The Hip Joint
The Hip Joint
HIP JOINT
It is the ball n socket variety of synovial joint.
It is unique in having a high degree of stability n mobility.
ARTICULAR SURFACES HEAD OF THE FEMUR ARTICULATES
WITH THE ACETABULUM OF THE HIP BONE.
HEAD OF THE FEMUR IS COVERED BY HYALINE CARTILAGE EXCEPT AT FOVEA CAPITIS.
ACETABULUM PRESENTS A LUNATE ARTICULAR SURFACE,ACETABULAR NOTCH N ACETABULAR FOSSA.
ACETABULUM
Is the large cup-shaped cavity or socket on the lateral aspect of the hip bone
Articulates with the head of the femur to form the hip joint
The Ilium, Ishium, and Pubis join to form the acetabulum
FEMUR The largest and heaviest bone in the
body The head of the femur projects
superomedially and slightly anterior The head is attached to the femoral
body by the neck of the femur Lesser trochanter Greater trochanter Intertrochanteric line
LIGAMENTS
1. FIBROUS CAPSULE2. ILIO FEMORAL3. PUBO FEMORAL4. ISCHIO FEMORAL5. LIGAMENT OF HEAD OF FEMUR6. ACETABULAR LABRUM7. TRANSVERSE ACETABULAR
LIGAMENTS
FIBROUS CAPSULE: IT IS ATTACHED TO THE ACETABULAR
LABRUM N TO THE BONE ABOVE N BEHIND THE ACETABULUM.
ON THE FEMUR TO THE INTER TROCANTRIC LINE INFRONT,INTER TROCANTRIC CREST BEHIND.
LIGAMENTS Illiofemoral ligament-also known as the Y ligament-runs from the base of the AIIS to the
intertrochantic line-reinforces the fibrous capsule anteriorly-strongest ligament in the hip-prevents hyperextension of the hip during
standing by screwing the femoral head into the acetabulum
LIGAMENTS
Pubofemoral ligament-runs from the anterior pubis ramus to
the anterior surface of the intertrochantic fossa
-reinforces the fibrous capsule inferiorly and anteriorly
-tighten during abduction and extension-prevents overabduction of the hip joint
LIGAMENTS
Ischiofemoral ligament-the ischial portion of the acetabulum
and spirls to the neck of the femur and base of the greater trochanter
-prevents hyperextension of the hip-fibers relaxed during flexion
LIGAMENTS Ligamentum teres-known also as the ligament of the head
of the femur-attaches to the acetabular notch and
the transverse acetabular ligament to the pit in the head of the femur
-is weak-supplies the blood for the femur head
LIGAMENTS
ACETABULAR LABRUM: Fibrocartilaginous rimattached to the
margins of acetabulum It narrows the mouth of
acetabulum,helps in holding the head.
TRANSVERSE LIGAMENT OF ACETABULUM: Part of acetabular labrum which bridges
the acetabular foramen.
MUSCLES
Origin/Insertion/Action Adductor Brevis
O - Inferior Pubic Ramus I - Pectineal Line and Linea Aspera A - adducts, flexes, and medially
rotates femur
Gracillis O - pubic Symphysis and inferior
pubic ramus I - medial surface of the tibia A - adducts thigh, flexes medially
and medially rotates thigh, flexes leg
Origin/Insertion/Action
Pectineus-O - Superior ramus of
pubis-I - Pectineal line of
femur-A – adducts and flexes
thigh
Origin/Insertion/Action
Adductor Longus O - med portion of the
superior pubic ramus I - linea aspera of femur A - adducts, flexes, and
medially rotates the femur
Origin/Insertion/Action
Adductor Magnus O - ischiopubic ramus and
ischial tuberosity I - linea aspera of the femur; the
ischiocondylar part inserts on the adductor tubercle of the femur
A - adducts, flexes, and medially rotates the femur; extends the femur
Inn - post div of oburator nerve; tibial nerve
Origin/Insertion/Action
Biceps Femoris Longus-O - long head: ischial
tuberosity, short head: linea aspera of femur
-I - lateral side of head of fibula
-A - extends the thigh
Origin/Insertion/Action
Gluteus Maximus-O - ilium posterior to
posterior gluteal line-I - end in the iliotibial tract
that inserts into the lateral condyle of the tibia
-A - extends the thigh
Origin/Insertion/Action
Gluteus Medius-O – external surface of ilium-I – lateral surface of greater
trochanter of femur-A – abducts and internally
rotates the thigh
Origin/Insertion/Action
Gluteus Minimus-O – external surface of ilium-I – anterior surface of
greater trochanter of femur
-A – abducts and internal rotates
Origin/Insertion/Action
Quadratus femoris-O – lateral border of ischial
tuberosity-I – quadrate tubercle on
intertrochanteric crest of femur
-A - external rotation extended thigh and abducts flexed thigh
Origin/Insertion/Action
Obturator Externus-O – pelvis surface of obturator
membrane-I – medial surface of greater
trochanter-A - external rotation extended
thigh and abducts flexed thigh
Origin/Insertion/Action
Iliopsoas-O – sides of T12-L5
vertebrae, iliac crest-I – lesser trochanter of
femur, pectineal line, lesser trochanter
-A – flexing the thigh
Origin/Insertion/Action
Rectus Femoris-O – AIIS and ilium superior
to acetabulum-I – base of patella-A – flex thigh
Origin/Insertion/Action
Sartorius-O – ASIS-I – superior part of medial surface
of tibia-A – flexes, abducts, and external
rotates thigh Tensor Fascia Lata-O – ASIS-I – iliotibial tract -A- abducts, medial rotates, and
flexes thigh
Origin/Insertion/Action
Semimembranosus-O – ischial tuberosity-I – posterior part of medial
condyle of tibia-A – extend thigh
Origin/Insertion/Action
Semitendinosus-O – ischial tuberosity-I – medial surface of
superior part of tibia-A – extend thigh
Origin/Insertion/Action
Vastus lateralis-O – greater trochanter and lateral lip
of linea aspera of femur Vastus medialis-O – intertrochanteric line and medial
lip of linea aspera of femur Vastus intermedius-O – anterior and lateral surfaces of
body of femur*Same for all 3-I – base of patella and A – helps flex
thigh
Blood Supply
Medial Circumflex Lateral Circumflex Obturator Inferior gluteal
Nerve supply
Femoral Obturator Sciatic Nerve to quadratus femoris Direct branches of sacral plexus
Movements The hip joint is the most mobile joint in
the lower limb. It is capable of flexion and extension, abduction and adduction, medial and lateral rotation and all of these in a circular motion- circumduction
second largest range of movement (second only to the shoulder) supports the weight of the body, arms and head.
Flexion- mainly due to
contraction of the iliopsoas muscle, with help from the sartorius, rectus femoris, and pectineus
Extension- chiefly by the guteus maximus muscles with help by the hamstrings
Adduction- by the adductor longus, brevis, magnus and the gracilis
Abduction- by the gluteus medius and gluteus minimus
Lateral rotation- by
the gluteus maximus, quadratus femoris, piriformis, obturator internus and externus, gemelli
Medial rotation- by the anterior part of the glueteus minimus and medius and tensor fasciae latae muscles.
CLINICAL ANATOMY
CONGENITAL DISLOCATION OF HIP More common in hip than any other. Head of femur slips upward on to the
gluteal surface of the ilium bcz the upper margin of acetabulum is developmentally deficient. Below 5yrs.
PERTHES DISEASE:destruction n flattening of the head of femur. 5 to 10 yrs.
COXA VERA:reduced neck shaft angle. 10 to 20 yrs.
OSTEO ARTHRITIS:Growth of osteophytes at articular ends. In above 40 yrs.
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