Gracilis (m. Gracilis/тонкая мышца)

• Origin. From the inferior ramus of the pubis and the ramus of the ischium.

• Insertion. To the medial side of the tibia between sartorius and semitendinosus.

• Action. Adduction of the thigh.

• Nerve supply. Obturator nerve.

The posterior group

Biceps femoris (m. biceps femoris/двуглавая мышца бедра)

• Origin. Long head from the ischial tuberosity and short head from the linea aspera.

• Insertion. By a thick tendon into the head of the fibula.

• Actions. Extension of the hip and flexion of the knee.

• Nerve supply. Sciatic nerve (both components).

Semitendinosus (m. semitendinosus/полусухожильная мышца)

• Origin. From the ischial tuberosity.

• Insertion. To the medial side of the front of the tibia, behind sartorius and gracilis.

• Actions. Extension of the hip and flexion of the knee joint.

• Nerve supply. Sciatic nerve (tibial component).

Semimembranosus (m. semimembranosus/полуперепончатая мышца)

• Origin. From the ischial tuberosity.

• Insertion. To a groove on the tibial medial condyle.

• Actions. Extension of the hip and flexion of the knee.

• Nerve supply. Sciatic nerve (tibial component).

Fasciae of the hip region and the thigh

The iliac fascia (fascia iliaca/подвздошная фасция)

• This fascia covers the iliopsoas muscle (it is the part of the common subperitoneal fascia).

• Below the inguinal ligament the iliac fascia descends on the thigh, where it is continues with the fascia lata.

The fascia lata (fascia lata/широкая фасция)

• It covers the muscles of the thigh.

• Just below the inguinal ligament, within the boundaries of the femoral triangle, the fascia is divided into two layers.

• The deep layer passes behind the vessels of the thigh.

• The superficial layer passes in front of the thigh vessels and terminates as a free falciform margin (margo falciformis/серповидный край).

• Two horns are distinguished in the falciform margin: the inferior horn (cornu inferius/нижний рог) blends with the deep layer of fascia lata, the superior horn (cornu superius/верхний рог) attaches to the inguinal ligament and, curving under it, fuses with the lacunar ligament.

• The falciform margin bounds a depression called the saphenous opening (hiatus saphenus/подкожная щель).

• The saphenous opening is covered by the cribriform fascia (fascia cribrosa/решётчатая фасция).

• The fascia lata forms the processes which attaché to the bone:

• The lateral femoral intermuscular septum (septum intermusculare femoris laterale/латеральная межмышечная перегородка бедра) separates the vastus lateralis from the posterior muscles.

• The medial femoral intermuscular septum (septum intermusculare femoris mediale/медиальная межмышечная перегородка бедра) separates the vastus medialis from the medial muscles.

• The fascia lata on the lateral side forms a wide thickened band, the iliotibial tract (tractus iliotibialis/подвдошно-большеберцовый тракт) extending for the entire length of the thigh. It serves as a tendon for the tensor fascia lata and the gluteus maximus muscles.

• Distally the fascia lata continues with the fascia of the leg. Posteriorly it covers the popliteal fossa.

Topography of the hip region

The suprapiriform and infrapiriform foramen

The piriform muscle passes through the greater sciatic foramen. The suprapiriform and infrapiriform foramen (foramen suprapiriforme, infrapiriforme/надгрушевидное, подгрушевидное отверстие) remain above and below which narrow openings. They transmit the gluteal nerves and vessels.

The obturator canal

The obturator groove of the pubic bone is supplemented below by the obturator membrane and thus converted to the obturator canal (canalis obturatorius/запирательный канал), transmiting the obturator vessels and nerves.

Topography of the thigh

• The fascia iliaca passes in the space between the inguinal ligament and hip bone. It fuses in its lateral part with the inguinal ligament, while its medial part diverges from the ligament and attaches to the iliopubioc eminence. This part is distinguished artificially under the name of the iliopectineal arch (arcus iliopectineus/подвдошно-гребенчатая дуга).

• The iliopectineal arch divides the space below the inguinal ligament into two parts:

• The muscular space (lacuna musculorum/мышечная лакуна) lodging the iliopsoas muscle and the femoral nerve.

• The vascular space (lacuna vasorum/сосудистая лакуна) for passage of the femoral artery and vein (lies medially).

• From vascular space the vessels pass to the thigh, leg and foot. According to the passage of the vessels and nerves, the folloving grooves and canals are distinguished:

• The vascular space continues with the iliopectineal groove (sulcus iliopectineus/подвздошно-гребенчатая борозда). It lies between the iliopsoas (laterally) and pectineus (laterally) muscles and then continues with the anterior femoral groove.

• The anterior femoral groove (sulcus femoralis anterior/передняя бедренная борозда) is bounded by the vastus medialis (laterally) and the adductor longus and magnus (medially) muscles. Both grooves are in the femoral triangle (trigonum femorale/бедренный треугольник). It is bounded by the inguinal ligament superiorly, the sartorius muscle laterally and the adductor longus muscle medially. The floor of this triangle is the iliopsoas and pectineus muscles. The anterior femoral groove continues with the adductor canal.

• The adductor canal (canalis adductorius/приводящий канал) passes on the lower third of the thigh into popliteal fossa. The canal is formed by the vastus medialis muscle laterally, the adductor magnus muscle medially and the anteromedial intermuacular septum (septum intermusculare vasoadductorium/), running over them anteriorly. The canal has three openings:

• The proximal opening (inlet) is bounded by the adductor magnus, vastus medialis muscles and the anteromedial intermuacular septum.

• The distal opening (outlet) is called the adductor hiatus (hiatus adductorius/сухожильная щель) and formed by the diverging bundles of the adductor magnus tendon.

• The anterior opening is in the anteromedial intermuacular septum.

The femoral canal (canalis femoralis/бедренный канал)

• The femoral canal is bounded by the femoral vein laterally, the deep layer of the fascia lata posteriorly and the inguinal ligament and the superior horn of the falciform margin anteriorly.

• The femoral canal has two openings:

• The femoral ring (annulus femoralis/бедренное кольцо) is the internal opening (inlet). The ring is bounded by the femoral vein laterally, by the inguinal ligament anteriorly and superiorly, by the lacunar ligament medially, by the pectineal ligament posteriorly. The lacunar ligament is a continuation of the inguinal ligament, the pectineal ligament is a continuation of the lacunar ligament on the pubic bone.

• The external opening (outlet) is the saphenous opening.

• Under normal conditions the femoral canal does not exist, there is the femoral ring only.