The Gluteal Region & Hip Joint (AP)

Question 1

What type of joint is the hip joint?

Answer 1

Ball and socket type synovial

Question 2

What movements are attainable at the hip joint?

Answer 2

• Flexion
• Extension
• Abduction
• Adduction
• Circumduction
• Hip rotation

Question 3

Intra-capsular ligaments of the hip joint

Answer 3

Ligament of head of femur

Question 4

Extra-capsular ligaments of hip joint

Answer 4

• Iliofemoral ligament
• Pubofemoral ligament
• Ischiofemoral ligament

Question 5

Where do each of the extra-capsular ligaments attach?

Answer 5

• Ilio = ASIS to intertrochanteric line
• Pubo = superior pubic ramus to intertrochanteric line
• Ischio = body of ischium to greater trochanter

Question 6

Superficial muscles of gluteal region

Answer 6

• Gluteus maximus
• Gluteus medius
• Gluteus minimus
• Tensor fascia lata

Question 7

Deep muscles of gluteal region

Answer 7

• Quadratus femoris
• Piriformis
• Gemellus superior
• Gemellus inferior
• Obturator internus

Question 8

Muscles that perform flexion of the thigh at the hip joint

Answer 8

• Iliacus
• Psoas major
• Pectineus
• Rectus femoris
• Sartorius

Question 9

Origin, insertion and innervation of iliacus

Answer 9

• O = superior 2/3 iliac fossa (majority), inner lip of iliac crest, ala of sacrum, anterior sacroiliac + iliolumbar ligaments
• Ins = lesser trochanter of femur (blends with tendon of psoas major - forms common tendon for iliopsoas)
• Inn = femoral nerve (L2-4)

Question 10

Origin, insertion and innervation of psoas major

Answer 10

• O = T12-L5 vertebral bodies, L1-5 transverse processes, adjacent intervertebral discs
• Ins = lesser trochanter of femur
• Inn = anterior rami L1-3 spinal nerves

Question 11

Origin, insertion and innervation of pectineus

Answer 11

• O = superior pubic ramus
• Ins = pectineal line of femur
• Inn = femoral nerve (L2-3), obturator nerve (L2-3)

Question 12

Origin, insertion and innervation of rectus femoris

Answer 12

• O = AIIS, supraacetabular groove of ilium
• Ins = tibial tuberosity (via quadriceps femoris tendon + patellar ligament)
• Inn = femoral nerve (L2-4)

Question 13

Origin, insertion and innervation of sartorius

Answer 13

• O = ASIS
• Ins = medial aspect of proximal tibia
• Inn = femoral nerve (L2-3)

Question 14

Origin, insertion, innervation and function of gluteus maximus

Answer 14

• O = thoracolumbar fascia, gluteal surface of ilium, posterolateral aspect of sacrum + coccyx, sacrotuberous ligament, gluteal aponeurosis
• Ins = iliotibial tract, gluteal tuberosity of femur
• Inn = inferior gluteal nerve (L5-S2)
• F = extend + abduct thigh, assist external rotation + adduction of thigh

Question 15

Origin, insertion, innervation and function of gluteus medius

Answer 15

• O = gluteal surface of ilium (between anterior + posterior gluteal lines)
• Ins = lateral side of greater trochanter
• Inn = superior gluteal nerve (L4, S1)
• F = abduct + internally rotate thigh, stabilisation of pelvis in gait cycle

Question 16

Origin, insertion, innervation and function of gluteus minimus

Answer 16

• O = gluteal surface of ilium (between anterior + inferior gluteal lines)
• Ins = anterolateral aspect of greater trochanter
• Inn = superior gluteal nerve (L4, S1)
• F = abduct + internally rotate thigh, stabilisation of pelvis in gait cycle

Question 17

Origin, insertion, innervation and function of tensor fascia lata

Answer 17

• O = outer lip of anterior iliac crest, ASIS
• Ins = fascia lata
• Inn = superior gluteal nerve (L4, S1)
• F = abduct thigh, externally rotate leg at knee joint, stabilise knee + hip

Question 18

What neurovascular structure can be damaged in a posterior dislocation of the hip, and what would be the implications?

Answer 18

• Sciatic nerve
• Weakness in lower leg + impaired ability to move knee, ankle + foot

Question 19

Paralysis of which muscles causes a positive Trendelenburg sign?

Answer 19

Hip abductors (primarily gluteus medius + minimus)