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The Hip (Iliofemoral) Joint

The Hip (Iliofemoral) Joint. Heather Friedland , Liz Huisman, Josh McCoy. Surface Anatomy. Iliac Crest?. Iliac Crest! (and Inguinal Ligament). Surface Anatomy, continued. Gluteal Fold/Sulcus Intergluteal Cleft Sacrum Iliac Crest. Surface Anatomy, continued.

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The Hip (Iliofemoral) Joint

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  1. The Hip (Iliofemoral) Joint Heather Friedland, Liz Huisman, Josh McCoy

  2. Surface Anatomy Iliac Crest? Iliac Crest! (and Inguinal Ligament) Josh McCoy

  3. Surface Anatomy, continued Gluteal Fold/Sulcus Intergluteal Cleft Sacrum Iliac Crest Josh McCoy

  4. Surface Anatomy, continued Anterior Superior Iliac Spine Iliac Crest Tip of Greater Trochanter Josh McCoy

  5. Surface Anatomy, continued Posterior Superior Iliac Spine Josh McCoy

  6. Surface Anatomy, continued • Supracristal Plane • Inguinal Ligament Josh McCoy

  7. The Hip Joint Liz Huisman

  8. Pubofemoral Ligament (green) • Prevents overabduction. IliofemoralLigament(red) Prevents hyperextension Liz Huisman

  9. Ishiofemoral ligament • Slackens during adduction, tenses during abduction Liz Huisman

  10. Ligaments that support walking posterior anterior Inguinal ligament Sacrotuberous ligament Liz Huisman

  11. Bursae • Trochanteric bursa • Gluteofemoral bursa • Ischial bursa Liz Huisman

  12. Bones of the Hip Joint Heather Friedland

  13. Os Coxa • Pubis • Inferior ramus • Acetabulum • Ischial tuberosity • Iliac fossa • Lesser sciatic notch • Superior pubic ramus • Pubic (or suprapubic) arch • Obturator foramen • Superior ramus • Obturator foramen • Ischium • Iliac crest • Ischial spine • Symphysis pubis • Inferior pubic ramus • Pubic crest • Greater sciatic notch Heather Friedland

  14. Heather Friedland Click to add text

  15. Iliac Spines • Anterior superior • Anterior Inferior • Posterior superior • Posterior inferior Heather Friedland

  16. Femur • Head • Neck • Greater Trochanter • Lesser Trochanter • Linea Aspera • Pectineal line • Adductor tuberacle • Condyles (medial and lateral) • Epicondyles (medial and lateral) Heather Friedland

  17. Bones: Tibia • Lateral and Medial Condyles • Intercondylar Eminence • Tibial Tuberosity • Crest Josh McCoy

  18. Muscles of the Hamstrings Heather Friedland A&P 106 11/18/2015

  19. Muscles • Semitendinosus • Semimembranosus • Gracilis • Pectinius • Biceps Femoris • Piriformis Heather Friedland

  20. Semitendinosus • Nerve: Tibial Nerve • Roots: L5, S1 & S2 • Origin: Ischial tuberosity • Insertion: Proximal medial shaft of the tibia at Pes Anserinus tendon Heather Friedland

  21. Semitendinosus • Synergist: • Knee Flexion: Biceps femoris, Semimembranosus, gracilis, sartorius, gastrocnemius, popliteus • Hip extension: Gluteus Maximus, Biceps femoris, semimembranosus • Medial rotation: semimembranosus, gracilus, Sartorius, popliteus, Semimembranosus • Antagonist: • Knee extension: Rectus femoris, Vastus (medialis, lateralis, and intermedialis) • Hip Flexion: Rectus femoris, iliopsoas, pectineus, Sartorius • Lateral rotation: Biceps femoris • Action: Flexes knee. Medially rotates knee. Extends the knee Heather Friedland

  22. Semimembranosus Heather Friedland

  23. Semimembranosus • Nerve: Tibial Nerve • Roots: L5, S1 & S2 • Origin: Ischial tuberosity • Insertion: Posterior medial condyle of the tibia • Synergist: Same as Semitendinosis • Antagonist: Same as Semitendinosis • Action: Flexes knee. Medially rotates flexed knee and extends the hip Heather Friedland

  24. Gracilis • Nerve: Obturator nerve • Roots: L2 and L3 • Origin: Body and inferior ramus of pubis • Insertion: Anterior medial proximal tibia Heather Friedland

  25. Gracilis • Synergist: • Adduction: Adductor(magnus, brevis, and longus), Gracilis, pectineus • Medial rotation: Gluteus (medius and minimus), adductor (all 3), Pectinius, TFL, Gracilis • Knee flexion: Semimembranosus, Semiteninosis, biceps femoris, gracilis, gastrocnemius, Popliteus, Sartorius • Antagonist: • Abduction: Gluteus (maximus, medius, and minimus), TFL, Sartorius • Lateral Rotation: Gluteus maximus, Sartorius, piriformis, iliopsoas • Knee extension: Rectus femoris, Vastus (medialis, lateralis, and intermedialis) • Action: Adducts and medially rotates hip. Flexes the knee Heather Friedland

  26. Pectineus Heather Friedland

  27. Pectinius • Nerve: Femoral Nerve, also fibers from the Obturator nerve • Roots: L2 - L4 • Origin: Superior ramus of the pubis • Insertion: Pectineal line inferior to lesser trochanter of femur Heather Friedland

  28. Pectineus • Synergist: • Flexion: Rectus femoris, Iliopsoas, TFL, Sartorius, Adductor (longus & brevis) • Adduction: Adductor (longus, brevis, and magnus), Gracilis, Pectineus • Medial rotation: Gluteus(medius & minimus), Adductor (longus and brevis), Gracilis • Antagonist: • Extension: Gluteus maximus, Semimembranosus, Semitendinosis, Biceps femoris, Adductor magnus • Abduction: Gluteus(medius and minimus), TFL, Sartorius • Lateral Rotation: Gluteus maximus, Piriformis, Sartorius • Action: Flexes, adducts, and assists with medial rotation of the hip Heather Friedland

  29. Biceps Femoris Heather Friedland

  30. Biceps Femoris • Nerve: Tibial nerve (LH) and Fibular nerve (SH) • Roots: L5, S1 & S2 • Origin: Long head: Ischial tuberosity Short Head: Linea aspera of femur • Insertion: Head of fibula and lateral condyle of tibia Heather Friedland

  31. Biceps Femoris • Synergist: • Hip Extension: Gluteus maximus, Semitendinosis, Semimembranosis, Adductor • Lateral Rotation: Gluteus Maximus, Piriformis, Iliopsoas, Sartorius • Knee Flexion: Semitendinosis, Semimembranosis, Gastrocnemius, Gracilis, Sartorius • Antagonist: • Hip Flexion: Rectus femoris, Iliopsoas, Pectinus, TFL, Sartorius • Medial Rotation: Gluteus(medius and minimus), TFL, Adductor (magnus, longus, and brevis), pectineus, Gracilis • Knee Extension: Vastus (medialis, lateralis, and intermedialis), Rectus femoris • Action: • Long head: Extends hip and flexes knee Short Head: Flexes knee and laterally rotates hip Laterally rotates flexed knee Heather Friedland

  32. Piriformis Heather Friedland

  33. Piriformis • Nerve: Piriformis Nerve • Roots: L5, S1 & S2 • Origin: Anterior Surface of lateral process of sacrum and gluteal surface of ilium at the margin of the greater sciatic notch • Insertion: Superior border of greater trochanter Heather Friedland

  34. Piriformis • Synergist: • Abduction: Gluteus (medius, minimus), TFL, Sartorius • Lateral rotation: Gluteus maximus, Iliopsoas, piriformis, Sartorius • Medial rotation: Glutues (minimus, medius), TFL, Adductor (all 3), Gracilis • Antagonist: • Adduction: adductors (all 3), Gracilis, Pectinius, Gluteus maximus • Medial rotation: Gluteus (Minimus and medius), TFL, Adductor (all 3), Pectinius, Gracilis • Action: Laterally rotates and abducts thigh when hip is flexed Heather Friedland

  35. Adductors Brevis & Longus • Actions: • Adduction • Flexion • Assists in medial hip rotation Liz Huisman

  36. Adductors Brevis Origin: • Anterior surface of the inferior ramus of the pubis Insertion: • Pectineal line, medial lip of lineaaspera of femur. Nerve: • Obturator nerve Roots: • L2-L4 Liz Huisman

  37. Adductor Brevis Synergists Antagonists Abduction: Gluteus (all 3), TFL, Sartorius Lateral Rotation: Gluteus maximus, Sartorius, piriformis, Iliopsoas Extension: Gluteus maximus, semimembgranosus, semitendinosus, biceps femoris, adductor magnus Adduction: • Adductor (longus & magnus), gracilis, pectineus Medial Rotation: • Gluteus (minimus & medius), adductor (longus & magnus), pectineus, tensor fascaielatae, gracilic Flexion: • Rectus femoris, Iliopsoas, pectineus, TFL, sartorius Liz Huisman

  38. Adductor longus Origin: • Body of pubis inferior to pubic crest & lateral pubic symphysis. Insertion: • Middle 1/3 of lineaaspera of the femur Nerve: • Obturator nerve Roots: • L2-L4 Liz Huisman

  39. Adductor Longus Synergists Antagonists Abduction: Gluteus (all 3), TFL, Sartorius Lateral Rotation: Gluteus maximus, Sartorius, piriformis, Iliopsoas Extension: Gluteus maximus, semimembranosus, semitendinosus, biceps femoris, adductor magnus Adduction: • Adductors (brevis & magnus), gracilis, pectineus Medial Rotation: • Gluteus (minimus &medius), adductor (brevis & magnus), pectineus, TFL, gracilis Flexion: • Rectus femoris, Iliopsoas, pectineus, TFL, sartorius Liz Huisman

  40. Adductor Magnus Origin: • Inferior ramus of pubis and ischium to ischial tuberosity. Insertion: • Linea aspera of femur. Medial supracondylar line and adductor tubercle. Nerve: • Obturator and tibial nerve Roots: • L2-L4 Actions: Adducts thigh, superior horizontal fibers flexes thigh, posterior portion extends thigh at hip joint Liz Huisman

  41. Adductor Magnus Synergists Antagonists Abduction: Gluteus (all 3), TFL, Sartorius Hip Extension: Gluteus maximus, semimembranosus, semitendinosus, biceps femoris Adduction: • Adductor (longus & brevis), gracilis, pectineus Hip Flexion: • Rectus femorus, Iliopsoas, pectineus, TFL, gluteus (medius & minimus), adductor (longus & brevis) Liz Huisman

  42. The Glutes • Actions • Gluteus medius & minimus • Hip abduction • Medial rotation of hip • Gluteus maximus • Extends the hip Liz Huisman

  43. Gluteus Minimus Origin: • Dorsal ilium between inferior and anterior gluteal lines Insertion: • Greater trochanter of femur Nerve: • Superior gluteal nerve Roots: • L4 & L5, S1 Liz Huisman

  44. Gluteus Minimus Synergists Antagonists Adduction: Adductors (all3), gracilis, pectineus, gluteus maximus Lateral Rotation: Gluteus maximus, piriformis, iliopsoas, sartorius Abduction: • Gluteus medius, tensor fasciae latae, Sartorius Medial Rotation: • Gluteus medius, tensor fasciae latae, Adductor (all 3) Liz Huisman

  45. Gluteus Medius Origin: • Dorsal ilium inferior to iliac crest Insertion: • Greater trochanter of femur Nerve: • Superior Gluteal nerve Roots: • L4 & L5, S1 Liz Huisman

  46. Gluteus Medius Synergists Antagonists Adduction: Adductors (all 3), gracilis, pectineus Lateral Rotation: Gluteus maximus, piriformis, iliopsoas, sartorius Abduction: • Gluteus (maximus & minimus), tensor fasciae latae, Sartorius Medial Rotation: • Gluteus minimus, tensor fasciae latae, adductors (all 3), pectineus, gracilis Liz Huisman

  47. Gluteus Maximus Origin: • Iliac crest, sacrum, coccyx and aponeurosis of sacrospinalis Insertion: • Lateral part of lineaaspera under greater trochanter (gluteal tuberosity) of femur Nerve: • Inferior gluteal nerve Roots: • L5, S1 & S2 Liz Huisman

  48. Gluteus Maximus Synergists Antagonists Flexion: Gluteus (medius & minimus), rectus femoris, iliopsoas, pectineus, TFL, Sartorius Medial Rotation: Gluteus (medius & minimus), TFL, adductors (all 3), pectineus, gracilis Extension: • Semimembranosus, semitendinosus, biceps femoris, adductor magnus Lateral Rotation: • Piriformis, iliopsoas, sartorius Liz Huisman

  49. Psoas Major (of Iliopsoas) • Action: Hip/Thigh Flexion • Origin: Transverse Processes of T12-L5 • Insertion: Lesser Trochanter • Nerve: Lumbar Nerves (L1-L3) Josh McCoy

  50. Iliacus (of Iliopsoas) • Action: Hip/Thigh Flexion • Origin: Iliac Crest, Fossa, Anterior Sacroiliac Ligament • Insertion: Lesser Trochanter • Synergist (Iliopsoas): Rectus Femoris, Pectineus • Antagonist (Iliopsoas): Gluteus Maximus, Semimembranosus, Semitendinosus, Biceps Femoris Josh McCoy

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