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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 CAPSULE
2. ILIO FEMORAL
3. PUBO FEMORAL
4. ISCHIO FEMORAL
5. LIGAMENT OF HEAD OF FEMUR
6. ACETABULAR LABRUM
7. 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.
Thank you