Chapter 8

Hip Joint & Pelvic Girdle

 Bones
Ball & Socket Joint
• Head of femur connecting w/ acetabulum of pelvic girdle

• Pelvic Girdle
• Right & left pelvic bone joined together posteriorly by the
sacrum
• Pelvic bones are: ilium, ischium, & pubis

• Femur
• Longest bone in body
Bones
 Bones
Sacrum

• Extension of spinal column c/ five fused vertebrae

• Coccyx extends from the inferior

Pelvic Bone: Divided into three areas

1. Upper two-fifths equals an ilium

2. Posterior & lower two-fifths equals an ischium
3. Anterior & lower one-fifth equals a pubis
Bones
 Bony Landmarks

Anterior Pelvis: Origin for hip flexors

• Tensor Fasciae Latae: Anterior Iliac Crest

• Sartorius: Anterior Superior Iliac Spine
• Rectus Femoris: Anterior Inferior Iliac Spine

Lateral Pelvis: Origin for hip abductors

• Gluteus Medius & Minimus: Just below Iliac Crest

 Bony Landmarks

Medially: Origin for hip adductors

• Adductor Magnus, Adductor Longus, Adductor
Brevis, Pectineus, & Gracilis - Pubis & its Inferior
Ramus

Posteriorly: Origin for hip extensors

• Gluteus Maximus: Posterior Iliac Crest &
Posterior Sacrum & Coccyx
 Bony Landmarks

Posteroinferiorly:
Origin for hip extensors

• Hamstrings: Ischial
Tuberosity
 Bony Landmarks

Proximal Thigh: Insertion for short muscles of hip

• Gluteal muscles & most of six deep external rotators:

Greater Trochanter
• Iliopsoas: Lesser Trochanter

Proximal Thigh: Origin for three knee extensors

• 3 vasti muscles of quadriceps: Anteriorly

• Hip Adductors: Linea Aspera
 Bony Landmarks

Patella: Insertion for all four quadriceps muscles

Proximal Tibia/Fibula: Insertion for remainder of

the hip muscles

• Sartorius, Gracilis, & Semitendinosus: Upper

anteromedial tibial surface below medial condyle
after crossing knee posteromedially
 Bony Landmarks

• Semimembranosus: Posteromedially on medial

tibial condyle

• Biceps Femoris: Laterally, it inserts primarily on

fibula head c/ some fibers attaching on lateral
tibial condyle
 Joints

Anteriorly
• Two pelvic bones join to form Symphysis Pubis, an
amphiarthrodial joint

Posteriorly
• Sacrum is btw/ the two pelvic bones & forms the
sacroiliac joints

• Strong ligaments unite these bones to form rigid,

slightly movable joints
 Joints
Hip: Most mobile joint except the glenohumeral joint
• Multiaxial arrangement
• Bony architecture provides stability
• Resulting in relatively few hip joint subluxations &
dislocations
 HIP

• Enarthrodial-type joint

• Femoral head inserts into acetabulum

• Reinforced by an extremely strong & dense

ligamentous capsule, especially anteriorly
 Joints

Acetabulofemoral Joint

• Iliofemoral or Y ligament:
Located anteriorly &
prevents hyperextension

• Pubofemoral Ligament:
Located
anteromedially &
inferiorly, limits excessive
extension
& abduction
 Joints
• Teres Ligament/
Ligamentum Teres:
Attaches from deep in
acetabulum to a
depression in femoral head,
slightly limits adduction

• Similar to glenoid fossa of

shoulder joint, acetabulum
is lined around most of its
periphery c/ a labrum to
enhance stability, provide
shock absorption
 Joints

• Ischiofemoral Ligament:
Extends from ischium to
trochanteric fossa of
femur, located
posteriorly, limits
internal rotation
 Joints

Lumbar spine
Pelvic rotation Right hip motion Left hip motion
motion

Anterior rotation Extension Flexion Flexion

Posterior rotation Flexion Extension Extension

Right lateral rotation Left lateral flexion Abduction Adduction

Left lateral rotation Right lateral flexion Adduction Abduction

Right transverse
Left lateral rotation Internal rotation External rotation
rotation

Left transverse
Right lateral rotation External rotation Internal rotation
rotation
Muscles
 Muscles

• Muscles involved in hip & pelvic girdle motions

depend largely on direction of movement & position
of body in relation to earth & gravitational forces

• Body part moves the most will be the part least

stabilized
 Muscles

• Ex: When standing on both feet & contracting hip

flexors, trunk & pelvis rotate anteriorly, but when
lying supine & contracting hip flexors, thighs
move forward into flexion on the stable pelvis

Hip flexor muscles are used in moving thighs up

toward the trunk
 Muscles

Hip Extensor muscles are:

• Used eccentrically when the pelvis & trunk move

downward slowly on the femur

• Used concentrically when the trunk is raised on

the femur, rising to a standing position
 Muscles

Hip Joint & Pelvic Girdle Muscles

• Anterior: Primarily Hip Flexion

• Iliopsoas
• Pectineus
• Rectus Femoris
• Sartorius
 Muscles
Pelvic muscles acting on hip joint

• Iliac Region: Iliopsoas Flexes Hip

• Iliacus
• Psoas major
Iliopsoas Muscle
Rectus Femoris Muscle
Sartorius Muscle
Pectineus Muscle
 Muscles

Medial: Primarily Hip Adduction

• Adductor Brevis
• Adductor Longus
• Adductor Magnus
• Gracilis
 Muscles

Posterior: Primarily Hip Extension

• Gluteus Maximus
• Biceps Femoris
• Semitendinosus
• Semimembranosus
• External Rotators
 Muscles

Posterior Compartment: Hamstring Group

• Biceps Femoris
• Semitendinosus
• Semimembranosus
Semitendinosus Muscle
Semimembranosus Muscle
Biceps Femoris Muscle
Gluteus Maximus Muscle
 Muscles

Lateral: Primarily Hip Abduction

• Gluteus Medius
• Gluteus Minimus
• External Rotators
• Tensor Fasciae Latae
 Muscles

Gluteal Region: Extends & Rotates Hip

• Gluteus Maximus
• Gluteus Medius
• Gluteus Minimi
• Tensor Fascia Latae

• 6 Deep External Rotators: Piriformis, Obturator Externus,

Obturator Internus, Gemellus Superior, Gemellus Inferior,
& Quadratus Femoris
Gluteus Medius Muscle
Gluteus Minimus Muscle
Tensor Fasciae Latae Muscle
 Muscles
Thigh: Divided into three compartments by
intermuscular septa
 Muscles

Anterior Compartment:
Primarily Knee Extensors

• Rectus Femoris
• Vastus Medialis
• Vastus Intermedius
• Vastus Lateralis
• Sartorius
 Muscles

Medial Compartment:
Primarily Adductors

• Adductor Brevis
• Adductor Longus
• Adductor Magnus
• Pectineus
• Gracilis
Adductor Brevis Muscle
Adductor Longus Muscle
Adductor Magnus Muscle
Gracilis Muscle
 Hip Flexion
Agonists

• Psoas
• Iliacus / Iliopsoas
• Rectus Femoris
• Pectineus
• Sartorius
• Tensor Fasciae Latae
 Hip Extension
Agonists

• Gluteus Maximus
• Biceps Femoris Long Head
• Semitendinosus
• Semimembranosus
 Hip Abduction

Agonists

• Gluteus Medius
• Tensor Fasciae Latae
• Gluteus Maximus
• Gluteus Minimus
 Hip Internal Rotation

Agonists

• Gluteus Minimus
• Gluteus Medius
• Tensor Fasciae Latae
 Hip External Rotation

Agonists

• Gluteus Maximus

• 6 Deep External
Rotators
 Nerves
• All Hip & Pelvic Girdle
Muscles: Innervated from lumbar & sacral plexus or
lumbosacral plexus
 Lumbar Plexus

• Femoral Nerve: Anterior

Muscles

• Iliopsoas
• Rectus femoris
• Vastus medialis
• Vastus intermedius
• Vastus lateralis
• Pectineus
• Sartorius
 Lumbar Plexus

• Provides sensation to anterior

and medial thigh and medial
leg and foot

Obturator Nerve
• Adductor brevis
• Adductor longus
• Adductor magnus
• Gracilis
• Obturator externus
 Sacral Plexus

Superior Gluteal Nerve

• Arises from L 4, L 5, and S 1 to innervate the gluteus
medius, gluteus minimus, and tensor fasciae latae

Inferior Gluteal Nerve

• Arises from L 5, S 1, and S 2 to supply the gluteus maximus
 Sacral Plexus
Sciatic Nerve
• Tibial Division
• Semitendinosus,
semimembranosus,
biceps femoris long head and
adductor magnus
• Supplies sensation for
posterolateral lower leg and
plantar aspect of foot

• Common Peroneal or Fibular

Division
• Sensation to anterolateral
lower leg and dorsum of foot