Miologia_Greya
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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
