The Hip (Iliofemoral) Joint
 Presented by:
 Heidi
 Jackie
 Kayla
 Paul
Surface Anatomy
Surface Anatomy
Surface Anatomy
Surface Anatomy
Right Hip Bone
Medial View
© Trail Guide to the Body by Books of Discovery
Lateral View
© Trail Guide to the Body by Books of Discovery
Iliac Spines
Femur
Adductor
Tubercle
Tibia
Muscles of Hip Flexion
 Psoas Major
 Iliacus
 Sartorius
 Pectineus
 Rectus femoris
 Tensor fascia latae
© Trail Guide to the Body by Books of Discovery
Psoas Major
O: Anterior and lateral surfaces of T12 thru L5
I: Lesser trochanter
A: Hip Flexion
Inv: L2 and L3
Iliacus
O: Iliac Fossa
I: Lesser trochanter
A: Hip flexion
Inv: Femoral Nerve
© Trail Guide to the Body by Books of Discovery
Sartorius
Pectineus
O: Anterior superior iliac spine
I: Proximal medial aspect of tibia
A: Combination of hip flexion, abduction, lateral rotation
Inv: Femoral nerve
Vas: Lateral circumflex femoral artery
O: Superior ramus of pubis
I: Pectineal line of femur
A: Hip flexion and adduction
Inv: Femoral nerve
Vas: Medial circumflex femoral artery
© Trail Guide to the Body by Books of Discovery
Rectus Femoris
O: Anterior inferior iliac spine
I: Tibial tuberosity
A: Hip flexion, knee extention
Inv: Femoral nerve
Vas: Lateral circumflex femoral artery
Tensor Fascia Latae
O: Anterior superior iliac spine
I: Lateral condyle of tibia
A: Combined hip flexion and abduction
Inv: Superior gluteal nerve
Vas: Superior gluteal artery
© Trail Guide to the Body by Books of Discovery
Muscles of Extension
 Semimembranosus
 Semitendinosus
 Biceps femoris
 Gluteus maximus
© Trail Guide to the Body by Books of Discovery
Semimembranosus
O: Ischial tuberosity
I: Posterior surface of medial condyle of tibia
A: Extend hip and flex knee
Inv: Sciatic nerve
Vas: Inferior gluteal artery
Semitendinosis
O: Ischial tuberosity
I: Anteromedial surface of proximal tibia
A: Extend hip and flex knee
Inv: Sciatic nerve
Vas: Deep femoral
© Trail Guide to the Body by Books of Discovery
Biceps Femoris
O: LH Ischial tuberosity; SH Lateral lip of linea aspera
I: Fibular head
A: LH extend hip and flex knee; SH flex knee
Inv: LH Sciatic nerve; SH Common peroneal nerve
Vas: Inferior gluteal artery
Gluteus Maximus
O: Posterior sacrum and ilium
I: Posterior femur distal to greater trochanter
A: Hip extension, hyperextension, lateral rotation
Inv: Inferior gluteal nerve
Vas: Superior gluteal artery
© Trail Guide to the Body by Books of Discovery
Muscles of Adduction
 Adductor Brevis
 Adductor Magnus
 Adductor Longus
 Gracilis
 Pectineus
© Trail Guide to the Body by Books of Discovery
Adductor Brevis
O: Pubis
I: Pectineal line and proximal linea aspera
A: Extend hip and flex knee
Inv: Obturator nerve
Vas: Deep femoral artery
Adductor Magnus
O: Ischium and pubis
I: Entire linea aspera and adductor tubercle
A: Hip adduction
Inv: Obturator nerve
Vas: Obturator and Deep femoral artery
© Trail Guide to the Body by Books of Discovery
Adductor
Longus
O: Pubis
I: Middle onethird of the linea
aspera
A: Hip adduction
Inv: Obturator
nerve
Vas: Obturator
artery and Deep
Femoral artery
© Trail Guide to the Body by Books of Discovery
Gracilis
O: Pubis
I: Anterior medial surface of proximal end of tibia
A: Hip adduction
Inv: Obturator nerve
Vas: Obturator artery
Pectineus
O: Superior ramus of pubis
I: Pectineal line of femur
A: Hip flexion and adduction
Inv: Femoral nerve
Vas: Medial circumflex femoral artery
© Trail Guide to the Body by Books of Discovery
Muscles of Abduction
 Sartorius
 Gluteus medius
 Gluteus minimus
 Piriformis
 Tensor fascia latae
© Trail Guide to the Body by Books of Discovery
Gluteus Medius
O: Lateral ilium
I: Greater trochanter
A: Hip Abduction
Inv: Superior gluteal nerve
Vas: Superior gluteal artery
Gluteus Minimus
O: Lateral ilium
I: Anterior surface of the greater trochanter
A: Hip abduction, medial rotation
Inv: Superior gluteal nerve
Vas: superior gluteal artery
© Trail Guide to the Body by Books of Discovery
Piriformis
O: Internal surface of
sacrum;
Sacrotuberous
ligament
I: Superior border of
greater trochanter
A: Lateral rotation,
abduction, helps hold
femur in acetabulum
Inv: L5, S1 and S2
Vas: Superior and
inferior gluteal
arteries
© Trail Guide to the Body by Books of Discovery
Lateral Rotation
 Sartorius
 Gluteus Maximus
 Piriformis
© Trail Guide to the Body by Books of Discovery
Gluteus
Maximus
O: Posterior
sacrum and ilium
I: Posterior femur
distal to greater
trochanter
A: Hip extension,
hyperextension,
lateral rotation
Inv: Inferior
gluteal nerve
Vas: Superior
gluteal artery
© Trail Guide to the Body by Books of Discovery
Medial Rotation
 Gluteus minimus
© Trail Guide to the Body by Books of Discovery
Ligaments
of Hip Joint:
fibrous tissue that
connects bones to other
bones
1)
Iliofemoral
Ligament: lies anterior
of hip joint, serves great
strength to joint by
resisting
hyperextension.
2) Pubofemoral
Ligament: lies inferior
to hip joint, helps
thicken the capsule.
http://en.wikipedia.org/wiki/Iliofemoral_ligament
http://en.wikipedia.org/wiki/Pubofemoral_ligament
Fundamentals of Anatomy & Physiology 6th edition
http://www.laboratorium.dist.unige.it/~piero/Teaching/Gait/Malanga%20and%20DeLisa%20Clinical%20Observation.htm
Ligaments
Continued
1)
Ischiofemoral
Ligament: lies
posterior to hip joint,
consist of triangular
band of strong fibers,
helps thicken capsule.
2) Zona Orbicularis
Ligament: lies at
lower and back of
capsule, forms a
circular collar around
the neck of femur .
http://en.wikipedia.org/wiki/Ischiofemoral_ligament
http://en.wikipedia.org/wiki/Zona_orbicularis
Fundamentals of Anatomy & Physiology 6th edition
http://content.answers.com/main/content/wp/en-commons/thumb/d/de/250px-Gray343.png
http://www.laboratorium.dist.unige.it/~piero/Teaching/Gait/Malanga%20and%20DeLisa%20Clinical%20Observation.htm
Ligaments
Continued
1)
Transverse of
Acetabulum
Ligament: crosses the
acetabular notch, fills in
gap of inferior border of
acetabulum.
2) Ligament of femoral
head: lies along
transverse acetabular
ligament, attaches to a
small pit in the center of
femoral head & acts
when hip is flexed and
thigh is laterally rotated.
Fundamentals of Anatomy & Physiology 6th edition
http://www.laboratorium.dist.unige.it/~piero/Teaching/Gait/Malanga%20and%20DeLisa%20Clinical%20Observation.htm
Ligaments
Continued
1)
Sacrotuberous
Ligament: runs from
sacrum to ischial
tuberosity of ischium, is
flat and triangular
shape, in a study was
absent in 13% of
cadavers.
2) Inguinal Ligament:
formed by external
oblique aponerurotic
fibers , runs from
anterior superior iliac
spine to pubic tubercle.
Strengthens the
abdominal wall. Is
concerned with hernias.
http://en.wikipedia.org/wiki/Sacrotuberous_ligament
http://www.med.mun.ca/anatomyts/digest/abwall.htm
http://www.laboratorium.dist.unige.it/~piero/Teaching/Gait/Malanga%20and%20DeLisa%20Clinical%20Observation.htm
http://www.smbs.buffalo.edu/ana/newpage32.htm
Articular Cartilage:
provide smooth and slick surfaces
to reduce friction during
movements of joint.
1)
Acetabular labrum:
is a ring of cartilage that
surrounds the acetabulum
to deepen the socket,
making it harder for the
femur head to slip out of
place.
2) Articular cartilage of
head of femur: Is
smooth and tough material
that covers the femur head
that help cushion between
the bones and lets the
femur move easily.
http://en.wikipedia.org/wiki/Acetabular_labrum
http://www.lasvegaspaininstitute.com/pain.htm
http://www.aafp.org/afp/991015ap/1687_f7.jpg
Fundamentals of Anatomy and Physiology sixth edition
Articular Capsule
Articular capsule: The joint cavity
that is enclosed by a two-layered
articular (joint) capsule.
Fibrous Capsule: A tough external
layer composed of dense irregular
tissue that is continuous with the
periostea of the articulating bones.
It strengthens the joint so that the
bones are not pulled apart.
Synovial membrane: The inner layer
of the joint capsule that is composed
of loose connective tissue. The
synovial membrane secretes
synovial fluid. Synovial fluid is found
within the articular cartilages, it
provides a slippery weight-bearing
film that reduces friction between the
cartilages.
Bursae: small fluid
filled pockets located in
connective tissue. They
develop where tendons or
ligaments rub against other
tissue.
1)
Trochanteric Bursae: is
2)
Ischial Bursae:
inflammation to the hip
located on the tip of
greater trochanter. Is
common cause of hip
pain. Most often caused
by overuse or direct
trauma to joint. More
likely to involve in
women.
inflammation that
separates the gluteal
maximus muscle from
the ischial tuberosity.
Usually formed from
prolonged sitting on hard
surfaces that press
against the bones.
Fundamentals of Anatomy & Physiology 6th edition
http://www.medterms.com/script/main/art.asp?articlekey=17111
http://www.clevelandclinic.org/arthritis/treat/facts/Tronchanteric%20Bursitis.htm
http://d2844653.temp75.hostica.com/images/Trochanteric-bursitis.jpg
Bursae
Continued
1)
Glutealfemoral
Bursae: contains 2 or3
small bursae located
between the tendon of the
gluteus maximus and the
rough line of the femur
shaft.
http://dictionary.reference.com/search?q=intermuscular%20gluteal%20bursa
Piriformis Syndrome
Piriformis Syndrome
is caused when the
sciatic nerve is
compressed by the
piriformis muscle.
Piriformis syndrome will
cause a dull pain in the
hip or buttock region and
sometimes may be
experienced from the
lower back all the way to
the foot.
Piriformis Syndrome
Piriformis Syndrome is caused by two main groups:
Overload- caused by training errors, sports that require a lot of running, and sedentary
lifesyles.
•
•
•
•
Exercising on hard surfaces
Exercising on uneven surfaces
Exercsing in worn-out shoes
Sitting for long periods of time
Biomechanical Inefficiencies- faulty foot and body mechanics, gait disturbances, and
poor posture or sitting habits.
•
•
•
Poor running or walking habits
Walking with your toes pointing out
Stiff muscles in the lower back, buttocks, and hips
Treatment
•
•
•
•
Have a thorough warm-up to help prepare the tendons and muscles for an upcoming
activity. This way the muscles will not be tight or stiff when you are exercising.
Always allow your muscles for rest and recovery after heavy exercise.
Strengthening and conditioning of the hips, buttocks, and lower back will help prevent
piriformis syndrome.
Flexible muscles and tendons are significant in the prevention of strains or sprains.
When muscles and tendons are flexible they are able to move and perform without being
overstretched unlike muscles that are tight or stiff.
Name That
Surface
Anatomy!!
Posterior
Superior Iliac
Spine
Greater
Trochanter
Bone Quiz!
Acetabulum
Ischial Spine
YOU DID IT!!
Do You Know
Your
Muscles?!
What muscle is
shown?
Rectus Femoris
What action
does it assist
in?
Flexion
How About
Those
Ligaments?!
What three ligaments
are shown?
Iliofemoral
Ligament:
Ischiofemoral
Ligament
Zona Orbicularis
Ligament