Download Learning objectives

Learning objectives
1. Understand the formation of hip joint
2. The ligaments involved in stability of the joint
3. The joint capsule and its attachment around the joint.
4. To know the muscles acting on the joint and different movements
performed
5. The nerve and blood supply of the joint
6. The radiographic appearance and the dissection of the joint
Lecture outline
The Hip Joint
• The hip joint is formed by the articulation of the head of the femur
into the acetabulum of the hip.
• ball-and-socket joint.
• Synovial joint
Bones
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Ilium
Ischium
Pubis
Femur
• The acetabulum is formed by the pubis, ischium and ilium bones
Joint Capsule
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Strong fibrous sleeve
specialized thickening, called ligaments, add stability
Anteriorly
– proximally to the bone surrounding the acetabulum.
– Distally to the trochanteric line
Posteriorly
– to the margins of the acetabulum and surrounding bone
– neck of the femur- not to the trochanteric crest
Ligaments
Iliofemoral ligament:
• Strongest ligament in the human body.
• Attaches to the illium between the two heads of the rectus femoris
muscle.
• Y shaped. One goes to the base of the greater trochanter and the
other to the base of the lesser trochanter.
• Seeks to resist excessive extension of the hip joint.
Ischiofemoral ligament:
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Attaches from the ischial part of the acetabular rim to the femur.
Posterior joint capsule is reinforced by this ligament.
Pubofemoral ligament:
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Attaches to the base of the lesser trochanter and the superior
ramus of the pubis, just above the obturator foramen.
It is inferior to the iliofemoral ligament and reinforces the inferior
part of the hip joint capsule.
It also blends with the medial parts of the iliofemoral ligament
• The round ligament of the head of the femur is attached to the
transverse acetabular ligament and extends to the fovea centralis
on the head of the femur
• A fibrocartilaginous ring called the acetabular labrum deepens the
acetabulum and clasps the head of the femur which makes the joint
more stable
Muscles
• External rotators: piriformis, quadratus femoris, Obturator internus
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and externus, gemellus superior and inferior,
Flexors: iliopsoas, rectus femoris
Adductors: adductor magnus, adductor longus and brevis,
pectineus, gracilis
Internal rotators: gluteus medius, gluteus minimus, tensor fascia
latae
Extensors: semitendinosus and semimembranosus, biceps
femoris, gluteus maximus
Abductors: gluteus medius, gluteus minimus
Nerves
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Femoral
Obturator
Sciatic
Nerve to quadratus femoris
Direct branches of sacral plexus
Blood Supply
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Medial Circumflex
Lateral Circumflex
Obturator
Inferior gluteal
Movements
• Flexion- mainly due to contraction of the iliopsoas muscle, with
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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