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