BMS MSK Asynchronous Lecture 11 .pdf

BMS Anatomy Asynchronous Lecture 11 Gluteal and Posterior Thigh Muscles Presented By: Dr. M. Doroudi; [email protected] Boucher Campus) Moore's Clinically Oriented Anatomy, by Arthur F. Dalley II Ph.D. FAAA (Author), Anne M. R. Agur BSc (OT) MSc Ph.D. FAAA (Author), 9th ed. Upper Limb Chapter; Pages...

BMS Anatomy Asynchronous Lecture 11 Gluteal and Posterior Thigh Muscles Presented By: Dr. M. Doroudi; [email protected] Boucher Campus) Moore's Clinically Oriented Anatomy, by Arthur F. Dalley II Ph.D. FAAA (Author), Anne M. R. Agur BSc (OT) MSc Ph.D. FAAA (Author), 9th ed. Upper Limb Chapter; Pages: 696 – 697, 731 – 741 Link to this module recording Boucher Campus: https://ccnm.ca.panopto.com/Panopto/Pages/Viewer.aspx?id =a8c98db5-c0ba-4b51-a383-af540092f7d9&instance=Moodle Toronto Campus: https://ccnm.ca.panopto.com/Panopto/Pages/Viewer.aspx?id =a9700055-ebf1-49a4-b15aaf5400930384&instance=Moodle Lower Limb Joints Movements 3 Thigh Deep Fascia (Fascia Lata) Deep fascia of the thigh (fascia lata): A tough fibrous sheath that invests the thigh like a sleeve. It is thickened laterally where it forms a band called the iliotibial tract or band (ITT or ITB). The ITT is split in its upper part and invests the tensor fascia lata muscle between its two layers and acts as a tendon for this muscle. Abdominal Palpation 7 Superficial Gluteal Muscles 8 Gluteal Region (superficial) Gluteus maximus, – Ori: 1. Posterior Iliac crest 2. Sacrum 3. Coccyx 4. Sacrotuberous ligament – Ins: 1. Iliotibial tract (band) 2. Gluteal tuberosity of femur – Fun: – N: Gluteus Maximus Notes Main Function Attachment to ITT and its role on knee stability 10 Gluteus medius, is a broad, thick muscle situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus muscle. – Ori: External surface of ilium between the anterior and posterior gluteal lines – Ins: Lat. surface of greater trochanter – Fun: – N: 11 Gluteus minimus – Ori: Gluteal surface of ilium; between the anterior and inferior gluteal lines – Ins: Anterior surface of greater trochanter – Fun: – N: 12 Trendelenburg Sign & Gait 13 Tensor fascia lata: Ori: – Lateral side of ASIS & anterior part of the iliac crest Ins: – Tibia (Gerdy’s tubercle) via ITB (ITT) (1/3 of the way down the thigh) – Fun: – N: 14 Deep Gluteal Muscles (Name, Innervation & Common Function 15 Gluteal Region (Deep) Piriformis – Ori: Anterior sacrum – Ins: Superior border of greater trochanter – Fun: – N: 16 Piriformis Syndrome 17 Piriformis Syndrome 18 Superior gemellus – Ori: Ischial spine – Ins: Medial surface of the greater trochanter – Fun: – N: Nerve to obturator internus (from sacral plexus) 19 Obturator internus – Ori: Inner surface of obturator membrane – Ins: Medial surface of the greater trochanter –Fun: – N: Nerve to obturator internus (from sacral plexus) 20 Inferior gemellus – Ori: Ischial tuberosity – Ins: Medial surface of greater trochanter – Fun: – N: Nerve to quadratus femoris (from sacral plexus) 21 Quadratus femoris – Ori: Ischial tuberosity – Ins: Quadrate tubercle of femur – Fun: – N: Nerve to quadratus femoris (from sacral plexus) 22 Obturator externus – Ori: Outer surface of the obturator membrane – Ins: Trochanteric fossa –Fun: – N: 23 Thigh Compartments o Three intermuscular septae are derived from the fascia lata in the thigh and divide it into 3 compartments: ³ The anterior (extensor) compartment which houses the extensor muscles in the thigh (knee joint extensor) innervated by the femoral nerve. (The sartorius muscle is located in this compartment and is innervated by the femoral nerve; however, it is an exception in that it flexes the hip and knee joints.) ³ The medial (adductor) compartment which houses the adductor muscles of the thigh (hip joint adductor ) innervated by the obturator nerve (with an exception for pectineus muscle that is innervated by femoral nerve and adductor magnus muscle that is innervated by both obturator and tibial nerves). ³ The posterior (flexor) compartment which houses the flexor muscles in the thigh (knee joint flexor) innervated by the sciatic nerve. 24 Posterior Compartment of Thigh Biceps femoris Ori: – Long head: Ischial tuberosity – Short head: Linea aspera Ins: – Head of fibula – Lateral condyle of tibia – Fun: – N:Tibial (long head) and common fibular (peroneal) (short head) 25 Semitendinosus – Ori: Ischial tuberosity – Ins: Proximal part of medial surface of shaft of tibia (forms Pes anserine tendon) – Fun: – N: 26 Semimembranosus – Ori: Ischial tuberosity – Ins: Posterior aspect of medial condyle of tibia. – Fun: – N: 27 Hamstring Muscles Note Biceps is known as the lateral hamstring & ST & SM as the medial hamstrings Shortening of the hamstring and its effect on LBP 28