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Gluteus medius
Aponeurosis covering
erector spinae
Tensor fasciae latae

Gluteus maximus

Iliotibial tract

Gracilis

Adductor magnus
Semitendinosus
Biceps femoris
Vastus lateralis

Fig.46.3
The superficial muscles of the gluteal region

• Synovium: the synovial membrane lines the capsule of the hip joint These are derived from branches of the circumflex femoral arteries
and is reflected back along the femoral neck. It invests the ligamentum via the cruciate and trochanteric anastomoses. This is the most
teres as a sleeve and attaches to the articular margins. A psoas bursa important supply in the adult.
occurs in 10% of the population. This is an outpouching of synovial 2 Vessels in the ligamentum teres which enter the head through
membrane through a defect in the anterior capsular wall under the small foramina in the fovea. These are derived from branches of
psoas tendon. the obturator artery.
• Blood supply (Fig. 46.6): the femoral head derives its blood supply 3 Through the diaphysis via nutrient femoral vessels.
from three main sources: • Nerve supply: is from branches of the femoral, sciatic and obturator
1 Vessels which pass along the neck with the capsular retinacula and nerves.
enter the head through large foramina at the base of the head.

The hip joint and gluteal region 103