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THE PELVIS IS HIP

A Partial Survey of the Bones, Joints, Muscles, Nerves, and Blood Vessels of the Pelvic Girdle and Associated Areas
Please note: For the muscles, and certain nerves and vessels, I have two models on your power points, which are numbered differently. To distinguish between the two, I will call one, the flexed leg model; the other, the extended
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leg model. Please be able to identify the structures in this exercise on both models. The internal dorsal region model will also be used. For a few structures I have no models; for them, I will test you from illustrations
A. The Coxal Bones (Martini, figure 7.10, pages 196-197)

Part I: Bones
There are three coxal bones, the ilium, the ischium and the pubis. These coxal bones (or os coxae) are separated from each other by hyaline cartilage at birth, but eventually fuse together to form one bony mass, the coxa. Even though these bones are fused, we will eventually study them as if they were still separate. A good landmark for separating these bones is the acetabulum, that deep fossa that we see on the lateral side of each coxa. It is the place where the head of the femur joins the coxa to form the hip joint. If you divide the acetabulum into superior and inferior halves, the superior half demarcates the ilium. Now split the remaining half vertically into two equal quarters, so that there is an anterior quarter and a posterior quarter. The anterior quarter is the pubis; the posterior quarter is the ischium. 1. Pelvic Girdle: Male and Female (Martini, figures 7.11, 7.12, & 7.13, pages 198-201) When the right and left coxae are articulating with the sacrum, they form the pelvic girdle. The superior cavity of the pelvic girdle is called the pelvic inlet; the inferior cavity is the pelvic outlet. The pelvic outlet completes the birth canal; the beginning of the birth canal is the pelvic brim. Anatomists often refer to two regions of the pelvis in relation to the birth canal, the true pelvis and the false pelvis. The true pelvis is composed of the walls the birth canal itself. The iliac crests form a broad superior region called the false pelvis. Males can be distinguished from females in that the brim of the true pelvis is narrower in males. Another distinction is the pubic angle. The pubic angle is marked anteriorly by the union of the pubic bones. Here the pubic bones are joined together by a piece of fibrocartilage, the symphysis pubis. This angle is less than 900 in males and greater than 1000 in females. Women must have broader hips to handle birth. If men gave birth, their children would have conical heads. I guess we shouldnt question nature. Now lets examine the ilium, ischium and pubic bones individually.

1. Ilium (Martini, Figure 7.10m pages 196-197 Probably the most notable feature of the ilium is the iliac crest. This archlike promontory is the superior most region of the ilium. If we follow the iliac crest posteriorly you will find a very blunt surface, ironically called the posterior superior iliac spine. Actually, before we seek this elusive spine, lets make sure youre actually on the posterior side of the ilium. You will know youre on the posterior side by looking for a big notch at the base of the iliac crest. If youre not on the side of the notch, youre studying the wrong thing! The notch incidentally is called the greater sciatic notch. Well get to that soon enough. Meantime, back to the posterior superior iliac spine. Right at the widest part of the slope of the iliac crest rests this amazingly blunt spine. If youve found the widest point, youre there, even if you cant find a spine per se. Another spine rests at the end of the iliac crest, dangling down between the crest and notch. This is a little more obvious, but the spine is still not sharp. What is it with these blunt spines! Because there are two posterior spines, and one rests above the other, we will call the upper spine, superior, and the lower spine, inferior. Putting the names together, we have the posterior superior iliac spine (acronym: PSIS), and the posterior inferior iliac spine (acronym: PIIS). These pissy acronyms may help you to remember where to place the names. At least remember that the names begin with posterior. OK. Its time for the anterior side. Go back to the top of the iliac crest again and travel down the slope that does not terminate at the greater sciatic

notch. For those of you in the know, youre traveling toward the pubis. For those of you who are not, please be patient. Jutting out from the widest anterior portion of the ilium is the anterior superior iliac spine. Yes, its blunt. Theyre all blunt on the ilium. Now lets follow the tip of this spine and travel into a shallow notch, the superior iliac notch. Keep coursing downward until you rise out of the superior iliac notch until you come to the next promontory which is (you guessed it) a blunt spine. So as with the posterior ilium, there are two blunt spines on the anterior ileum. These are the anterior inferior iliac spine (acronym: AIIS) and the anterior superior iliac spine (acronym: ASIS). Some people find acronyms helpful while others do not. Use them or leave it AS IS. Now lets distinguish the internal and external ilium. The internal ilium will have no acetabulum. That makes sense, because how could the femur articulate from within the body. Lets see what features the internal ilium does have. At the posterior region, we find a rough surface called the auricular surface where the ilium articulates with the sacrum. There is also a sharp ridge that runs at about a 450 angle from the inner most region of the auricular surface to the start of the pubis. This is yet another arcuate line. This line is also called the ileopectineal line, but I will try to stay consistent with your textbook for now. If youre still confused about anterior and posterior, remember that arcuate line always terminates at the pubis (specifically, the pubic crest), which is anterior part of the coxa. There is one more feature of the ilium worth mentioning, the iliac fossa. The iliac fossa is the shallow depression

below the iliac crest. The iliac fossa will be the point of origin for the iliacus muscle described below. Lets go to the more interesting external ilium. Find the acetabulum and off we go! Im going to start us off on a search for something that is not altogether obvious, and sometimes downright absent, the gluteal lines. The anterior gluteal line rests just below the iliac crest, following the same arch. It terminates in the deepest part of the greater sciatic notch so sometimes following this clue can lead you to the line. The anterior gluteal line is important because it marks a region of origin for the gluteus medius and gluteus minimus muscles. Even harder to find is the inferior gluteal line. This terminates at the anterior superior iliac spine and works its way down at about a 300 angle toward the acetabulum. Once again, the gluteus medius and minimus have origins here, with the minimus originating closer to the inferior gluteal line. Now for the real search, the short posterior gluteal line, one of the points of origin for the gluteus maxiumus muscle. It forms a concave arch deep to the region between the posterior superior iliac spine and the posterior inferior iliac spine. Real coxal bones will show these lines better than plastic ones, but even then, the lines are usually faint. Good luck. 2. Ischium The next coxal bone is the ischium. To find the ischium, drop straight down from the greater sciatic notch until you hit a pretty obvious little spine. This one is not so blunt, but I wouldnt call it sharp either. The spine is the ischial spine and its a good starting

point for the superior region of the ischium. The ischial spine is also the point of origin for the little superior gemellus muscle, so well see it again later in this exercise. Below the spine is a shallow notch, called the lesser sciatic notch. Below the notch rests a large, rough, rounded promontory which is the ischial tuberosity. This ischial tuberosity is the point of origin for many muscles including the inferior gemellus, quadriceps femoris, adductor magnus, biceps femoris, semimembranosus and semitendinosus. Some of these well discuss today; others well save for later. Its a busy place to say the least. The final part of the ischium we must learn is the ischial ramus. The term ramus means branch (remember). This is the part that projects forward at the very base of the bone, joining the inferior pubic ramus to form the largest foramen in the body, the obturator foramen. The obturator is a product of both inferior coxal bones, the ischium and the pubis. Well talk about the pubis in a minute, but let me say a couple of things about the obturator foramen first. The word obturator means plugged, and indeed there are two muscles that plug this hole, the obturator muscles. Isnt that sweet! A small canal that travels between these muscles called the obturator canal, permits the passage of the obturator nerve. More on that later. One final point. The ischium is the bone we sit upon. To remember this imagine yourself sitting on a cushion with air in it. When the air is released, the sound it makes is ISSHHHHHH-ium. 3. Pubis The anterior inferior coxal bone is the pubis. Remember, finding the

pubis is easy. Since were on the ischium, simply cross the obturator foramen to the anterior side, and voila! Youre there! Unlike the ischium, the pubis has two rami, a superior one that leads toward the acetabulum and an inferior one that fuses with the ischial ramus. Both of these rami are important origins for muscles. All three adductor muscles and the gracilis muscle originate on the inferior ramus; the pectinatus originates on the superior ramus. In fact, the shape superior edge of the superior ramus is called the pectineal line. The rami terminate anteriorly to form the symphysis pubis, a fibrocartilaginous joint that joins the coxal bones together in front. The most superior point of the pubic bone at the symphysis pubis is the pubic tubercle. The rectus abdominis originates from here. B. The Femur, Proximal Region The femur is the thigh bone. It articulates with the acetabulum of the coxa with its well rounded head. We will discuss this joint later in this exercise, but for now note that the head of the femur contains a tiny little pit that holds a ligament. The pit is called the fovea capitis, or simple the fovea for the head of the femur. Beneath the head of the femur lies a prominent neck. The neck terminates into two large processes, one superior and one inferior. These processes are the trochanters (the word means runner). The greater trochanter is superior to the lesser trochanter and is the larger of the two. The greater trochanter is the point of insertion for several muscles, including the gluteus

medius, gluteus minimus, obturator internus, and piriformis; the lesser trochanter is the point of insertion for the pectinatus, and the iliopsoas muscles. In addition, between the posterior region of the trochanters lies the intertrochanteric crest, the point of insertion for the quadratus femoris muscle. By contrast, the intertrochanteric line lies between the trochanters on the anterior side of the femur. There are three more regions of interest on the proximal end of the femur. On the posterior side we find a sharp line that runs all the way down the diaphysis. This line is the linea aspera (rough line) and it is the point of origin for the vastus medius muscle as well as the three adductor muscles. Following the line upward, we see that it branches into a Y. The line traveling to the greater trochanter is called the gluteal tuberosity. It is the point of insertion for the gluteus maxiumus muscle. The line traveling toward the lesser trochanter is the pectineal line. The pectineal line is the point of insertion for the pectinate muscle. The pectinates are also considered adductor muscles, but well get to that soon.

Part II: Joints (Martini, figure 8.14, page 231; Calais-Germain, p. 184)

The hip joint is one of two ball and socket joints and was designed as such because it has much to do. Lets examine the interior of this joint first. As with the glenoid cavity, there is a fibrocartilage pad on the articular surface of the acetabulum. This pad is sometimes called the lunate surface. Within the acetabular fossa, a deep depression within the acetabulum itself, is a fatty pad covering the synovial membrane. This pad acts as a shock absorber for the head of the femur. It should be noted that the circular articular surface within the acetabulum is not completed by bone. What does complete the circle of the acetabulum is a ligament called the transverse ligament. Coming from the transverse ligament is the ligament of the head of the femur that attaches to the fovea capitis. This little ligament is surrounded by a tendon sheath. If this tendon sheath becomes inflamed, bursitis may result. OW! Recall that the tendon sheath is a bursa built like a bun.

This little tendon stabilizes the head of the femur within a acetabulum, which is no small task considering how much we punish this joint. That little tendon is a real hot dog! Now lets examine the hip model and view the extrinsic ligaments of the hip. The hip joint is surrounded by a joint capsule that is held in place by several ligaments. The superior ligaments extend from the ilium and attach to the head of the femur. These are the iliofemoral ligaments. Inferior to these on the posterior side are the ligaments running from the ischium to the femur, the ischialfemoral ligaments. Finally, the ligaments arising from the pubis constitute the inferior anterior set, the pubofemoral ligaments. I think you may start to develop an appreciation for the ligaments. All you have to do with most of them is find them, and the names come automatically.

Part III: Musculature

A. Lateral Rotator Group

1. Piriformis (Martini, figure 11.10, page 307; Calais-Germain, page 209) [Model: Flexed 2; Extended 2]. A deep, but rather easy muscle to locate is the piriformis. To find it, the gluteus maximus must be removed. Once youre managed that, look for the sciatic nerve, which is a huge nerve nearly the width of my little finger. You cant miss it. Follow the sciatic nerve upward until it disappears below a muscle. That muscle is the piriformis. The term means pyramid-shaped, because there is a triangular quality to this muscle. The origin of the piriformis is the anterior lateral edge of the sacrum, but not the entire edge. To be more exact, find the second, third and fourth anterior sacral foramen and follow that region to the edge of the sacrum. Thats the origin. The insertion is the greater trochanter of the femur. The piriformis helps to laterally rotate the leg along with its peers: the obturators, gemelli, quadratus femoris, and the biceps femoris, and the adductors. In addition, it abducts the thigh at the hip, being more of a synergist for several other muscles including the gluteus medius and minimus muscles. It also tilts the superior region of the hip backward, thus thrusting the inferior pelvis forward (retroversion). If you know how to ride, this entire group is used extensively in horse-back riding. 2. Quadratus Femoris (Martini, figure 11.10, page 307; Calais-Germain, page 210) [Model: Flexed 6; Extended 8]. The quadratus femoris is a squat little job thats shaped like a square, hence the name. It originates from the lateral border of the ischial tuberosity

and inserts on the lower part of the greater trochanter. It does the same work as the piriformis. This makes the quadratus femoris one of the peers of the piriformis, then there are others to follow. 3. Obturator internus (Martini, figure 11.10, page 307; Calais-Germain, page 210) [Model: Flexed 4; Extended 6]. Recall that the obturator foramen is plugged by muscles and membranes and so its time to refer to at least the muscular part. The muscles are often referred to as simply the obturators. The most internal one is the obturator internis. No startling news. It originates from the medial border of the obturator foramen and inserts in the greater trochanter after making its way through the greater sciatic notch and bending around the body of the ischium. This muscle is readily seen when viewing the floor of the pelvic cavity from the inside. You can also see it between the two gemelli muscles that will be discussed below. The action of the obturator internus is primarily to assist the gluteus maximus in lateral rotation of the hip and medial flexion of the pelvis, so its another piriformis peer. 4. & 5. Gemulus, Superior and Inferior (Martini, figure 11.10, page 307; CalaisGermain, page 211) [Superior, Model: Flexed 3; Extended 7a; Inferior, Model: Flexed 5; Extended 7b ]. Both of the gemelli muscles (gemellus singular) assist the piriformis muscle. More peers. The term gemellus means twin and both look pretty much

alike, although one is superior and one is inferior. Recall that between these muscles lie the obturator internis. Ill talk about a way of learning this group soon, but first lets finish the obturators. 6. Obturator externus (Martini, figure 11.10, page 307; Calais-Germain, page 211-12) [No not the models] The obturator externus originates from the lateral region of the obturator canal and passes around the back of the neck of the femur and inserts into the greater trochanter. Its job is the same as the obturator internus, lateral rotation. It rests deep to the quadratus femoris muscle, although a bit of it can usually be seen if the fascia has been removed. Note: When the gluteus maximus is removed and the piriformis is found, it is easy to find the obturator internis and gemelli muscles. The superior Gemellus rests below the piriformis. The Obturator internus rests below the superior gemellus. The inferior Gemellus rests below the obturator internus, and the Obturator externus rests below the inferior gemellus, but it is covered by the quadratus femoris. But if you remove the square-like quadratus femoris, you cant miss it. However, our models have the quadratus femoris in tact, so the obturator externis remains obscured. So the gemelli and obturator muscles are the GO-GO muscles. Putting them altogether in order working superiorly to inferiorly, you might get something like Performing Go-Go Queens. No further comment. B. Ilipsoas Group

Because there is a close association between the ilacus and the psoas major and minor, this muscle set is often called the iliopsoas muscles. However, they have very distinct features as well as distinct origins so we will learn these muscles separately. Be aware that they perform the same actions. 7. Psoas Major & Minor (Martini, figure 11.11, page 308;Calais-Germain, page 213) [See internal dorsal model] Deep in the dorsal part of the abdominal cavity rest two strap-like muscles that form an inverted V. These are the psoas muscles. Their points of origin are the anterior surfaces and transverse processes of T12 through L-5. They insert into the lesser trochanter. The action of this muscle is flexion of the hip, accompanying the iliacus and gluteus muscles as well as many of the long leg muscles that will be discussed in the next exercise. Both the psoas major and minor perform the same function, but psoas minor rests atop psoas major, and it has a thin, straplike appearance. They are easily seen on the dorsal cavity model and are good reference points for the lumbar plexus (see below). 8. Iliacus (Calais-Germain, page 214) [Model: Flexed 14a; Extended 2; also see internal dorsal model] . If you find the internal iliac fossa of the ileum, you will see the iliacus muscle originating from there. This is tough muscle to miss, lying dorsally to the psoas muscles and following the contours of the ilium. This muscle is also involved in flexion of the hip. The insertion is once again, the lesser trochanter of the femur. Together, the

psoas and iliacus make the high stepper muscles. C. Gluteal Group We will discuss only part of the gluetal group today, finishing off with gluteus maximus and tensor fascia latae in the next exercise. The gluteus medius and minimus muscles should be discussed together as this pair performs the same actions; abduction and medial rotation of the hip. Both have the greater trochanter as a point of insertion. 9. Gluteus medius (Calais-Germain, page 215) [Model: Flexed 1a; Extended 4]. The gluteus medius lies somewhat anteriorly and deeply to the gluteus maximus. It originates at the iliac crest and between the anterior and posterior gluteal lines. This is the favored region for giving injections,

because giving an injection in the superior gluteal region ensures that you will miss the sciatic nerve (described below). The gluteus medius also helps to stabilize the pelvis during walking. 10. Gluteus minimus (Calais-Germain, page 216) [Not on models] Similar to the gluteus medius is the gluteus minimus. It also originates between the anterior and posterior gluteal lines, but its origin is inferior to the gluteus medius muscle. Although it is a relatively small muscle compared to its gluteal cousins, the gluteus minimus is about twice the size of the piriformis. These are sometimes confused because they both have a triangular shape. Recall that the sciatic nerve passes from under the piriformis. Also, the gluteus minimus lies superior to the piriformis, but deep to the gluteus medius.

Part IV: Nerves

A. Lumbar Plexus (Martini: Figure 14.13 a & c, Page 371) [See internal dorsal model] The lumbar plexus is responsible for innervating the lower limbs. You will

find it is less complex than the brachial plexus, because we will only concern ourselves with the nerves, not their origins. Six nerves arise from the lumbar plexus. You can see these nerves labeled on the inner dorsal body wall model labeled by the letters of the alphabet: (a) iliohypogastric,(b) ilioinguinal, (c) genitofemoral, (d) lateral femoral cutaneous, (e) femoral and (f) obturator. An easy way to recall these nerves is the sentence: (I hope) I Get Lasagna From Omar. I hope =Iliohypogastric; I = Ilioinguinal; Get = Genitofemoral; Lasagna = Lateral Femoral Cutaneous; From = Femoral; Omar = Obturator. The following is a brief description of the nerves of the lumbar plexus. I will not discuss the effects of damage to these nerves individually. It should suffice to say that paralysis or weakness and numbness results from damage; overall paralysis of the lower limb or limbs many result when the spinal cord is injured above the lumbar plexus because communicating routes to the cerebrum have been hindered or destroyed. 1. Iliohypogastric (a): Even though we will be using a model in the class, I want to impress upon you how you can locate these nerves on a cadaver. Once the intestines are removed, the lumbar plexus is easy enough to find. The problem is that at first glance, everything looks the same. To find the most superior nerve of the lumbar plexus, it is best to find the subcostal nerve first. The subcostal nerve is the nerve that rests below the last rib, and ribs are easy enough to find. It will be part of a neurovascular

bundle; often a blue costal vein can be seen. The next nerve you find traveling inferiorly should branch into a Y. The superior nerve of this branch is the iliohypogastric nerve. The inferior branch is the ilioinguinal nerve which will be discussed shortly. The iliohypogastric nerve innervates the lateral muscles and skin of the abdomen as well as the Skin of the buttocks (ilio = hip; gastric = stomach region). It is located between T 12 and L1, depending upon your specimen. The Y distinguishes this nerve pair from the subcostal nerve and the inferior nerves of the lumbar plexus. Ilioinguinal (b): The ilioinguinal nerve is the inferior branch of the nerve described above. Like the iliohypogastric nerve, the ilioinguinal nerve innervates the lateral abdominal muscles, but it differs from its superior neighbor in that it innervates the skin of the medial upper thigh, not the buttocks). As its name implies, the root of the penis and the scrotum are innervated by this nerve in males; it innervates the mons pubis and labia majora in females. Ilio means, hip; inguinal refers to the groin. Genitofemoral (c): The genitofemoral nerve is easy to find because it exits from lower region of the psoas muscle. It innervates the skin over the anterior region of the thigh and in males; it innervates the cremaster muscle that pulls the scrotum into the body when it is exposed to cold. If any of you are Seinfeld fans, this should explain Georges phrase And there was considerable shrinkage.

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Lateral Femoral Cutaneous (d): The lateral femoral cutaneous nerve innervates the lateral surfaces of the thigh. It is extremely easy to find as long as it has not been cut, so this nerve is quite long and travels laterally into the dermis of the skin from the lower abdominal cavity. Its origin is around L3-L4. Femoral (e). The femoral nerve is a large nerve that can be found under or immediately lateral to the lowest part of the psoas muscle. As the name implies, the femoral nerve innervates the anterior thigh, but branches follow down the medial side of the leg and foot. The hip and knee joints are also innervated by this nerve. Muscles which are governed by the femoral nerve are the iliacus, pectineus, sartorius, and quadriceps femoris muscles. Obturator The final nerve in the lumbar plexus is the obturator nerve. This is another easy nerve to find because it travels through an opening in the lateral floor of the pelvic cavity. This opening is called the obturator canal, the highest point of the obturator foremen. Recall that the obturator foramen is created by the rami of the ischium and pubis. The obturator canal is associated with the superior ramus of the pubis. The obturator nerve innervates the adductor muscles of the thigh as well as the skin over the medial aspect of the thigh. You cant call the adductors without going through the obturator. It shares the obturator canal with the obturator

artery and vein (that makes it easy), but these vessels are affiliated with the head of the femur and the ilium. Branches of the femoral supply blood to the adductors, but thats a different story. B. Sacral Plexus The sacral plexus is easy enough to find. It comes from the union of nerve roots that travel through the ventral foramen of the sacrum. To locate it, find the sacrum and then find the nerve roots that exit from it. Note how these roots form a large braid. They merge with a nerve that originates in L4-L5 called the lumbosacral trunk. One they have joined together, the sciatic nerve, the largest nerve of the body is formed and it is the only nerve of the sacral plexus you will need to learn for this class. The following is a description of the sciatic nerve. 1. Sciatic Nerve [Model: Flexed 41; Extended 63]. The sciatic nerve, once again, is the largest nerve of the body and as such is easy to find. You will see it as a thick white band in the gluteal region that courses from underneath the piriformis muscle. On the internal dorsal model, you will see the sacral plexus as well as the thick sciatic nerve if you follow the description above. Its tough to miss. As you might have guessed, the sciatic nerve is responsible for innervating the posterior thigh and the leg. Sciatica, a condition painful condition caused by compression to the sciatic nerve, is usually the result of a slipped or ruptured intervertebral disk, bone spurs, and several other conditions that can inflame this nerve. Another

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common cause worth mentioning is pregnancy. This is due to pressure created by the enlarged uterus; in this case the symptoms typically subside after child birth. Strengthening the abdominal muscles and erector spinae can often relieve this condition, but surgery may be necessary if bone spurs are the cause. The term sciatic is another word for ischial and many books have taken to calling it the ischial nerve. Some people

have little more to do than to cause trouble.

Summary of Muscular Innervation

The muscles in this chapter are all innervated by branches of the sacral plexus which I have not covered in this text. We will, however, discuss the work of the sciatic nerve in the next chapter.

Part V: Vasculature
Here are some easy, and I mean easy, arteries and veins to find. It doesnt get better than this, so enjoy yourself while you can. A. Arteries (Martini, figure 22.16, page 589). 1. Abdominal Aorta or Descending Abdominal Aorta

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The artery carrying oxygenated blood that leaves the heart is called the aorta. The aorta forms an arch over the heart, and then courses downward through the thoracic cavity and then into the abdominal cavity. This great vessel is called the abdominal aorta, and it from here that all the other arteries of the abdominal region and lower limbs branch, either directly or indirectly. Some of these branches we will discuss when we visit the various organs, but for now be able to recognize the abdominal aorta in your text, and on our torso models on land, on sea or in the air. Sometimes I just get carried away. 2. Common Iliacs The abdominal aorta descends to form an inverted Y. The vessels that form this "Y" are called the right and left common iliac arteries. Both of the common iliacs are short, for they will travel only so far before they each split into Ys of their own. One branch goes internally and one branch goes externally. Can you guess what these branches are called? For the answer to Y, see below. 3. Internal Iliacs The Y of the common iliac that travels inward is called the internal iliac artery. I wish all anatomy were this simple. The internal iliac travel posteriorly into the dorsal side of the pelvic cavity. They will branch again and again into the superior gluteal, the pudental and the obturator arteries. You wont need to know these, but I thought you might like to know where the obturator artery comes from. So much for the internal iliac. Lets look at its external cousin.

4. External Iliacs If you thought the name of this artery was the external iliac you would be correct. These arteries travel to and then course along the psoas muscles. Eventually, the external iliac form two small branches, the iliolumbar and the superior gluteal arteries before it passes through the pelvic cavity region of the inguinal ligament. The inguinal ligament is easy to visualize. If you wear brief underwear, or have a cousin who does, the leg holes follow the contour of the inguinal ligament. This ligament is easy to see on the cadaver, and is also reasonably well depicted on the torso models. B. Veins (Martini, figure 22.23 page 597). 1. Inferior Vena Cava Most of the deoxygenated blood from the body, except blood from the head and upper limbs travels back to the heart via a great vein, the inferior vena cava. As the organs of the abdominal cavity receive blood from the abdominal aorta, they return blood to be sent back to the heart into the inferior vena cava. This great blue structure is another one thats tough to confuse with anything else. You will find it nicely depicted in your text, as well as the torso models. 2. Common Iliacs As with the abdominal aorta, the inferior vena cava splits into two common iliac veins, or perhaps I should say the common iliacs merge into the inferior vena cava, as blood is traveling

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to the heart not away from it. Once again, these vessels are short, as they will branch into our next guests, the external and internal iliac veins. 3. Internal Iliacs The internal iliac veins course along with the internal iliac arteries. 4. External Iliacs The external iliac veins course along with the external iliac arteries. I told you it was easy.