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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/01/25 17:32:43」(JST)

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The term iliopsoas (ilio-so-as) refers to the combination of the psoas major and the iliacus at their inferior ends. These muscles are distinct in the abdomen, but usually indistinguishable in the thigh. As such, they are usually given the common name "iliopsoas" and are referred to as the "dorsal hip muscles"^[1] or "inner hip muscles".^[2] The psoas minor does not contribute to the iliopsoas muscle.

Structure

The psoas major originates along the lateral surfaces of the vertebral bodies of T12 and L1-L3 and their associated intervertebral discs. The iliacus originates in the iliac fossa of the pelvis.^[2]

The psoas major unites with the iliacus at the level of the inguinal ligament and crosses the hip joint to insert on the lesser trochanter of the femur. The iliopsoas is involved in flexion and lateral rotation (supination) of the thigh. If the limb is fixed they involve in flexion of the trunk.

Innervation

It is a composite muscle. The psoas major is innervated by direct branches of the anterior rami off the lumbar plexus at the levels of L1-L3, while the iliacus is innervated by the femoral nerve (which is composed of nerves from the anterior rami of L2-L4).

Function

The iliopsoas is the strongest of the hip flexors (others are rectus femoris, sartorius, and tensor fasciae latae). The iliopsoas is important for standing, walking, and running.^[2] The iliacus and psoas major perform different actions when postural changes occur.

The iliopsoas muscle is covered by the iliac fascia, which begins as a strong tube-shaped psoas fascia, which surround the psoas major muscle as it passes under the medial arcuate ligament. Together with the iliac fascia, it continues down to the inguinal ligament where it forms the iliopectineal arch which separates the muscular and vascular lacunae.^[3]

Clinical significance

It is, however, a typical posture muscle dominated by slow-twitch red type 1 fibers. Therefore, it is susceptible to pathological shortening or contracture, especially in older people with a sedentary lifestyle, and requires regular stretching to maintain normal length. Since most of the muscle is in the abdominal and pelvic cavities, it is very difficult to stretch it effectively in the conventional sense. With the advent of computers and sedentary work and school environments, it affects more younger people and children than ever before. Such shortening can lead to increased anterior pelvic tilt and lumbar lordosis (unilateral shortening), and limitation of hip extension (bilateral weakness).^[2] It is a major contributing factor of scoliosis.^[4]^{[unreliable medical source?]} Since it originates from the lumbar vertebrae and discs and then inserts onto the femur, any structure from the lumbar spine to the femur can be affected directly. A short and tight iliopsoas often presents as externally rotated legs and feet. The externally rotated leg is probably the most significant factor affecting posture and function. It can cause pain in the low or mid back, SI joint, hip, groin, thigh, knee, or any combination. Since the iliopsoas is a major postural muscle, shortening of the iliopsoas causes abnormal curvature of the spine, which can cause issues in the mid back and upper body as well as problems in the lower extremities. In effect, a tight and short iliopsoas can theoretically cause symptoms anywhere in the body. The iliopsoas gets innervation from the L2-4 nerve roots of the lumbar plexus which also send branches to the superficial lumbar muscles. Treating these superficial muscles can potentially help the deeper iliopsoas to loosen and lengthen. The femoral nerve passes through the muscle and innervates the quadriceps, pectineus, and sartorius muscles. It also comprises the intermediate femoral cutaneous and medial femoral cutaneous nerves which are responsible for sensation over the anterior and medial aspects of the thigh, medial shin, and arch of the foot nerves. 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 (external obturator, adductor longus, adductor brevis, adductor magnus, gracilis) and sometimes the pectineus. Any of these innervated structures can be affected.

Additional Images

Iliopsoas muscle

References

^ Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol 1: Locomotor system (5th ed.). Thieme. p. 234. ISBN 3-13-533305-1.
^ ^a ^b ^c ^d Thieme Atlas of Anatomy. Thieme. 2006. pp. 422–423. ISBN 3131421010.
^ Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol 1: Locomotor system (5th ed.). Thieme. p. 254. ISBN 3-13-533305-1.
^ http://www.massagetherapy.com/articles/index.php/article_id/500/The-Opinionated-Psoas-Part-3

"Iliopsoas". Retrieved 1 September 2010.

External links

Muscles/Iliopsoas at exrx.net
UCC
Cross section image: pelvis/pelvis-e12-15 - Plastination Laboratory at the Medical University of Vienna

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 下肢ランニング障害の概要 overview of running injuries of the lower extremity
2. 股関節痛を有する成人の評価 evaluation of the adult with hip pain
3. 腰筋膿瘍 psoas abscess
4. 腸脛靱帯症候群 iliotibial band syndrome
5. 小児における急性虫垂炎：臨床症状および診断 acute appendicitis in children clinical manifestations and diagnosis

English Journal

Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis.

Asmar A1, Ozcan C, Diederichsen AC, Thomassen A, Gill S.Author information 1Department of Cardiology, Odense University Hospital, Sdr Boulevard 29, 5000 Odense C, Denmark.AbstractOBJECTIVE: The purpose of this study was to assess the clinical importance of 18F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE).
European heart journal cardiovascular Imaging.Eur Heart J Cardiovasc Imaging.2014 Apr 7. [Epub ahead of print]
OBJECTIVE: The purpose of this study was to assess the clinical importance of 18F-FDG-PET/CT used in the extra cardiac work-up of patients with infective endocarditis (IE).BACKGROUND: IE is a serious condition with a significant mortality. Besides the degree of valvular involvement, the prognosis re
PMID 24711514

Spinal non-Hodgkin's lymphoma mimicking a flare of disease in a patient with ankylosing spondylitis treated with anti-TNF agents: case report and review of the literature.

Monti S1, Boffini N, Lucioni M, Paulli M, Montecucco C, Caporali R.Author information 1Divisione di Reumatologia, IRCCS Fondazione Policlinico S. Matteo, Università di Pavia, Pz.le Golgi 3, Pavia, PV, 27100, Italy, sara.saramonti@gmail.com.AbstractWe report the case of a 52-year-old man with long-standing HLAB27-positive ankylosing spondylitis treated with anti-tumour necrosis factor (TNF) alpha therapy who was admitted to our rheumatology department complaining of increasing lumbar and buttock pain radiating to the posterior thigh, associated with numbness in the leg, gait disturbance and low-grade fever. The clinical picture was initially interpreted as a flare of disease but was not responsive to treatment. A contrast-enhanced spinal MRI was performed with evidence of a diffuse signal abnormality involving the sacroiliac joints and the spine, with evidence of spondylodiscitis of L5 and with a lesion causing L5-S1 root compression and infiltrating the iliopsoas muscle. These findings confirmed the possibility of a reactivation of disease associated with an infectious process. The most frequent causes of infectious spondylodiscitis were excluded, and a biopsy was then performed. Histological analysis revealed a high-grade B-cell non-Hodgkin's lymphoma of the spine. This case highlights how a differential diagnosis of low back pain with neurological symptoms can be particularly troublesome in ankylosing spondylitis and that continuous vigilance is warranted in patients treated with long-term immunosuppressive therapies.
Clinical rheumatology.Clin Rheumatol.2014 Apr 5. [Epub ahead of print]
We report the case of a 52-year-old man with long-standing HLAB27-positive ankylosing spondylitis treated with anti-tumour necrosis factor (TNF) alpha therapy who was admitted to our rheumatology department complaining of increasing lumbar and buttock pain radiating to the posterior thigh, associate
PMID 24699989

Results of Labral-Level Arthroscopic Iliopsoas Tenotomies for the Treatment of Labral Impingement.

Nelson IR1, Keene JS2.Author information 1Division of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation Medicine, University of Wisconsin, Madison, Wisconsin, U.S.A.2Division of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation Medicine, University of Wisconsin, Madison, Wisconsin, U.S.A.. Electronic address: Keene@ortho.wisc.edu.AbstractPURPOSE: To document the clinical results of arthroscopic iliopsoas tenotomies performed at the level of the labrum to treat labral injuries caused by iliopsoas impingement.
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.Arthroscopy.2014 Apr 3. pii: S0749-8063(14)00158-3. doi: 10.1016/j.arthro.2014.02.027. [Epub ahead of print]
PURPOSE: To document the clinical results of arthroscopic iliopsoas tenotomies performed at the level of the labrum to treat labral injuries caused by iliopsoas impingement.METHODS: From a review of the database of the senior author (J.S.K.) of 300 hip arthroscopies that were performed between Septe
PMID 24704071

Japanese Journal

研究・症例粟粒結核の治療中に発生した腰部大腿流注膿瘍の1例

石渡祐作,伊藤玲子,佐藤真紀 [他]
日本胸部臨床 72(3), 293-299, 2013-03-00
NAID 40019603005

臨床室腸腰筋血腫による大腿神経麻痺の診断にMRI脂肪抑制併用最大値投影法が有用であった1例

浦田隆司,関庄二,川口善治 [他]
整形外科 = Orthopedic surgery 64(3), 227-229, 2013-03-00
NAID 40019595287

血液透析用カテーテル留置中に転移性感染症としての腰椎化膿性脊椎炎および腸腰筋膿瘍を合併した1例

村上穣,萩原正大,大沢紘介,佐々本格,津田勝路,関浩道,降籏俊一,山崎諭,山口博,池添正哉
日本透析医学会雑誌 46(8), 727-732, 2013
血液透析用カテーテル留置中に腰椎化膿性脊椎炎および腸腰筋膿瘍を合併した1例を経験したので報告する．患者は80歳代，男性．末期腎不全による尿毒症のため他院に入院し，右大腿静脈より非カフ型カテーテル挿入のうえ血液透析を導入された．カテーテル留置から24日目に黄疸が認められ，当院に転院した．精査により<I>Enterococcus faecalis</I>によるカテーテル関連血流 …
NAID 130003372806

Related Pictures

Iliopsoas Iliopsoas muscle

★リンクテーブル★

リンク元	「腸腰筋」
拡張検索	「iliopsoas abscess」

「腸腰筋」

Iliopsoas (Hip Flexor)
	Anterior hip muscles. The iliopsoas is not labeled but can be seen as the psoas major and the iliacus join inferiorly.
Details
Latin	Musculus iliopsoas
Origin	Iliac fossa and lumbar spine
Insertion	Lesser trochanter of femur
Artery	Medial femoral circumflex artery and iliolumbar artery
Nerve	Branches from L1-L3
Actions	Flexion of hip
Antagonist	Gluteus maximus and the posterior compartment of thigh
Identifiers
Dorlands; /Elsevier	m_22/12549330
TA	A04.7.02.002
FMA	64918
	Anatomical terms of muscle [edit on Wikidata]

　　[★]

英: iliopsoas muscle (N,KA), iliopsoas (K,N)
ラ: musculus iliopsoas
関: 大腰筋、腸骨筋

前大腿筋群の１つ
大腰筋と腸骨筋が鼡径靭帯の深層を通り、大腿で融合し、小転子に停止する

筋名	起始	停止	支配神経	機能
大腰筋	T12(椎体) L1-L5(椎体、横突起)	大腿骨(小転子)	腰神経叢	股関節の屈曲(わずかに外旋) 脊柱の屈曲
腸骨筋	腸骨(腸骨窩)	大腿骨(小転子)	腰神経叢大腿神経	股関節の屈曲(わずかに外旋) 脊柱の屈曲

Henry Gray (1825-1861). Anatomy of the Human Body. 1918.

「iliopsoas abscess」

　　[★]

腸腰筋膿瘍

関: psoas abscess

[Platzer-234-1] Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol 1: Locomotor system (5th ed.). Thieme. p. 234. ISBN 3-13-533305-1.

[Thieme-atlas-422-423-2] Thieme Atlas of Anatomy. Thieme. 2006. pp. 422–423. ISBN 3131421010.

[Platzer-254-3] Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol 1: Locomotor system (5th ed.). Thieme. p. 254. ISBN 3-13-533305-1.

[4] ttp://www.massagetherapy.com/articles/index.php/article_id/500/The-Opinionated-Psoas-Part-3

匿名

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案内

案内

iliopsoas