Chapter 8 The Hip Joint and Pelvic Girdle

Chapter 8 The Hip Joint and Pelvic Girdle PPT Series 8 A The Hip Joint and Pelvic Girdle Copyright © 2018 Mc. Graw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of Mc. Graw-Hill Education

The Hip Joint and Pelvic Girdle Hip joint (acetabular femoral joint) • Relatively stable due to: • Bony architecture • Strong ligaments • Large supportive muscles • Functions in weight bearing and locomotion • Enhanced significantly by its wide range of motion • Ability to run, cross-over cut, sidestep cut, jump, and many other directional changes

The Hip Joint and Pelvic Girdle Ball-and-socket joint • Head of the femur connecting with the acetabulum of pelvic girdle • Pelvic girdle • Right and left pelvic bone joined together posteriorly by the sacrum • Pelvic bones are the ilium, ischium, and pubis • Femur • Longest bone in the body

The Hip Joint and Pelvic Girdle • Sacrum • Extension of spinal column with five fused vertebrae • The coccyx extends from the inferior sacrum Pelvic bone - Divided into three areas • Upper two-fifths = Ilium • Posterior and lower two-fifths = Ischium • Anterior and lower one -fifth = Pubis

The Hip Joint and Pelvic Girdle

The Hip Joint and Pelvic Girdle Anterior pelvis - Origin for hip flexor muscles • Tensor fasciae latae - Anterior iliac crest • Sartorius - Anterior superior iliac spine • Rectus femoris - Anterior inferior iliac spine

The Hip Joint and Pelvic Girdle Lateral pelvis - Origin for hip abductors • Gluteus medius and minimus Medial Pelvis - Origin for hip adductors • Adductor magnus, adductor longus, adductor brevis, pectineus, and gracilis

The Hip Joint and Pelvic Girdle Posterior Pelvis - Origin for hip extensors • Gluteus maximus Posterior iliac crest and posterior sacrum and coccyx Posteroinferior Pelvis Origin for hip extensors • Hamstrings - Ischial tuberosity

The Hip Joint and Pelvic Girdle – Arthroses and Ligamentous Structures Anterior Pelvis • Two pelvic bones join to form the symphysis pubis, an amphiarthrodial joint Posterior Pelvis • Sacrum is between the two pelvic bones and forms the sacroiliac joints • Strong ligaments unite these bones to form rigid, slightly movable joints • Large and heavy bones are covered by thick, heavy muscles • Very minimal oscillating-type movements occur in the sacroiliac joints, as in walking • Body movements usually involve the entire pelvic girdle and hip joints • In walking, hip flexion and extension occur with pelvic girdle rotation, forward in hip flexion and backward in hip extension

The Hip Joint and Pelvic Girdle – Arthroses and Ligamentous Structures Acetabulofemoral Joint - Most mobile joint (except the glenohumeral joint) • Multiaxial arrangement • Bony architecture provides stability • Resulting in relatively few hip joint subluxations and dislocations • Enarthrodial-type joint • Femoral head inserts into the acetabulum • Reinforced by an extremely strong and dense ligamentous capsule, especially anteriorly

The Hip Joint and Pelvic Girdle – Arthroses and Ligamentous Structures Acetabulofemoral Joint

The Hip Joint and Pelvic Girdle – Arthroses and Ligamentous Structures Acetabulofemoral Joint • Iliofemoral or Y ligament - Located anteriorly and prevents hyperextension • Pubofemoral ligament - Located anteromedially and inferiorly and limits excessive extension and abduction

The Hip Joint and Pelvic Girdle – Arthroses and Ligamentous Structures Acetabulofemoral Joint • Teres ligament – (ligamentum teres) Attaches from deep in the acetabulum to a depression in femoral head and slightly limits adduction • Similar to glenoid fossa of the shoulder joint, the acetabulum is lined around most of its periphery with a labrum to enhance stability and provide some shock absorption

The Hip Joint and Pelvic Girdle – Arthroses and Ligamentous Structures Acetabulofemoral Joint • Ischiofemoral ligament - Extends from the ischium to the trochanteric fossa of the femur, is located posteriorly, and limits internal rotation

The Hip Joint and Pelvic Girdle - ROM • 0 to 130 degrees of flexion • 0 to 30 degrees of extension

The Hip Joint and Pelvic Girdle - ROM • 0 to 35 degrees of Abduction • 0 to 30 degrees of Adduction

The Hip Joint and Pelvic Girdle - ROM • 0 to 45 degrees of internal rotation • 0 to 50 degrees of external rotation

The Hip Joint and Pelvic Girdle Movements Hip flexion • Movement of the anterior femur toward the anterior pelvis Hip extension • Movement of the posterior femur straight away from the pelvis • Sometimes referred to as hyperextension

The Hip Joint and Pelvic Girdle Movements Hip abduction • Movement of the femur laterally to the side away from the midline Hip adduction • Movement of the femur medially toward the midline

The Hip Joint and Pelvic Girdle Movements Hip external rotation • Rotary movement of the femur laterally around its longitudinal axis away from the midline • Lateral rotation Hip internal rotation • Rotary movement of the femur medially around its longitudinal axis toward the midline • Medial rotation

The Hip Joint and Pelvic Girdle Movements Hip diagonal abduction • Movement of the femur in a diagonal plane away from the midline of the body Hip diagonal adduction • Movement of the femur in a diagonal plane toward the midline of the body

The Hip Joint and Pelvic Girdle Movements Hip horizontal abduction • Movement of the femur in a horizontal or transverse plane away from the pelvis Hip horizontal adduction • Movement of the femur in a horizontal or transverse plane toward the pelvis 8 -22

The Hip Joint and Pelvic Girdle Movements Pelvic girdle moves (right and left) between three planes for a total of six different movements All pelvic girdle rotation results from motion at one or more locations: 1)Right hip; 2) Left hip, and, 3) Lumbar spine. Hip and lumbar spine motions accompany pelvic rotation

The Hip Joint and Pelvic Girdle Movements Anterior and posterior pelvic rotation

The Hip Joint and Pelvic Girdle Movements Anterior and posterior pelvic rotation

The Hip Joint and Pelvic Girdle Movements Right and left lateral pelvic rotation

The Hip Joint and Pelvic Girdle Movements Right and left transverse pelvic rotation

The Hip Joint and Pelvic Girdle Movements

The Hip Joint and Pelvic Girdle - Skeletal Muscles • Seven two-joint muscles have one action at the hip and another at the knee • Anterior Hip - Primarily hip flexion • Iliopsoas • Pectineus • Rectus femoris • Sartorius

The Hip Joint and Pelvic Girdle - Skeletal Muscles • Medial - Primarily hip adduction • Adductor brevis • Adductor longus • Adductor magnus • Gracilis

The Hip Joint and Pelvic Girdle - Skeletal Muscles • Posterior - Primarily hip extension • Gluteus maximus • Biceps femoris • Semitendinosus • Semimembranosus • Lateral - Primarily hip abduction • Gluteus medius • Gluteus minimus • Tensor fasciae latae

The Hip Joint and Pelvic Girdle - Skeletal Muscles • Gluteal region - Extends and rotates the hip • Gluteus maximus • Gluteus medius • Gluteus minimi • Tensor fascia latae • Six deep external rotators Piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris

The Hip Joint and Pelvic Girdle - Skeletal Muscle Compartments in Thigh The thigh is divided into three compartments by the intermuscular septa

The Hip Joint and Pelvic Girdle - Skeletal Muscle Compartments in Thigh • Anterior • Medial compartment • Rectus femoris • Vastus medialis • Vastus intermedius • Vastus lateralis • Sartorius • Posterior compartment Hamstring group • Biceps femoris • Semitendinosus • Semimembranosus End of PPT Series 08 A Adductor brevis • Adductor longus • Adductor magnus • Pectineus • Gracilis