The Hip

Presented by: Dan McReynolds Tracy Reed Lance Best Natalie Nord

Surface AnatomyGluteal Region

Intergluteal cleft

Gluteal Fold

Gluteal Sulcus

Iliac Crest

Dimple for Posterior Superior

Iliac Spine

Sacrum

Greater Trochanter

Surface AnatomyAnterior Pelvic Region

Supracristal Plane

Anterior Superior Iliac Spine

Inguinal Ligament

*Os Coxa(e) Bone

*Os Coxa(e) Bone

Superior Pubic Ramus

Inferior Pubic Ramus

Pubic Crest

Femur

Anterior

Posterior

Femur

Proximal Tibia

Several strong ligaments, including the iliofemoral and Pubofemoral anteriorly and the Ischiofemoral ,that spirals posterior, are arranged so that they “screw” the femur head into the socket when a person stands upright.

Ligaments

Iliofemoral Ligament: Strong Y-shaped ligament that supports front of the hip joint. It connects the lower front iliac spine of the coxal bone to the Intertrochanteric line extending between the greater and lesser Trochanters of the femur. The iliofemoral ligament is the strongest ligament in the body.

Intertrochantericline

Ligaments

Ischiofemoral Ligament: Consists of a triangular band of strong fibers on the POSTERIOR SIDE of the hip joint. Its fibers connect from the Ischium at the point below and behind the acetabulum to blend with the circular fibers at the posterior end of the joint capsule and attach at the Intertrochanteric line of the femur.

Ligaments

http://gopokes.exblog.jp/i2/

Pubofemoral Ligament: Attached to the Obturator crest and the Superior Ramus of the Pubis and then blends with the capsule and with the deep surface of the vertical band of the Iliofemoral Ligament and also attaches on the Intertrochanteric line of the femur.

Ligaments

http://depts.washington.edu/msatlas/hipligant.html

Runs from the sacrum to the Ischial tuberosity.

Ligaments

http://www.prohealthsys.com/anatomy/grays/myology/muscles_of_the_gluteal_region.php

Inguinal Ligament: This band runs from the Anterior Superior Iliac Spine of the Ilium to the Pubic Tubercle of the Pubic bone

Ligaments

Ligament of the Head (Ligamentum Teres): Helps to secure the head of the femur in the acetabulum and provides some of its blood supply

Acetabular Labrum: Ring of tough Fibrocartilage attached to the rim of the acetabulum.

www.studyblue.com

Transverse Acetabular Ligament: Consists of strong, flattened fibers, which cross the acetabular notch, and prevent inferior displacement of the head of the femur

Ligaments

Fibrous Layer: Attaches proximally on the hip bone to the bony rim of the acetabulum and the transverse acetabular ligament. Distally, it attaches to the femoral neck only anteriorly at the intertrochanteric line and the root of the greater trochanter. Posteriorly, the fibrous layer has an arched border that crosses the neck proximal to the Intertrochanteric crest but is not attached to it.

Synovial Membrane: Lines the Fibrous layer as well as any intracapsular bony surfaces not lined with articular cartilage. Where the fibrous layer attaches to the femur, the synovial membrane reflects proximally along the femoral neck to the edge of the femoral head.

Articular Capsule

http://healthpages.org/anatomy-function/hip-structure-function-common-problems/#common-problems-of-the-hip

Capsule: Encloses the hip joint and attaches to the Acetabular Labrum. Covers approximately the proximal two thirds of the neck of the femur posteriorly.

Zona Orbicularis: Deep fibers most marked in the posterior part of capsule, wind circularly around the neck of the femur.

http://www.mendmyhip.com/hip-trochanteric-bursitis-pain/hip-trochanteric-bursitis-treatment.php

Inflammation or infection of the bursa called bursitis.

Trocanteric Bursa: Separates the superior part of the Gluteus Maximus form the Treater Trochanter of the femur.

Ischial Bursae: Separates the inferior part of the Gluteus Maximus from the Ischial Tuberosity.

Gluteofemoral bursa: Separates the Iiotibial tract from the superior part of the proximal attachment of the Vastus Lateralis.

Bursa

Psoas Major

Muscles of the hip

Origin Anterior & lateral surfaces of T12-L5

Insertion Lesser trochanter

Action Hip flexion

Innervation

L2-L3

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Anterior & lateral surfaces of T12-L5

Insertion Lesser trochanter

Action Hip flexion

Innervation

L2-L3

Iliacus

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Posterior sacrum & Ilium

Insertion Posterior femur distal to greater trochanter

Action Hip extension, hyperextension, lateral rotation

Innervation

Inferior gluteal nerve

Gluteus maximus

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Lateral ilium

Insertion Greater trochanter

Action Hip adduction

Innervation

Superior gluteal nerve

Gluteus medius

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Lateral ilium

Insertion Anterior surface of the greater trochanter

Action Hip adduction & medial rotation

Innervation

Superior gluteal nerve

Gluteus minimus

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Interal surface of sacrumSacrotuberous ligament

Insertion Superior border of greater trochanter

Action Lateral rotation, abduction, helps hold femur in acetabulum

Innervation

L5, S1 & S2

Piriformis

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Anterior superior iliac spine

Insertion Lateral condyle of tibia

Action Combined hip flexion & abduction

Innervation

Superior gluteal nerve

Tensor fascia latae

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Anterior superior iliac spine

Insertion Proximal medial aspect of tibia

Action Combined hip flexion, abduction & lateral rotation

Innervation

Femoral nerve

Sartorius (tailor's muscle)

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Pubis

Insertion Middle 1/3rd of the linea aspera

Action Hip adduction

Innervation

Obturator nerve

Adductor longus

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Ischium & Pubis

Insertion Entire linea aspera & adductor tubercle

Action Hip adduction

Innervation

Obturator nerve

Adductor magnus

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Pubis

Insertion Pectineal line and proximal linea aspera

Action Hip adduction

Innervation

Obturator nerve

Adductor Brevis

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Superior ramus of pubis

Insertion Pectineal line of femur

Action Hip flexion & adduction

Innervation

Femoral nerve

Pectineus

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Pubis

Insertion Anterior medial surface of proximal end of tibia

Action Hip adduction

Innervation

Obturator nerve

Gracilis

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Long head: Ischial tuberosityShort head: Lateral lip of linea aspera

Insertion Fibular head

Action Long head: Extend hip & flex kneeShort head: Flex knee

Innervation

Long head: Sciatic nerveShort head: Common peroneal nerve

Biceps femoris (hamstrings)

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Ischial tuberosity

Insertion Posterior surface of medial condyle of tibia

Action Extend hip & flex knee

Innervation

Sciatic nerve

Semimembranosus (hamstrings)

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Ischial tuberosity

Insertion Anteromedial surface of proimal tibia

Action Extend hip & flex knee

Innervation

Sciatic nerve

Semitendinosus (hamstrings)

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Muscles of the hip

Origin Anterior inferior iliac spine

Insertion Tibial tuberosity

Action Hip flexion & knee extension

Innervation

Femoral nerve

Rectus femoris

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Nerves of the hipSciatic Nerve

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

SemimembranosusSemitendinosusBiceps femoris (long head)

Nerves of the hipSuperior Gluteal Nerve

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Gluteus MediusGluteus MinimusTFL (Tensor fascia latae)

Nerves of the hipInferior Gluteal Nerve

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Gluteus MaximusGluteus Medius

Femoral Nerve

Nerves of the hip

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion:

IlliacusRectus FemorisSartoriusPectineus

Nerves of the hipObturator Nerve

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Adductor BrevisAdductor LongusAdductor MagnusGracilis

Muscles of the hipCommon Peroneal Nerve

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Biceps femoris (short head)

Arteries of the hipSuperior Gluteal Artery

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Gluteus MaximusGluteus MediusGluteus MinimusPiriformisTFL

Arteries of the hipInferior Gluteal Artery

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

SemimembranosusBiceps femorisPiriformis

Arteries of the hipObturator Artery

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Adductor BrevisAdductor LongusAdductor MagnusGracilis

Arteries of the hipLateral Circumflex Femoral Artery

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Rectus FemorisSartorius

Arteries of the hipMedial Circumflex Femoral Artery

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Pectineus

Arteries of the hipDeep Femoral (Profunda) Artery

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Insertion

Adductor BrevisAdductor LongusSemitendinosus

Veins of the hip

Musculoskeletal Images are from the University of Washington "Musculoskeletal Atlas: A Musculoskeletal Atlas of the Human Body" by Carol Teitz, M.D. and Dan Graney, Ph.D.

"Copyright 2003-2004 University of Washington. All rights reserved including all photographs and images. No re-use, re-distribution or commercial use without prior written permission of the authors and the University of Washington."

Reference: