Download The Hip Joint

THE HIP JOINT
AND
MOVEMENTS
Learning objectives
At the end of the lecture, the student should be able to:
– Discuss the characteristics features of synovial joint
– Describe the Articular surfaces of hip joint
– Mark the the capsule of hip joint
– Describe the synovial membrane, cavity & fluid of hip joint
– Enumerate the ligaments of hip joint & tell their attachments
– Discuss the movements possible at hip joint
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
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
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•
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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
X-ray Pelvis and Proximal
Femur
1. Anterior Superior Iliac
Spine
2. Acetabular rim of pelvis
3. Sacral foramina for
Spinal nerve
4. Pubic symphysis
5. Inferior Ramus of Pubis
6. Obturator Foramen
7. Ischium
8. Head of Femur
9. Neck of Femur
10. Greater Trochanter
11. Lesser Trochanter
DISSECTION OF HIP JOINT
The hip joint capsule is exposed after reflecting Iliopsoas and Pectineus
muscles
Pubofemoral ligament (2) which is partially seen inferiorly and the
ischiofemoral ligament (1) which is viewed posteriorly.
Head of the femur is exposed by opening the capsule along in the same
direction of capsular ligaments.
The arrow points to where the hip capsule has been opened.
After evulsing the head of the femur, the internal structure of the joint is
viewed including the round ligament of the femur.
LEARNING RESOURCES
• Gray’s Anatomy by Henry Gray
• Last’s Anatomy by R.J.Last
• Netter’s Atlas
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