebral bodies, transverse processes, and IV discs. | Lesser trochanter of femur. | Hip flexion. |
| Iliacus | Iliac fossa. | Lesser trochanter of femur. | Hip flexion. |
| Sartorius | ASIS. | Anterior, medial, proximal surface of tibia via pes anserinus. | "Cross leg". Flex, abdcuts, laterally rotates thigh at hip, flexes knee. |
Innervated by femoral nerve (ventral rami L2-4).
Medial Compartment of the Thigh: Hip Adductors
| Adductor longus | Pubic tubercle/body of pubis. | Middle 3rd of medial lip of linea aspera. | Hip adduction. |
| Adductor brevis | Body & inferior ramus of pubis. | Pectineal line & medial lip of linea aspera. | Hip adduction. |
| Adductor magnus | Inf. ramus of pubis, raus of ischium, ischial tuberosity. | Gluteal tuberosity, medial linea aspera, adductor tubercle of femur. | Hip adduction & flexes & extends thigh. |
| Gracilis | Body & inf. ramus of pubis. | Anterior proximal medial surface of tibia; pes anserinus. | Hip adduction; flexes leg at knee. |
- Gracilis
- Adductor longus
- Adductor brevis
- Adductor magnus
- Innervated by the obturator nerve (ventral rami of L2-4).
- Memorization: “Grab My Leg Baby Please”.
Joints of the Pelvic Girdle
- Pubic symphasis: between the two halves of coxa at the pubic tubercle; fibrocartilaginous joint.
- Sacroiliac: between the sacrum and ilium; synovial joint, plane/gliding.
- Coxofemoral (hip): between the coxa and femur; synovial joint, ball and socket.
Ligaments/Tendons
- Anterior longitudinal ligament (extracapsular).
- Iliolumbar ligament (extracapsular).
- Anterior sacroiliac ligament (extracapsular).
- Sacrospinous ligament (extracapsular).
- Sacrotuberous ligament (extracapsular).
- Posterior sacroiliac ligament (extracapsular).
- Interosseous sacroiliac ligaments (extracapsular).
- Iliofemoral ligament.
- Pubofemoral ligament.
- Ischiofemoral ligament.
- Inguinal ligament.
Vascular Supply
- Common iliac artery
- External iliac artery
- Internal iliac artery
- Superior gluteal artery
- Inferior gluteal artery
- Lateral circumflex femoral artery
- Medial circumflex femoral artery
- Deep artery of thigh/profunda femoris artery
- First perforating artery
- Obturator artery
- Femoral artery
- Great saphenous vein
- Femoral vein
- Small saphenous vein
- Popliteal vein
- External iliac vein
Innervation
- Obturator nerve (ventral rami of L2-4).
- Femoral nerve (ventral rami L2-4).
Clinical/Pathology
Other Features
Pes Anserinus (“goose foot”)
Where the 3 tendons (sartorius, gracilis, semitendinosus) insert at the anterior, medial, proximal surface of the tibia (SGT AMP).
Femoral Triangle
- The triangular region bounded by: inguinal ligament, adductor longus, sartorius, pectineus/iliopsoas, fascia lata.
- Inside the triangle: femoral nerve, femoral artery, femoral vein, deep inguinal lymph nodes, all of which is wrapped in a fascial femoral sheath.
- https://radiopaedia.org/images/51434733
Retro-Inguinal Space or “Bogro’s Space”
- Deep to the inguinal ligament, in the extraperitoneal space (i.e. outside the peritoneum), there are two compartments.
- Medial compartment contains: vessels including femoral artery and vein.
- Lateral compartment is a passageway for iliopsoas to attach to the lesser trochanter of the femur along the femoral nerve.
- https://www.imaios.com/en/e-Anatomy/Anatomical-Parts/Retroinguinal-space
Adductor Canal aka Subsartorial Canal aka Hunter’s Canal
- It is a narrow aponeurotic tunnel/channel from the middle 1/3 of the thigh from the apex of the femoral triangle to adductor hiatus (opening of adductor magnus, the “hole”).
- https://teachmeanatomy.info/lower-limb/areas/adductor-canal/
Adductor Hiatus
- The gap/hole in the adductor magnus muscle which allows passageway for the anterior thigh’s femoral vessels to pass through to the posterior thigh and then to the popliteal fossa.
Detailed Studies
Notes
- Joint capsule and ligaments that appear twisted are due to the development stages in embryology.
- Acetabular labrum is an extension of hyaline cartilage in order to increase the surface/contact area for a better fit with the femoral head.
- There is superficial fascia, adipose layer, cutaneous nerves-arteries-veins. These are all very superfiscial.
- Then before you get down to business in the muscles, there’s a deep fascia that acts as an organizer to bundle things up and keep things tidy. The deep fascia organizes not only by compartment, but also by “layers”. E.g. there might be a middle layer of muscle, then there may be another layer of muscle/compartments underneath that middle layer. Fascial compartments also help to separate muscles, nerves, veins and arteries by “likeness” or function.
- When going from superficial to deeper layers, look for those openings/holes/hiatus etc. that connects the more superficial layer to the more deep layer. Usually those openings are for nerves-veins-arteries to pass through and “join up” somewhere or diverge and feed/supply another area.
- Fascia lata is the deep fascia of the thigh.
- The thigh has 3 compartments: anterior, medial, and posterior.
- Muscles in the same compartment are usually (but not always) innervated by one nerve.
- Important nerves/vessels/etc. are deeper for protection. E.g. You don’t want some major artery so close to the skin that it runs a very high risk of getting severed frequently (that just isn’t smart design).
- Sesamoid bones typically add mechanical advantage.
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.
