Slideshow: Hip Bone

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Transcript of Slideshow: Hip Bone

The Hip Bone(Os Coxae)

Hip Bone

Anterior View

Anatomical Position

Hip Bone

The Hip Bone is a composite of 3 bones

Pubis

The Hip Bone is a composite of 3 bones

Pubis

Pubis

Ischium

The Hip Bone is a composite of 3 bones

Pubis

Ischium

Pubis

Ischium

Ilium

The Hip Bone is a composite of 3 bones

Pubis

Ischium

Ilium

These three bones meet within the Acetabulum

Acetabulum (Latin for Vinegar Cup)

Pubis

Ischium

Ilium

During development they are separated from each other by the Triradiate

Cartilage

During development they are separated from each other by the Triradiate

Cartilage

In the Acetabulum is a horseshoe shaped facet

covered in life by articular hyaline

cartilage

It is one of the two articular surfaces in the

Hip Joint

The Pubis consists of 3 main sections and

has a number of interesting features

The Pubis consists of 3 main sections and

has a number of interesting features

Superior Ramus of Pubis

The Pubis consists of 3 main sections and

has a number of interesting features

Body of Pubis

The Pubis consists of 3 main sections and

has a number of interesting features

Inferior Ramus of

Pubis

The Pubis consists of 3 main sections and

has a number of interesting features

Obturator Crest

Obturator Groove

Pubic Tubercle

provides attachment for Inguinal Ligament

Pubic Tubercle

provides attachment for Adductor Longus

The Inferior Pubic Ramus joins with the Ramus of the Ischium

Ischial Ramus

Inferior Pubic Ramus

Body of Ischium

Body of Ischium

Ischial Tuberosity

The Ischial Tuberosity is the part of the Hip Bone upon which the

upper body rests when a person is seated

The Ischial Tuberosity is the part of the Hip Bone upon which the

upper body rests when a person is seated

Hip Bone has been tilted to demonstrate the

ischial tuberosity

Ischial Spine

Hip Bone has been tilted to demonstrate the

ischial spine

The ‘Hole’ in the Hip Bone is the

Obturator Foramen

The ‘Hole’ in the Hip Bone is the

Obturator Foramen

Posterolateral view of the right Hip Bone

The Ilium also has a number of interesting

features

It has an internal (or medial) surface

The Ilium also has a number of interesting

features

Posterolateral view of the Hip Bone

And a Gluteal or Posterolateral surface

The Ilium also has a number of interesting

features

Ilium

Body of the Ilium

Ala of Ilium

Iliac Crest

Iliac Crest

Runs from Anterior Superior Iliac Spine

Iliac Crest

Runs from Anterior Superior Iliac Spine

to the Posterior Superior Iliac Spine

Iliac Crest

Below thePosterior Superior Iliac Spine is the Posterior Inferior Iliac Spine

Iliac Crest

The Anterior Inferior Iliac Spine is below the Anterior Superior Iliac Spine

Posterolateral view of the Hip Bone

The Gluteal Surface of the Ilium provides attachment for the

Gluteal Muscles

Gluteus Maximus

The Medial Surface of the Ilium is divided into 2 parts

The Medial Surface of the Ilium is divided into 2 parts

Auricular Facet

The Medial Surface of the Ilium is divided into 2 parts

Auricular Facet

The Auricular Facet Articulates with the

Sacrum at the Sacroiliac Joint

The Auricular Facet Articulates with the

Sacrum at the Sacroiliac Joint

Iliac Fossa

The Iliac Fossa provides attachment for

Iliacus

which inserts onto the Lesser Trochanter of the Femur

Iliacus flexes the Hip Joint

Muscle Attachments

Postero-lateral View

Tensor Fasciae LataeOriginates from •anterior superior iliac spine •outer lip of anterior 1/4th of iliac crest•fascia lata

Postero-lateral View

Tensor Fasciae Latae

Inserts via the Iliotibial Tract (band)

onto Gerdy’s Tubercle

on anterior aspect of Lateral Tibial

Condyle

Originates from •anterior superior iliac spine •outer lip of anterior 1/4th of iliac crest•fascia lata

Postero-lateral View

SartoriusOriginates from the

Anterior Superior Iliac Spine

Postero-lateral View

SartoriusOriginates from the

Anterior Superior Iliac Spine

Inserts onto the medial aspect of

upper Tibia

Postero-lateral View

SartoriusOriginates from the

Anterior Superior Iliac Spine

Inserts onto the medial aspect of

upper Tibia

• Flexes, adducts and laterally rotates the hip

• Flexes the knee

Postero-lateral View

Gluteus MediusOriginates from outer surface of

Ilium between Posterior and Anterior (middle)

Gluteal Lines

Postero-lateral View

Gluteus Medius

Inserts onto lateral surface of

Greater Trochanter of Femur

Originates from outer surface of Ilium between

Posterior and Anterior (middle)Gluteal Lines

Postero-lateral View

Gluteus MediusOriginates from outer surface of

Ilium between Posterior and Anterior (middle)

Gluteal Lines

Inserts onto lateral surface of

Greater Trochanter of Femur

• Abducts thigh• Medially rotates hip

Postero-lateral View

Gluteus MinimusOriginates from outer surface of

Ilium between Inferior and Anterior (middle)

Gluteal lines

Postero-lateral View

Gluteus Minimus

Inserts onto anterior surface of Greater Trochanter

of Femur

Originates from outer surface of Ilium between

Inferior and Anterior (middle) Gluteal lines

Postero-lateral View

Gluteus Minimus

Inserts onto anterior surface of Greater Trochanter

of Femur

Abducts and medially rotates the

hip joint

Originates from outer surface of Ilium between

Inferior and Anterior (middle) Gluteal lines

Postero-lateral View

Gluteus MaximusOriginates from•Posterior aspect of dorsal ilium posterior to posterior gluteal line•posterior superior iliac crest •posterior surface of sacrum and coccyx •sacrotuberous ligament

Postero-lateral View

Gluteus MaximusInserts onto•Iliotibial band•Gluteal Tuberosity posterior Femur

Postero-lateral View

Gluteus MaximusInserts onto•Iliotibial band•Gluteal Tuberosity posterior Femur

Extends and laterally rotates hip

Postero-lateral View

PiriformisOriginates from •anterior surface of Sacrum •gluteal surface of Ilium at the margin of the greater sciatic notch

Postero-lateral View

PiriformisOriginates from •anterior surface of Sacrum •gluteal surface of Ilium at the margin of the greater sciatic notch

Inserts onto superior aspect

Greater Trochanter of Femur

Postero-lateral View

PiriformisOriginates from •anterior surface of Sacrum •gluteal surface of Ilium at the margin of the greater sciatic notch

Inserts onto superior aspect

Greater Trochanter of Femur

Laterally rotates Hip Joint

Postero-lateral View

Superior GemellusOriginates from a small area on the

outer surface of hip bone below Ischial Spine

Postero-lateral View

Superior GemellusOriginates from a small area on the

outer surface of hip bone below Ischial Spine

Inserts onto the medial surface of Greater Trochanter of Femur

Postero-lateral View

Superior Gemellus

Inserts onto the medial surface of Greater Trochanter of Femur

Laterally rotates the

Hip

Originates from a small area on the outer surface of hip bone below

Ischial Spine

Postero-lateral View

Semitendinosus

Originates from supero-medial quadrant on the posterior surface

of the Ischial Tuberosity

Postero-lateral View

Semitendinosus

Originates from supero-medial quadrant on the posterior surface

of the Ischial Tuberosity

Inserts onto superior aspect

medial Tibial shaftbehind Sartorius and

Gracilis

Postero-lateral View

Semitendinosus

Originates from superior medial quadrant on the posterior surface

of the Ischial Tuberosity

Inserts onto superior aspect

medial Tibial shaft behind Sartorius and

Gracilis

• Extends Hip• Flexes and medially

rotates the Knee

Postero-lateral View

Originates from superior medial quadrant on the posterior surface

of the Ischial Tuberosity

Biceps Femoris (long head)

Postero-lateral View

Originates from superior medial quadrant on the posterior surface

of the Ischial Tuberosity

Inserts in common with the short head onto•Fibular head•Lateral Collateral Ligament of Knee•Lateral Tibial Condyle

Biceps Femoris (long head)

Postero-lateral View

Biceps Femoris (long head)

Originates from superior medial quadrant on the posterior surface

of the Ischial Tuberosity

Inserts in common with the short head onto•Fibular head•Lateral Collateral Ligament of Knee•Lateral Tibial Condyle

• Flexes the Knee• Rotates Tibia laterally• Extends the Hip

Postero-lateral View

Semimembranosus

Originates from superior lateral quadrant on the posterior surface

of the Ischial Tuberosity

Postero-lateral View

SemimembranosusOriginates from superior lateral

quadrant on the posterior surface of the Ischial Tuberosity

Inserts onto•Medial Tibial Condyle•Fascia over Popliteus•Oblique Popliteal Ligament

Postero-lateral View

SemimembranosusOriginates from superior lateral

quadrant on the posterior surface of the Ischial Tuberosity

• Extends Hip• Flexes and medially

rotates Knee

Inserts onto•Medial Tibial Condyle•Fascia over Popliteus•Oblique Popliteal Ligament

Quadratus Femoris

Originates from lateral border of Ischial Tuberosity

Inferior-lateral View

Quadratus Femoris

Originates from lateral border of Ischial Tuberosity

Inferior-lateral View

Inserts onto Quadrate tubercle on Intertrochanteric

Crest and adjacent area of posterior Femur

Quadratus Femoris

Originates from lateral border of Ischial Tuberosity

Laterally rotates hip

Inferior-lateral View

Inserts onto Quadrate tubercle on Intertrochanteric

Crest and adjacent area of posterior Femur

Adductor Magnus

Has two different functional componentsAdductor portion originates from the Inferior pubic ramus and ischial ramusHamstring portion originates from ischial tuberosity

Inferior-lateral View

Adductor MagnusAdductor portion originates from the Inferior Pubic Ramus and Ischial RamusHamstring portion originates from Ischial Tuberosity

Adductor portion inserts onto Linea Aspera

Hamstring portion inserts onto the Adductor

Tubercle

Inferior-lateral View

Adductor MagnusAdductor portion originates from the Inferior Pubic Ramus and Ischial RamusHamstring portion originates from Ischial Tuberosity

Adductor portion inserts onto Linea Aspera

Hamstring portion inserts onto the Adductor

Tubercle

Adductor portion: adducts and medially rotates Hip JointHamstring portion: extends Hip JointInferior-lateral View

Adductor BrevisOriginates from Pubis •Inferior ramus •Body

Inferior-lateral View

Adductor BrevisOriginates from Pubis •Inferior ramus •Body

Inserts onto upper third Linea Aspera of Femur

Inferior-lateral View

Adductor BrevisOriginates from Pubis •Inferior ramus •Body

Inserts onto upper third Linea Aspera of Femur

Adducts and flexes Hip

Inferior-lateral View

Adductor Longus

Originates from anterior surface of body of Pubis

Inferior-lateral View

Adductor Longus

Originates from anterior surface of body of Pubis

Inserts onto Linea Aspera of Femur

Inferior-lateral View

Adductor Longus

Originates from anterior surface of body of Pubis

Inserts onto Linea Aspera of Femur

Adducts, flexes and medially rotates the Hip

Joint Inferior-lateral View

GracilisOriginates from •Inferior ramus of pubis•Ramus of ischium

Inferior-lateral View

GracilisOriginates from •Inferior ramus of pubis•Ramus of ischium

Inserts onto medial surface of upper Tibial

shaft

Inferior-lateral View

Gracilis

• Adducts Hip• Flexes Knee

Medially rotates Tibia on Femur

Inferior-lateral View

Originates from •Inferior ramus of pubis•Ramus of ischium

Inserts onto medial surface of upper Tibial

shaft

Obturator ExternusOriginates from •Outer surface of Obturator Membrane Posterior bony margins of Obturator Foramen

Inferior-lateral View

Obturator ExternusOriginates from •Outer surface of Obturator Membrane Posterior bony margins of Obturator Foramen

Inserts onto Greater Trochanter of Femur

Inferior-lateral View

Obturator ExternusOriginates from •Outer surface of Obturator Membrane Posterior bony margins of Obturator Foramen

Inserts onto Greater Trochanter of Femur

Laterally rotates hip

Inferior-lateral View

Rectus FemorisStraight head originates from Anterior Inferior Iliac Spine

Inferior-lateral View

Rectus FemorisStraight head originates from Anterior Inferior Iliac Spine

Reflected head originates from Ilium just above Acetabulum

Inferior-lateral View

Inferior-lateral View

Rectus FemorisStraight head originates from Anterior Inferior Iliac Spine

Reflected head originates from Ilium just above Acetabulum

Inserts onto Patella to form central portion of

Quadriceps Femoris tendon

Rectus FemorisStraight head originates from Anterior Inferior Iliac Spine

Reflected head originates from Ilium just above Acetabulum

Inserts onto Patella to form central portion of

Quadriceps Femoris tendon

Extends the knee

Inferior-lateral View

Iliacus

Originates from •Upper 2/3 of Iliac Fossa of Ilium•Lateral aspect of sacrum

Medial View right hip bone

Inserts onto Lesser trochanter of Femur

Flexes and medially rotates Hip

Muscle Summaries

Tensor Fasciae LataeOrigin Anterior superior iliac spine, outer

lip of anterior iliac crest and fascia lata

Insertion Via the Iliotibial band onto Gerdy’s tubercle on lateral tibial condyle

Action Assists gluteus maximus in maintaining extended knee, abducts hip

Nerve Supply Superior gluteal nerve (L4, L5, S1) Blood Supply Superior gluteal and lateral

circumflex femoral artery

Anterior Thigh

SartoriusOrigin Anterior superior iliac spine

Insertion Superior aspect medial surface of tibial shaft

Action Flexes, adducts and laterally rotates the hip joint and flexes the knee

Nerve Supply Anterior division of femoral nerve (L3, L4)

Blood Supply Femoral artery

Anterior Thigh

Gluteus Medius Origin Outer surface of ilium between

posterior and anterior gluteal lines

Insertion Lateral and superior surfaces of greater trochanter of femur

Action Abducts thigh; medially rotates hip

Nerve Supply Superior gluteal nerve (L4, L5, S1)

Blood Supply Superior gluteal artery

Gluteal Region

Gluteus MinimusOrigin Outer surface of ilium between

inferior and anterior gluteal linesInsertion Anterior surface of greater

trochanter of femurAction Abducts and medially rotates the

hip jointNerve Supply Superior gluteal nerve (L4, L5, S1)

Blood Supply Superior gluteal artery

Gluteal Region

Gluteus Maximus Origin Posterior aspect of dorsal

ilium posterior to posterior gluteal line, posterior superior iliac crest, lateral sacrum and coccyx, and sacrotuberous ligament

Insertion Iliotibial band; gluteal tuberosity posterior femur

Action Extends and laterally rotates hip

Nerve Supply Inferior gluteal nerve (L5, S1, S2)

Blood Supply Inferior and superior gluteal arteries

Gluteal Region

PiriformisOrigin Anterior surface of lateral

process of sacrum and gluteal surface of ilium at the margin of the greater sciatic notch

Insertion Superior aspect greater trochanter of femur

Action Lateral rotator of the hip jointNerve Supply Anterior primary rami S1, S2 Blood Supply Superior and inferior gluteal

and internal pudendal arteries

Gluteal Region

Gluteal Region Superior Gemellus

Origin Outer aspect of Ischium

Insertion Medial surface of greater trochanter of femur, in common with obturator internus

Action Laterally rotates hip

Nerve Supply Nerve to the obturator internus

Blood Supply Inferior gluteal artery

SemitendinosusOrigin Superior medial quadrant,

posterior surface ischial tuberosityInsertion Superior aspect, medial tibial shaftAction Extends hip, flexes and medially

rotates kneeNerve Supply Tibial portion sciatic nerve (L5, S1)Blood Supply Perforating branches of profunda

femoris artery, inferior gluteal artery, superior muscular branches of popliteal artery

Posterior thigh

Posterior ThighBiceps Femoris

Origin Long Head: Superior medial quadrant of the posterior surface of the ischial tuberosityShort Head:Middle third linea aspera, lateral supracondylar ridge of femur

Insertion Fibular head, lateral collateral ligament, lateral tibial condyle

Action Flexes the knee, rotates tibia laterally, extends the hip joint

Nerve Supply Long head: tibial portion of sciatic nerve, Short head: common peroneal portion of sciatic nerve (L5, S1)

Blood Supply Perforating branches of profunda femoris artery, inferior gluteal artery, superior muscular branches of popliteal artery

SemimembranosusOrigin Superior lateral quadrant of

posterior surface ischial tuberosity

Insertion Posterior surface of the medial tibial condyle, fascia over popliteus, oblique popliteal ligament

Action Extends hip, flexes and medially rotates the knee

Nerve Supply Tibial portion of sciatic nerve (L5, S1)

Blood Supply Perforating branches of profunda femoris artery, inferior gluteal artery, and the superior muscular branches of popliteal artery

Posterior thigh

Gluteal Region Quadratus Femoris

Origin Lateral border ischial tuberosity

Insertion Quadrate tubercle and adjacent bone of intertrochanteric crest of posterior aspect femur

Action Laterally rotates hipNerve Supply Nerve to the quadratus

femorisBlood Supply Medial circumflex femoral

artery, inferior gluteal artery, obturator artery,

Anterior Thigh

Adductor MagnusOrigin Adductor portion: Inferior pubic

ramus, ischial ramusHamstring portion: ischial tuberosity

Insertion Adductor portion: Linea asperaHamstring portion: Medial supracondylar ridge and adductor tubercle

Action Adductor portion:adducts and medially rotates hipHamstring portion: extends hip

Nerve Supply Adductor portion: Posterior division of obturator nerve (L2-4)Hamstring portion: tibial nerve portion of sciatic nerve (L4-S3)

Blood Supply Medial circumflex femoral artery, inferior gluteal artery, 1st - 4th perforating arteries, obturator artery, popliteal artery

Adductor BrevisOrigin Inferior ramus and body of pubis

Insertion Upper third linea aspera of femur

Action Adducts and flexes hip jointNerve Supply Anterior division obturator nerve

(L2, L3, L4)Blood Supply Medial circumflex femoral branch

of femoral artery and obturator artery

Anterior Thigh

Adductor LongusOrigin Anterior surface of body of pubis,

just lateral to pubic symphysisInsertion Middle third of linea aspera,

between the more lateral adductor magnus and brevis insertions and the more medial origin of the vastus medialis

Action Adducts, flexes and medially rotates the hip joint

Nerve Supply Anterior division of obturator nerve (L2, L3, L4)

Blood Supply Obturator artery and medial circumflex femoral artery

Anterior Thigh

Gluteal Region Obturator Externus

Origin Outer surface of obturator membrane and posterior bony margins of obturator foramen

Insertion Trochanteric Fossa on medial aspect greater trochanter of femur

Action Laterally rotates hip

Nerve Supply Posterior division obturator nerve L2,3,4

Blood Supply Internal pudendal and superior and inferior gluteal arteries

Anterior Thigh

Rectus FemorisOrigin Straight head: anterior inferior iliac

spineReflected head: ilium just above acetabulum

Insertion Base of patella to form the more central portion of the quadriceps femoris tendon

Action Extends the knee

Nerve Supply Posterior division of femoral nerve (L2, L3, L4)

Blood Supply Lateral circumflex femoral artery

Hip FlexorsIliacus

Origin Upper 2/3 of iliac fossa of ilium, lateral aspect of sacrum

Insertion Lesser trochanter of femur

Action Flexes and medially rotates hip

Nerve Supply Muscular branch of femoral nerve (L2, L3)

Blood Supply Lumbar branch of iliolumbar branch of internal iliac artery