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The ilium is the largest of the three bones that make up the pelvis, with the primary purpose of supporting the upper body and facilitating locomotion and walking. The iliac crest is the superior margin of the ilium, forming a thick, curved border on the edge of the bone. It is a vulnerable site for injury, especially in athletes who play contact sports. Many muscles are attached to the ilium, including the gluteus maximus, medius, and minimus, the iliopsoas, and the iliacus. These muscles play a crucial role in hip movement and stabilisation.
| Characteristics | Values |
|---|---|
| Iliac Crest | The iliac crest is the superior margin of the ilia, forming a curved area on the sides of the hip bones of the pelvic girdle. |
| Iliac Crest Functions | The iliac crest stabilizes the body by bearing the weight of the spine and upper body. It is also the site where many important muscles attach. |
| Muscles Attached to Iliac Crest | Hip flexors, internal and external abdominal oblique muscles, gluteal muscles (gluteus maximus, medius, and minimus), iliopsoas, iliacus, tensor fascia latae, sartorius, rectus femoris, piriformis, gemellus superior, gemellus inferior, obturator internus, obturator externus, and quadratus femoris. |
| Iliac Crest Injuries | Hip pointer injuries are common in athletes, especially in contact sports such as football and hockey. Iliac crest pain syndrome can occur when the iliolumbar ligament tears due to trauma. |
| Iliac Crest Blood Supply | The deep circumflex iliac artery provides most of the blood supply to the iliac crest. |
| Iliac Crest Bone Marrow | The iliac crest contains an ample supply of bone marrow, which is a source of mesenchymal stem cells and growth factors for tissue regeneration. |
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What You'll Learn
The gluteus maximus, medius, and minimus muscles
The gluteus maximus is the primary hip extensor and makes up most of the mass of the buttocks. It originates at the ilium and sacrum and attaches to the femur. The gluteus medius is a large, fan-shaped muscle located in the posterior hip, extending from the ilium to the proximal femur. It is similar in shape and function to the gluteus minimus, with both muscles working together to abduct and internally rotate the thigh. The gluteus medius also stabilises the pelvis during walking or standing.
The gluteus minimus is the deepest and smallest of the superficial gluteal muscles. It originates from the ilium and inserts into the greater trochanter of the femur. It assists the gluteus medius in abduction and medial rotation of the lower limb, and it stabilises the pelvis during locomotion.
The gluteus medius and minimus muscles are both innervated by the superior gluteal nerve. Weakness or damage to this nerve can result in a Trendelenburg gait, where the pelvis drops on the unsupported side.
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The iliopsoas muscle
The psoas major and iliacus muscles produce the flexion of the hip, but the psoas major can also produce additional movements of the lumbar vertebral column due to its proximal attachments. The iliopsoas muscle is covered by the iliac fascia, which begins as a strong tube-shaped psoas fascia that surrounds the psoas major muscle as it passes under. The iliopsoas is classified as an "anterior hip muscle" or "inner hip muscle". The inferior portion of the iliopsoas below the inguinal ligament forms part of the floor of the femoral triangle. The iliopsoas is the prime mover of hip flexion and is the strongest of the hip flexors.
The obturator nerve also passes through the muscle, which is 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. The iliopsoas muscle is a common site of bleeding in patients undergoing blood anticoagulation. The iliopsoas muscle is essential for correct standing or sitting lumbar posture, stabilising the coxofemoral joint, and is crucial during walking and running.
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The iliacus muscle
A portion of the iliacus muscle is attached to the iliac fossa, two-thirds from its top. Another portion is attached to the inside portion of the iliac crest, the top, outer portion of the pelvic bone. The iliac crest is the curved area on the sides of the hip bones of the pelvic girdle. It is vulnerable to injuries and conditions that affect the nerves and ligaments attached to it, such as hip pointer injuries, which are common in athletes who play contact sports.
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The tensor fascia latae muscle
The tensor fasciae latae (TFL) is a muscle of the proximal anterolateral thigh that lies between the superficial and deep fibres of the iliotibial (IT) band. The TFL muscle belly is approximately 15 cm long, although there is high variability in its length, and in most patients, the muscle belly ends before reaching the greater trochanter of the femur. The TFL works in conjunction with the gluteus maximus, gluteus medius, and gluteus minimus in various hip movements, including flexion, abduction, and internal rotation. It also assists with knee flexion and lateral rotation through the attachment of the IT band to the tibia.
The tensor fasciae latae is innervated by the superior gluteal nerve, originating from lumbar nerve 4, 5, and the first sacral nerve (L4-S1) roots. It also innervates the gluteus minimus and medius muscles before terminating with the innervation of the tensor fasciae latae muscle. The TFL is vascularized by the ascending branch of the lateral circumflex femoral artery.
The TFL is most important clinically for assisting pelvic stability while standing and walking. It originates from the anterior superior iliac spine (ASIS) and the anterior aspect of the iliac crest and descends between the deep fascia and the superficial fascia of the IT band. The TFL is the most superficial muscle of the anterolateral aspect of the thigh. It is positioned lateral to the hip joint, immediately beneath the skin. In its superior aspect, the TFL is found between the sartorius and gluteus medius muscle, where it overlays the gluteus minimus muscle.
The main function of the TFL is to produce the extension and lateral rotation of the leg at the knee joint. Additionally, it contributes to the movements of the thigh, acting as a relatively weak abductor and medial rotator on the hip joint. The TFL also assists the rectus femoris in the flexion of the hip. The TFL acts on the tibia via the IT band's attachment to the Gerdy tubercle of the lateral tibia.
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The sartorius muscle
The ilium is a large, superior, and fan-shaped bone that forms the uppermost and widest portion of the pelvis. Several muscles attach to the ilium, including the sartorius muscle.
This muscle has a unique diagonal course across the anterior aspect of the thigh, and it is superficial in its origin and deep in its insertion. Because of its attachments, the sartorius muscle is involved in multiple actions at the hip and knee joints. At the hip, it functions to flex, abduct, and laterally rotate the thigh. At the knee joint, the sartorius muscle helps to flex the leg and rotate the tibia inward.
The blood supply to the sartorius muscle is primarily from the medial femoral circumflex artery, a branch of the deep femoral artery. This muscle also receives additional blood supply from the lateral femoral circumflex artery and the descending genicular artery, a branch of the popliteal artery. Innervation of the sartorius muscle is provided by the femoral nerve, which arises from the lumbar spine and supplies motor and sensory function to the anterior thigh and leg.
In terms of function, the sartorius muscle plays an important role in various movements. When sitting cross-legged, for example, the sartorius muscle helps to hold this position by keeping the leg crossed. It is also active during movements such as running, particularly when the knee is bent and the hip is extended. Additionally, the sartorius muscle is involved in the "long sit" position, where the hips are flexed and the knees are straight, as it helps to stabilize the pelvis and maintain balance.
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Frequently asked questions
Many muscles attach to the ilium, including the gluteus maximus, medius, and minimus, the iliopsoas, and the iliacus.
The iliac crest is the curved area on the sides of the hip bones of the pelvic girdle. It is the superior border of the ilium.
The internal and external oblique abdominal muscles attach to the iliac crest, as well as the hip flexors.
