Maximus Gage
The anterior superior iliac spine (ASIS) is a bony prominence of the ilium. It plays a crucial role in muscle attachment, with several important muscles and ligaments attaching to it. One such muscle is the sartorius, which is the longest muscle in the human body. The sartorius muscle originates at the ASIS and winds around the front of the thigh, eventually inserting on the medial side of the tibia. This muscle is responsible for producing movements at both the hip and knee joints, demonstrating the significance of its origin at the ASIS.
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What You'll Learn
Sartorius muscle
The sartorius muscle is the longest muscle in the human body. It is a thin, long, superficial muscle that runs down the length of the thigh in the anterior compartment. The sartorius muscle originates from the anterior superior iliac spine of the pelvis and part of the notch between the anterior superior iliac spine and the anterior inferior iliac spine. It runs obliquely across the upper and anterior part of the thigh in an inferomedial direction, crossing the surfaces of the iliopsoas, pectineus, and adductor longus muscles. The upper portion of the sartorius muscle forms the lateral border of the femoral triangle, and the point where it crosses the adductor longus marks the apex of the triangle.
The sartorius muscle is innervated by the femoral nerve and receives vascular supply from several sources, including the femoral, deep femoral, lateral circumflex femoral arteries, and the artery of quadriceps. The muscle may be divided into three parts, each receiving blood supply from different branches of the arteries mentioned above. The sartorius muscle can move both the hip joint and the knee joint, allowing for flexion, weak abduction, and lateral rotation of the femur at the hip, and flexion and medial rotation of the leg at the knee.
The name "sartorius" comes from the Latin word sartor, meaning "tailor," and it is sometimes referred to as the "tailor's muscle." This name likely refers to the cross-legged sitting position commonly associated with tailors, which demonstrates all four actions of the sartorius muscle. Another hypothesis suggests that the name refers to the location of the inferior portion of the muscle, the "inseam" or area of the inner thigh that tailors typically measure when fitting trousers. Additionally, antique sewing machines required continuous crossbody pedalling, which would have resulted in particularly well-developed sartorius muscles in tailors.
One condition that can affect the sartorius muscle is pes anserine bursitis, an inflammatory condition of the medial portion of the knee. This condition is common in athletes due to overuse and is characterised by pain, swelling, and tenderness. It occurs when the bursae underlying the tendons of the gracilis, semitendinosus, and sartorius muscles become inflamed, causing the tendons to separate from the head of the tibia.
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Quadriceps femoris
The quadriceps femoris is a large, fleshy muscle group covering the front and sides of the thigh. It is made up of four muscles: the rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius. These muscles originate at the ilium (upper part of the pelvis or hipbone) and femur (thighbone). They come together in a tendon that surrounds the patella (kneecap) and insert at the tibia (shinbone). The quadriceps femoris is the most powerful extensor of the knee and is essential for standing, walking, and most other leg activities.
The rectus femoris is supplied by the artery of the quadriceps, which can stem from three sources: the femoral, deep femoral, or lateral circumflex femoral arteries. It occasionally has a third head that originates from the iliofemoral ligament. The vastus lateralis is the largest of the four quadriceps femoris muscles and originates from various sites on the femur, including the proximal half of the intertrochanteric line and the anterior and inferior borders of the greater trochanter. The vastus medialis is supplied by three muscular branches of the femoral artery and also receives minor contributions from the deep femoral and descending genicular arteries.
The quadriceps femoris is a hip flexor and a knee extensor, and its strength can be tested through resistance of knee extension and hip flexion. The muscle is also used to test the femoral nerve in suspected cases of nerve palsy. The myoelectric balance of the quadriceps is crucial for the correct movement of the patella, and the proprioceptive afferents of the muscle help maintain adequate posture and improve coordination.
In certain chronic respiratory diseases, such as COPD, the quadriceps femoris muscle experiences a decrease in muscle mass, an increase in connective tissue, and fibrosis. This results in decreased contractile capacity, reduced strength, and impaired balance during walking or standing. Similar effects are observed in multiple sclerosis, where the muscle loses mass and strength, with a decrease in oxidative fibers and an increase in anaerobic fibers.
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Iliopsoas
The iliopsoas muscle is a complex muscle system that can function as a unit or as separate muscles. It is made up of three muscles: the iliacus, psoas major, and psoas minor. The psoas minor is only present in 60-65% of individuals.
The iliopsoas muscle is the primary hip flexor and assists in the external rotation of the hip joint, playing a crucial role in maintaining the strength and integrity of the hip joint. It is classified as an "anterior hip muscle" or "inner hip muscle". The iliopsoas crosses the hip joint to insert onto the lesser trochanter of the femur. It is supplied by the lumbar spinal nerves L1-L3 (psoas) and parts of the femoral nerve (iliacus).
The psoas major originates along the outer surfaces of the vertebral bodies of T12 and L1-L4 and their associated intervertebral discs. The muscle bundles are directed downwards, parallel to the lumbar vertebrae, reaching the iliac fossa where there are the bundles of the iliac muscle. The psoas major has a fusiform shape. The iliacus originates in the iliac fossa of the pelvis, or more specifically, on the upper two-thirds of the iliac fossa and the lateral parts of the wing of the sacrum. The psoas major and iliacus join together, passing under the inguinal ligament, to insert onto the femoral lesser trochanter.
The iliopsoas muscle is a common site of bleeding in patients undergoing blood anticoagulation. The iliopsoas tendon can also develop tendinopathy, which can cause chronic groin pain and a limited hip range of motion.
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Pectineus
The pectineus muscle is a flat, quadrangular muscle, situated at the anterior (front) part of the upper and medial (inner) aspect of the thigh. It is considered a transitional muscle between the anterior thigh and medial thigh. The muscle's primary action is hip flexion; it also produces adduction, external rotation, and internal (medial) rotation of the hip. The pectineus is one of the muscles located on the medial thigh, alongside a group of four primary large muscles: the adductor longus, adductor brevis, adductor magnus, and gracilis muscles, which primarily function in hip adduction.
The pectineus muscle arises from the pectineal line of the pubis and, to a slight extent, from the surface of the bone in front of it, between the iliopectineal eminence and pubic tubercle. The muscle then slides over the superior margin of the superior pubic ramus and courses posterolaterally down the thigh, sometimes being partially divided into a larger anterior (superficial) layer and a smaller posterior (deep) layer. The pectineus muscle is considered a composite muscle as it is innervated by the femoral nerve (L2 and L3) and, occasionally, by a branch of the obturator nerve called the accessory obturator nerve. The femoral nerve is always present and provides the sole innervation for the pectineus muscle in over 90% of cases.
The pectineus muscle assists in hip adduction and flexion and is classified in the medial compartment of the thigh when emphasising its function. However, when emphasising the nerve, it is classified in the anterior compartment of the thigh. The muscle lies in the same plane as, and medially to, the adductor longus. Laterally, it is related to the psoas major muscle and the medial circumflex femoral artery and vein. The anterior surface of the pectineus forms the medial part of the floor of the femoral triangle, along with the adductor longus. This surface of the pectineus is covered with the deep layer of fascia lata, which separates it from the femoral artery, femoral vein, and great saphenous vein that course through the femoral triangle.
The pectineus muscle can become injured by overstretching, such as stretching a leg or legs too far out to the side or front of the body. Pectineus injuries can also be caused by rapid movements like kicking or sprinting, changing directions too quickly while running, or even by sitting with a leg crossed for too long. Treatment of a pectineus muscle injury involves protecting the injured area from further harm, minimising activities that use the muscle, and icing the injury to reduce swelling and pain.
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Adductor longus
The adductor longus is a large, fan-shaped muscle located in the medial aspect of the thigh. It is one of the hip adductors, along with the adductor brevis, adductor magnus, gracilis, and obturator externus. The adductor longus is situated most anteriorly in this group and covers the middle part of the adductor magnus and the anterior part of the adductor brevis.
The adductor longus originates from the anterior surface of the body of the pubis, inferior to the pubic crest and lateral to the pubic symphysis. It then expands into a fan shape, attaching broadly to the linea aspera on the middle third of the femur. This insertion point is between the insertion of the adductor magnus and the origin of the vastus medialis muscle, and inferior to the adductor brevis insertion.
The adductor longus is innervated by the anterior division of the obturator nerve (L2-L4). Its blood supply comes from two arteries: the deep femoral artery (a branch of the femoral artery) and the obturator artery (a branch of the internal iliac artery). The proximal part of the muscle is supplied by the medial circumflex artery, a branch of the deep femoral artery.
The main action of the adductor longus, along with the other adductor muscles, is to adduct the thigh at the hip joint. The adductor longus also participates in external/lateral rotation and flexion of the thigh. These adductors help to stabilize the body while standing and play an important role in balancing the body on the lower limb during walking.
Injuries to the adductor longus muscle are common in sports such as ice skating, horse riding, soccer, football, karate, and running. These injuries often occur due to sudden changes in direction, causing a quick adduction against a large abduction force that stresses the tendon.
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Frequently asked questions
The anterior superior iliac spine (ASIS) is a bony prominence of the ilium.
The sartorius muscle originates at the ASIS. It is the longest muscle in the human body and winds around the front of the thigh, inserting onto the tibia.
The sartorius muscle is capable of flexion, external rotation, and abduction of the leg at the hip joint. It also produces movements at the knee joint.
