Lower Limb
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
The anterior (developmentally dorsal, or extensor) compartment of the thigh includes six muscles: the iliopsoas, the sartorius, and the four muscles that form the quadriceps femoris: the rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis (Plate 5.5a; Table 5.2). The iliopsoas is a composite muscle that mainly flexes the thigh and is formed by two fused muscles: the iliacus (mainly innervated by the femoral nerve) and the psoas major (mainly innervated directly by lumbar nerves of the lumbar plexus). The four muscles that make up the quadriceps femoris (quad = four) extend the leg. The rectus femoris is also able to flex the thigh because it originates from the pelvis and not from the femur as do the vastus lateralis, intermedius, and lateralis. The name “sartorius” comes from the Latin word sartor, which means tailor, and the sartorius accordingly is often called the tailor’s muscle. Its name indicates its three main functions—from anatomical position, you need to perform three movements to sit in the cross-legged posture of early tailors: First you flex the thigh, then you flex the leg, and lastly you laterally rotate the thigh (but not abduct the thigh, as is sometimes stated in anatomical texts). Rather than memorizing the functions of the sartorius, you can logically deduce them: The muscle lies mainly anterior, not lateral, to the femur, so it mainly flexes—not abducts—the thigh. Its fibers are directed distomedially, in an appropriate direction to laterally rotate the thigh. Lastly, its fibers pass posterior to the knee joint, giving it the ability to flex the leg.
Neurologic disorders in pregnancy
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Incidence of femoral neuropathy in parturients has considerably declined with modern obstetric care. Branches of the lumbar plexus (L2–4) do not enter the true pelvis; the compression of femoral nerve therefore usually occurs at the inguinal ligament due to prolonged lithotomy position (29). Findings include difficulty walking and knee buckling, weakness of quadriceps femoris, absent patellar reflex, and impaired sensation in saphenous nerve distribution. Weakness of iliopsoas when present indicates a more proximal lesion due to nerve stretch from abduction and external rotation of hip or injury from instrumentation. Proximal part of femoral nerve has poor blood supply and is also prone to ischemia. Prognosis is favorable in majority of patients consistent with neurapraxic injury.
Spinal Cord Disease
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Lower limbs: Wasting of muscles may occur but is mild and limited to the anterior and posterior tibial compartment in wheelchair-dependent elderly patients.Tone is increased in the hamstrings, quadriceps, and ankles. Ankle clonus is present uniformly.Weakness is most notable of the iliopsoas, tibialis anterior, and, to a lesser extent, hamstring muscles.Deep tendon reflexes are pathologically increased. Crossed adductor reflexes and extensor plantar responses are present uniformly.Sensation to sharp stimuli is decreased below the knees in occasional patients and vibratory sense is often diminished mildly in the distal lower limbs.Gait: circumduction is present due to difficulty with hip flexion and ankle dorsiflexion.
Imaging changes following surgery for ischiofemoral impingement
Published in Baylor University Medical Center Proceedings, 2023
Munif Hatem, Richard Feng, Jordan Teel, Hal David Martin
Atrophy of the iliacus and psoas muscles has been reported following iliopsoas tenotomy in association with hip arthroscopy.11,12 However, these studies reported no significant difference in the mHHS relative to the amount of atrophy.11,12 In the present study, no correlation between the mHHS and the amount of iliopsoas atrophy was observed. The primary function of the iliopsoas muscle is hip flexion, and tenotomy or detachment from the LT could result in hip flexion weakness. In the present study, one patient reported hip flexion weakness in the early postoperative period, which was resolved at 4-month follow-up. Previous studies have reported improvement of hip flexor weakness by at least 8 weeks postoperatively after iliopsoas tendon release.13,14 Brandenburg et al reported a 19% reduction in seated hip flexion strength following iliopsoas tenotomy at the level of the hip joint.15 Those authors also reported no significant difference in hip flexion strength in the supine position when comparing the operated with the nonoperated side.15 The reinsertion of the iliopsoas onto the femur following the LT resection could prevent flexor weakness. While the technique for iliopsoas reinsertion following LT resection is published, clinical results on hip flexor strength are not reported.16
Effects of backrest and seat-pan inclination of tractor seat on biomechanical characteristics of lumbar, abdomen, leg and spine
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Qichao Wang, Yihuan Huo, Zheng Xu, Wenjie Zhang, Yujun Shang, Hongmei Xu
In this study, the muscles with high activities, including gluteus maximus, semitendinosus, Rectus femoris, iliopsoas, vastus lateralis and sartorius, were analyzed, and those muscles with low activities or small muscle tissues were not taken into account. Gluteus maximus has a wide and thick quadrilateral shape, and mainly drives the extension and external rotation of the thigh. Semitendinosus is located at the back of the thigh and helps the extension of the hip joint and bending of the knee joint. Rectus femoris is located in the front of the thigh, whose main function is to extend the knee joint and bend the thigh. Iliopsoas is composed of psoas major muscle and iliacus, which is mainly responsible for the external rotation of the thigh and forward flexion of the pelvis and trunk. The sartorius is flat and banded, and is one of the longest in the leg muscles, starting from the anterior superior iliac spine, passing through the inner side of the knee joint, and finally to the inner side of the upper end of the tibia. The main function of sartorius is for the bending of the hip and knee.
Long-standing groin pain in an elite athlete: usefulness of ultrasound in differential diagnosis and patient education – a case report
Published in European Journal of Physiotherapy, 2018
Kingsley S. R. Dhinakar, Anjanette Cantoria Lacaste
There are four defined clinical entities for groin pain described in Doha agreement. Adductor-related groin pain presents with adductor tenderness and pain on resisted adduction testing. Iliopsoas tenderness, pain on resisted hip flexion and/or pain on stretching the hip flexors are noted in iliopsoas-related groin pain. Inguinal-related groin pain presents with pain and tenderness in the inguinal canal, aggravated by resistance testing of abdominal muscles or on valsalva/cough/sneeze and with no palpable inguinal hernia. Tenderness of the pubic symphysis and adjacent bone with no particular resistance or provocation test are associated with pubic-related groin pain. Although DOHA agreement has defined clinical entities for groin pain, the exact physical examination was not being discussed and more than one clinical entity can be presented and instrumental diagnosis is not mandatory. Instrumental diagnosis can be often helpful as differential diagnosis needs multifactorial cause elimination. In addition, exploring the role of imaging in the prediction of treatment response or prognosis in those with groin pain is encouraged during the Doha agreement [5]. This information will enable better understanding of the clinical relevance and aid in diagnosis. There is consensus in the literature that groin pain and conjoint tendon laxity or loading variation are effectively diagnosed using ultrasound examination [13,14].
Related Knowledge Centers
- Femoral Nerve
- Femur
- Iliacus Muscle
- Lesser Trochanter
- Lumbar Nerves
- Psoas Major Muscle
- Thigh
- Vertebra
- Abdomen
- Composite Muscle