Question

after childbirth, a woman begins experiencing tremendous pain in her groin, making it difficult for her to walk. an x-ray shows a fracture extending from her symphysis pubis to the inferior ramus of the pubis. as a result of the fracture, which group of muscles might be impaired?

a hip flexors
b thigh abductors
c hip extensors
d lateral rotators
e thigh adductors

Explanation:

Identify the anatomical location of the fracture

The patient has a fracture extending from her symphysis pubis to the inferior ramus of the pubis. This region is located in the anterior and inferior portion of the pelvis (Hip Bone Structure).

Determine the muscles originating from this region

The inferior pubic ramus and the body of the pubis near the symphysis serve as the primary origin sites for the medial compartment muscles of the thigh. These muscles include:

• Adductor longus
• Adductor brevis
• Adductor magnus (anterior part)
• Gracilis
• Pectineus (originates slightly superiorly on the pectineal line of the pubis)

Correlate muscle origins with functional groups

These muscles belong to the functional group of Thigh adductors (or adductors of the hip/thigh), which are responsible for pulling the thigh toward the midline of the body (Muscle Functional Groups).

Evaluate the clinical impact of the fracture

Because the bone structure where these muscles attach (origin) is fractured and disrupted, the stability and function of these muscles will be compromised. Therefore, the thigh adductors are the group of muscles most likely to be impaired.

Match with the given multiple-choice options

• Option A (Hip flexors): Primarily originate from the ilium, lumbar vertebrae, and fossa (e.g., iliopsoas).
• Option B (Thigh abductors): Primarily originate from the lateral surface of the ilium (e.g., gluteus medius and minimus).
• Option C (Hip extensors): Primarily originate from the posterior ilium, sacrum, and ischial tuberosity (e.g., gluteus maximus, hamstrings).
• Option D (Lateral rotators): Primarily originate from the sacrum, ischium, and obturator membrane (e.g., piriformis, obturator internus/externus, gemelli, quadratus femoris).
• Option E (Thigh adductors): Originate directly from the pubis and its inferior ramus, matching our anatomical analysis.

Answer:

• A Hip flexors
• B Thigh abductors
• C Hip extensors
• D Lateral rotators
• E Thigh adductors (Correct answer)