Transcript The Hip
The Hip is a ball and socket joint like the shoulder, but because it is me stable it has less motion than the shoulder. The hip is a triaxial joint meaning that it moves in all three planes. Flexion/extension/hyperextension Abduction/adduction Internal and external rotation Which motion is each plan in??? Hip consists of 3 bones, one of which has 3 parts. Sacrum Coccyx Pelvis Illium Ischium Pubis The pelvis articulates with the sacrum on the posterior side of the hip The pelvis articulates with the two pubic portions of the pelvis on the anterior side of the hip. The pelvic girdle articulates with the femur at the head of the femur and the acetabulum of the pelvic girdle. First part of the pelvis is the Illium. The fan shaped illium makes up the superior portion of the hip bone Illica Fossa- large smooth concave on the anterior surface of the illium Illiac Crest- superior part of the illium that you can touch. The Illica Crest runs from the anterior superior illiac spine ASIS to the posterior superior illiac spine PSIS. You can palpate these easily There is also a posterior inferior and anterior inferior illiac spine that are just below the ASIS and PSIS. There muscles that attach to each. The Ischium is the posterior inferior portion of the pelvic bone. Ramus- inferior/medial part. It is attachment site for adductor magnus, and obturator muscles Ischial tuberosity is rough blunt projection of the inferior ischium, it is the part that you bear weight on when you sit. The pubis form the anterior inferior portion of the pelvis. The symphysis pubis is a cartilaginous joint connecting the bodies of the two pubic bones at the anterior midline. Superior and Inferior ramus are above and below the symphysis pubis. Attachment for various muscles. Acetabulum is the concave socket that the femoral head fits into. It is made up of the all three pelvic bones. Obterator foramen- a large opening made up of the bodies and rami of the ischium and pubis through which passes blood vessels and nerves. Femur is the longest and strongest bone in the body. A person’s height is roughly 4x the length of their femur. Head is the rounded portion covered with articular cartilage The Neck is the narrower portion between the head and the trochanters. Greater Trochanter is the large projection located laterally between the neck of the femur and the body. Provides attachments for glute medius and minimus. Lesser trochanter- smaller projection located medially and posterior and just distal to the greater trochanger. Attachment for the iliopsoas. Medial and Lateral Condyle- distal medial and lateral end of the femur. Medial and Lateral Epicondyle- projection proximal to the condyle -Linea Aspera- prominent longitudinal ridge running most of the posterior femur length. Tibial Tuberosity is the large projection on the tibia at the proximal end where the patellar tendon attaches. There are 3 main ligaments in the hip joint. They attach from the rim of the acetabulum to the femoral neck. They are in a spiral fashion and allow flexion and restrict hyperextension. Acetabular Labrum helps increase the depth of the labrum, it is fibrocartilage like the meniscus. Iliotibial band- is the very long tendinous portion of the tensor fascia latae muscle. It runs from the anterior iliac crest to the lateral tibia. The gluteus maximus has tendons that are attached to it. Iliotibial band syndromeoveruse injury causing lateral knee pain. Repeated friction of the band sliding over the lateral femoral epicondyle, caused by tight muscles, or worn down shoes Trochanteric bursitis- result of either acute trauma or overuse. Tight glute muscles and Iliotibial band can create overuse among runners and bikers. Hamstring Strain “pulled hamstring”- most common muscle problem in body, often recurrent and a result of overload, or moving the muscle too fast. Hip Pointer/Iliac crest contusion- due to a direct blow to the iliac crest. Iliopsoas Muscles- actually two muscles with separate proximal attachments, and a common distal attachment. Prime hip flexor muscle. Sartorius – longest muscle in the body. It is also called the tailor muscle and it has many actions, when combined they are most powerful. Adductor Longus- most superficial of the adductor muscles, it can be palpated most easily due to the long tendon in the medial anterior groin. Adductor Magnus- largest, most massive and deepest of the adductor muscles. It is a very strong adductor muscle. Gracilis- the only hip flexor that is a two joint muscle. It starts at the pubic symphysis, and attaches to the proximal medial tibia and assists with knee flexion. Gluteus Maximus- large, quadrilateral shaped muscle located on the superficial buttocks. Posterior hip muscle that is a very strong hip extensor. Gluteus Medius- Triangular shaped muscle like the deltoid. It spans the hip laterally and is a primary adductor muscle. Piriformis- This is one of the deep rotator muscles of the hip, it goes from the sacrum to the greater trochanter of the femur. It laterally or externally rotates the hip. Tensor Fascia Lataeshort muscle with a long tendinous attachment. It starts at ASIS and attaches to the IT band. It is a hip adductor and is most powerful in a bit of hip flexion.