Hip & Pelvis Notes



Hip & Pelvis Anatomy Notes

PELVIS

• Made up of 2 innominate bones making up 3 areas

o Ilium

o Ischium

o Pubis

ACETABULUM

• Accepts the femoral head – 75% of head is always in the socket

• The joint is considered Ball & Socket Joint

• The joint is very stable; but not very mobile

• Labrum – fibrocartilage that deepens the articular area on the acetabulum – like adding a washer to a nut and bolt – it adds congruency

• When walking, most force is on the superior aspect because the femur hit it more causing more stress to the labrum and acetabulum

FEMUR

• Longest & Strongest bone in the body

• Almost completely covered by muscle

• 4 components of the proximal femur

o Lesser Trochanter

o Greater Trochanter

o Femoral Head – in the Acetabulum

o Femoral Neck – most commonly fractured

• Greater trochanter

o Palpable at lateral buttock

o Reinforced knob of bone

o Attachment site for muscles that abduct (move out) and externally rotate

• Lesser trochanter

o Distal attachment for Iliospoas

• Femoral head

o Femur tapers and thickens medially into a spherical head

o Covered by articular cartilage except medial – attachment for ligamentum teres

• Femoral neck

o Angle of inclination – 125 degrees is normal

o Shape of the neck creates an overhang system

PUBIC SYMPHYSIS

• Pelvic bones articulate anteriorly at this relatively immobile joint

• Small degree of spreading, compression, and rotation

• Bones are separated by fibrocartilagenous disc.

SACROILIAC JOINT (SI JOINT)

• Each illium articulates with sacrum

• Very sturdy with limited ROM

• Strong ligaments bind the sacrum to the pelvis

• SI joints are located at the triangle part of thong underwear

INGUINAL LIGAMENT

• From ASIS to Pubic Symphysis

• Palpated along underwear line in groin

FEMORAL TRIANGLE

• The femoral pulse is located within the triangle

• 3 sided

o Superiorly (top) – Inguinal Ligament

o Laterally (outside) – Sartorius Muscle

o Medially (inside) – Adductor Longus Muscle

ARTHROLOGY (study of the joint)

• The hip joint is surrounded by a large and complex joint capsule

• Superiorly & Anteriorly, the capsule is thickest – corresponds to the areas of greatest force

• 3 ligaments

o Iliofemoral (resist excessive internal rotation and flexion; main stabilizer)

o Pubofemoral

o Ischiofemoral

Muscles:

|MOTION |ROM |PRIME MOVER(S) |

|Hip Flexion |0-120 |Rectus Femoris |

| | |Sartorius |

| | |Iliopsoas |

|Hip Extension |0-30 |Gluteus Maximus |

| | |Hamstring |

|Hip Abduction |0-45 |Gluteus Medius |

|Hip Adduction |0-15/20 |Adductor Longus |

| | |Adductor Brevis |

| | |Adductor Magnus |

| | |Gracilis |

|Hip Internal Rotation |0-45 |Gluteus Minimus |

|Hip External Rotation |0-45 |Gluteus Maximus |

Important landmarks & structures:

ASIS – where your pants should sit; most prominent bump on anterior side

Iliac Crest – superior to ASIS; sides of hips

Iliac Tubercle – widest part of iliac crest; superior to ASIS

Greater Trochanter – lie on side and it is the “bump” on the outside of the hip

Pubic Tubercle – front of pubic region

PSIS – dimples in your low back; below L5 vertebrae; lateral to sacrum

SI joint – step off medially from PSIS; triangle of thong above butt crack

Ischial tuberosity – “butt bones”; “sitting bones”; go inferior from greater trochanter; origin of hamstrings

Trochanteric bursa – on greater trochanter

Sciatic nerve – ½ way between greater trochanter and ischial tuberosity

Hamstring origin – step off ischial tuberosity

Piriformis muscle – ½ way between sacrum and greater trochanter; fans out across top of buttock region

Inguinal ligament – runs from ASIS to pubic symphysis

Femoral Artery – inferior to inguinal ligament; in femoral triangle

Illiopsoas muscle – lateral to umbilicus (belly button)

Rectus Femoris – origin @ AIIS (below ASIS)

Adductor Longus Muscle – inner thigh

Sartorius muscle – origin ASIS

Gluteus Maximus – buttock

Gluteus Medius – lie on side and lift leg against resistance; muscle is at top of hip; top of underwear line

Iliotibial (IT) band – runs from iliac crest to lateral knee; starts as a muscle (tensor fascia latae) and becomes tendon like on the outside of the leg

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