Human anatomy consisting of the back, shoulder, pectoral girdle, elbow, wrist and hand, hip, knee, ankle and foot joints. Focusing on joint capsule, muscles origin, insertion and function, ligaments, nervous system, myotomes, dermatomes.
Hip Joint
Ball and socket synovial joint.
Articulation between acetabulum and head of femur which are both covered in
articular cartilage.
The acetabulum is a cup like depression located on the inferolateral aspect of
pelvis. Its cavity is deepened by the presence of a fibrocartilaginous collar – the
acetabulum.
The head of the femur is hemispherical and fits completely into the concavity of
the acetabulum.
The capsule of the hip joint attaches to the edge of the acetabulum proximally.
Distally, it attaches to the intertrochanteric line anteriorly and the femoral neck
posteriorly.
Hip Joint Ligaments:
Intracapsular:
→Ligament of head of femur:
-From acetabular fossa to the fovea of the femur.
-It encloses a branch of the obturator artery, a minor source of arterial supply to
the hip joint.
Extracapsular:
→Iliofemoral ligament:
-Arises from A.I.I.S and bifurcates before inserting into the trochanteric line of the
femur.
-Y shaped appearance and prevents hyperextension of the hip joint. Strongest of
the 3 ligaments.
→Pubofemoral ligament:
-From superior pubic rami and the intertrochanteric line of the femur, reinforcing
the capsule anteriorly and inferiorly.
-Triangular shape and prevents excessive abduction and extension.
→Ischiofemoral Ligament:
-From the body of the ischium to greater trochanter of femur, reinforcing the
capsule posteriorly.
-Spiral orientation and prevents hyperextension and holds femoral head in the
acetabulum.
Hip Joint Innervation:
The hip joint is innervated by the articular branches of multiple nerves that emerge from
the lumbosacral plexus (L2-S1). The nerve supply to a specific region of the joint typically
corresponds to the innervation of the muscle that crosses it:
, The femoral nerve innervates the anterior aspect
The obturator nerve supplies the inferior aspect
The superior gluteal nerve supplies the superior aspect
The nerve to the quadratus femoris innervates the posterior aspect.
It is important to note that pain sensations from the vertebral column can be referred to
the hip joint, while primary hip pain may be referred to the knee as they share similar
innervation.
Hip Joint Blood Supply:
From the medial and lateral circumflex femoral arteries (branches of the deep
artery of the thigh), the obturator artery and the superior and inferior gluteal
arteries.
Together, these arteries form a periarticular anastomosis around the hip joint. This
anastomotic network gives rise to the retinacular arteries which supply the greatest
volume of blood to the head and neck of the femur. Additionally, the obturator
artery gives rise to the artery of the head of the femur within the ligament of the
head of the femur.
Movements:
Flexion = 110-120 degrees
Extension = 10-15 degrees
Abduction = 30-50 degrees
Adduction = 30 degrees
Lateral rotation = 40-60 degrees
Medial rotation = 30-40 degrees
Anterior Hip Muscles (Hip Flexors):
Psoas Major
-Origin = Vertebral bodies and intervertebral discs of T12-L4 and transverse
processes of L1-L5 vertebrae
-Insertion = Lesser trochanter of femur as iliopsoas tendon
-Action = Flexion of hip joint, lateral rotation of hip and lateral flexion of trunk
-Innervation = Anterior rami of spinal nerves L1-L3
-Blood Supply = Iliolumbar artery
Iliacus
-Origin = Upper 2/3 of iliac fossa, internal lip of iliac crest, lateral aspect of
sacrum, ventral sacroiliac ligament and lower portion of iliolumbar ligament
-Insertion = Lesser trochanter of femur
, -Action = Flexes and laterally rotates the hip and trunk flexion
-Innervation = Femoral nerve L2-L4
-Blood supply = Medial femoral artery
Pectineus
-Origin = Pectineus line along the superior ramus of pubis
-Insertion = Posterior surface of femur, inferior to lesser trochanter
-Action = Flexes and adducts hip
-Innervation = Femoral nerve L2-L4
-Blood Supply = Obturator nerve
Sartorius
-Origin = Anterior superior iliac spine (A.S.I.S)
-Insertion = Anteromedial surface of proximal tibia
-Action = Flexes, abducts and laterally rotates hip and flexes the knee.
-Innervation = Femoral nerve L2-L4
-Blood Supply = Branches of femoral artery
Tensor Fascia Lata
-Origin = A.S.I.S
-Insertion = Joins with gluteus maximus to form the iliotibial tract, which attaches
to lateral condyle of tibia.
-Action = Flexes, medially rotates and abducts hip.
-Innervation = Superior gluteal nerve L4-S1
-Blood Supply = Deep branch of superior gluteal artery.
Posterior Hip Muscles (Hip Extensors):
Short Lateral Rotators:
Piriformis
-Origin = Gluteal surface of the ilium and pelvic surface of the Sacro tuberous
ligament
-Insertion = Medial side of the greater trochanter of the femur
-Action = Abducts the hip
-Innervation = Anterior rami of the sacral plexus L5-S2
-Blood Supply = Branch of the inferior gluteal artery
Gemellus Superior
-Origin = Gluteal surface of ischial spine
-Insertion = Medial surface of greater trochanter of femur
-Action = Lateral rotation of the hip
-Innervation = Obturator internus nerve L5-S2
Blood Supply = Inferior gluteal artery
, Gemellus Inferior
-Origin = Upper part of ischial tuberosity
-Insertion = Medial surface of greater trochanter of femur
-Action = Lateral rotation of the hip
-Innervation = Quadratus femoris nerve L4-S1
-Blood Supply = Inferior gluteal artery
Obturator Internus
-Origin = Posterior surface of the obturator membrane
-Insertion = Medial surface of the greater trochanter of the femur
-Action = Lateral rotation of the hip
-Innervation = Obturator internus nerve L5-S2
-Blood Supply = Obturator artery
Obturator Externus
-Origin = Anterior surface of obturator membrane
-Insertion = Trochanteric fossa
-Action = Lateral rotation of hip
-Innervation = Obturator nerve L3,4
-Blood Supply = Obturator and femoral arteries
Gluteus Maximus
-Origin = Lateroposterior surface of sacrum, coccyx, gluteal surface of ilium and
sacrotuberous ligament
-Insertion = Iliotibial tract and gluteal tuberosity of femur
-Action = Extension, lateral rotation, abduction and adduction of hip
-Innervation = Inferior gluteal nerve L5-S2
-Blood Supply = Inferior gluteal and superior gluteal arteries
Hip Abductors
Gluteus Minimums
-Origin = Gluteal surface of ilium
-Insertion = Anterior surface of greater trochanter of femur
-Action = Abduction and medial rotation of hip and helps to stabilize the hip
during functional single leg activity
-Innervation = Superior gluteal nerve L4-S1
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