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Obturator internus (m. obturator internus/внутренняя запирательная мышца)
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· Origin: From the inner surface of the hip bone and the obturator membrane.
· Insertion: To the greater trochanter via the lesser sciatic notch.
· Action: Lateral rotation of the thigh.
· Nerve supply: From the sacral plexus.
Gemellus superior and inferior (mm. gemelli superior et inferior /верхняя, нижняя близнецовые мышцы)
· Origin. The superior muscle arises from the ischial spine; the inferior muscle arises from the iscial tuberosity.
· Insertion. To the greater trochanter via the lesser sciatic notch, together with the obturator internus..
· Action. Lateral rotation of the thigh.
· Nerve supply. From the sacral plexus.
Quadratus femoris (m. quadratus femoris /квадратная мышца бедра)
· Origin. From the outer surface of the ischial tuberosity.
· Insertion. To the quadrate tubercle on the intertrochanteric сrest of the femur.
· Action. Lateral rotation of the thigh.
· Nerve supply. From the sacral plexus.
Obturator externus (m. obturator externus /наружная запирательная мышца)
· Origin. From the obturator membrane and the surrounding bone.
· Insertion. To the trochanteric fossa of the femur.
· Action. Lateral rotation of the thigh.
· Nerve supply. Obturator nerve.
Muscles of the thigh
The anterior group
Sartorius (m. sartorius/портняжная мышца)
· Origin. From the anterior superior iliac spine.
· Insertion. To the medial side of the upper end of the tibia just in front of gracilis and semitendinosus.
· Actions. Flexion and abduction of the thigh and flexion of the knee (the ‘tailor’s position’).
· Nerve supply. Femoral nerve.
Quadriceps femoris (m. quadriceps femoris /четырехглавая мышца бедра):
Rectus femoris
· Origin. From the anterior inferior iliac spine (straight head) and the upper lip of the acetabulum (reflected head).
Vastus medialis
· Origin. From the medial lip of the linea aspera.
Vastus lateralis
· Origin. From the lateral lip of the linea aspera.
Vastus intermedius
· Origin. From the lateral and anterior surfaces of the femur.
· Insertion of quadriceps. The four parts of quadriceps are inserted into the patella and, from here, to the tubercle of the tibia. The patella is thus a sesamoid hone in the tendon of quadriceps.
· Actions. Extension and stabilization of the knee. Rectus is also a weak flexor of the thigh.
· Nerve supply. Femoral nerve.
The medial group
Pectineus (m. pectineus /гребенчатая мышца)
· Origin. From the superior ramus of the pubis.
· Insertion. To the back of the femur between the lesser trochanter and the linea aspera.
· Acrions. Adduction and flexion of the thigh.
· Nerve supply. Femoral and obturator nerves.
Adductor longus (m. adductor longus /длинная приводящая мышца)
· Origin. From the front of the pubis just below the pubic tubercle.
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· Insertion. To the middle third of the linea aspera.
· Action. Adduction of the thigh.
· Nerve supply. Obturator nerve.
Adductor brevis (m. adductor brevis/короткая приводящая мышца)
· Origin. From the inferior ramus of the pubis.
· Insertion. To the upper part of the linea aspera.
· Action. Adduction of the thigh.
· Nerve supply. Obturator nerve.
Adductor magnus (m. adductor magnus /большая приводящая мышца)
· Origin. From the inferior ramus of the pubis and the ramus of the ischium. back as far as the ischial tuberosity.
· Insertion. To the whole length of the linea aspera and to the adductor tubercle of the femur.
· Actions. Adduction and extension of the thigh (the latter action is carried out by the ‘hamstring’ part of the muscle which arises from the ischial tuberosity).
· Nerve supply. Adductor part by the femoral nerve and hamstring part by the sciatic nerve.
Gracilis (m. gracilis/тонкая мышца)
· Origin. From the inferior ramus of the pubis and the ramus of the ischium.
· Insertion. To the medial side of the tibia between sartorius and semitendinosus.
· Action. Adduction of the thigh.
· Nerve supply. Obturator nerve.
The posterior group
Biceps femoris (m. biceps femoris /двуглавая мышца бедра)
· Origin. Long head from the ischial tuberosity and short head from the linea aspera.
· Insertion. By a thick tendon into the head of the fibula.
· Actions. Extension of the hip and flexion of the knee.
· Nerve supply. Sciatic nerve (both components).
Semitendinosus (m. semitendinosus /полусухожильная мышца)
· Origin. From the ischial tuberosity.
· Insertion. To the medial side of the front of the tibia, behind sartorius and gracilis.
· Actions. Extension of the hip and flexion of the knee joint.
· Nerve supply. Sciatic nerve (tibial component).
Semimembranosus (m. semimembranosus /полуперепончатая мышца)
· Origin. From the ischial tuberosity.
· Insertion. To a groove on the tibial medial condyle.
· Actions. Extension of the hip and flexion of the knee.
· Nerve supply. Sciatic nerve (tibial component).
Fasciae of the hip region and the thigh
The iliac fascia (fascia iliaca/подвздошная фасция)
· This fascia covers the iliopsoas muscle (it is the part of the common subperitoneal fascia).
· Below the inguinal ligament the iliac fascia descends on the thigh, where it is continues with the fascia lata.
The fascia lata (fascia lata/широкая фасция)
· It covers the muscles of the thigh.
· Just below the inguinal ligament, within the boundaries of the femoral triangle, the fascia is divided into two layers.
- The deep layer passes behind the vessels of the thigh.
- The superficial layer passes in front of the thigh vessels and terminates as a free falciform margin (margo falciformis /серповидный край).
- Two horns are distinguished in the falciform margin: the inferior horn (cornu inferius /нижний рог) blends with the deep layer of fascia lata, the superior horn (cornu superius /верхний рог) attaches to the inguinal ligament and, curving under it, fuses with the lacunar ligament.
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- The falciform margin bounds a depression called the saphenous opening (hiatus saphenus /подкожная щель).
- The saphenous opening is covered by the cribriform fascia (fascia cribrosa /решётчатая фасция).
· The fascia lata forms the processes which attaché to the bone:
- The lateral femoral intermuscular septum (septum intermusculare femoris laterale /латеральная межмышечная перегородка бедра) separates the vastus lateralis from the posterior muscles.
- The medial femoral intermuscular septum (septum intermusculare femoris mediale /медиальная межмышечная перегородка бедра) separates the vastus medialis from the medial muscles.
· The fascia lata on the lateral side forms a wide thickened band, the iliotibial tract (tractus iliotibialis /подвдошно-большеберцовый тракт) extending for the entire length of the thigh. It serves as a tendon for the tensor fascia lata and the gluteus maximus muscles.
· Distally the fascia lata continues with the fascia of the leg. Posteriorly it covers the popliteal fossa.
Topography of the hip region
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