The gluteus medius one of the three gluteal muscles, is a broad, radiating muscle, situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeurosis, which separates it from the superficial fascia and integument; the gluteus medius muscle starts, or "originates," on the outer surface of the ilium between the iliac crest and the posterior gluteal line above, the anterior gluteal line below. The fibers of the muscle converge into a strong flattened tendon that inserts on the lateral surface of the greater trochanter. More the muscle's tendon inserts into an oblique ridge that runs downward and forward on the lateral surface of the greater trochanter. A bursa separates the tendon of the muscle from the surface of the trochanter; the posterior border may be more or less united to the piriformis, or some of the fibers end on its tendon. The posterior fibres of gluteus medius contract to produce hip extension, lateral rotation and abduction.
During gait, the posterior fibres help to decelerate internal rotation of the femur at the end of swing phase. • The anterior part acting alone helps to flex and internally rotate the hip. • The posterior part acting alone helps to extend and externally rotate the hip. • The anterior and posterior parts working together abduct the hip and stabilize the pelvis in the coronal plane. Dysfunction of the gluteus medius or the superior gluteal nerve can be indicated by a positive Trendelenburg's sign. Trendelenburg gait This article incorporates text in the public domain from page 474 of the 20th edition of Gray's Anatomy Anatomy photo:13:st-0404 at the SUNY Downstate Medical Center Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna
Anterior compartment of thigh
The anterior compartment of thigh contains muscles which extend the knee and flex the hip. The anterior compartment is one of the fascial compartments of the thigh that contains groups of muscles together with their nerves and blood supply; the anterior compartment contains the sartorius muscle and the quadriceps femoris group, which consists of the rectus femoris muscle and the three vasti muscles – the vastus lateralis, vastus intermedius, the vastus medialis. The iliopsoas is sometimes considered a member of the anterior compartment muscles, as is the articularis genus muscle; the anterior compartment is separated from the posterior compartment by the lateral intermuscular septum and from the medial compartment by the medial intermuscular septum. The nerve of the anterior compartment of thigh is the femoral nerve. Innervation for the quadriceps muscles come from the posterior division of the femoral nerve, while the anterior division gives a lateral and a medial branch, the second being responsible for the innervation of the sartorius muscle.
The iliacus and the psoas major and psoas minor muscles, sometimes considered part of the anterior compartment, do not share the same innervation. Whereas the iliacus is innervated by the femoral nerve, the psoas is innervated by ventral rami of L1-L3; when the external iliac artery crosses the inguinal ligament, it becomes the femoral artery, which supplies blood to the anterior compartment and is the largest blood vessel of the inferior member. The anterior compartment of thigh contains muscles which are extensors of the knee and flexors of the hip joints; the anterior compartment may be affected as part of a compartment syndrome. Antthigh at The Anatomy Lesson by Wesley Norman knee/muscles/thigh1 at the Dartmouth Medical School's Department of Anatomy Overview at stanford.edu
The gluteus maximus is the main extensor muscle of the hip. It is the largest and most superficial of the three gluteal muscles and makes up a large portion of the shape and appearance of each side of the hips, its thick fleshy mass, in a quadrilateral shape, forms the prominence of the buttocks. Its large size is one of the most characteristic features of the muscular system in humans, connected as it is with the power of maintaining the trunk in the erect posture. Other primates can not sustain standing erectly; the muscle is remarkably coarse in function and structure, being made up of muscle fascicles lying parallel with one another, collected together into larger bundles separated by fibrous septa. It arises from the posterior gluteal line of the inner upper ilium, a pelvic bone, the portion of the bone including the crest of the ilium above and behind it; the fibers are lateralward. Three bursae are found in relation with the deep surface of this muscle: One of these, of large size, separates it from the greater trochanter.
When the gluteus maximus takes its fixed point from the pelvis, it extends the acetabulofemoral joint and brings the bent thigh into a line with the body. Taking its fixed point from below, it acts upon the pelvis, supporting it and the trunk upon the head of the femur, its most powerful action is to cause the body to regain the erect position after stooping, by drawing the pelvis backward, being assisted in this action by the biceps femoris, semitendinosus and adductor magnus. The gluteus maximus is a tensor of the fascia lata, by its connection with the iliotibial band steadies the femur on the articular surfaces of the tibia during standing, when the extensor muscles are relaxed; the lower part of the muscle acts as an adductor and external rotator of the limb. The upper fibers act as abductors of the hip joints; the gluteus maximus is involved from running to weight-lifting. A number of exercises focus on the gluteus maximus as well as other muscles of the upper leg. Hip thrusts Glute bridge Quadruped hip extensions Kettlebell swings Squats and variations like split squats, pistol squats and wide-stance lunges Deadlift Reverse hyperextension Four-way hip extensions Glute-ham raise Functional assessment can be useful in assessing injuries to the gluteus maximus and surrounding muscles.
These tests include: 30 Second Chair to Stand testThis test measures a participant's ability to stand up from a seated position as many times as possible in a thirty-second period of time. Testing the number of times a person can stand up in a thirty-second period helps assess strength, flexibility and endurance, which can help determine how far along a person is in rehabilitation, or how much work is still to be done. Passive piriformis stretch; the piriformis test measures flexibility of the gluteus maximus. This requires a trained professional and is based on the angle of external and internal rotation in relation to normal range of motion without injury or impingement. In other primates, gluteus maximus consists of ischiofemoralis, a small muscle that corresponds to the human gluteus maximus and originates from the ilium and the sacroiliac ligament, gluteus maximus proprius, a large muscle that extends from the ischial tuberosity to a more distant insertion on the femur. In adapting to bipedal gait, reorganization of the attachment of the muscle as well as the moment arm was required.
Table of muscles of the human body Coccyx This article incorporates text in the public domain from page 474 of the 20th edition of Gray's Anatomy Anatomy photo:13:st-0403 at the SUNY Downstate Medical Center Cross section image: pelvis/pelvis-female-17—Plastination Laboratory at the Medical University of Vienna Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna Cross section image: pembody/body18b—Plastination Laboratory at the Medical University of Vienna Muscles/GluteusMaximus at exrx.net
Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, other animals that walk on the soles of their feet, are described as being plantigrade. There are five toes present on each human foot; each toe consists of three phalanx bones, the proximal and distal, with the exception of the big toe. For a minority of people, the little toe is missing a middle bone; the hallux only contains the proximal and distal. The joints between each phalanx are the interphalangeal joints; the proximal phalanx bone of each toe articulates with the metatarsal bone of the foot at the metatarsophalangeal joint. Each toe is surrounded by skin, present on all five toes is a toenail; the toes are, from medial to lateral: the first toe known as the hallux, the innermost toe. Toe movement is flexion and extension via muscular tendons that attach to the toes on the anterior and superior surfaces of the phalanx bones. With the exception of the hallux, toe movement is governed by action of the flexor digitorum brevis and extensor digitorum brevis muscles.
These attach to the sides of the bones. Muscles between the toes on their top and bottom help to abduct and adduct the toes; the hallux and little toe have unique muscles: The hallux is flexed by the flexor hallucis longus muscle, located in the deep posterior of the lower leg, via the flexor hallucis longus tendon. Additional flexion control is provided by the flexor hallucis brevis, it is extended by the adductor hallucis muscle. The little toe has a separate set of control muscles and tendon attachments, the flexor and abductor digiti minimi. Numerous other foot muscles contribute to fine motor control of the foot; the connective tendons between the minor toes account for the inability to actuate individual toes. The toes receive blood from the digital branches of the plantar metatarsal arteries and drain blood into the dorsal venous arch of the foot. Sensation to the skin of the toes is provided by five nerves; the superficial fibular nerve supplies sensation to the top of the toes, except between the hallux and second toe, supplied by the deep fibular nerve, the outer surface of the fifth toe, supplied by the sural nerve.
Sensation to the bottom of the toes is supplied by the medial plantar nerve, which supplies sensation to the great toe and inner three-and-a-half toes, the lateral plantar nerve, which supplies sensation to the little toe and half of the sensation of the fourth toe. In humans, the hallux is longer than the second toe, but in some individuals, it may not be the longest toe. There is an inherited trait in humans, where the dominant gene causes a longer second toe while the homozygous recessive genotype presents with the more common trait: a longer hallux. People with the rare genetic disease fibrodysplasia ossificans progressiva characteristically have a short hallux which appears to turn inward, or medially, in relation to the foot. Humans have five toes on each foot; when more than five toes are present, this is known as polydactyly. Other variants may include arachnodactyly. Forefoot shape, including toe shape, exhibits significant variation among people; such deviations may fit for various shoe types.
Research conducted for the U. S. Army indicated that larger feet may still have smaller arches, toe length, toe-breadth; the human foot consists of multiple bones and soft tissues which support the weight of the upright human. The toes assist the human while walking, providing balance, weight-bearing, thrust during gait. A sprain or strain to the small interphalangeal joints of the toe is called a stubbed toe. A sprain or strain where the toe joins to the foot is called turf toe. Long-term use of improperly sized shoes can cause misalignment of toes, as well as other orthopedic problems. Morton's neuroma results in pain and numbness between the third and fourth toes of the sufferer, due to it affecting the nerve between the third and fourth metatarsal bones; the big toe is the most common locus of ingrown nails and the proximal phalanx joint of the hallux is the most common locus for gout attacks. Deformities of the foot include hammer toe, trigger toe, claw toe. Hammer toe can be described as an abnormal contraction or “buckling” of a toe.
This is done by a complete dislocation of one of the joints, which form the toes. Since the toes are deformed further, these may press against a cause pain. Deformities of the foot can be caused by rheumatoid arthritis and diabetes mellitus. Deformities may predispose to ulcers and pain when shoe-wearing. A common problem involving the big toe is the formation of bunions; these are structural deformities of the bones and the joint between the foot and big toe, may be painful. Similar deformity involving the fifth toe is described as tailor's bunionette. A favourable option for the reconstruction of missing adjacent fingers/multiple digit amputations, i.e. such as a metacarpal hand rec
Lateral rotator group
The lateral rotator group is a group of six small muscles of the hip which all externally rotate the femur in the hip joint. It consists of the following muscles: Piriformis, gemellus superior, obturator internus, gemellus inferior, quadratus femoris and the obturator externus. All muscles in the lateral rotator group originate from the hip bone and insert on to the upper extremity of the femur; the muscles are innervated by the sacral plexus, except the obturator externus muscle, innervated by the lumbar plexus. This group does not include all muscles which aid in lateral rotation of the hip joint: rather it is a collection of ones which are known for performing this action. Other muscles that contribute to lateral rotation of the hip include: Gluteus maximus muscle Gluteus medius muscle and gluteus minimus muscle when the hip is extended Psoas major muscle Psoas minor muscle Sartorius muscle Hip anatomy Glutealregion at The Anatomy Lesson by Wesley Norman
Dorsalis pedis artery
In human anatomy, the dorsalis pedis artery, is a blood vessel of the lower limb that carries oxygenated blood to the dorsal surface of the foot. It is located 1/3 from medial malleolus, it arises at the anterior aspect of the ankle joint and is a continuation of the anterior tibial artery. It terminates at the proximal part of the first intermetatarsal space, where it divides into two branches, the first dorsal metatarsal artery and the deep plantar artery; the dorsalis pedis communicates with the plantar blood supply of the foot through the deep plantar artery. Along its course, it is accompanied by the dorsalis pedis vein; the dorsalis pedis artery pulse can be palpated lateral to the extensor hallucis longus tendon on the dorsal surface of the foot, distal to the dorsal most prominence of the navicular bone which serves as a reliable landmark for palpation. It is examined, by physicians, when assessing whether a given patient has peripheral vascular disease, it is unilaterally or bilaterally, in 2 -- 3 % of young healthy individuals.
Gray's s157 - "The Arteries of the Lower Extremity" Gray's s160 - "Dorsalis pedis artery" Gray's s95 - "Ankle joint" Anatomy figure: 12:04-19 at Human Anatomy Online, SUNY Downstate Medical Center - "Arteries of the lower extremity shown in association with major landmarks." Image at umich.edu http://www.dartmouth.edu/~humananatomy/figures/chapter_17/17-3. HTM
Lateral plantar nerve
The lateral plantar nerve is a branch of the tibial nerve, in turn a branch of the sciatic nerve and supplies the skin of the fifth toe and lateral half of the fourth, as well as most of the deep muscles, its distribution being similar to that of the ulnar nerve in the hand. It passes obliquely forward with the lateral plantar artery to the lateral side of the foot, lying between the flexor digitorum brevis and quadratus plantae and, in the interval between the flexor muscle and the abductor digiti minimi, divides into a superficial and a deep branch. Before its division, it supplies the quadratus abductor digiti minimi, it divides into superficial branches. This article incorporates text in the public domain from page 963 of the 20th edition of Gray's Anatomy