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HK 3402 Midterm Review Note

Bones

Pelvis
• acetabulum
• acetabular labrum
• obturator foramen
• ala
• anterior/posterior sacral foramina

Ilium Ischium Publis

• anterior superior iliac spine • ischial spine • pectineal line

• anterior inferior iliac spine • lesser sciatic notch • superior pubic ramus
• iliac crest • ischial tuberosity • pubic tubercle
• arcuate line • ischial ramus • inferior pubic ramus
• iliac fossa
• posterior superior iliac spine
• posterior inferior iliac spine
• greater sciatic notch

Femur
• greater trochanter
• head
• fovea
• neck
• lesser trochanter
• intertrochanteric line (anterior)
• quadrate tubercle (posterior)
• spiral line (posterior-medial)
• intertrochanteric crest (posterior)
• gluteal tuberosity (posterior-lateral)
• linea aspera
• medial/lateral epicondyle
• patellar surface
• medial/lateral supracondylar line (posterior)
• medial/later condyle
• adductor tubercle

Tibia
• tubercles of intercondylar eminence
• medial/lateral condyle
• tibial tuberosity (patellar tendon)
• soleal line
• medial malleolus
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Fibula
• apex
• neck
• shaft
• lateral malleolus

Patella
• medial/lateral facet
• apex/base

Foot
• calcaneus (articulates with talus and cuboid)
• talus (articulates with tibia, medial malleolus (distal tibia), navicular)
• navicular
• cuboid
• 3 cuneiforms
• 5 metatarsals
• 14 phalanges
• distal interphalangeal joints
• proximal interphalangeal joints
• metatarsophalangeal joints
Force bearing: distal metatarsals and calcaneus

Ligaments

Pelvis
• lumbosacral
• iliolumbar
• anterior longitudinal
• greater/lesser sciatic foramen
• sacrospinous
• sacrotuberous
• obturator membrane
• obturator canal
• pubic symphysis
• transverse acetabular ligament
• ligament of head of femur
• iliofemoral ligament (acetabular artery)
• pubofemoral ligament
• ischiofemoral ligament
• superior/inferior public ligaments
• pubovesical ligament (female)
• perineal membrane
• puboprostatic ligament (male)
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Knee
• iliotibial band
• medial/lateral patellar retinaculum
• patellar ligament
• quadriceps tendon
• tendons of sartorial, gracilis and semitendinosus (medial-proximal tibia)
• medial/lateral collateral ligament
• popliteus tendon
• biceps femoris tendon (lateral-proximal tibia)
• anterior cruciate ligament (broken with posterior force on tibia or anterior force on femur)
• posterior cruciate ligament (broken with anterior force on tibia or posterior force on femur)
• medial/lateral meniscus
• coronary ligaments
• transverse ligament (anterior)
• anterolateral ligament

• achilles tendon

Muscles
Muscle Origin Insertion Action Innervation

Psoas Major lateral surfaces of T12- lesser trochanter spine anterior branches
(along lumbar L5 vertebral bodies, of the femur compression/ L1-L3
spine) TPs, IV discs flexion, hip flexion

Psoas Minor lateral surfaces of T12- pectineal line of mild spine flexion anterior branch of
(often absent) L1 vertebral bodies, IV pelvis L1
discs

Iliacus upper ⅔ of iliac fossa, lesser trochanter hip flexion femoral nerve (L2-
iliolumbar & anterior fo the femur L4)
sacroiliac ligaments,
upper antero-lateral
surface of femur

Quadratus TPs of lumbar inferior border for spine lateral anterior branch of
leborum vertebrae, iliac crest rib 12 bend, depress/ T12, L1-L4
stabilize rib 12

Piriformis anterior surface of medial side of abduction of the L5,S1,S2

sacrum btw anterior superior greater flexed hip,
sacral foramen trochanter of femur external rotation
of the extended
hip

Obturator deep surface of medial surface of abduction of the L5,S1,S2

internus obturator membrane greater trochanter flexed hip,
of femur external rotation
of the extended
hip
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Muscle Origin Insertion Action Innervation

Levator ani posterior pubis, ischial perineal supports pelvis, pudendal nerve,
spine membrane, anal reinforces anal S4
canal, sphincter
anococcygeal
ligament

Coccygeus ischial spine, lateral coccyx, supports pelvis S3,S4

sacrospinous ligament inferior sacrum contents

External anal surrounds anal canal anchored to closes anal canal, pudendal nerve,
sphincter anococcygeal tonically S4
ligament and contracted
perineal body

Gemellus external iliac spine medial greater abduction of the L5,S1

superior trochanter of femur flexed hip, (nerve to obturator
(with obturator external rotation internus)
internus tendon) of the extended
hip

Gemellus upper aspect of ischial medial greater abduction of the L5,S1 (nerve to
inferior tuberosity trochanter of femur flexed hip, quadratus femoris)
(with obturator external rotation
internus tendon) of the extended
hip

Obturator external surface of trochanteric fossa external rotation obturator nerve

externus obturator membrane of femur of hip

Quadratus lateral ischium quadrate tubercle external rotation L5,S1 (nerve to

femoris on of hip, adduction quadratus femoris)
intertrochanteric of hip
crest of femur

Gluteus gluteal surface anterolateral internal rotation, superior gluteal

minimus btwn inferior & anterior aspect of greater abduction of hip, nerve
gluteal ines trochanter of femur support pelvis

Gluteus gluteal surface lateral surface of internal rotation, superior gluteal

medius btwn anterior & greater trochanter abduction of hip, nerve
posterior gluteal lines of femur support pelvis

Gluteus fascia covering gluteus posterior iliotibial hip extension, inferior gluteal
maximus medium, gluteal surface band, gluteal external rotation, nerve
behind posterior gluteal tuberosity of femur stabilize hip
line, lumbar facia,
posterior inferior
sacrum & coccyx,
sacrotuberous ligament

Pectineus pectineal line of pelvis pectineal line of hip adduction, hip femoral nerve
femur flexion
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Muscle Origin Insertion Action Innervation

Adductor superior ramus of pubis linea aspera mid ⅓ hip adduction obturator nerve
longus femur

Adductor medial pubis and posterior proximal hip adduction obturator nerve
brevis inferior ramus of pubis femur, proximal ⅓
of linea aspera

Adductor adductor part: ischial posterior proximal hip adduction, hip obturator nerve
magnus ramus, inferior pubic femur, linea flexion
(perforations ramus aspera, medial
for deep supracondylar line
artery of the
thigh) hamstring part: ischial adductor tubercle, hip adduction, hip sciatic nerve
tuberosity medial extension
supracondylar line

Gracilis medial pubis and medial-proximal hip adduction, obturator nerve

inferior ramus of pubis tibia knee flexion

Biceps long head: ischial head of fibula knee flexion, hip sciatic nerve
femoris tuberosity extensions (long
short head: lateral linea head only)
aspera

Semitendinos ischial tuberosity medial-proximal knee flexion, hip sciatic nerve

us tibia extension, medial
rotation

Semimembra ischial tuberosity medial condyle of knee flexion, hip sciatic nerve
nosus tibia extension, medial
rotation

Tensor fasciae lateral iliac crest iliotibial band knee and hip superior gluteal
latea stability nerve

Vastus intertrochanteric line, quadriceps tendon knee extension femoral nerve

medialis pectineal line, medial
linea aspera, medial
supracondylar line

Vastus intertrochanteric line, quadriceps tendon knee extension femoral nerve

lateralis greater trochanter,
gluteal tuberosity,
lateral line aspera

Vastus upper ⅔ anterior-lateral quadriceps tendon knee extension femoral nerve

intermedius femur

Sartorius ASIS medial tibia knee flexion, hip femoral nerve

flexion

Rectus anterior head: ASIS quadriceps tendon knee extension femoral nerve
femoris posterior head: superior
ilium
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Muscle Origin Insertion Action Innervation

Popliteus lateral condyle of femur posterior tibia unlocks the knee tibial nerve
above soleal line by externally
rotating the femur
on the tibia

Pelvic Muscles
• trigone (bladder triangle)
• external/internal urethral sphincters (external = skeletal, internal = smooth muscle)
• detrusor (smooth muscle that contracts to empty the bladder)
• external/internal anal sphincters (external = skeletal, internal = smooth muscle)
• puborectalis skeletal muscle
• levator ani
• coccygeus

Kidney (T12-L3)
• renal vein anterior
• renal artery to
• ureter posterior
• renal pelvis
• suprarenal gland/adrenal gland
• minor calyx
• major calyx
• renal cortex
• renal columns
• renal papilla
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Nerves

Lumbosacral Plexus
Nerve Roots

ilioinguinal L1

iliohypogastric L1 over quadratus leborum

genitofemoral L1,L2 through psoas major

lateral femoral curaneous L2,L3 across iliacus

femoral (anterior) L2,L3,L4 deep to inguinal ligament to:

pectineus
vastus medialis
vastus lateralis
sartorius
rectus femoris
vastus intermedius

obturator (medial) L2,L3,L4 through obturator canal to:

obturator externus
adductor longus
adductor brevis
adductor magnus (adductor)
gracilis

lumbosacral trunk L4,L5

superior gluteal L4,L5,S1 gluteus minimus

gluteus medius
tensor fasciae latea

inferior gluteal L5,S1,S2 gluteus maximus

sciatic (posterior) L4,L5,S1,S2,S3 adductor magnus (hamstring)

biceps femoris
semiteninosus
semimembranosus

pudendal S2,S3,S4 levator ani

external anal sphincters
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Arteries
Name

superior gluteal artery exits pelvic cavity with nerve through greater
sciatic foramen above piriformis

inferior gluteal artery exits pelvic cavity with nerve and pudendal nerve
through greater sciatic foramen below piriformis

umbilical artery obliterated

uterine artery (females only) uterus

internal pudendal artery exits pelvic cavity with pudendal nerve through
greater sciatic foramen and enters again via lesser
sciatic foramen

vaginal artery vagina

obturator artery exits pelvic cavity with nerve to hip

superior vesicle artery bladder

inferior vesicle artery prostate and seminal vesicle

common iliac artery

external iliac artery up to inguinal ligament

femoral artery (anterior to femur) gives deep artery of thigh as branch anterior-
proximal femur, changes name at adductor hiatus

deep artery of the thigh branch off of femoral artery

popliteal artery name of femoral artery after passing through

adductor hiatus (adductor magnus)
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Organs
Female Organs
• ovary
• ligament of the ovary (between ovary and uterus)
• suspensory ligament of the ovary (holds ovarian artery and vein)
• broad ligament
• uterine tube
• uterus
• cervix
• vagina
• bladder
Male Organs
• prostate
• bulbospongiosus muscle
• ischiocavernosus muscle (along inferior ischium)
• superficial transverse muscle (horizontal)
• suspensory ligament of the penis
• seminal vesicle
• corpus cavernosum (engulfs with blood)
• corpus spongiosum (protect urethra)

Popliteal Fossa
• semitendinosus
• popliteal artery
• popliteal vein
• tibial nerve (posterior path) branches
• common fibular nerve (goes lateral-anterior) from sciatic
nerve
• biceps femoris
• medial and lateral heads of gastrocnemius

Femoral Triangle
• inguinal ligament (superior)
• adductor longus (medial)
• sartorius (lateral)
• pectineus (floor)
• femoral nerve
• femoral artery (prev. external iliac artery)
• femoral vein (prev. external iliac vein)
• lateral femoral cutaneous (lateral to triangle)