Lecture 13 - Hip Muscles and Hip Joints Flashcards
what makes up the hip joint
size of ball (head of femur) and socket (acetabulum) is bigger than shoulder
parts of the hip bone (Lateral view)
made up of 3 bones fused together
- > illium
- > ishium
- > pubis
(acetabulum is made up of all three)
important structure of the hip bone (medial view)
parts of the femur
what actions can we do with our hip joint
- > Flex/Extension
- > Add/Abduction
- > Internal/external rotation
combine for circumduction
muscles that flex the hip
- > psoas major (don’t worry about this one)
- > illiacus
- > minor flexors
*rectus femoris
*sartorius
O/I/I/A of illiacus
Origin
- > upper ⅔ of the iliac fossa
Insertion
- > base of the lesser trochanter
Nerve
- > femoral nerve
Action
- > flexes and laterally rotates the hip joint
Hip extensors
Glueus maxiums
Hamtring Muscles (extend hip and flex the knee)
- > biceps femoris (long head only)
- > semitendiosis
- > semimembranosis
OIIA of gluteus maximus
Origin
- > gluteal surface of the ilium, lumbar fascia, sacrum
Insertion
- > gluteal tuberosity of the femur and iliotbial band
Nerve
- > inferior gluteal nerve
Action
- > external rotation and extension of the hp joint, supports the extended knee through the IT band, abduction of the hip
gluteal tuberosity
where glut max attaches to
IT band
- > attaches to glut max and tensor fasciae latae
- > foam rollers help with tight IT band
general characteristics of the hamstring muscles
- > all attach to ischial tuberosity
- > short head of bicep femoris does not help with hip extension since it doesn’t cross the hip joint
- > semimemranosis is flat like a membrane
- > semitendiosis is a tube like structure
O/I/I/A of bicep femoris
Origin
- > Long head: ischial tuberosity
- > Short head: linea aspera of the femur
Insertion
- > head of fibula
Nerve
- > LH fibial nerve
- > SH common fibular nerve
Action
- > both heads flex and extend the nee but only LH extends the hip
O/I/I/A of semitendinosus
Origin
- > ischial tuberosity
Insertion
- > Pes anserinun (tibia)
Nerve
- > sciatic nerve (tibial)
Action
- > flex knee and extends hip
O/I/I/A of semimembranosus
Origin
- > ischial tuberosity
Insertion
- > medial condyle of the tibia
Nerve
- > sciatic nerve (tibial)
Action
- > flex knee extends hip
where is the pes anserinus and which muscles attach to it
tibia
- > sartorius
- > gracialis
- > semitendonosus
- say grace before T*
muscles that adduct the hip
- > adductor magnus
- > adductor longus
- > adductor brevis
- > pectineus
- > gracilis
O/I/I/A of gracilis
Origin
- > ischipubic ramus
Insertion
- > pes anserinus
Innervation
- > obturator nerve
Action
- > flexes, medial rotates, adducts the hip
O/I/I/A of adductor magnus
(ad-adductorp part and hs- hamstring par of add. magnus)
Origin
- > pubis(ad) and ischial tuberosity(hs)
Insert
- > linea aspera and adductor tubercle of the femur
Nerve
- > obturaator nerve (ad) sciatic nerve (hs)
Action
- > extends hip (hs) flexes hip (ad) and adducts hip (both)
O/I/I/A of adductor longus
Origin
- > pubic body, just below crest)
Insertion
- > middle ⅓ of the linea aspera
Nerve
- > obturator nerve
Action
- > adducts hip
O/I/I/A of adductor brevis
Origin
- > ant surface of the inf ramus of the body of the pubis
Insert
- > lesser trochanter and linea aspera
Innervation
- > obturator nerve
Action
- > adducts hip, some flexion
O/I/I/A of pectineus
Origin
- > pectineal line of the pubic bone
Insert
- > pectineal line of the femur
Innervation
- > obturator nerve
Action
- > flexes and adducts hip, assists with medial rotation
muscles that abduct the hip
- > glueus maximus
- > gluteus medius
- > gluteus minimim
- > tensor fascia lata
O/I/I/A of gluteus medius
Origin
- > gluteal surface of ilium
Insertion
- > greater trochanter
Nerve
- > superior gluteal nerve
Action
- > abduction of the hip, lat rotation of thigh
O/I/I/A of gluteal minimus
Origin
- > area between ant gluteal line and inferior gluteal line of gluteal surface of ilium
Insert
- > greater trochanter
Nerve
- > superior gluteal nerve
Action
- > hip abductor, med roation of the thigh
O/I/I/A of tensor fascia latae
Origin
- > illiac crest
Insert
- > illiotbial band
Nerve
- > superior guteal nerve
Action
- > at the hip: flexion, med roation, abduction
- > at the knee: lateral rotation
- > also stabilizes torso in the frontal plane
Medial rotators of the hip
- > gluteus medius (depends of certain factors, not always)
- > gluteal minimus
- > tensor facia lata
- > adductor brevis and longus
- > superior portion of the adductor magnus
actions of gluteus medius
lateral rotators of the hip
DEEP 6
- > piriformis
- > gemellus superior
- > obturator internus
- > gemellus inferior
- > quadratus femoris
- > obturator externus
others
- > sartorius
O/I/I/A of Piriformis
Origin
- > sacrum
Insert
- > greater trochanter
Nerve
- > sciatic nerve
Action
- > external rotator of the hip joint, abducts hip in a flexed position
O/I/I/A of sartorius
Origin
- > ant super illiac spine
Insertion
- > pres anserinus
Nerve
- > femoral
Action
- > flexes hip and knee, abducts hip, externally rotates hip
tailors position, longest muscle in the human body
male vs female pelvis
Left is male, right is female
male vs female Q-Angle
- > caused by pelvis shape
parts of the femur involved in the hip joint
- > head
- > neck
- > fovea (ball)
femur landmarks important for hip joint movement
- > greater trochanter
- > lesser trochanter
Acetabulum
- > lined with cartilage
- > aprox 70% of the head of the femur articulates with the acetabulum
acetabular labrum
rim of fibrocartilage
3 ligaments that blend with the capsule
the ligaments are blended together to create a structure like a Chinese finger trap, get tighter when your pull on them keeping the femur in the acetabulum
- > illiofemoral
- > pubofemoral
- > ischiofemoral
illiofemoral ligament
- > y shaped
- > located on anterior side
- > resists extension, ex rotation and some adduction
- > supports most of the body wight so it plays an important role in standing posture
Pubofemoral ligament
located on anterior side
- > resists abduction, some ex rotation and extension
ischiofemoral ligament
located on posterior side
- > resists extension, adduction and internal rotation
what ligaments resist hip flexion
none of them
- > the main resister of hip flexion are the hamstrings
*your get more flexion with knee bent knee (low tension in hamstrings) compared to straight leg
ROM of hip join
Flexion - > 120-125
*primarily limited by soft tissue (muscles)
Extension - > 10-15
Abduction - > 30-45
*limited by abductor muscles
Adduction - > 15-30
*limited by tensor fascia lata
Med/Lat rotation - > 30-50
*limited by antagonist muscles and ligaments
pelvofemoral rhythm
- > posterior and anterior tilt of pelvis with flexion and extension respectively
the femoral triangle
important area that houses a bunch of important structures (femoral artery, nerve and vein)
borders
- > iguinal ligament
- > sartorius
- > adductor longus
piriformis syndrome and different piriformis and sciatic nerve variations
tight piriformis puts pressure of the sciatic nerve which can cause pain
a) normal
b) nerve goes through muscle that can cause pain, numbness
c) rare, split in two, half above half under
why is hip rotation important
it’s important in walking
- > if we don’t rotate/extend hip, then we’ll walk slow as our strides are smaller
what typically breaks when your break your hip
heck of femur head
typical hip dislocation
posteriorly dislocates
hip replacement
breakdown of cartilage in the hip which causes irritation, fake acetabulum and head
