gluteus medius
outer surface of ilium
gluteal aponeurosis
lat. surface of greater trochanter에 있는 oblique ridge
superiorgluteal n.의 br.(L4, 5, S1)
ant. portion: flexes and rotates medially
post. portion: extends and rotates laterally
gluteus minimus
outer surface of ilium(ant. gluteal line과 inf. gluteal line 사이)
greater sciatic notch의 margin
anterosuperior border of greater trochanter of femur
superior gluteal n.(L4, L5, S1)
rotates thigh medially
abducts thigh
flexes thigh
rectus femoris
ant. inf. iliac spine, brim of acetabulum위 groove base of patella
femoral n.(L2, 3, 4)
flexes thigh, extends leg
muscle
proximal attachment
distal attachment
nerve innervation
main action
iliacus
iliac crest, iliac fossa, ala of sacrum, ant. sacroiliac lig. tendon of psoas major, body femur, lesser trochanter의 inf. part femoral n.(L2, 3)
flexion of thigh
(3) Sup. border (Iliac Crest)
① external lip : Fascia lata
Tensor Fasciae lata m.(O)
Ext. Oblique Abdominis m.(I)
Latissimus Dorsi m.(O)
② internal lip : Transverse Abdominis m.(O)
Quadratus Lumborum m.(O)
Erector Spinae m.(O)
Iliacus m.(O)
Lumbodorsal fascia
Iliac fascia
③ intermediate line : Int. Oblique Abdominis m.(O)
muscle
proximal attachment
distal attachment
nerve innervation
main action
tensor fasciae lata
ASIS, ant. part of ext. lip of iliac crest
lat. condyle of tibia
sup. gluteal(L4, 5)
abduction, med. rotation & flexion of thigh
ext. oblique abdominis
ext. surface of 5th to 12th ribs
linea alba, pubic tubercle and ant. half of iliac crest inf. six thoracic nn. and subcostal n.
compress and support abdominal viscera
flex and rotate trunk
int. oblique abdominis
thoracolumbar fascia, ant. two-thirds of iliac crest, and lat. half of inguinal lig. inf. borders of 10th to 12th ribs, linea alba and the pubis via the conjoint tendon ventral rami of inf. six thoracic and first lumbar nn.
compress and supports abdominal viscera
transverse abdominis
int. surface of 7th to 12th costal cartilage, thoracolumbar fascia, iliac crest and lateral third of inguinal lig.
linea alba with aponeurosis of internal oblique, pubic crest and pectin pubis via conjoint tendon vertebral branches of T12 and L1 to L5
quadratus lumborum
medial half of inf. border of 12th rib and tips of lumbar transverse proc.
iliolumbar lig. and int. lip of iliac crest
extends and laterally flexes the vertebral column ; fixes 12th rib during inspiration
erector spinae
sacrum, spinous process of lumbar vertebrae, spinous proc. of 11th and 12th thoracic vertebrae and iliac crest longissimus m., spinalis m. and iliocostal m.
thoracic and lumbar spinal n.
extend the vertebral column, stabilize the position of the vertebral column
iliacus
superior two- thirds of iliac fossa, ala of sacrum and ant. sacroiliac lig. lesser trochanter to femur and shaft of femur inferior to it
femoral n. (L2 to L4)
flexes thigh and stabilizes hip joint ; acts with psoas major
latissimus dorsi
spinous processes of the inferior six thoracic vertebrae, thoracolumbar fascia, iliac crest, and inferior 3 or 4 ribs floor of intertubercular groove of humerus
thoracodorsal n. (C6, C7 and C8)
extends, adducts and medially rotates humerus ; raise body towards arms during climbing
(4) Ant. border
① Ant. Sup. Iliac Spine (ASIS)
-Fascia lata
-Tensor Fasciae lata m.
-Iliacus m.(O)
-Inguinal lig.
-Sartorius m.(O)
** Inguinal lig.**
-Abdomen과 Thigh의 경계
-attachment
ant. Sup. Iliac Spine
pubic Tubercle
muscle
proximal attachment
distal attachment
nerve innervation
main action
tensor fasciae lata
ASIS, ant. part of ext. lip of iliac crest
lat. condyle of tibia
sup. gluteal(L4, 5)
abduction, med. rotation & flexion of thigh
iliacus
iliac crest, iliac fossa, ala of sacrum, ant. sacroiliac lig. tendon of psoas major, body femur, lesser trochanter의 inf. part femoral n.(L2, 3)
flexion of thigh
sartorius
ant. superior iliac spine
med. surface of tibia의 상부(tuberosity의 med.)
femoral n.(L2, 3)
flexes and rotates laterally (thigh), leg의 flexion & medial rotation
abduction of thigh
② Ant. Inf. Iliac Spine (AIIS)
-Rectus Femoris m.의 straight tendon.(O)
-Iliofemoral lig.
muscle
proximal attachment
distal attachment
nerve innervation
main action
rectus femoris
ant. inf. iliac spine, brim of acetabulum위의 groove base of patella
femoral n.(L2, 3, 4)
flexes thigh, extends leg
③ Iliopubic Eminence (Iliopectineal Eminence)
-Ilium과 Pubis의 융합지점
(5) Post. border
① Post. Sup. Iliac Spine (PSIS)
-Dorsal Sacroiliac lig.의 oblique 부분.
-Multifidus m.(I)
② Post. Inf. Iliac Spine (PIIS)
muscle
proximal attachment
distal attachment
nerve innervation
main action
multifidus
dorsal surface of the sacrum, transverse processes of the all lumbar, thoracic and lower cervical vertebrae (1st∼3rd span) spinous proc. of lumbar, thoracic and cervical vertebrae up to axis
dorsal primary divisions of cervical, thoracic and lumbar spinal nn.
extend the vertebral column, stabilize the position of the vertebral column
C. Ischium
-Hip Bone의 post. & inf.의 부분으로 L-shape.
-구성: body + ramus
1) Body
① Ischial Spine
-Sup. Gemellus m.
-Coccygeus m.
-Levator Ani m.
-Pelvic Fascia
-Sacrospinous lig.
muscle
proximal attachment
distal attachment
nerve innervation
main action
sup. gemellus
ischial spine의 outer surface med. surface of greater trochanter br. of n. to obturator internus(L5, S1, 2) rotates thigh laterally
coccygeus
ischial spine
lat, surface of lower sacrum and coccyx
br. of sacral nn. (S4 and S5)
strengthens the pelvic diaphragm in conjunction with the sacrospinal lig.
levator ani
tendinous arch of the levator ani muscle which bridges the obturator internus muscle
external sphincter muscle, sacrum and coccyx
br. of sacral nn. (S3 and S4)
the muscular sling around the rectum ; its free medial border forms the urogenital hiatus for the urethra ; the muscle acts as a support for the pelvic diaphragm
② Greater Sciatic Notch
-Post. Inf. Iliac Spine과 Ischial Spine 사이의 notch
③ Lesser Sciatic Notch
-Ischial Spine과 Ischial tuberosity 사이의 notch.
④ Ischial tuberosity
a. Upper part: Quadrilateral shape.
Hamstring m.(O)
b. Lover Part: Triangular shape 앉은 자세시 닿는 부위.
Adductor magnus m.
Sacrotuberous lig.
muscle
proximal attachment
distal attachment
nerve innervation
main action
adductor magnus
adduction part(upper portion): inf. ramus of pubis, inf. ramus of ischium
extension part: ischial tuberosity
extension part: br. of sciatic nerve (tibial n.)
adduction part: linea aspera of femur
extension part: adductor tubercle of femur
adduction part: br. of post. division of obturator n. (L2,3,4)
entire muscle: adducts thigh
upper portion: rotates thigh medially and flexes it
lower portion: extends thigh and rotates it laterally
** Hamstring m. **
-2개의 joint 경유. (hip & knee joint)
-Tibial division of Sciatic n. 지배받음.
-3개의 m.구성: Semitendinous
Semimembranosus
long head of Biceps Femoris m.
muscle
proximal attachment
distal attachment
nerve innervation
main action
semitendinous
ischial tuberosity(lower, med. impression) med. surface of body of tibia tibial n.
(L5, S1, S2)
extends thigh, flexes leg
semimembranosus
proximal, outer impression of ischial tuberosity post. med. aspect of med. condyle of tibia tibial n.
(L5, S1, S2)
extends thigh, flexes leg
biceps femoris
long head:
① ischial tuberosity의 inner med. part
② inf. part of sacrotuberous lig.
short head:
lat. lip of linea aspera of femur, lat. intermuscular septum
long head: head of fibula, lat. condyle of tibia
short head: lat. condyle of tibia
long head: tibial n. (S1, 2, 3)
short head: common peroneal n. (S1, 2, L5)
long head: extends thigh, flexes leg
short head: flexes leg
** Greater Sciatic foramen **
-Sacrotuberous lig.와 Sacrospinous lig.에 의해 Greater Sciatic notch로 부터 형성.
-Piriformis m.이 통과: 이것에 의해 foramen을 2부분으로 나눔.
a. Suprapiriformic foramen: Sup. Gluteal a., v., n. 통과.
b. Infrapiriformic foramen: Inf. Gluteal a., v., n.
Internal Pudendal a., v.
Pudendal n.
Post. Femoral Cutaneous n.
n. to Obturator Internus m.
n. to Quadratus Femoris m.
Sciatic n.
muscle
proximal attachment
distal attachment
nerve innervation
main action
priformis
pelvic surface of sacrum의 2nd, 3rd, 4th ant. sacral foramen
greater sciatic notch, ant. surface of sacrotuberous lig.
sup. border of greater trochanter
S1 or S1, 2에서 나오는 sacral or sciatic n.
abducts thigh and rotates it laterally
obturator internus
internal surface of sup. & inf. rami of pubis
ramus of ischium
obturator membrane의 internal surface
obturator foramen의 margin
ant. part of med. surface of greater trochanter
L5, S1, 2
rotates thigh laterally
extends and abducts when it is flexed
-Sacrotuberous lig.와 Sacrospinous lig.에 의해 Lesser Sciatic notch로 부터 형성.
-통과구조물: Internal Pudendal a., v.
Pudendal n.
n. to Obturator Internus m.
tendon of Obturator Internus m.
2) Ramus
-pubis의 inf. ramus와 융합
D. PUBIS
-Hip Bone의 ant. & inf. 부분.
-구성: body + sup. ramus + inf. ramus
** Symphysis Pubis **
-2개의 Pubis가 중앙에서 Fibrocartilaginous Disc의 개재로 형성.
-Slightly movable joint.
1) Body
-Acetabulum의 ant. & inf.의 1/5.
2) Sup. Ramus
① Pubic Tubercle: Inguinal lig.부착(Another?)
② Pubic Crest
-sup. & inf. ramus 내측경계
-부착구조물
Inguinal Falx
Rectus Abdominis m.
Pyramidalis m.
Superf. Inguinal lig.
muscle
proximal attachment
distal attachment
nerve innervation
main action
rectus abdominis
pubic symphysis and pubic crest xiphoid process and 5th to 7th costal cartilage ventral rami of inf. six thoracic nn. flexes trunk and compress abdominal viscera
pyramidalis
ventral surface of the pubic, ant. pubic lig. linea alba, midway between umbilicus and pubis tenses the linea alba ; the size of this triangular muscle varies considerably intercostal n.
③ Obturator Crest
-sup. & inf. ramus의 외측경계.
-obturator memb.부착.
④ Iliopectineal Eminence (=Iliopubic eminence)
⑤ Pecten Pubis: Inguinal Falx
Lacunar lig.
Reflected Inguinal lig.
⑥ Iliopectineal line (Arcuate line): Pecten Pubis의 연장.
E. ACETABULUM
-Hip Bone의 lat. surface의 cup-shaped cavity.
-구성: Ilium (2/5)
Ischium (2/5)
Pubis (1/5)
① Lunate Surface
-articular part.
-femur의 head와 관절.
② acetabular fossa
-nonarticular part.
③ acetabular notch
-transverse acetabular lig.
-capitis femoris lig. (head of femur의 fovea에 부착)
** Obturator Foramen **
-Hip bone에 존재하는 foramen.
-위 부분에 Obturator Groove 존재.
-생체에서는 Obturator memb.에 쌓임.
-Obturator Groove와 Obturator memb. 사이에 canal 존재.
→ Obturator a., v., n. 통과.
? BONY PELVIS
A. INTRODUCTION
-구성: 2개 Hip bone + Sacrum + Coccyx
-기능: Truck와 lower Limb연결.
Pelvic viscera보호.(임산부-태아보호)
Pressure에 지탱.
m.부착장소.
** Linea Terminalis **
-Pelvis를 둘 (true & false pelvis)로 나누는 oblique plane.