Download Hip

Review:
Muscles that act on the spine
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Look out for the
penguin!!!
What muscles extend the vertebral
column?
Erector spinae
Rotatores
Multifidi
Semispinalis (capitis)
Quadratus Lumborum
What muscles flex the spine?
Rectus abdominis
External oblique
Internal oblique
What muscle rotates the spine to the
SAME side?
Internal Oblique
Hip
Pelvic Girdle
Fx of hip
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Supports the visceral organs
(pelvic floor)
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Attaches lower limbs
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Bears weight of body when
standing and moving.
Bony Connections of the Pelvis - An
Overview
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The word pelvis means
“basin”
It is a cylindrical
structure composed of 3
articulating bones,
associated muscles, and
ligaments that make up
the pelvic floor.
Bones of the Pelvic Girdle
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Two hip bones: Coxa
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Sacrum
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Coccyx
The Hip Bones (or Coxal Bones)
The bones have 3 fused
segments:
1. Ilium (in yellow)
2. Ischium (in light pink)
3. Pubis (in fushcia)
Joints of the Pelvis
Pelvic Girdle Articulates with Femur
Articulates with Femur
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Articulates with the Acetabulum
of the Coxa = Acetabulofemoral Joint
Acetabulum
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The junction of these 3 segments
forms the acetabulum
 Ischium,
 Ilium,
 Pubis
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The acetabulum is a deep, bony socket that
articulates with the head of the femur to
form the hip joint.
Posterior View . Hip Joint
Boney landmarks of the Hip
Ischial Tuberosity – is the bony prominence most inferior
and posterior on the ischium; this is the bone we call the
"sitz bones" that bears weight when we sit.
Medial surface of the Ilium
this is the internal bowl
or scoop-shaped area of the ilium
that houses the internal iliac fossa.
In this fossa is the location
of the iliacus muscle.
)
Boney landmarks of the Hip . Lateral surfaces
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Iliac Crest
Anterior Superior Iliac Spine (ASIS)
Anterior Inferior Iliac Spine (AIIS)
Posterior Superior Iliac Spine (PSIS)
Greater Sciatic Notch (GSN)
Iliac Crest –The most superior aspect of the Ileum. You can
feel this when you place your hands on your hips. It is the bone
your hands rest on.
Anterior Superior
Iliac Spine (ASIS)
this is the most
anterior portion of
the ilium; it is a
small, sharp bony
prominence.
Posterior Superior Iliac Spine
(PSIS) – this is the posterior
bony prominence of the ilium.
Greater Sciatic Notch
(GSN)– this is the opening in
the posterior aspect of the
ilium. It provides the
pathway by which the sciatic
nerve passes into the lower
extremity.
Differences in the Pelvic Structure
Female pelvis
Male Pelvis
Female pelvis:
wider iliac crest
larger pelvic bowl
greater distance between ischeal tuberosities
The Sacrum
Made from 5 fused vertebrae.
Sacrum
The Sacrum articulates with the fifth lumbar vertebrae
and Coccyx.
Joints of the Sacrum
The Sacrum also
articulates with the
right and left coxal
bone.
The Sacrum
The Sacral Foramina – small openings
on the sacrum through which branches
of the sacral nerves pass.
Sacral base –
The superior surface of S1 that
articulates with L5
The Sacral Promontory –
upper, anterior edge of S1.
The Apex of the Sacrum –
this is the caudal surface of S5
and makes up the lower portion
of the sacrum.
Ligaments of the Pelvis: posterior view
Ligaments
of the Pelvis:
anterior view
The Sacrospinous and
Sacrotuberous ligaments
add stability to the pelvis
though they don’t attach to
the hip joint.
Ileolumbar ligaments
Iliofemoral Lig anteriorly strengthens the capsule
Ischiofemoral Lig posteriorly strengthens the capsule
Pubofemoral Lig strengthens the inferior anterior capsule
Movements allowed by Hip
ball and socket joint
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Flexion
Extension
Adduction
Abduction
Medial Rotation
Lateral Rotation
Transverse Abduction
Transverse Adduction
Hip ROM
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The hip has the
second greatest
range of motion in
the human body,
with the
glenohumeral joint
having the greatest
range.
Flexion 
Bending the joint resulting in a decrease of angle;
moving the thigh or top of the pelvis forward.
Hip Movements
Flexion
Extension  Straightening the joint resulting in an
increase of angle; moving the thigh or
top of the pelvis backward.
Hip Movements
Extension
Adduction
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Medial movement of the thigh
toward the midline of the body.
Hip Movements
Adduction
Abduction
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Lateral movement of thigh away
from the midline of the body
Hip Movements
Abduction
Transverse
Adduction
Moving the thigh inward
(toward the midline) with hip
bent.
Hip Movements
Transverse Adduction
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Adductors
adductor magnus
adductor longus
adductor brevis
pectineus
gracilis
Tensor fasciae latae
Transverse
Abduction
Moving the thigh outward (laterally)
with hip bent.
Hip Movements
Transverse Abduction
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Gluteus maximus
Gluteus medius
Gluteus minimus
Piriformis
Obturator externus
Hip Movements
Medial Rotation (Internal Rotation)
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Rotary movement around the longitudinal
axis of the bone toward the center of the body;
turning the thigh or pelvis inward.
Hip Movements
Medial Rotation (Internal Rotation)
Hip Movements
Lateral Rotation (External Rotation)
Rotary movement around the longitudinal axis of
the bone away from the center of the body
- turning the thigh or pelvis outward.
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Gemellus superior
Gemellus inferior
Obturator internus
Obturator externus
Quadratus femoris
Piriformis
Gluteus maximus
Gluteus medius, posterior fibers
Sartorius
Ileopsoas
Biceps Femoris
End of show
www.gla.ac.uk/ibls/ fab/tutorial/anatomy/hipt.html
The next three slides are from above source
Biomechanics
The capsular thickenings form a spiral around the hip. In
extension these fibres become taut with the result that the
head of the femur is held securely in the acetabulum and
the joint becomes "locked" or "close-packed" - the
position of maximum stability and firmness.
There is a general point here: all the major joints (hip, knee,
ankle) become close-packed at full extension and this
coincides with the limb becoming a rigid, vertical,
weight-bearing pillar. This is clearly the essential
prerequisite for standing upright on two legs i.e. the
adoption of bipedal stance.
Biomechanics
•
When standing erect the centre of gravity passes behind
the hip joint. This should result in hyperextension i.e. the
trunk falling backwards at the hip. This is prevented by a
more slouching stance, in which the centre of gravity is
bought forwards, and by the iliofemoral ligament (one of
the strongest ligaments in the body) which resists
hyperextension.