Добавил:
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:

Miologia_Greya

.pdf
Скачиваний:
27
Добавлен:
06.09.2020
Размер:
4.34 Mб
Скачать

Tables 4

1

2

3

4

5

8

7

6

9

207

PELVIS AND PERINEUM • Tables

Muscles of the pelvic walls

(spinal segments in bold are the major segments innervating the muscle)

Muscle

Origin

Insertion

Innervation

Function

Obturator internus 1

Anterolateral wall of true

Medial surface of greater

Nerve to

Lateral rotation of the extended

 

pelvis (deep surface of

trochanter of femur

obturator

hip joint; abduction of flexed

 

obturator membrane and

 

internus L5, SI

hip

 

surrounding bone)

 

 

 

Piriformis

2 Anterior surface of sacrum

 

between anterior sacral

 

foramina

Medial side of superior

Branches from

Lateral rotation of the extended

border of greater trochanter

L5, SI, and S2

hip joint; abduction of flexed hip

of femur

 

 

Muscles of the pelvic diaphragm

Levator ani

3 In a line around the pelvic

 

wall beginning on the

 

posterior aspect of the pubic

 

bone and extending across

 

the obturator internus

 

muscle as a tendinous arch

 

(thickening of the obturator

 

internus fascia) to the ischial

 

spine

The anterior part is attached to the superior surface of the perineal membrane; the posterior part meets its partner on the other side at the perineal body, around the anal canal, and along the anococcygeal ligament

Branches direct from the anterior ramus of S4, and by the inferior rectal branch of the pudendal nerve (S2 to S4)

Contributes to the formation of the pelvic floor, which supports the pelvic viscera; maintains an angle between the rectum and anal canal. Reinforces the external anal sphincter and, in women, functions as a vaginal sphincter

Coccygeus

4 Ischial spine and pelvic

 

surface of the sacrospinous

 

ligament

Lateral margin of coccyx and related border of sacrum

Branches from the anterior rami of S3 and S4

Contributes to the formation of the pelvic floor, which supports the pelvic viscera; pulls coccyx forward after defecation

Muscles within the deep perineal pouch

External urethral

5

From the inferior ramus of

Surrounds membranous

Perineal

Compresses the

sphincter

 

the pubis on each side and

part of urethra

branches of the

membranous urethra;

 

 

adjacent walls of the deep

 

pudendal nerve

relaxes during micturition

 

 

perineal pouch

 

(S2 to S4)

 

Deep transverse

6

Medial aspect of ischial

Perineal body

Perineal

Stabilizes the position of the

perineal

 

ramus

 

branches of the

perineal body

 

 

 

 

pudendal nerve

 

 

 

 

 

(S2 to S4)

 

Compressor

7 Ischiopubic ramus on each

urethrae

side

(in women only)

 

Blends with partner on other

Perineal

Functions as an accessory

side anterior to the urethra

branches of the

sphincter of the urethra

 

pudendal nerve

 

 

(S2 to S4)

 

Sphincter

8 Perineal body

Passes forward lateral to

Perineal

Functions as an accessory

urethrovaginalis

 

the vagina to blend with

branches of the

sphincter of the urethra (also

(in women only)

 

partner on other side

pudendal nerve

may facilitate closing the

 

 

anterior to the urethra

(S2 to S4)

vagina)

286

Tables 5

3

5

6

1

2

4

5

7

6

8

Male

Female

287

Tables 5

Muscles of the superficial perineal pouch

Muscle

 

Origin

Insertion

Innervation

Function

Ischiocavernosus

1

Ischial tuberosity and

Crus of penis and clitoris

Pudendal nerve

Move blood from crura into

 

 

ramus

 

(S2 to S4)

the body of the erect penis

 

 

 

 

 

and clitoris

Bulbospongiosus

2

In women: perineal body

In women: bulb of vestibule,

Pudendal nerve

Move blood from attached

 

 

In men: perineal body,

perineal membrane, body

(S2 to S4)

parts of the clitoris and penis

 

 

midline raphe

of clitoris, and corpus

 

into the glans

 

 

 

cavernosum

 

In men: removal of residual

 

 

 

In men: bulbospongiosus,

 

urine from urethra after

 

 

 

perineal membrane, and

 

urination; pulsatile emission

 

 

 

corpus cavernosum

 

of semen during ejaculation

Superficial transverse

3

Ischial tuberosity and

Perineal body

Pudendal nerve

Stabilize the perineal body

perineal

 

ramus

 

(S2 to S4)

 

 

 

 

 

 

 

1

1

2

2

3

3

Male

Female

289

LOWER LIMB • Tables

Muscles of the gluteal region

(spinal segments in bold are the major segments innervating the muscle)

Muscle

Origin

Insertion

Innervation

Function

 

 

 

 

 

Piriformis

1 Anterior surface of sacrum

 

between anterior sacral

 

foramina

Medial side of superior border of

Branches from

Laterally rotates the extended

greater trochanter of femur

L5, S1, S2

femur at hip joint; abducts

 

 

flexed femur at hip joint

Obturator

2 Anterolateral wall of true

internus

pelvis; deep surface of

 

obturator membrane and

 

surrounding bone

Medial side of greater trochanter

Nerve to obturator

Laterally rotates the extended

of femur

internus (L5, S1)

femur at hip joint; abducts

 

 

flexed femur at hip joint

Gemellus

3 External surface of ischial

superior

spine

Along length of superior surface

Nerve to obturator

Laterally rotates the extended

of the obturator internus tendon

internus (L5, S1)

femur at hip joint; abducts

and into the medial side of

 

flexed femur at hip joint

greater trochanter of femur with

 

 

obturator internus tendon

 

 

Gemellus

4 Upper aspect of ischial

inferior

tuberosity

Along length of inferior surface of the obturator internus tendon and into the medial side of greater trochanter of femur with obturator internus tendon

Nerve to quadratus femoris (L5, S1)

Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

Quadratus

5 Lateral aspect of the ischium

femoris

just anterior to the ischial

 

tuberosity

Quadrate tubercle on the

Nerve to

Laterally rotates femur at hip

intertrochanteric crest of the

quadratus femoris

joint

proximal femur

(L5, S1)

 

Gluteus

6 External surface of ilium

minimus

between inferior and anterior

 

gluteal lines

Linear facet on the anterolateral

Superior gluteal

Abducts femur at hip joint;

aspect of the greater trochanter

nerve (L4, L5, S1)

holds pelvis secure over

 

 

stance leg and prevents

 

 

pelvic drop on the opposite

 

 

swing side during walking;

 

 

medially rotates thigh

Gluteus

7 External surface of ilium

medius

between anterior and

 

posterior gluteal lines

Elongate facet on the lateral

Superior gluteal

Abducts femur at hip joint;

surface of the greater trochanter

nerve (L4, L5, S1)

holds pelvis secure over

 

 

stance leg and prevents

 

 

pelvic drop on the opposite

 

 

swing side during walking;

 

 

medially rotates thigh

Gluteus

8 Fascia covering gluteus

maximus

medius, external surface of

 

ilium behind posterior gluteal

 

line, fascia of erector spinae,

 

dorsal surface of lower

 

sacrum, lateral margin of

 

coccyx, external surface of

 

sacrotuberous ligament

Posterior aspect of iliotibial tract

Inferior gluteal

Powerful extensor of flexed

of fascia lata and gluteal

nerve (L5, S1, S2) femur at hip joint; lateral

tuberosity of proximal femur

 

stabilizer of hip joint and knee

 

 

joint; laterally rotates and

 

 

abducts thigh

Tensor

9 Lateral aspect of crest of ilium

Iliotibial tract of fascia lata

Superior gluteal

Stabilizes the knee in

fasciae latae

between anterior superior iliac

 

nerve (L4, L5, S1)

extension

 

spine and tubercle of the crest

 

 

 

370

Tables 6

 

6

 

9

1

3

 

5

4

 

2

 

7

8

371

LOWER LIMB • Tables

Muscles of the anterior compartment of thigh

(spinal segments in bold are the major segments innervating the muscle)

Muscle

 

Origin

Insertion

Innervation

Function

Psoas major

1

Posterior abdominal wall

Lesser trochanter of femur

Anterior rami

Flexes the thigh at the hip

 

 

(lumbar transverse

 

[L1, L2, L3]

joint

 

 

processes, intervertebral

 

 

 

 

 

discs, and adjacent bodies

 

 

 

 

 

from TXII to LV and tendinous

 

 

 

 

 

arches between these points)

 

 

 

Iliacus

2

Posterior abdominal wall

Lesser trochanter of femur

Femoral nerve

Flexes the thigh at the hip

 

 

(iliac fossa)

 

[L2, L3]

joint

Vastus medialis

3

Femur—medial part of

Quadriceps femoris tendon

Femoral nerve

Extends the leg at the knee

 

 

intertrochanteric line,

and medial border of patella

[L2, L3, L4]

joint

 

 

pectineal line, medial lip of the

 

 

 

 

 

linea aspera, medial

 

 

 

 

 

supracondylar line

 

 

 

Vastus

4

Femur—upper two thirds of

Quadriceps femoris tendon

Femoral nerve

Extends the leg at the knee

intermedius

 

anterior and lateral surfaces

and lateral margin of patella

[L2, L3, L4]

joint

Vastus lateralis

5

Femur—lateral part of

Quadriceps femoris tendon

Femoral nerve

Extends the leg at the knee

 

 

intertrochanteric line, margin

 

[L2, L3, L4]

joint

 

 

of greater trochanter, lateral

 

 

 

 

 

margin of gluteal tuberosity,

 

 

 

 

 

lateral lip of the linea aspera

 

 

 

Rectus femoris

6

Straight head originates from

Quadriceps femoris tendon

Femoral nerve

Flexes the thigh at the hip

 

 

the anterior inferior iliac spine;

 

[L2, L3, L4]

joint and extends the leg at

 

 

reflected head originates from

 

 

the knee joint

 

 

the ilium just superior to the

 

 

 

 

 

acetabulum

 

 

 

Sartorius

7

Anterior superior iliac spine

Medial surface of tibia just

Femoral nerve

Flexes the thigh at the hip

 

 

 

inferomedial to tibial

[L2, L3]

joint and flexes the leg at the

 

 

 

tuberosity

 

knee joint

 

 

 

 

 

 

372

Tables 6

1

2

3

4

7

 

 

5

6

373

LOWER LIMB • Tables

Muscles of the medial compartment of thigh

(spinal segments in bold are the major segments innervating the muscle)

Muscle

 

Origin

Insertion

Innervation

Function

Gracilis

1 A line on the external surfaces

Medial surface of proximal

Obturator nerve

Adducts thigh at hip joint and

 

 

of the body of the pubis, the

shaft of tibia

[L2, L3]

flexes leg at knee joint

 

 

inferior pubic ramus, and the

 

 

 

 

 

ramus of the ischium

 

 

 

Pectineus

2 Pectineal line (pecten pubis)

 

and adjacent bone of pelvis

Oblique line extending from

Femoral nerve

Adducts and flexes thigh at

base of lesser trochanter to

[L2, L3]

hip joint

linea aspera on posterior

 

 

surface of proximal femur

 

 

Adductor longus 3 External surface of body of

Linea aspera on middle

Obturator nerve

Adducts and medially rotates

pubis (triangular depression

one third of shaft of femur

(anterior division)

thigh at hip joint

inferior to pubic crest and

 

[L2, L3, L4]

 

lateral to pubic symphysis)

 

 

 

Adductor brevis

4 External surface of body of

 

pubis and inferior pubic ramus

Posterior surface of proximal

Obturator nerve

Adducts and medially rotates

femur and upper one third of

[L2, L3]

thigh at hip joint

linea aspera

 

 

Adductor

5

Adductor part—ischiopubic

Posterior surface of proximal

Obturator nerve

Adducts and medially rotates

magnus

 

ramus

femur, linea aspera, medial

[L2, L3, L4]

thigh at hip joint

 

 

Hamstring part—ischial

supracondylar line

Sciatic nerve

 

 

 

 

 

 

 

tuberosity

Adductor tubercle and

(tibial division)

 

 

 

 

supracondylar line

[L2, L3, L4]

 

Obturator

6

External surface of obturator

Trochanteric fossa

Obturator nerve

Laterally rotates thigh at hip

externus

 

membrane and adjacent bone

 

(posterior division)

joint

 

 

 

 

[L3, L4]

 

 

 

6

2

 

 

 

4

5

 

 

1

3

 

 

 

374

Tables 6

Muscles of the posterior compartment of thigh

(spinal segments in bold are the major segments innervating the muscle)

Muscle

 

Origin

Insertion

Innervation

Function

Biceps femoris

1

Long head—inferomedial part

Head of fibula

Sciatic nerve

Flexes leg at knee joint; extends

 

 

of the upper area of the

 

[L5, S1, S2]

and laterally rotates thigh at hip

 

 

ischial tuberosity; short

 

 

joint and laterally rotates leg at

 

 

head—lateral lip of linea

 

 

knee joint

 

 

aspera

 

 

 

Semitendinosus

2

Inferomedial part of the upper

Medial surface of

Sciatic nerve

Flexes leg at knee joint and

 

 

area of the ischial tuberosity

proximal tibia

[L5, S1, S2]

extends thigh at hip joint; medially

 

 

 

 

 

rotates thigh at hip joint and leg at

 

 

 

 

 

knee joint

Semimembranosus

3

Superolateral impression on

Groove and adjacent

Sciatic nerve

Flexes leg at knee joint and

 

 

the ischial tuberosity

bone on medial and

[L5, S1, S2]

extends thigh at hip joint; medially

 

 

 

posterior surface of

 

rotates thigh at hip joint and leg at

 

 

 

medial tibial condyle

 

knee joint

 

 

 

 

 

 

1

2

3

375

Соседние файлы в предмете Нормальная анатомия