gemellus, obturator muscle, quadratus femoris 등에 대하여

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이상근, 상쌍자근, 내폐쇄근, 하쌍자근, 외폐쇄근, 대퇴방형근

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1. 상쌍자근

The superior gemellus muscle is a muscle of the human body. The Gemelli are two small muscular fasciculi, accessories to the tendon of the Obturator internus which is received into a groove between them. The Gemellus superior, the smaller of the two, arises from the outer surface of the spine of the ischium, blends with the upper part of the tendon of the Obturator internus, and is inserted with it into the medial surface of the greater trochanter.

Etymology: Gemellus is the diminutive of "geminus" meaning twin, doubled or duplicated. The superior and inferior Gemellus muscles are paired and perform the same action.

2. 내폐쇄근

The obturator internus muscle originates on the medial surface of the obturator membrane, the ischium near the membrane, and the rim of the pubis. It exits the pelvic cavity through the lesser sciatic foramen.

The obturator internus is situated partly within the lesser pelvis, and partly at the back of the hip-joint.

It functions to help laterally rotate femur with hip extension and abduct femur with hip flexion, as well as to steady the femoral head in the acetabulum.

It arises from the inner surface of the antero-lateral wall of the pelvis, where it surrounds the greater part of the obturator foramen, being attached to the inferior rami of the pubisand ischium, and at the side to the inner surface of the hip bone below and behind the pelvic brim, reaching from the upper part of the greater sciatic foramen above and behind to the obturator foramen below and in front. It also arises from the pelvic surface of the obturator membrane except in the posterior part, from the tendinous arch which completes the canal for the passage of the obturator vessels and nerve, and to a slight extent from the obturator fascia, which covers the muscle. The fibers converge rapidly toward the lesser sciatic foramen, and end in four or five tendinous bands, which are found on the deep surface of the muscle; these bands are reflected at a right angle over the grooved surface of the ischium between its spine and tuberosity. The tendon inserts on the greater trochanter of the proximal femur. Obturator Internis muscle is also innervated by the nerve to obturator internis (L5, S1).

Bursa/bands[edit]

This bony surface is covered by smooth cartilage, which is separated from the tendon by a bursa, and presents one or more ridges corresponding with the furrows between the tendinous bands. These bands leave the pelvis through the lesser sciatic foramen and unite into a single flattened tendon, which passes horizontally across the capsule of the hip-joint, and, after receiving the attachments of the superior and inferior gemellus muscles, is inserted into the forepart of the medial surface of the greater trochanter above the trochanteric fossa.

A bursa, narrow and elongated in form, is usually found between the tendon and the capsule of the hip-joint; it occasionally communicates with the bursa between the tendon and the ischium.

3. 하쌍자근

The inferior gemellus muscle is a muscle of the human body. The Gemelli are two small muscular fasciculi, accessories to the tendon of the Obturator internus which is received into a groove between them.

The Gemellus inferior arises from the upper part of the tuberosity of the ischium, immediately below the groove for the Obturator internus tendon. It blends with the lower part of the tendon of the Obturator internus, and is inserted with it into the medial surface of the greater trochanter. Rarely absent.

4. 외폐쇄근

The obturator externus muscle (/ˌɒbtjʉˈreɪtər ɨkˈstɜrnəs/) (OE) is a flat, triangular muscle, which covers the outer surface of the anterior wall of the pelvis.

It is sometimes considered part of the medial compartment of thigh,^[1] and sometimes considered part of the gluteal region.^[2]

Structure[edit]

It arises from the margin of bone immediately around the medial side of the obturator foramen, viz., from the inferior ramus of the pubis, and the ramus of the ischium; it also arises from the medial two-thirds of the outer surface of the obturator membrane, and from the tendinous arch which completes the canal for the passage of the obturator vessels and nerves.

The fibers springing from the pubic arch extend on to the inner surface of the bone, where they obtain a narrow origin between the margin of the foramen and the attachment of the obturator membrane.

The fibers converge and pass posterolateral and upward, and end in a tendon which runs across the back of the neck of the femur and lower part of the capsule of the hip joint and is inserted into the trochanteric fossa of the femur.

Relations[edit]

The obturator vessels lie between the muscle and the obturator membrane; the anterior branch of the obturator nerve reaches the thigh by passing in front of the muscle, and the posterior branch by piercing it.

Variation[edit]

In 33% of people a supernumerary muscle is found between the adductor brevis and minimus. While this muscle, when present, is similar to its neighbouring adductors, it is formed by separation from the superficial layer of the obturator externus, and is thus not ontogentically related to the adductor muscles of the hip. This muscle originates from the upper part of the inferior ramus of the pubis from where it runs downwards and laterally. In half of cases, it inserts into the anterior surface of the insertion aponeurosis of the adductor minimus. In the remaining cases, it is either inserted into the upper part of the pectineal line or the posterior part of the lesser trochanter.^[3]

It has been demonstrated by the course of the posterior branch of obturator nerve that the obturator externus is divided into a superior fasciculus and a main belly. The supernumerary muscle described above originates from the superior fasciculus, while an anomalous fasciculus — also derived from the obturator externus — originates from the main belly. The "original" obturator externus, i.e. without these supernumerary muscular parts, actually occurs in only 20% of cases, and apparently the obturator externus readily undergoes ontogenetic variations.^[4]

Obturator externus act as lateral rotator hip joint. As a short muscle around hip joint it stabilizes hip joint as a postural muscle.

5. 대퇴방형근

The quadratus femoris is a flat, quadrilateral skeletal muscle. Located on the posterior side of the hip joint, it is a strong external rotator and adductor of the thigh,^[2] but also acts to stabilize the femoral head in the Acetabulum.

It originates on the lateral border of the ischial tuberosity of the ischium of the pelvis.^[1] From there, it passes laterally to its insertion on the posterior side of the head of the femur: the quadrate tubercle on the intertrochanteric crest and along the quadrate line, the vertical line which runs downward to bisect the lesser trochanter on the medial side of the femur. Along its course, quadratus is aligned edge to edge with the inferior gemellus above and the adductor magnus below, so that its upper and lower borders run horizontal and parallel.^[3] At its origin, the upper margin of the adductor magnus is separated from it by the terminal branches of the medial femoral circumflex vessels. A bursa is often found between the front of this muscle and the lesser trochanter. Sometimes absent.

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