이상근 - 정리 추가 2022년

[문형철]

1. 좌골신경의 이중압박증후군, 이상근 증후군으로 하지 저림

2. 고관절 외회전 근육, 고관절을 굴곡하면 이상근은 외전 - 보행시 안정성에 중요한 역할

3. 이상근과 좌골신경의 variation은 12-17%나 됨. 

https://youtu.be/dOuc3ZimZok

panic bird..

ak(applied kinesiology)

-  비타민 a

- 신경림프 반사점 전방은 치골결합 상부위, 후방은 후상장골극과 5요추 극돌기 사이 

이상근 촉진법

Structure[edit]

The piriformis muscle originates from the anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the superior margin of the greater sciatic notch(as well as the sacroiliac joint capsule and the sacrotuberous ligament). It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur. Itstendon often joins with the tendons of the superior gemellus, inferior gemellus, and obturator internus muscles prior to insertion.

The piriformis is a flat muscle, pyramidal in shape, lying almost parallel with the posterior margin of the gluteus medius. It is situated partly within the pelvis against its posterior wall, and partly at the back of the hip-joint.

It arises from the front of the sacrum by three fleshy digitations, attached to the portions of bone between the first, second, third, and fourth anterior sacral foramina, and to the grooves leading from the foramina: a few fibers also arise from the margin of the greater sciatic foramen, and from the anterior surface of the sacrotuberous ligament.

The muscle passes out of the pelvis through the greater sciatic foramen, the upper part of which it fills, and is inserted by a rounded tendon into the upper border of the greater trochanter behind, but often partly blended with, the common tendon of the obturator internus and superior and inferior gemellus muscles.

Variation[edit]

In 17% of people, the piriformis muscle is pierced by parts or all of the sciatic nerve. Several variations occur, but the most common type of anomaly (81% of anomalies) is the Beaton's type B which is when the common peroneal nerve pierces the piriformis muscle.

It may be united with the gluteus medius, send fibers to the gluteus minimus, or receive fibers from the superior gemellus.

It may have one or two sacral attachments; or it may be inserted in to the capsule of the hip joint.

Function[edit]

The piriformis muscle is part of the lateral rotators of the hip, along with the quadratus femoris, gemellus inferior, gemellus superior, obturator externus, and obturator internus. The piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion. 

Abduction of the flexed thigh is important in the action of walking because it shifts the body weight to the opposite side of the foot being lifted, which keeps us from falling. The action of the lateral rotators can be understood by crossing your legs to rest an ankle on the knee of the other leg. This causes the femur to rotate and point the knee laterally. The lateral rotators also oppose medial rotation by the gluteus medius and gluteus minimus. When the hip is flexed to 90 degrees, piriformis abducts the femur at the hip (Netter's Clinical Anatomy, 2010)

Clinical significance[edit]

Main article: 

Piriformis syndrome

This syndrome occurs when the piriformis irritates the sciatic nerve, which comes into the gluteal region beneath the muscle, causing pain in the buttocks and referred pain along the sciatic nerve.

 This referred pain is known as sciatica. Seventeen percent of the population has their sciatic nerve coursing through the piriformis muscle. This subgroup of the population is predisposed to developing sciatica. Sciatica can be described by pain, tingling, or numbness deep in the buttocks and along the sciatic nerve. Sitting down, stretching, climbing stairs, and performing squats usually increases pain. Diagnosing the syndrome is usually based on symptoms and on the physical exam. More testing, including MRIs, X-rays, and nerve conduction tests can be administered to exclude other possible diseases.

 If diagnosed with piriformis syndrome, the first treatment involves progressive stretching exercises and physical treatment. Corticosteroids can be injected into the piriformis muscle if pain continues. Findings suggest the possibility thatBotulinum toxin type B may be of potential benefit in the treatment of pain attributed to piriformis syndrome.

 A more invasive, but sometimes necessary treatment involves surgical exploration as a last resort.

Landmark[edit]

The piriformis is a very important landmark in the gluteal region. As it travels through the greater sciatic foramen, it effectively divides it into an inferior and superior part.

This determines the name of the vessels and nerves in this region – the nerve and vessels that emerge superior to the piriformis are the superior gluteal nerve and superior gluteal vessels. Inferiorly, it is the same, and the sciatic nerve also travels inferiorly to the piriformis.

이상근 Trp 탐구

에반스의 이상근 고립스트레칭

[heoss]

감사합니다.

[이상진]

감사합니다^^

[lonlytopl]

이상근은 천골의 전면, 천골결절인대의 골반면에서 기시하고,대퇴 대전자 상연의 내측에 종지합니다. 신전을 돕는 작용르 합니다. 천골신경근(S1,2)의 지배를 받습니다. 종합하면 천골의 전면과 천골결절인대의 골반면에서 기시하여 대좌골궁을 통해 골반을 빠져나와 대퇴골 대전자의 상연에 종지하는 작은 서양배 모양 근육입니다. 둔부에서 핵심위치에 있는 표지점 역할을 하며, 이상근을 기준으로 위로는 상둔신경과 혈관이, 아래로는 하둔신경과 혈관이 나옵니다. 고관절을 안정화시키고 대퇴골두가 관골두안의 위치를 유지하도록 도와주고, 고관절의 굴곡 또는 신전된 상태에 따라 작용이 다릅니다. 보행시 초기 입각기에서 체중을 지탱합니