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. FIBROUS CAPSULE2. ILIO FEMORAL3. PUBO FEMORAL4. ISCHIO FEMORAL5. LIGAMENT OF HEAD OF FEMUR6. ACETABULAR LABRUM7. 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

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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