21.Hip Joint.ppt muscle orgin and insertion

Hip joint ppt

1. HIP JOINTHIP JOINT
By: Dr. Mujahid KhanBy: Dr. Mujahid Khan

2. ArticulationArticulation

The hip joint is the articulation between the The hip joint is the articulation between the
hemispherical head of femur and the cup hemispherical head of femur and the cup
shaped acetabulum of the hip boneshaped acetabulum of the hip bone

The articular surface of the acetabulum is The articular surface of the acetabulum is
horseshoe shaped and is deficient horseshoe shaped and is deficient
inferiorly at the acetabular notchinferiorly at the acetabular notch

4. ArticulationArticulation
The cavity of acetabulum is deepened by The cavity of acetabulum is deepened by
the presence of a fibrocartilaginous rim the presence of a fibrocartilaginous rim
called acetabular labrumcalled acetabular labrum
The labrum bridges across the acetabular The labrum bridges across the acetabular
notch and is here called the transverse notch and is here called the transverse
acetabular ligamentacetabular ligament
The articular surfaces are covered with The articular surfaces are covered with
hyaline cartilagehyaline cartilage

5. Type & CapsuleType & Capsule
It is a synovial ball and socket jointIt is a synovial ball and socket joint
The capsule encloses the joint and is The capsule encloses the joint and is
attached to the acetabular labrum mediallyattached to the acetabular labrum medially
Laterally it is attached to the Laterally it is attached to the
intertrochanteric line of the femur in front intertrochanteric line of the femur in front
and along the posterior aspect of the neck and along the posterior aspect of the neck
of the bone behindof the bone behind

7. Iliofemoral LigamentsIliofemoral Ligaments
 It is a strong, inverted Y-shaped ligamentIt is a strong, inverted Y-shaped ligament
Its base is attached to the anterior inferior iliac Its base is attached to the anterior inferior iliac
spine abovespine above
Below the two limbs of Y are attached to the Below the two limbs of Y are attached to the
upper and lower parts of the intertrochanteric upper and lower parts of the intertrochanteric
line of the femurline of the femur
The strong ligament prevents overextension The strong ligament prevents overextension
during standingduring standing

9. Pubofemoral LigamentPubofemoral Ligament

It is a triangular ligamentIt is a triangular ligament

The base of the ligament is attached to the The base of the ligament is attached to the
superior ramus of the pubissuperior ramus of the pubis

The apex is attached below to the lower part of The apex is attached below to the lower part of
the intertrochanteric linethe intertrochanteric line

This ligament limits extension and abduction This ligament limits extension and abduction

10. Ischiofemoral LigamentIschiofemoral Ligament

It is a spiral shaped ligament It is a spiral shaped ligament

Attached to the body of the ischium near Attached to the body of the ischium near
the acetabular marginthe acetabular margin

Fibers pass upward and laterally and Fibers pass upward and laterally and
attached to the greater trochanterattached to the greater trochanter

This ligament limits the extensionThis ligament limits the extension

12. Transverse Acetabular LigamentTransverse Acetabular Ligament

It is formed by the acetabular labrum as it It is formed by the acetabular labrum as it
bridges the acetabular notchbridges the acetabular notch

It converts the notch into a tunnel through It converts the notch into a tunnel through
which blood vessels and nerves enter the which blood vessels and nerves enter the
jointjoint

14. Ligament of Head of FemurLigament of Head of Femur

It is flat and triangular ligamentIt is flat and triangular ligament

It is attached by its apex to the pit on the head of It is attached by its apex to the pit on the head of
the femur (fovea capitis)the femur (fovea capitis)

Attached by its base to the transverse ligament Attached by its base to the transverse ligament
and the margins of the acetabular notchand the margins of the acetabular notch

It lies within the joint and is ensheathed by It lies within the joint and is ensheathed by
synovial membranesynovial membrane

15. Synovial MembraneSynovial Membrane

The synovial membrane lines the capsule The synovial membrane lines the capsule
It is attached to the margins of the articular It is attached to the margins of the articular
surfacessurfaces

It covers the portion of the neck of the femur that It covers the portion of the neck of the femur that
lies within the joint capsulelies within the joint capsule

It ensheathes the ligament of the head of the It ensheathes the ligament of the head of the
femur femur

17. Synovial MembraneSynovial Membrane
It covers the pad of fat contained in the It covers the pad of fat contained in the
acetabular fossaacetabular fossa
A pouch of synovial membrane frequently A pouch of synovial membrane frequently
protrudes through a gap in the anterior protrudes through a gap in the anterior
wall of the capsulewall of the capsule
Forms the psoas bursa beneath the psoas Forms the psoas bursa beneath the psoas
tendontendon

19. Nerve SupplyNerve Supply

Femoral nerveFemoral nerve

Obturator nerveObturator nerve

Sciatic nerveSciatic nerve

Nerve to the quadratus femorisNerve to the quadratus femoris

20. MovementsMovements

The hip joint has a wide range of movement The hip joint has a wide range of movement
but less so than the shoulder jointbut less so than the shoulder joint

Some of the movement has been sacrificed Some of the movement has been sacrificed
to provide strength and stabilityto provide strength and stability

The strength of the joint depends largely on The strength of the joint depends largely on
the shape of the bones taking part in the the shape of the bones taking part in the
articulation and on strong ligamentsarticulation and on strong ligaments

21. MovementsMovements
When the knee is flexed, flexion is limited When the knee is flexed, flexion is limited
by the anterior surface of the thigh coming by the anterior surface of the thigh coming
in contact with the anterior abdominal wallin contact with the anterior abdominal wall
When the knee is extended, flexion is When the knee is extended, flexion is
limited by the tension of the hamstring limited by the tension of the hamstring
musclesmuscles
Abduction is limited by the tension of the Abduction is limited by the tension of the
pubofemoral ligamentpubofemoral ligament

22. MovementsMovements

Adduction is limited by contact with the Adduction is limited by contact with the
opposite limb and by the tension of the opposite limb and by the tension of the
ligament of the head of the femurligament of the head of the femur

Lateral rotation is limited by the tension in Lateral rotation is limited by the tension in
the iliofemoral and pubofemoral ligamentsthe iliofemoral and pubofemoral ligaments

Medial rotation is limited by the Medial rotation is limited by the
ischiofemoral ligamentischiofemoral ligament

23. MovementsMovements

Flexion: It is performed by the iliopsoas, rectus Flexion: It is performed by the iliopsoas, rectus
femoris, sartorius, also by adductor musclesfemoris, sartorius, also by adductor muscles

Extension: it is performed by the gluteus Extension: it is performed by the gluteus
maximus and the hamstring musclesmaximus and the hamstring muscles

Abduction: It is performed by the gluteus medius Abduction: It is performed by the gluteus medius
and minimus, assisted by sartorius, tensor and minimus, assisted by sartorius, tensor
fasciae latae, and piriformis fasciae latae, and piriformis

24. MovementsMovements

Adduction: It is performed by the adductor longus Adduction: It is performed by the adductor longus
and brevis and the adductor fibers of the adductor and brevis and the adductor fibers of the adductor
magnusmagnus

Lateral rotation: It is performed by the piriformis, Lateral rotation: It is performed by the piriformis,
obturator internus and externus, superior and obturator internus and externus, superior and
inferior gamelliinferior gamelli

Medial rotation: It is performed by the anterior Medial rotation: It is performed by the anterior
fibers of gluteus medius and gluteus minimus and fibers of gluteus medius and gluteus minimus and
the tensor fasciae lataethe tensor fasciae latae

Circumduction: It is a combination of the previous Circumduction: It is a combination of the previous
movementsmovements

25. MovementsMovements

The extensor group of muscles is more The extensor group of muscles is more
powerful than the flexor grouppowerful than the flexor group

The lateral rotators are more powerful than The lateral rotators are more powerful than
the medial rotatorsthe medial rotators

26. RelationsRelations
Anteriorly: Iliopsoas, pectineus, and rectus Anteriorly: Iliopsoas, pectineus, and rectus
femorisfemoris
Posteriorly: The obturator internus, the Posteriorly: The obturator internus, the
gamelli, and the quadratus femoris muscle gamelli, and the quadratus femoris muscle
separate the joint from sciatic nerveseparate the joint from sciatic nerve
Superiorly: Piriformis and gluteus minimusSuperiorly: Piriformis and gluteus minimus
Inferiorly: Obturator externus tendonInferiorly: Obturator externus tendon