Hip JointHip Joint

Hip JointHip Joint

• The hip is the most proximal of the lower The hip is the most proximal of the lower extremity joints. It is very important in extremity joints. It is very important in weight-bearing and walking activities. Like weight-bearing and walking activities. Like the shoulder, it is a ball-and-socket joint. the shoulder, it is a ball-and-socket joint. The rounded or convex-shaped femoral The rounded or convex-shaped femoral head fits into and articulates with the head fits into and articulates with the concave-shaped acetabulum. Unlike the concave-shaped acetabulum. Unlike the shoulder, the hip is a very stable joint and shoulder, the hip is a very stable joint and therefore sacrifices some range of motion. therefore sacrifices some range of motion. The hip joint (a triaxial joint) has motions in The hip joint (a triaxial joint) has motions in all three planes.all three planes.

Motions of the HipMotions of the Hip

• FlexionFlexion

• ExtensionExtension

• HyperextensionHyperextension

• AbductionAbduction

• AdductionAdduction

• Lateral RotationLateral Rotation

• Medial RotationMedial Rotation

Muscles of the HipMuscles of the Hip

• IliopsoasIliopsoas• Rectus FemorisRectus Femoris• SartoriusSartorius• PectineusPectineus• GracilisGracilis• Adductor magnusAdductor magnus• Adductor longusAdductor longus• Adductor brevisAdductor brevis• Gluteus maximusGluteus maximus• SemimembranosusSemimembranosus• Deep rotators (6)Deep rotators (6)• SemitendonosusSemitendonosus• Biceps femorisBiceps femoris• Gluteus medius Gluteus medius • Tensor fascia lataeTensor fascia latae• Gluteus minimusGluteus minimus

Iliopsoas Iliopsoas

Iliopsoas Iliopsoas

• O: Iliac fossa, anterior and lateral surfaces O: Iliac fossa, anterior and lateral surfaces of T12 through L5of T12 through L5

• I: Lesser trochanterI: Lesser trochanter

• A: Hip flexionA: Hip flexion

• N: Iliacus portion: Femoral nerve (L2, L3)N: Iliacus portion: Femoral nerve (L2, L3)

• Psoas major portion: L2 and L3Psoas major portion: L2 and L3

*The iliopsoas muscle is actuall two *The iliopsoas muscle is actuall two muscles: iliacus muscle and psoas major muscles: iliacus muscle and psoas major muscle*muscle*

Rectus Femoris Rectus Femoris

Rectus Femoris Rectus Femoris

• O: Anterior inferior iliac spineO: Anterior inferior iliac spine

• I: Tibial tuberosityI: Tibial tuberosity

• A: Hip flexion, knee extensionA: Hip flexion, knee extension

• N: Femoral nerve (L2, L3, L4)N: Femoral nerve (L2, L3, L4)

SartoriusSartorius

SartoriusSartorius

• O: Anterior superior iliac spineO: Anterior superior iliac spine

• I: Proximal medial aspect of tibiaI: Proximal medial aspect of tibia

• A: Combination of hip flexion, A: Combination of hip flexion, abduction, lateral rotation and knee abduction, lateral rotation and knee flexionflexion

• N: Femoral nerve (L2, L3) N: Femoral nerve (L2, L3)

Pectineus Pectineus

Pectineus Pectineus

• O: Superior ramus of pubisO: Superior ramus of pubis

• I: Pectineal line of femurI: Pectineal line of femur

• A: Hip flexion and adductionA: Hip flexion and adduction

• N: Femoral nerve (L2, L3, L4)N: Femoral nerve (L2, L3, L4)

Adductor LongusAdductor Longus

Adductor LongusAdductor Longus

• O: PubisO: Pubis

• I: Middle third of the linea asperaI: Middle third of the linea aspera

• A: Hip adductionA: Hip adductionN: Obturator nerve (L3, L4)N: Obturator nerve (L3, L4)

Adductor BrevisAdductor Brevis

Adductor BrevisAdductor Brevis

• O: PubisO: Pubis

• I: Pectineal line and proximal linea I: Pectineal line and proximal linea asperaaspera

• A: Hip adductionA: Hip adduction

• N: Obturator nerve (L3, L4)N: Obturator nerve (L3, L4)

Adductor MagnusAdductor Magnus

Adductor MagnusAdductor Magnus

• O: Ischium and pubisO: Ischium and pubis

• I: Entire linea aspera and adductor I: Entire linea aspera and adductor tubercle tubercle

• A: Hip adductionA: Hip adduction

• N: Obturator and sciatic nerve (L3, N: Obturator and sciatic nerve (L3, L4)L4)

GracilisGracilis

GracilisGracilis

• O: PubisO: Pubis

• I: Anterior medial surface of proximal I: Anterior medial surface of proximal end of tibiaend of tibia

• A: Hip adductionA: Hip adduction

• N: Obturator nerve (L2, L3)N: Obturator nerve (L2, L3)

Gluteus MaximusGluteus Maximus

Gluteus MaximusGluteus Maximus

• O: Posterior sacrum and iliumO: Posterior sacrum and ilium

• I: Posterior femur distal to greater I: Posterior femur distal to greater trochanter and to iliotibial bandtrochanter and to iliotibial band

• A: Hip extension, hyperextension, A: Hip extension, hyperextension, lateral rotationlateral rotation

• N: Inferior gluteal nerve (L5, S1, S2)N: Inferior gluteal nerve (L5, S1, S2)

Gluteus MediusGluteus Medius

Gluteus MediusGluteus Medius

• O: Outer surface of the iliumO: Outer surface of the ilium

• I: Lateral surface of the greater I: Lateral surface of the greater trochantertrochanter

• A: Hip abductionA: Hip abduction

• N: Superior gluteal nerve (L4, L5, S1)N: Superior gluteal nerve (L4, L5, S1)

Gluteus MinimusGluteus Minimus

Gluteus MinimusGluteus Minimus

• O: Lateral iliumO: Lateral ilium

• I: Anterior surface of the greater I: Anterior surface of the greater trochantertrochanter

• A: Hip abduction, medial rotationA: Hip abduction, medial rotation

• N: Superior gluteal nerve (L4, L5, S1)N: Superior gluteal nerve (L4, L5, S1)

Deep Rotator MusclesDeep Rotator Muscles

• Obturator externusObturator externus

• Obturator internusObturator internus

• Quadratus femorisQuadratus femoris

• PiriformisPiriformis

• Gemellus superiorGemellus superior

• Gemellus inferiorGemellus inferior

Obturator ExternusObturator Externus

Obturator ExternusObturator Externus

• O: Rami of pubis and ischiumO: Rami of pubis and ischium

• I: Trochanteric fossaI: Trochanteric fossa

• A: Hip lateral rotationA: Hip lateral rotation

• N: Obturator nerveN: Obturator nerve

Obturator InternusObturator Internus

Obturator InternusObturator Internus

• O: Rami of pubis and ischiumO: Rami of pubis and ischium

• I: Greater trochanterI: Greater trochanter

• A: Hip lateral rotationA: Hip lateral rotation

• N: Nerve to obturator internusN: Nerve to obturator internus

Quadratus FemorisQuadratus Femoris

Quadratus FemorisQuadratus Femoris

• O: Ischial tuberosityO: Ischial tuberosity

• I: Intertrochanteric crestI: Intertrochanteric crest

• A: Hip lateral rotationA: Hip lateral rotation

• N: Nerve to quadratus femorisN: Nerve to quadratus femoris

PiriformisPiriformis

PiriformisPiriformis

• O: SacrumO: Sacrum

• I: Greater trochanterI: Greater trochanter

• A: Hip lateral rotationA: Hip lateral rotation

• N: S1, S2N: S1, S2

Gemellus superiorGemellus superior

Gemellus superiorGemellus superior

• O: IschiumO: Ischium

• I: Greater trochanterI: Greater trochanter

• A: Hip lateral rotationA: Hip lateral rotation

• N: Nerve to obturator internusN: Nerve to obturator internus

Gemellus inferiorGemellus inferior

Gemellus inferiorGemellus inferior

• O: Ischial tuberosityO: Ischial tuberosity

• I: Greater trochanterI: Greater trochanter

• A: Hip lateral rotationA: Hip lateral rotation

• N: Nerve to quadratus femorisN: Nerve to quadratus femoris

Hamstring MusculatureHamstring Musculature

• SemimembranosusSemimembranosus

• SemitendinosusSemitendinosus

• Biceps FemorisBiceps Femoris

Semimembranosus Semimembranosus

Semimembranosus Semimembranosus

• O: Ischial tuberosityO: Ischial tuberosity

• I: Posterior surface of medial condyle I: Posterior surface of medial condyle of tibiaof tibia

• A: Extend hip and flex kneeA: Extend hip and flex knee

• N: Sciatic nerve (L5, S1, S2)N: Sciatic nerve (L5, S1, S2)

SemitendinosusSemitendinosus

SemitendinosusSemitendinosus

• O: Ischial tuberosityO: Ischial tuberosity

• I: Anteromedial surface of proximal I: Anteromedial surface of proximal tibiatibia

• A: Extend hip and flex kneeA: Extend hip and flex knee

• N: Sciatic nerve (L5, S1, S2)N: Sciatic nerve (L5, S1, S2)

Biceps FemorisBiceps Femoris

Biceps FemorisBiceps Femoris

• O: Long head: ischial tuberosityO: Long head: ischial tuberosity

• Short head: lateral lip of linea asperaShort head: lateral lip of linea aspera

• I: Fibular headI: Fibular head

• A: Long head: extend hip and flex kneeA: Long head: extend hip and flex knee

• Short head: flex kneeShort head: flex knee

• N: Long head: Sciatic nerve (S1, S2, S3)N: Long head: Sciatic nerve (S1, S2, S3)

• Short head: Common peroneal nerve Short head: Common peroneal nerve (L5, S1, S2)(L5, S1, S2)

Tensor Fascia LataeTensor Fascia Latae

Tensor Fascia LataeTensor Fascia Latae

• O: Anterior superior iliac spineO: Anterior superior iliac spine

• I: Lateral condyle of tibiaI: Lateral condyle of tibia

• A: Combined hip flexion and A: Combined hip flexion and abductionabduction

• N: Superior gluteal nerve (L4, L5)N: Superior gluteal nerve (L4, L5)