Anatomy of Hip joint.pptx

anatomy of hip joint , for Medical students

1. Anatomy of H ip joint By: Dr.Ritika Dixit Associate professor Dept. of Rachana sharir Shubhdeep Ayurved Medical College & hospital Indore

2. Introduction -- It is the largest joint of the body. -- 2 nd largest weight bearing joint of the body. Type : - ball & socket variety of synovial joint. Multiaxial joint According to Ayurveda: Ulukhal Sandhi

3. Articular surfaces: Head of the femur Lunate surface of Acetabulum. -head of the femur is covered by hyaline cartilage. - Lunate surface of acetabulum is covered with cartilage

4. Hip joint is designed for stability over a wide range of movements. Stability and strength depends upon: Depth of acetabulum and narrowing of its mouth by acetabular labrum. Tension and strength of ligaments. Strength of surrounding muscles. Length & obliquity of neck of the femur. Atmospheric pressure.

5. Ligaments The fibrous capsule The iliofemoral ligament The pubofemoral lig. The ischiofemoral lig. The lig. Of the head of the femur The acetabular labrum Transverse acetabular ligament.

6. 1. Fibrous Capsule Attachment : - on the hip bone -- Acetabular labrum, transverse acetabular lig. a nd to bone above & behind acetabulam. On femur – to the intertrochanteric line in front, & intertrochenteric crest behind. Anterosuperiorly, the capsule is thick, firmly attached. Poster-inferiorly, capsule is thin & loosely attached. Femoral neck intracapsular Greater and lesser trochanter extracapsular.

7. 2. The Iliofemoral ligament( bigelow ) Lies anteriorly One of the strongest lig. of the body. Prevents trunk from falling backwards, in standing posture. Triangular in shape.

8. Attachment : Apex is attached to the lower half of AIIS. Base is attached to base of intertrochenteric line. Upper oblique and lower vertical fibres form thick and strong bands. Middle fibres are thin and weak.

9. 3. The pubofemoral ligament It supports the joint inferomedially. Triangular in shape. Attachment- superiorly to the iliopubic eminence, obturator crest and the obturator membrane. Inferiorly – merges with the anteroinferior part of the capsule & the with the lower band of iliofemoral ligament.

10. 4. The ischiofemoral ligament Comparatively weak ligament. It covers the joint posteriorly. Fibres are twisted and extend from ischium to acetabulum. It’s fibers form the zona orbicularis. Some attached to greater trochanter.

11.   Fibers of all three ligaments are oriented in a spiral fashion around the hip joint so that the become taught when joint is extended. This stabilizes the joint and reduces the amount of muscle energy required to maintain a standing position.

12. 5. The lig. Of the head of Femur(round lig. Or ligamentum teres) Flat & triangular lig. Apex attached to fovea capitis. Base attached to transverse lig. & margins of acetabular notch. It transmit arteries to the head of the femur.

13. 6. The Acetabular labrum It is a fibrocartilaginous rim . Attached to the margins of acetabulam. This helps in holding the head of femur in position.

14. 7. The T ransverse ligament It is a part of acetabular labrum. It bridges the acetabular notch.the notch is thus converted into foramen.

15. Relations of the joint Anterior relation: Tendon of iliopsoas Femoral vein Femoral artery Femoral nerve 2. Posterior : from below upwards – Tendon of obturator externusobturator internus Gamelli Piriformis Sciatic nerve Gluteus maximus muscle.

16. 3. Superior : Reflected head of rectus femoris covered by gluteus minimus & medius and partly by gluteus maximus . 4. Inferior: lat. Fibres of the pectineus and the obturator externus . Gracilis Adductors longus , brevis , magnus,hamstring muscle.

17. Blood Supply Obturator artery 2 circumflex femoral arteries. 2 gluteal arteries. Nerve supply Femoral nerve Ant. Division of obturator nerve The nerve of the quadratus femoris Sup. Gluteal nerve.

18. Movements Flexion Extension Adduction Abduction Medial rotation Lateral rotation Circumduction

19. Flexion : Occurs around transverse axis. Limited by contact of the thigh with the ant.abdominal wall. Muscles: Chief- Psoas Major and Iliacus accessory- pectineus , rectus femoris , sartorius , adductors

20. 2. Extension: Occurs around transverse axis. Muscles– Gluteus maximus & hamstrings. 3 . Adduction : Occurs around anteroposterior axis. Muscles : Chief – adductor longus , brevis magnus . Accessory – pectineus gracilis