class 6 ap1 muscles

Muscles of the Pelvis and Thigh

Review Week 5

Latissimus DorsiP: SPs of T7-L5, posterior

sacrum, and the posterior iliac crest

D: Medial lip of bicipital groove of the humerus

1. Medially rotates the arm at the shoulder joint

2. Adducts the arm at the shoulder joint

3. Extends the arm at the shoulder joint

4. Anteriorly tilts the pelvis at the lumbosacral joint

Rhomboid Major and Minor

• P: SPs of C7-T5• D: Medial border of

the scapula from the root of the spine of the scapula to the inferior angle of the scapula

1. Retracts (Adducts) the scapula at the scapulocostal joint

2. Elevates the scapula

Serratus Anterior

O: Ribs 1-9

I: Anterior surface of the entire medial border of the scapula

1. Protracts (abducts) the scapula at the scapulocostal joint

2. Upwardly rotates the scapula at the scapulocostal joint

Serratus Posterior Superior

• 1. Elevates ribs #2-5 at the sternocostal and costospinal joints

Serratus Posterior Inferior

• 1. Depresses ribs #9-12 at the sternocostal and costospinal joints

Erector Spinae Group

O: PelvisI: Spine, ribcage, and head

1. Extends the trunk, neck, and the head at the spinal joints

2. Laterally flexes the trunk, neck, and head at the spinal joints

3. Ipsilaterally rotates the trunk, neck, and head at the spinal joints


Transversospinalis Group

O: PelvisI: Spine and the head

1. Extends the trunk, neck, and head at the spinal joints

2. Laterally flexes the trunk, neck, and head at the spinal joints

3. Contralaterally rotates the trunk and the neck at the spinal joints

4. Anteriorly tilts the pelvis at the lumboscaral joint

Quadratus Lumborum

P: 12th rib and the TPs of L1-L4

D: Posterior Iliac crest

1. Elevates the pelvis at the lumbosacral joint


3. Laterally flexes the trunk at the spinal joints

4. Extends the trunk at the spinal joints

Pectoralis Major

• P: Medial clavicle, sternum, and the costal cartilages of ribs 1-7

• D: Lateral lip of the bicipital groove of the humerus

1. Adducts the arm at the shoulder joint

2. Medially rotates the arm at the shoulder joint

3. Flexes the arm at the shoulder joint (clavicular head)

Pectoralis Minor

P: Ribs 3-5

D: Coracoid process of the scapula

1. Protracts (abducts) the scapula at the scapulocostal joint

2. Depresses the scapula at the scapulocostal joint

3. Elevates ribs 3-5 at the sternocostal and costospinal joints

Diaphragm

• Increases the volume of the Thoracic Cavity (inspiration)

RectusAbdominis

P: Pubis

D: Xiphoid process and the cartilage of ribs 5-7

1.Flexes the trunk at the spinal joints

2.Posteriorly tilts the pelvis at the lumbosacral joint

External ObliqueP: Anterior iliac crest, pubic

bone, and the abdominal aponeurosis

D: Lower 8 ribs (5-12)

1. Flexes the trunk at the spinal joints


3. Contralateral rotates the trunk at the spinal joints

4. Posteriorly tilts the pelvis at the lumbosacral joints

Internal ObliqueO: Inquinal ligament, iliac crest,

and the thoracolumbar fascia

I: Lower three ribs (10-12) and the abdominal aponeurosis



3. Ipsilaterally rotates the trunk at the spinal joints

4. Posteriorly tilts the pelvis at the lumbosacral joints

Transverse Abdominis

• Compresses the abdominal contents

Psoas Major

P: Anterolateral lumbar spine

D: Lesser trochanter of the femur

1. Flexes the thigh at the hip joint

2. Laterally rotates the thigh at the hip joint



5. Anteriorly tilts the pelvis at the hip joints

Iliacus

P: Internal Ilium

D: Lesser trochanter of the femur



3. Anteriorly tilts the pelvis at the hip joints

Psoas Minor


2. Posteriorly tilts the pelvis at the lumbosacral joint

Gluteus Maximus

P: Posterior iliac crest, posterolateral sacrum, and the coccyx

D: Iliotibial band (ITB) and gluteal tuberosity of the femur

1. Extends the thigh at the hip joint


3. Abducts the thigh at the hip joint (upper 1/3)

4. Adducts the thigh at the hip joint (lower 2/3)

5. Posteriorly tilts the pelvis at the hip joint

Gluteus Medius

P: External Ilium

D: Greater trochanter of the femur

1. Abducts the thigh at the hip joint (entire muscle)

2. Flexes the thigh at the hip joint (anterior fibers)

3. Medially rotates the thigh at the hip joint (anterior fibers)

4. Extends the thigh at the hip joint (posterior fibers)

5. Laterally rotates the thigh at the hip joint (posterior fibers)

6. Posteriorly tilts the pelvis at the hip joint (posterior fibers)

7. Anteriorly tilts the pelvis at the hip joint (anterior fibers)

Gluteus Minimus

P: External Ilium


1. Abducts the thigh at the hip joint (entire muscle)

2. Flexes the thigh at the hip joint (anterior fibers)

3. Medially rotates the thigh at the hip joint (anterior fibers)

4. Extends the thigh at the hip joint (posterior fibers)

5. Laterally rotates the thigh at the hip joint (posterior fibers)

6. Posteriorly tilts the pelvis at the hip joint (posterior fibers)

7. Anteriorly tilts the pelvis at the hip joint (anterior fibers)

Deep Lateral Rotators of the Thigh

• Piriformis

• Superior Gemellus

• Obturator Internus

• Inferior Gemellus

• Obturator Externus

• Quadratus Femoris

Piriformis

P: Anterior sacrum



Tensor Fasciae Latae (TFL)

P: Anterior Superior Iliac Spine

D: Iliotibial band (ITB)


2. Abducts the thigh at the hip joint

3. Medially rotates the thigh at the hip joint

4. Anteriorly tilts the pelvis at the hip joint

Sartorius

P: Anterior superior iliac spine (ASIS)

D: Pes Anserine Tendon (at the proximal anteromedial tibia)


2. Abducts the thigh at the hip joint


4. Flexes the leg at the knee joint


Pes Anserine

• The three muscles that attach here are from anterior to posterior:

1.Sartorius

2.Gracilis

3.Semitendinosus

Rectus Femoris

P: Anterior Inferior iliac spine (AIIS)

D: Tibial Tuberosity

1.Extends the leg at the knee joint

2.Flexes the thigh at the hip joint

3.Anteriorly tilts the pelvis at the hip joint

Vastus Lateralis

P: Linea Aspera of the femur

D: Tibial tuberostiy

1. Extends the leg at the knee joint

Vastus Medialis

P: Linea Aspera of the femur

D: Tibial tuberosity


Vastus Intermedius

P: Anterior shaft and the linea aspera of the femur

D: Tibial tuberosity


Pectineus

P: Pubis

D: Proximal posterior shaft of the femur

1. Adducts the thigh at the hip joint



Adductor Longus

P: Pubis

D: Linea aspera of the femur

1.Adducts the thigh at the hip joint



GracilisP: Pubis

D: Pes anserine tendon (at the proximal anteromedial tibia)

1. Adducts the thigh at the hip joint


3. Flexes the leg at the knee joint


Adductor Brevis

P: Pubis





Adductor Magnus

P: Pubis and Ischium



2.Extends the thigh at the hip joint

3.Posteriorly tilts the pelvis at the hip joint

Biceps Femoris

P: Long head: Ischial tuberosity

Short head: Linea aspera

D: Head of the fibula

1. Flexes the leg at the knee joint (entire muscle)

2. Extends the thigh at the hip joint (long head)

3. Posteriorly tilts the pelvis at the hip joint (long head)

Semitendinosus

P: Ischial tuberosity

D: Pes Anserine tendon

1.Flexes the leg at the knee joint


3.Poseteriorly tilts the pelvis at the hip joint

Semimembranosus

P: Ischial tuberosity

D: Medial condyle of the tibia

1.Flexes the leg at the knee joint


3.Posteriorly tilts the pelvis at the hip joint

Have client supine with pillow under kneesPlace palpating hand on the abdomen

between the iliac crest and the 12th rib and palpate deeply with even pressure toward the psoas major. GO SLOW

Ask the client to slowly flex the thigh at the hip joint and feel for contraction of the psoas major

The distal tendon of the psaos major is palpable in the proximal anterior thigh between the pectineus and the sartorius

Have client supine with a pillow under the knees. Have the knee flexed and slightly laterally rotated

Place palpating hand on the anterior iliac crest and palpate into the iliac fossa with your finger tips. Most of the iliacus is not palpable

Ask the client to actively flex the thigh at the hip joint and feel for the contraction of the iliacus

Have client supinePlace palpating hand just distal and slightly

medial to the ASISAsk client to actively flex and laterally rotate

the thigh at the hip joint and feel for the contraction of the sartorius

Continue palpating the sartorius from the ASIS to the pes anserine tendon

To further bring out the muscle give the client resistance

Have client supinePlace palpating hand just distal and slightly

lateral to the ASISHave client actively hold the thigh in a

position of flexion and medial rotation at the hip joint

Resist the client from further flexion of the thigh at the hip joint and feel for the contraction of the TFL

Continue palpating the TFL distally and slightly posteriorly toward ITB attachment

Have client supine with a pillow under their knees

Place palpating hand just proximal to the patellaResist the client from actively extending the leg

at the knee joint and feel for the contraction of the rectus femoris

Continue palpating the muscle toward the ASISTo palpate the proximal attachment passively

flex the thigh at the hip joint and palpate slightly distal to the ASIS

Have client supinePlace palpating hand just distal to the greater

trochanterAsk the client to contract the quadriceps

femoris group and feel for contraction of the vastus lateralis

Continue palpating distally toward the patella

Have client supinePlace palpating hand just proximal and

medial to the patellaAsk the client to contract the quadriceps

femoris group and feel for the contraction of the vastus medialis

Continue palpating the vastus medialis proximally as far as possible

The vastus medialis is best palpated medially in the distal 1/3 of the thigh

Deep and difficult to palpateHave client supinePlace palpating hand just proximal to the patellaIf the rectus femoris can be lifted and/or moved

aside, the distal vastus intermedius may be palpated deep to the rectus femoris when approached from either the medial or lateral side

To feel the vastus intermedius deep to the rectus femoris, make sure that the direction of your pressure is directed toward the middle of the femur

Have the client supine with the their knee resting on a pillow or your inferior thigh

Palpate the medial thigh for the “guitar string” muscle. This is the gracilis

Ask the client to flex the leg at the knee joint against resistance of the table and only the gracilis will contract

Once located continue palpating medially toward the pubic attachment and distally to the pes anserine attachment. Ask the client to adduct the thigh at the hip joint to distinguish it from the semitendinosus

Have the client supine with their thigh flexed at the hip joint and slightly laterally rotated resting their thigh on a pillow or your inferior leg

Place palpating hand on the proximal anteromedial thigh

Ask the client to actively adduct the thigh at the hip joint

Follow the adductor longus’ tendon proximally toward the pubis

The tendon will be just lateral to the attachment of the gracilis

Have the client supinePlace palpating hand just lateral to the pubic

tubercle and feel for the pectineus Continue palpating just lateral and slightly

proximal to the adductor longusTo further bring out the pectineus ask the

client to actively adduct the thigh at the hip joint

The biceps femoris is superficial for most of its course in the posterolateral thigh and is easy to palpate

Have the client prone with the leg partially flexed at the knee joint

Place palpating hand on the distal posterolateral thigh

Resist the client from performing further flexion of the leg at the knee joint and feel for the distal tendon of the biceps femoris

Continue palpating the biceps femoris toward the ischial tuberosity

The semitendinosus is superficial for most of its course in the posteromedial thigh and is easy to palpate


Place palpating hand on the posteromedial thighFurther resist flexion of the leg at the knee joint

and feel for the distal tendon of the semitendinosus

Continue palpating the muscle proximally toward the ischial tuberosity. Its attachment is just medial to the long head of the biceps femoris

Best palpated distally in the posterior thigh, medial to the belly of the semitendinosus, and on either side of the distal tendon of the semitendinosus


Place palpating hand on the distal posteromedial thigh

Resist the client from performing further flexion of the leg at the knee joint and feel for contraction of the semimembranosus

The proximal attachment on the ischial tuberosity is lateral to the attachment of the long head of the biceps femoris

Have the client proneFind the ischial tuberosity attachment and

proximal belly of the hamstrings by having the client flex the leg at the knee joint against your resistance.

Locate the medial border of the hamstrings in the proximal thigh.

Palpate just anteromedial to the medial border of the hamstrings for the adductor magnus. This will feel like a natural depressionin the thigh

Continue palpating proximally to the attachment on the ischial tuberosity

Have client proneFollow palpation of the Adductor Magnus The tendon of the adductor brevis is just

medial to the attachment of the adductor magnus on the pubic bone

Have client pronePlace palpating hand just lateral to the sacrum

at a point mid way between the PSIS and the apex of the sacrum

Have client flex the leg at the knee joint to 90 degrees

Have client laterally rotate the thigh at the hip joint against resistance and feel for contraction of the piriformis

Continue palpating laterally to the greater trochanter of the femur

Have client lay pronePlace palpating hand on the lateral sacrumPalpate the gluteus maximus from its medial

attachment (lateral sacrum) to its lateral attachment (ITB)

Have the client actively extend and laterally rotate the thigh at the hip joint to further bring out the muscle.

The gluteus maximus does not cover the entire buttocks; the gluteus medius is just inferior to most of the posterior iliac crest

Have client side lyingMiddle portion: Place palpating hand between the

iliac crest and the greater trochanter of the femur. Ask client to abduct the thigh at the hip joint

Anterior portion: Place palpating hand just posterior and inferior to the ASIS and feel for the anterior fibers. Ask client to flex and medially rotate the thigh at the hip joint.

Posterior portion: Palpate just deep to the superolateral portion of the gluteus maximus and have the client extend and laterally rotate the thigh at the hip joint.

Distinguishing gluteus medius from glut max and piriformis can be difficult

It is difficult to differentiate the gluteus medius from the gluteus minimus because the gluteus medius entirely overlies the gluteus minimus and they have identical actions

Do the same procedure for gluteus medius and palpate deeper

class 6 ap1 muscles

Health & Medicine

hip joint flexes

hip joints

scapulocostal joint

hip joint lower

hip joint upper

hip joint posterior

hip joint anterior fibers

lumboscaral joint