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Hip Region

Learn about the different parts and regions of the lower limb, including the gluteal region, thigh, knee, leg, ankle, and foot. Understand the joints of the lower limb and their movements. Explore the surface anatomy and bony anatomy of the hip.

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Hip Region

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  1. Hip Region Dr. S. Nishan Silva (MBBS)

  2. Regional anatomy of the lower limb

  3. Parts and regions of the lower limb • Gluteal region－between iliac crest superiorly and gluteal fold inferiorly • Thigh－between hip and knee • knee－joint between leg and thigh • Leg－between knee and foot • Ankle • Foot

  4. Joints of Lower Limb • Hip (femur + acetabulum) • Ball + socket • Multiaxial • Synovial • Knee (femur + patella) • Plane • Gliding of patella • Synovial • Knee (femur + tibia) • Hinge • Biaxial • Synovial

  5. Joints of Lower Limb • Proximal Tibia + Fibula • Plane • Gliding • Synovial • Distal Tibia + Fibula • Slight “give” • Fibrous • Ankle (Tibia/Fibula + Talus) • Hinge • Uniaxial • Synovial pg 218

  6. Hip Flexion/extension Abduction/adduction Lateral/medial rotation Knee Flexion/extension Ankle Dorsiflexion/plantarflexion Inversion/eversion Toes Flexion/extension Bending on posterior side is flexion (except hip) Bending on anterior sided is extension (except hip) Lower Limb Movements

  7. Gluteal region and thigh anterior superior and inferior iliac spines tubercle of iliac crest ischial tuberosity greater trochanter pubic tubercle pubic crest superior border of pubic symphysis Surface anatomy of lower limb

  8. Surface Anatomy: Posterior Pelvis • Iliac crest • Gluteus maximus = cheeks • Natal/gluteal cleft = crack • Gluteal folds = bottom of cheek pg 789

  9. Surface Anatomy of the Lower Limb • Gluteus maximus muscle • Gluteus medius muscle • Gluteal cleft • Gluteal fold • Ischeal tuberosity • Greater trochanter

  10. Nelaton’s line • a line drawn from the anterior superior lilac spine to the ischial tuberosity, passing over or near the top of the greater trochanter. The trochanter can be felt superior to this line in a person which a dislocated hip or a fractured femoral neck.

  11. Hip - Anatomy • Multiaxial ball & socket joint • Acetabulum1/2 sphere • Femoral head2/3 sphere • Strong ligaments & capsule • Maximally stable

  12. Anatomy • Forces • Standing - 0.3 times body weight • Standing on 1 leg - 2.5 times body weight • Walking - 1.3 to 5.8 times body weight • Walking up stairs - 3 times body weight • Running - 4.5+ times body weight

  13. Movements of the Hip Joint • Flexion and Extension • Abduction and Adduction • External Rotation and Internal Rotation.

  14. Bony Anatomy • Femur • Femoral Head • Femoral Neck • Greater Trochanter • Lesser Trochanter • Intertrochanteric Crest • Intertrochanteric Line • Gluteal Tuberosity

  15. BONY ANATOMY OF THE HIP

  16. BONY ANATOMY OF THE HIP

  17. Bony Anatomy • Pelvic Girdle • Acetabulum • 3 bones fused together • Ilium • Iliac fossa • Iliac Crest • ASIS • AIIS • PSIS • PIIS • Gluteal Lines • Greater Sciatic Notch Lateral View

  18. Bony Anatomy • Ilium • Iliac fossa • Iliac Crest • Iliac Tuberosity • ASIS • AIIS • PSIS • PIIS • Gluteal Lines Medial View

  19. Bony Anatomy • Ilium • Ishium • Ramus of ishium • Ishial tuberosity • Ishial spine • Lessor Sciatic Notch

  20. Bony Anatomy • Ilium • Ishium • Pubis • Superior Ramus of Pubis • Inferior Ramus of Pubis • Pubic Crest • Pubic Tubercle • Pectin • Symphyseal Surface

  21. Anatomy • Ligaments • Iliofemoral ligament (Y ligament of Bigelow) • Reinforces anterior joint capsule (limits hyperextension) • Keeps us upright • Pubofemoral ligament • Limits abduction & hyperextension • Inguinal ligament • Runs from ASIS to pubic symphysis • Superior border of femoral triangle

  22. Anatomical Components: Added • Articular Capsule • Acetabular labrum • Ligaments: • Iliofemoral • Pubofemoral • Ischiofemoral • Ligament of the head of the femur • Transverse ligament of the acetabulum

  23. Anterior view

  24. Posterior view

  25. Medial view with acetabular floor removed

  26. Anterior view with capsule removed

  27. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Sacrotuberous • Sacrospinous • Function of these two ligaments • Iliolumbar • Interosseous Sacroiliac

  28. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Sacrotuberous • Sacrospinous • Function of these two ligaments • Iliolumbar • Interosseous Sacroiliac

  29. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Sacrotuberous • Sacrospinous • Function of these two ligaments • Iliolumbar • Interosseous Sacroiliac • Dorsal Sacroiliac

  30. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Hip Joint • Capsule • Three thickenings of the capsule • Iliofemoral • Pubofemoral • Ishiofemoral • Ligamentum Teres • Inguinal

  31. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Hip Joint • Capsule • Three thickenings of the capsule • Iliofemoral • Pubofemoral • Ishiofemoral • Ligamentum Teres • Inguinal

  32. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Hip Joint • Capsule • Three thickenings of the capsule • Iliofemoral • Pubofemoral • Ishiofemoral • Ligamentum Teres • Inguinal

  33. AP HIP ACETABLUM FEMORAL HEAD FEMORAL NECK GREATER TROCHANTER FOVEA CAPITIS LESSER TROCHANTER CORTICAL BONE MEDULLARY BONE

  34. CORONAL MRI RT. HIP

  35. Normal angle of inclination 1250-1300 Coxa valga (abnormally increased angle of inclination, in cases of congenital dislocation of the hip) Coxa vara (abnormally decreased angle of inclination, it occurs in fractures of the neck of the femur and slipping of the femoral epiphysis )

  36. ANGLE OF INCLINATION Coxa Vara Coxa Valga

  37. Articulations of the Hip and Pelvis • Pubic Symphysis • Interpubic disk • Some movement

  38. Articulations of the Hip and Pelvis • Pubic Symphysis • Sacroiliac Joints

  39. Articulations of the Hip and Pelvis • Pubic Symphysis • Sacroiliac Joints • Hip Joints

  40. Ligamentous and Cartilogenous Structures for the Hip and Pelvic Girdle • Sacroiliac Joint • Hip Joint • Capsule • Three thickenings of the capsule • Iliofemoral • Pubofemoral • Ishiofemoral • Ligamentum Teres • Inguinal

  41. Buttock • Supericial • Gluteus Maximus • Gluteus Medius – reverse action • Gluteus Minimus • Tensor Fascia Latae – iliotibial band, functional considerations • “Gower’s” Sign • Positive Trendelenburg

  42. Gluteus Maximus

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