REIDER PART 2 03
The tensor fascia lata is a superficial muscle that arises from the anterior portion of the iliac crest and inserts into the fascia lata, or enveloping fascia, of the lat-eral thigh. Its muscle belly is visible anteriorly in lean individuals, forming the lateral contour of the proximal thigh.
The anterior inferior iliac spine (AIIS) lies just medial and inferior to the ASIS. This smali bony promi-nence is not normally visible because it is obscured by the sartorius. It serves as the origin for a portion of the rectus femoris muscle, the only component of the quad-riceps femoris muscle group to arise superior to the hip joint.
The medial portion of each pelvic bonę is formed by the pubis. The contours of the pubie bonę are not normally visible. The upper portion of the pubis is known as the superior pubie ramus. The two pubie bones join together at the midline in a fibrocartilaginous joint called the pubie symphysis. The pectineus muscle inserts along the superior pubie ramus, and the pyramidalis and rectus abdomitiis muscles insert near the pubie symphysis.
_Chapter 5_Pelvis, Hip, and Thigh 163
Although not visible, the pubie symphysis can usually be palpated in the midline at the superior margin of the nor-mal area of growth of pubie hair. The disruption of the two halves of the pelvis may occur as a result of high velocity trauma. Pelvic disruption is often associated with fractures of the pubie ramus or dissociation of the pubie symphysis. Hip Joint. Although the hip joint itself lies deep to the muscles of the pelvis and thigh, the visible anterior land-marks of the pelvis can be used to identify the location of the hip joint. To do so, the examiner first locates the pulse of the femoral artery. This should be palpable approxi-mately midway between the ASIS and the pubie tubercle. The hip joint itself is located 2 cm lateral and 2 cm distal to the point at which the femoral pulse is palpable beneath the inguinal ligament. Pain arising from pathol-ogy of the hip joint, such as osteoarthritis, usually is local-ized to this site and often is described by the patient as “groin pain.”
Thigh. The ąuadriceps muscle group constitutes the primary bulk of the anterior thigh (Fig. 5-2). The quadri-ceps consists of four distinct muscles that coalesce as they
Figurę 5-2. A, B, and C, Anterior aspect of the thigh. A, rectus femoris; B, vastus medialis; C, vastus lateralis; D, iliotibial tract; E, adductor longus; F, gracilis; G, sartorius.
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