PTA Students Curtis, Tonya, Emilee, & Zeke Them Bones….. …Of the iliofemoral joint. And one extra. Os Coax: The Pelvic Trifecta Medial View Lateral View, with a side of landmarks Find the Angry Bird The Femur: Foreplay for cave men Tibia- Not part of the hip, but it was on the list, so here goes…. Iliofemoral ligament Pubofemoral ligament Ischiofemoral ligament Sacrotuberous ligament Transverse acetabular ligament Acetubular labrum Articular cartilage of head of femur Ligament of head of femur Synovial membrane Fibrous layer Zona orbicularis Trochanteric bursa Deep Superficial Gluteofemoral bursa Ischial Bursa Pectineus Innervation: Femoral Nerve, also fibers from obturator nerve Origin: Superior Ramus of Pubis Insertion: Pectineal line inferior to lesser trochanter of femur Action: Flexes, adducts and assists with medial rotation Synergist: Flexion = Rectus Femoris and Iliopsoas Adduction = Adductors (all 3) and gracilis Medial Rotation = Gluteus Minimus Antagonist: Extension = Gluteus Maximus, Semimembranosus, Semitendinosus, and Biceps Femoris Abduction = Gluteus Medius and Minimus Lateral Rotation = Gluteus Maximus Sartorius Innervation: Femoral Nerve Origin: Anterior superior iliac spine Insertion: Upper medial surface of body of tibia Action: Flexes knee Flexes, abducts and laterally rotates hip Synergist: Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Hip Abduction = Gluteus Medius and Minimus Antagonist Knee Extension = Quadriceps muscles Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps Femoris Hip Adduction = Adductors (all 3), Pectineus & Gracilis Iliopsoas Psoas Major & Iliacus Innervation: Lumbar Nerves Femoral Nerves Origin: Transverse Process of T12-L5 Iliac Crest, Iliac Fossa, Anterior Sacroiliac Ligament Insertion: Lesser Trochanter Action: Hip/Thigh Flexion Synergist: Hip Flexion = Rectus Femoris & Pectineus Antagonist: Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris Quadriceps Femoris: Rectus Femoris Innervation: Origin: Patella via quadriceps tendon and then tibial tuberosity via patellar ligament Action: Anterior inferior iliac spine Insertion: Femoral Nerve Knee Extension and Hip Flexion Synergist: Knee Extension = Vastus Medialis, Intermedialis & Lateralis Hip Flexion = Iliopsoas & Pectineus Antagonist: Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris Quadriceps Femoris: Vastus Medialis Innervation: Origin: Knee Extension Synergist: Patella via the quadriceps tendon and then tibial tuberosity via the patellar ligament Action: Linea Aspera of the femur Insertion: Femoral Nerve Knee Extension = Rectus Femoris, Vasus Lateralis and Intermedius Antagonist: Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris Quadriceps Femoris: Vastus Lateralis Innervation: Femoral Nerve Origin: Intertrochanteric line and linea aspera of the femur Insertion: Patella via the quadriceps tendon and then tibial tuberosity via the patellar ligament Action: Knee Extension Synergist: Knee Extension = Rectus Femoris, Vastus medialis and intermedialis Antagonist: Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris Quadriceps Femoris: Vastus Intermedius Innervation Femoral Nerve Origin Anterior 2/3 and lateral shaft of femur Insertion Patella via quadriceps tendon and then tibial tuberosity via patellar ligament Action Knee Extension Synergist Knee Extension = Rectus Femoris, Vastus Lateralis and Medialis Antagonist Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris Adductor Brevis Innervation: Origin Superior half of linea aspera of femur Action Anterior surface of the inferior ramus of the pubis Insertion Obturator Nerve Adducts, flexes and helps to laterally rotate the hip Syngerist Hip Adduction = Adductors longus and magnus, Gracilis & Pectineus Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Lateral Rotation = Gluteus Maximus Antagonist Hip Abduction = Gluteus medius and minimus Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps Femoris Medial Rotation = Gluteus Minimus Adductor Longus Innervation: Obturator Nerve Origin: Body of pubis inferior to pubic crest and lateral pubic symphysis Insertion: Middle 1/3 of linea aspera of the femur Action: Adducts, flexes & laterally rotates the hip Synergist: Hip Adduction = Adductors longus and magnus, Gracilis & Pectineus Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Lateral Rotation = Gluteus Maximus Antagonist: Hip Abduction = Gluteus medius and minimus Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps Femoris Medial Rotation = Gluteus Minimus Adductor Magnus Innervation: Obturator and Tibial Nerves Origin: Inferior ramus of pubis and ischium to ischial tuberosity Insertion: Linea aspera of the femur and medial supracondylar line Action: Adducts thigh, superior horizontal fibers flex the thigh and posterior portion extends thigh at hip joint Syngerist: Hip Adduction = Adductors longus and brevis, Gracilis & Pectineus Hip Flexion = Rectus femorus, Iliopsoas & Pectineus Antagonist: Hip Abduction = Gluteus medius and minimus Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris Gracilis Innervation: Obturator Nerve Origin: Body and inferior ramus of pubis Insertion: Anterior medial proximal tibis Action: Adducts and medial rotates hip Knee Flexion Synergist: Hip Adduction = Adductors Brevis, Longus & Magnus, Pectineus Medial rotation of hip = Gluteus Minimus Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris Antagonist: Hip Abduction = Gluteus Medius and Minimus Lateral rotation of hip = Gluteus Maximus Knee Extension = Rectus Femoris & Vastus medialis, lateralis & intermedius Tensor Fasciae Latae Innervation: Origin: Tibia by way of the iliotibial tract Action: Anterior superior iliac spine and anterior iliac crest Insertion: Superior Gluteal Nerve Flexes and abducts the thigh at the hip joint and helps to stabilize and stead the hip and knee joints by putting tension on the iliotibial band of fascia Synergist: Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Hip Abduction = Gluteus medius and minimus Antagonist: Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris Hip Adduction = All 3 Adductors, Gracilis & Pectineus Gluteus Maximus Innervation: Origin: Iliotibial tract of fascia lata and lateral part of linea aspera under greater trochanter (gluteal tuberosity) of the femur Action: Iliac crest, Sacrum, Coccyx & Aponeurosis of Sacrospinalis Insertion: Inferior Gluteal Nerve Extends the thigh at the hip and laterally rotates thigh – middle fibers abduct the hip Synergist: Hip Extension = Semimembranosus, Semitendinosus & Biceps Femoris Hip Abduction = Gluteus medius and minimus Antagonist: Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Hip Adduction = Adductors longus and brevis, Gracilis & Pectineus Medial Rotation of Hip = Gluteus Minimus Gluteus Medius Innervation: Origin: Abducts and medially rotates the hip Synergist: Greater Trochanter of the Femur Action: Dorsal ilium inferior to the iliac crest Insertion: Superior Gluteal Nerve Gluteus Minimus (for both) Antagonist: Hip Adduction = All 3 Adductors, Gracilis & Pectineus Lateral Rotation of the Hip = Gluteus Maximus Gluteus Minimus Innervation: Origin: Abducts and medially rotates the hip Synergist: Greater trochanter of the femur Action: Dorsal Ilium between inferior and anterior gluteal lines Insertion: Superior Gluteal Nerve Gluteus Medius (for both) Antagonist: Hip Adduction = All 3 Adductors, Gracilis & Pectineus Lateral Rotation of the Hip = Gluteus Maximus Piriformis Innervation: Origin: Superior border of the greater trochanter Action: Anterior surface of lateral process of sacrum and gluteal surface of ilium at the margin of the greater sciatic notch Insertion: Piriformis Nerve Laterally rotates and abducts the thigh at the hip joint Synergist: Hip Abduction = Gluteus medius and minimus Lateral Rotation of Hip = Gluteus Maximus Antagonist: Hip Adduction = All 3 Adductors, Gracilis & Pectineus Medial Rotation of Hip = Gluteus medius and minimus Biceps Femoris Innervation: Tibial Nerve Origin: Long Head: Ischial Tuberosity Short Head: Linea aspera of the femur Insertion: Head of fibula and lateral condyle of the tibia Action: Long Head: Extends hip and flexes knee Short Head: Flexes knee and laterally rotates hip Synergist: Hip Extension = Gluteus Maximus Extension of Hip and Flexion of Knee = Semitendinosus and semimembranosus Lateral Rotation of Hip = Gluteus Maximus Antagonist: Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Knee Flexion = Vastus (lateralis, medialis & intermedialis) Medial Rotation = Gluteus Minimus Semitendinosus Innervation: Origin: Ischial Tuberosity Insertion: Tibial Nerve Proximal part of medial surface of shaft Action: Knee Flexion Extends and medially rotates hip Synergist: Knee Flexion = Biceps Femoris, Semimembranosus Hip Extension = Gluteus Maximus, Biceps Femoris & Semimembranosus Medial Rotation of Hip = Gluteus Minimus Antagonist: Knee Extension = Rectus Femoris, Vastus (medialis, lateralis & intermdialis) Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus Lateral Rotation of Hip = Gluteus Maximus Semimembranosus Innervation: Origin: Ischial Tuberosity Insertion: Tibial Nerve Posterior medial condyle of tibia Action: Knee Flexion Extends and medially rotates the hip Synergist: Knee Flexion = Biceps femoris & Semitendinosus Medial Rotation = Gluteus minimus Antagonist: Knee Extension = Rectus Femoris & Vastus (medialis, lateralis & intermedialis) Lateral Rotation of Hip = Gluteus maximus Femoral Nerve Obturator Nerve Sciatic Nerve Superior Gluteal nerve Inferior gluteal nerve Common peroneal nerve Femoral artery Lateral circumflex artery Obturator artery Deep femoral (Profunda) artery Superior Gluteal Artery Inferior Gluteal Artery Femoral Vein Profunda (Deep Femoral) Vein Great Saphenous Vein -Gluteal fold/Gluteal Sulcus -Sacrum -Posterior superior iliac spine -Tip of Greater trochanter -Intergluteal cleft -Iliac crest -Supracristal plane -Anterior superior iliac spine -Inguinal ligament Piriformis Syndrome-is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the Piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg.