QuestionsHip Joint and Pelvic Gateways

The arrows are pointing to:

1 the greater sciatic foramen

2 the obturator foramen

3 the pudendal canal

4 the myopectineal orifice

5 the lesser sciatic foramen

The arrows are pointing to:

1 the greater sciatic foramen F

2 the obturator foramen F

3 the pudendal canal F

4 the myopectineal orifice T

5 the lesser sciatic foramen F

Concerning the myopectineal orifice:

1 the femoral nerve traverses (goes through) the myopectineal orifice

2 the superior pubic ramus forms the inferior limit of the myopectineal orifice

3 the external iliac vessels traverse (go through) the myopectineal orifice to become the femoral vessels

4 the sciatic nerve traverses the myopectineal orifice to reach the anterior thigh

5 the obturator nerve traverses the myopectineal orifice

The Sciatic nerve traverses the greater sciatic foramen and the obturator nerve traverses the obturator foramen. Neither traverses the myopectineal orifice.

Concerning the myopectineal orifice:

1 the femoral nerve traverses (goes through) the myopectineal orifice

T

2 the superior pubic ramus forms the inferior limit of the myopectineal orifice

T

3 the external iliac vessels traverse (go through) the myopectineal orifice to become the femoral vessels

T

4 the sciatic nerve traverses the myopectineal orifice to reach the anterior thigh

F

5 the obturator nerve traverses the myopectineal orifice F

The tendon of obturator internus crosses the lesser foramen, not the greater sciatic foramen.

The superior gluteal artery crosses the greater sciatic foramen above the piriformis, not below it.

The inferior gluteal nerve supplies gluteus maximus and of course crosses the greater sciatic foramen below piriformis.

Gluteus medius is supplied by the superior gluteal nerve which crosses the greater sciatic foramen, above priformis, not below it.

The circled area is known as the greater sciatic foramen. The following structures pass through it, below piriformis:

1 tendon of obturator internus

2 superior gluteal artery

3 posterior cutaneous nerve of thigh

4 the nerve which supplies gluteus maximus

5 the nerve which supplies gluteus medius

The circled area is known as the greater sciatic foramen. The following structures pass through it, below piriformis:

1 tendon of obturator internus F

2 superior gluteal artery F

3 posterior cutaneous nerve of thigh T

4 the nerve which supplies gluteus maximus T

5 the nerve which supplies gluteus medius F

Posteriorly the capsule of the hip joint attaches to the posterior surface of the femoral neck, medial to the intertrochanteric crest.

It is the iliofemoral, not ischiofemoral, ligament that reinforces the anterior aspect of the capsule of the hip joint.

The psoas bursa, also known as the iliac bursa, lies immediately in front of the capsule of the hip joint.

The capsule of the hip joint:

1 is attached along the intertrochanteric crest on the posterior aspect of the femoral neck

2 is attached along the intertrochanteric line on the anterior aspect of the femoral neck

3 carries blood vessels to the head of the femur

4 is reinforced on its anterior aspect by the ischiofemoral ligament

5 has the psoas bursa as an immediate anterior relation

The capsule of the hip joint:

1 is attached along the intertrochanteric crest on the posterior aspect of the femoral neck F

2 is attached along the intertrochanteric line on the anterior aspect of the femoral neck T

3 carries blood vessels to the head of the femur T

4 is reinforced on its anterior aspect by the ischiofemoral ligament F

5 has the psoas bursa as an immediate anterior relation T

The Gluteus maximus muscle:

1 is supplied by the superior gluteal nerve

2 is inserted onto the posterior aspect of the femur

3 is inserted into the iliotibial tract

4 is a flexor of the hip joint

5 is a lateral rotator of the hip joint

The Gluteus maximus muscle:

1 is supplied by the superior gluteal nerve F

2 is inserted onto the posterior aspect of the femur T

3 is inserted into the iliotibial tract T

4 is a flexor of the hip joint F

5 is a lateral rotator of the hip joint T

Gluteus maximus, the largest and most powerful of the gluteal muscles, runs obliquely behind the hip

joint to insert principally into the ilio-tibial tract. A part of the muscle, however, does attach directly to

the posterior aspect of the upper end of the femoral shaft over an area termed the gluteal tuberosity.

Gluteus maximus is innervated by the inferior gluteal nerve, not superior gluteal nerve.

Functionally, Gluteus maximus is an extensor and lateral rotator of the hip joint.

The following structures pass through the greater sciatic foramen above piriformis:

1 internal pudendal artery

2 pudendal nerve

3 superior gluteal artery

4 the nerve which supplies gluteus minimus

5 inferior gluteal artery

The following structures pass through the greater sciatic foramen above piriformis:

1 internal pudendal artery F

2 pudendal nerve F

3 superior gluteal artery T

4 the nerve which supplies gluteus minimus T

5 inferior gluteal artery F

The following muscles are lateral rotators of the hip joint:

1 gluteus minimus

2 piriformis

3 rectus femoris

4 gluteus maximus

5 quadratus femoris

The following muscles are lateral rotators of the hip joint:

1 gluteus minimus F

2 piriformis T

3 rectus femoris F

4 gluteus maximus T

5 quadratus femoris T

The following structures go through the lesser sciatic foramen:

1 inferior gluteal artery

2 pudendal nerve

3 internal pudendal artery

4 medial circumflex femoral artery

5 tendon of obturator internus

The following structures go through the lesser sciatic foramen:

1 inferior gluteal artery F

2 pudendal nerve T

3 internal pudendal artery T

4 medial circumflex femoral artery F

5 tendon of obturator internus T

The tendon of Piriformis lies immediately behind the posterior capsule of the hip joint, while the reflected head of Rectus femoris blends with the superior aspect of the capsule of the hip joint. The tendon of Obturator externus is intimately related to the inferior and posterior aspects of the hip joint capsule.Neither Sartorius nor Gracilis is an immediate relation of the hip joint capsule.

The following muscles/tendons are immediate topographical relations of the hip joint capsule:

1 Sartorius

2 Piriformis

3 Rectus Femoris

4 Gracilis

5 Obturator externus

The following muscles/tendons are immediate topographical relations of the hip joint capsule:

1 Sartorius F

2 Piriformis T

3 Rectus Femoris T

4 Gracilis F

5 Obturator externus T

With regard to movements at the hip joint:

1 Gluteus medius is a powerful adductor of the joint

2 Gluteus maximus is an extensor of the joint

3 Psoas minor is a powerful flexor of the joint

4 Gracilis is an adductor of the joint

5 Gluteus maximus is an external rotator of the joint

Gluteus medius runs above the hip joint and is inserted onto the lateral surface of the greater trochanter. It is thus a powerful abductor of the joint, not adductor. Gluteus maximus is both an extensor and external rotator of the hip joint.

It is Psoas major that is the powerful flexor of the hip joint, not Psoas minor. Psoas minor does not cross the hip joint, and consequently has no effect on the joint.

With regard to movements at the hip joint:

1 Gluteus medius is a powerful adductor of the joint F

2 Gluteus maximus is an extensor of the joint T

3 Psoas minor is a powerful flexor of the joint F

4 Gracilis is an adductor of the joint T

5 Gluteus maximus is an external rotator of the joint T