Thigh
In human anatomy, the thigh is the area between the hip and the knee. Anatomically, it is part of the lower limb; the single bone in the thigh is called the femur. This bone is thick and strong, forms a ball and socket joint at the hip, a modified hinge joint at the knee; the femur is the only bone in the thigh and serves for an attachment site for all muscles in the thigh. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia and kneecap forming the knee. By most measures the femur is the strongest bone in the body; the femur is the longest bone in the body. The femur is categorised as a long bone and comprises a diaphysis, the shaft and two epiphysis or extremities that articulate with adjacent bones in the hip and knee. In cross-section, the thigh is divided up into three separate compartments, divided by fascia, each containing muscles; these compartments use the femur as an axis, are separated by tough connective tissue membranes.
Each of these compartments has its own blood and nerve supply, contains a different group of muscles. Medial fascial compartment of thigh, adductor Posterior fascial compartment of thigh, hamstring Anterior fascial compartment of thigh, extensionAnterior compartment muscles of the thigh include sartorius, the four muscles that comprise the quadriceps muscles- rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Posterior compartment muscles of the thigh are the hamstring muscles, which include semimembranosus and biceps femoris. Medial compartment muscles are pectineus, adductor magnus, adductor longus and adductor brevis, gracilis; because the major muscles of the thigh are the largest muscles of the body, resistance exercises of them stimulate blood flow more than any other localized activity. The arterial supply is by the obturator artery; the lymphatic drainage follows the arterial supply and drains to the lumbar lymphatic trunks on the corresponding side, which in turn drains to the cisterna chyli.
The deep venous system of the thigh consists of the femoral vein, the proximal part of the popliteal vein, various smaller vessels. The venae perfortantes connect the deep and the superficial system, which consists of the saphenous veins. Thigh weakness can result in a positive Gowers' sign on physical examination; the thigh meat of some animals such as chicken and cow is consumed as a food in many parts of the world
Iliac fossa
The iliac fossa is a large, concave surface on the internal surface of the ileum. The fossa is bounded above by the iliac crest, below by the arcuate line; the fossa gives origin to the Iliacus muscle and is perforated at its inner part by a nutrient canal. When the "left" or "right" adjective is used, the iliac fossa means one of the nine regions of the abdomen. Right iliac fossa Anatomy photo:44:st-0710 at the SUNY Downstate Medical Center aplab - BioWeb at University of Wisconsin System Anatomy image: skel/oscoxm2 at Human Anatomy Lecture, Pennsylvania State University
Thieme Medical Publishers
Thieme Medical Publishers is a German medical and science publisher in the Thieme Publishing Group. It produces professional journals, atlases and reference books in both German and English covering a variety of medical specialties, including neurosurgery, endocrinology, radiology, chemistry, ophthalmology and speech-language pathology and alternative medicine. Thieme has more than 1,000 employees and maintains offices in seven cities worldwide, including New York City, Delhi and three other cities in Germany. Georg Thieme Verlag was founded in 1886 in Leipzig, Germany, by Georg Thieme when he was 26 years old. Thieme remains held and family-owned; the company received some early success in 1896 by publishing Wilhelm Röntgen's famous picture of his wife's hand in what is still one of Thieme's and Germany's oldest journals, the Deutsche Medizinische Wochenschrift. In 1919, Georg Thieme partnered with a young publisher from Leipzig; when Thieme died in 1925, ownership of the company passed to Hauff.
Members of the Hauff family have been the proprietors of the business since. In 1946, two years after Thieme had been bombed and forced to close during World War II, the Allies relocated the company from Leipzig in the eastern sector to Stuttgart in the west where it was provided with a license to publish and distribute journals and books. Guenther Hauff, son of Bruno, acquired Stratton International Medical Book of New York in 1979, several years in 1984, the two companies merged to become Thieme Medical Publishers New York. Official website Thieme Publishing Group
Lesser trochanter
The lesser trochanter of the femur is a conical eminence, which varies in size in different subjects. It projects from the lower and back part of the base of the femur neck. From its apex three well-marked borders extend: two of these are above a medial continuous with the lower border of the femur neck a lateral with the intertrochanteric crest the inferior border is continuous with the middle division of the linea asperaThe summit of the trochanter is rough, gives insertion to the tendon of the Psoas major and the Iliacus, it can be involved in an avulsion fracture. Greater trochanter Third trochanter This article incorporates text in the public domain from page 245 of the 20th edition of Gray's Anatomy Anatomy figure: 13:01-11 at Human Anatomy Online, SUNY Downstate Medical Center lljoints at The Anatomy Lesson by Wesley Norman
Sacroiliac joint
The sacroiliac joint or SI joint is the joint between the sacrum and the ilium bones of the pelvis, which are connected by strong ligaments. In humans, the sacrum is supported in turn by an ilium on each side; the joint is strong, supporting the entire weight of the upper body. It is a synovial plane joint with irregular elevations and depressions that produce interlocking of the two bones; the human body has two sacroiliac joints, one on the left and one on the right, that match each other but are variable from person to person. Sacroiliac joints are paired C-shaped or L-shaped joints capable of a small amount of movement that are formed between the auricular surfaces of the sacrum and the ilium bones; the joints are covered by two different kinds of cartilage. The SIJ's stability is maintained through a combination of only some bony structure and strong intrinsic and extrinsic ligaments; the joint space is 0.5 to 4 mm. As we age the characteristics of the sacroiliac joint change; the joint's surfaces are flat or planar in early life but as we start walking, the sacroiliac joint surfaces develop distinct angular orientations and lose their planar or flat topography.
They develop an elevated ridge along the iliac surface and a depression along the sacral surface. The ridge and corresponding depression, along with the strong ligaments, increase the sacroiliac joints' stability and makes dislocations rare; the fossae lumbales laterales correspond to the superficial topography of the sacroiliac joints. The ligaments of the sacroiliac joint include the following: Anterior sacroiliac ligament Interosseous sacroiliac ligament Posterior sacroiliac ligament Sacrotuberous ligament Sacrospinous ligamentThe anterior ligament is not much of a ligament at all and in most cases is just a slight thickening of the anterior joint capsule; the anterior ligament is thin and not as well defined as the posterior sacroiliac ligaments. The posterior sacroiliac ligaments can be further divided into long; the dorsal interosseous ligaments are strong ligaments. They are stronger than bone, such that the pelvis may fracture before the ligament tears; the dorsal sacroiliac ligaments include both short ligaments.
The long dorsal sacroiliac joint ligaments run in an oblique vertical direction while the short runs perpendicular from just behind the articular surfaces of the sacrum to the ilium and functions to keep the sacroiliac joint from distracting or opening. The sacrotuberous and sacrospinous ligaments limit the amount; the ligaments of the sacroiliac joint loosen during pregnancy due to the hormone relaxin. The long SI ligaments may be palpated in thin persons for pain and compared from one side of the body to the other; the interosseous ligaments are short and run perpendicular from the iliac surface to the sacrum, they keep the auricular surfaces from abducting or opening/distracting. Like most lower extremity joints, one of the SI joints' functions is shock absorption for the spine, along with the job of torque conversion allowing the transverse rotations that take place in the lower extremity to be transmitted up the spine; the SI joint, like all lower extremity joints, provides a "self-locking" mechanism that helps with stability during the push-off phase of walking.
The joint locks on one side as weight is transferred from one leg to the other, through the pelvis the body weight is transmitted from the sacrum to the hip bone. The motions of the sacroiliac joint Anterior innominate tilt of both hip bones on the sacrum Posterior innominate tilt of both hip bones on the sacrum Anterior innominate tilt of one innominate bone while the opposite innominate bone tilts posteriorly on the sacrum which occurs during gait Sacral flexion Motions of the sacrum occur simultaneous with motion of the ilium so you must be careful in the description of these as isolated motions. Sacral extension; the sacroiliac joints like all spinal joints are bicondylar joints, meaning that movement of one side corresponds to a correlative movement of the other side. Sacroiliitis refers to inflammation of one or both sacroiliac joints, is one cause of unilateral low back pain. With sacroiliitis, the individual may experience pain in the low back, buttock or thigh, depending on the amount of inflammation.
Common problems of the sacroiliac joint are called sacroiliac joint dysfunction. Sacroiliac joint dysfunction refers to pain in the sacroiliac joint region, caused by abnormal motion in the sacroiliac joint, either too much motion or too little motion, it results in inflammation of the SI joint, or sacroiliitis. The following are signs and symptoms that may be associated with an SI joint problem: Mechanical SIJ dysfunction causes a dull unilateral low back pain; the pain is a mild to moderate ache around the dimple or posterior superior i
Iliopsoas
The iliopsoas refers to the joined psoas and the iliacus muscles. The two muscles are separate in the abdomen, but merge in the thigh; as such, they are given the common name iliopsoas. The iliopsoas muscle joins to the femur at the lesser trochanter, acts as the strongest flexor of the hip; the iliopsoas muscle is supplied by parts of the femoral nerve. The iliopsoas muscle is a composite muscle formed from the psoas major muscle, the iliacus muscle; the psoas major originates along the outer surfaces of the vertebral bodies of T12 and L1-L3 and their associated intervertebral discs. The iliacus originates in the iliac fossa of the pelvis; the psoas major unites with the iliacus at the level of the inguinal ligament and crosses the hip joint to insert on the lesser trochanter of the femur. The iliopsoas is classified as an "anterior hip muscle" or "inner hip muscle"; the psoas minor does contribute to the iliopsoas muscle. The inferior portion below the inguinal ligament forms part of the floor of the femoral triangle.
The psoas major is innervated by direct branches of the anterior rami off the lumbar plexus at the levels of L1-L3, while the iliacus is innervated by the femoral nerve. The iliopsoas is the prime mover of hip flexion, is the strongest of the hip flexors; the iliopsoas is important for standing and running. The iliacus and psoas major perform different actions; the iliopsoas muscle is covered by the iliac fascia, which begins as a strong tube-shaped psoas fascia, which surround the psoas major muscle as it passes under the medial arcuate ligament. Together with the iliac fascia, it continues down to the inguinal ligament where it forms the iliopectineal arch which separates the muscular and vascular lacunae, it is a typical posture muscle dominated by slow-twitch red type 1 fibers. Since it originates from the lumbar vertebrae and discs and inserts onto the femur, any structure from the lumbar spine to the femur can be affected directly. A short and tight iliopsoas presents as externally rotated legs and feet.
It can cause pain in the low or mid back, SI joint, groin, knee, or any combination. The iliopsoas gets innervation from the L2-4 nerve roots of the lumbar plexus which send branches to the superficial lumbar muscles; the femoral nerve passes through the muscle and innervates the quadriceps and sartorius muscles. It comprises the intermediate femoral cutaneous and medial femoral cutaneous nerves which are responsible for sensation over the anterior and medial aspects of the thigh, medial shin, arch of the foot nerves; the obturator nerve passes through the muscle, responsible for the sensory innervation of the skin of the medial aspect of the thigh and motor innervation of the adductor muscles of the lower extremity and sometimes the pectineus. Any of these innervated structures can be affected. Psoas abscess Iliopsoas tendonitis Muscles of the hip Muscles/Iliopsoas at exrx.net Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna
Hip
In vertebrate anatomy, hip refers to either an anatomical region or a joint. The hip region is located lateral and anterior to the gluteal region, inferior to the iliac crest, overlying the greater trochanter of the femur, or "thigh bone". In adults, three of the bones of the pelvis have fused into the hip bone or acetabulum which forms part of the hip region; the hip joint, scientifically referred to as the acetabulofemoral joint, is the joint between the femur and acetabulum of the pelvis and its primary function is to support the weight of the body in both static and dynamic postures. The hip joints have important roles in retaining balance, for maintaining the pelvic inclination angle. Pain of the hip may be the result of numerous causes, including nervous, infectious, trauma-related, genetic; the proximal femur is covered by muscles and, as a consequence, the greater trochanter is the only palpable bony structure in the hip region. The hip joint is a synovial joint formed by the articulation of the rounded head of the femur and the cup-like acetabulum of the pelvis.
It forms the primary connection between the bones of the lower limb and the axial skeleton of the trunk and pelvis. Both joint surfaces are covered with a strong but lubricated layer called articular hyaline cartilage; the cuplike acetabulum forms at the union of three pelvic bones — the ilium and ischium. The Y-shaped growth plate that separates them, the triradiate cartilage, is fused definitively at ages 14–16, it is a special type of spheroidal or ball and socket joint where the spherical femoral head is contained within the acetabulum and has an average radius of curvature of 2.5 cm. The acetabulum grasps half the femoral ball, a grip augmented by a ring-shaped fibrocartilaginous lip, the acetabular labrum, which extends the joint beyond the equator; the joint space between the femoral head and the superior acetabulum is between 2 and 7 mm. The head of the femur is attached to the shaft by a thin neck region, prone to fracture in the elderly, due to the degenerative effects of osteoporosis.
The acetabulum is oriented inferiorly and anteriorly, while the femoral neck is directed superiorly and anteriorly. The transverse angle of the acetabular inlet can be determined by measuring the angle between a line passing from the superior to the inferior acetabular rim and the horizontal plane; the sagittal angle of the acetabular inlet is an angle between a line passing from the anterior to the posterior acetabular rim and the sagittal plane. It measures 7° at birth and increases to 17° in adults. Wiberg's centre-edge angle is an angle between a vertical line and a line from the centre of the femoral head to the most lateral part of the acetabulum, as seen on an anteroposterior radiograph; the vertical-centre-anterior margin angle is an angle formed from a vertical line and a line from the centre of the femoral head and the anterior edge of the dense shadow of the subchondral bone posterior to the anterior edge of the acetabulum, with the radiograph being taken from the false angle, that is, a lateral view rotated 25 degrees towards becoming frontal.
The articular cartilage angle is an angle formed parallel to the weight bearing dome, that is, the acetabular sourcil or "roof", the horizontal plane, or a line connecting the corner of the triangular cartilage and the lateral acetabular rim. In normal hips in children aged between 11 and 24 months, it has been estimated to be on average 20°, ranging between 18° to 25°, it becomes progressively lower with age. Suggested cutoff values to classify the angle as abnormally increased include:30° up to 4 months of age. 25° up to 2 years of age. The angle between the longitudinal axes of the femoral neck and shaft, called the caput-collum-diaphyseal angle or CCD angle measures 150° in newborn and 126° in adults. An abnormally small angle is known as an abnormally large angle as coxa valga; because changes in shape of the femur affects the knee, coxa valga is combined with genu varum, while coxa vara leads to genu valgum. Changes in CCD angle is the result of changes in the stress patterns applied to the hip joint.
Such changes, caused for example by a dislocation, changes the trabecular patterns inside the bones. Two continuous trabecular systems emerging on auricular surface of the sacroiliac joint meander and criss-cross each other down through the hip bone, the femoral head and shaft. In the hip bone, one system arises on the upper part of auricular surface to converge onto the posterior surface of the greater sciatic notch, from where its trabeculae are reflected to the inferior part of the acetabulum; the other system emerges on the lower part of the auricular surface, converges at the level of the superior gluteal line, is reflected laterally onto the upper part of the acetabulum. In the femur, the first system lines up with a system arising from the lateral part of the femoral shaft to stretch to the inferior portion of the femoral neck and head; the other system lines up with a system in the femur stretching from the medial part of the femoral shaft to the superior part of the femoral head. On the lateral side of the hip joint the fascia lata is strengthened to
