Chapter 18 Hip Joint

A. Laterally lean the trunk to the right

. What can this patient do to compensate for a left pelvis drop? A. Laterally lean the trunk to the right B. Laterally lean the trunk to the left C. Flex the trunk forward D. Extend the trunk backward

E. sagittal; anterior; posterior

1. Hip flexion occurs in the _____ plane. In open kinetic chain hip flexion, the femur rolls _____ and glides _____. A. frontal; anterior; posterior B. frontal; posterior; anterior C. horizontal; posterior; anterior D. sagittal; anterior; anterior E. sagittal; anterior; posterior

A. Left pelvis forward rotation

1. What motion is necessary at the pelvis in order to achieve an optimal step length on the right during single-limb stance? A. Left pelvis forward rotation B. Left pelvis backward rotation C. Right pelvis forward rotation D. Right pelvis backward rotation

A. Acetabulum

1. Which of the following is NOT considered part of the innominate? A. Acetabulum B. Ilium C. Ischium D. Pubis

A. anterior; anterior

10. If a person is standing erect and flexes the trunk on the hip, the center of mass will move __________ and the line of gravity moves __________ within the base of support. A. anterior; anterior B. anterior; posterior C. posterior; anterior D. posterior; posterior

A. contralateral; latissimus dorsi; abductor

10. Using a cane on the ____________ side of a hip injury helps to reduce weight-bearing on the involved hip by 15%. It is also instrumental in activating the ____________ on the cane side to assist the ____________ muscles on the involved side to overcome gravitational torque. A. contralateral; latissimus dorsi; abductor B. contralateral; piriformis; adductor C. ipsilateral; latissimus dorsi; adductor D. ipsilateral; piriformis; abductor

B. pubic symphysis

2. The two innominate bones articulate anteriorly via the: A. ischial tuberosity B. pubic symphysis C. sacroiliac

B. Left hip internal rotation

2. What motion at the hip must occur in order to allow for left forward pelvic motion during single-limb stance? A. Left hip external rotation B. Left hip internal rotation C. Right hip external rotation D. Right hip internal rotation

D. Right hip abductors

2. What muscle or muscles are responsible for preventing a left pelvic drop as seen at the beginning of this scenario? A. Right quadratus lomborum B. Left hip adductors C. Left hip abductors D. Right hip abductors

Innervation to Muscles of Hip: Sciatic Nerve

Largest nerve in body, composed of tibial nerve and common peroneal nerve (nerve roots L4, L5, S1, S2, and S3) Tibial portion innervates most hamstring muscles and extensor head of adductor magnus Common peroneal portion innervates remaining hamstring—short head of biceps femoris—and a number of muscles important to ankle function

Functional Considerations: High-Powered Hip Extension

Activities such as running or jumping can require immense hip extension torques; position of hip flexion elongates hip extensors, better enabling them to produce large forces Many hip adductor muscles are converted to extensors when hip is in flexed position Like switching gears in a car, position of hip flexion strongly engages available extension torque of numerous hip muscles

Innervation to Muscles of Hip

Femoral and obturator nerves are two largest nerves that exit lumbar plexus (T12-L4) Femoral nerve innervates most of hip flexors and all of knee extensors (L2-L4) Obturator nerve innervates primarily hip adductor muscles (L2-4)

Torsion Angle

Femoral neck normally projects anteriorly about 15 degrees Normal anteversion; associated with optimal alignment between femoral head and acetabulum Excessive anteversion may lead to anterior instability of hip

Hip allows six basic motions

Flexion, extension, abduction, adduction, internal rotation, and external rotation

Force-Couple for Performing Anterior Tilt of Pelvis

Force-Couple for Performing Anterior Tilt of Pelvis

Angle of Inclination

Frontal plane angle created between femoral neck and shaft of femur Measures about 125 degrees for optimal hip alignment Directs shaft of femur medially, thereby positioning knee joint directly under the weight of the body Deviations can occur from abnormal development in early childhood or trauma Coxa valga describes an angle of inclination significantly greater than 125 degrees Coxa vara describes an angle of inclination significantly less than 125 degrees

Functional Considerations: Closed-Chain Function of Hip Abductors

Hip abductor muscles play critical role in controlling pelvis within frontal plane while walking During stance phase of gait, hip abductor muscles of stance leg must hold pelvis level As hip abductor muscles stabilize pelvis, they also create significant forces against hip, relevant to treating someone with an unstable or painful hip joint

Abdominal Muscles as Proximal Stabilizers for Hip Flexors

Hip flexor muscles are used for variety of activities that are dependent on stabilization provided by abdominal muscles With weakened abdominal muscles, attempts at flexing extended leg often result in unwanted anterior pelvic tilt and excessive lumbar lordosis

Internal Rotators

Hip has no primary internal rotators, but several secondary internal rotators that help change direction of the advancing limb and balance force of other flexor muscles Secondary internal rotators include anterior fibers of gluteus medius and gluteus minimus, tensor fasciae latae, adductor longus, and adductor brevis

Lunate surface

Horseshoe-shaped superior surface of acetabulum Heavily lined with articular cartilage Contacts femoral head

Innominate or Os Coxae

Ilium Ischium Pubis Functions of Pelvis

sacroiliac joints

Ilium articulates with sacrum

Hip Internal Rotation and External Rotation

Internal and external rotation occurs in horizontal plane about a vertical or longitudinal axis of rotation

Pubic symphysis

Junction between pubic crests of each innominate, completing anterior "ring" of pelvis

Obturator foramen

Large circular opening formed by pubic rami and ischium

Hip Flexion Contracture

Limitation of passive hip extension When a person with hip flexion contracture attempts to stand, passive standing mechanism is disabled Results in need for continuous activation of hip and back extensor muscles to maintain upright position

Linea aspera

Line of slightly raised bone that courses along much of posterior side of femur Distal attachment for many adductor muscles, and proximal attachment for two quadriceps muscles

Iliac crest

Long ridge of bone that marks superior border of ilium Anterior-superior iliac spine (ASIS) Anterior-inferior iliac spine (AIIS)

Femur

Longest bone in body

What's the insertion of Adductor Longus Muscle?

Middle third of the linea aspera

Muscular Efficiency of Standing "at Ease"

Most adults can stand for long periods of time using only minimal amounts of muscular energy While standing in "good" upright posture, line of gravity normally travels just posterior to medial-lateral axis of rotation of hips Gravity provides a passive extension torque at hips, which, if not opposed, would cause a backward bending of the pelvis over femurs Because all three external ligaments of hip are stretched in extension, they generate a passive "rubber band-like" flexion torque at hips Tension between stretched ligaments of hip and action of gravity allows us to stand with little muscular intervention

Functional Considerations: Frontal Plane Function of the Adductor Muscles

Most obvious function of adductor muscles is to adduct femur, e.g., accelerating lower extremity across midline to kick soccer ball From a closed-chain perspective, this muscle group can also rapidly lower contralateral side of pelvis Adductors accelerate lower extremity toward ball, adding force by actively lowering right side of pelvis

Hip Adduction

Movement between femur and pelvis within frontal plane about an anterior-posterior axis of rotation Results in reduced distance between midline of pelvis and medial aspect of femur

Hip Abduction

Movement between femur and pelvis within frontal plane about an anterior-posterior axis of rotation Reduces distance between iliac crest and lateral aspect of thigh

Hip Extension

Movement between femur and pelvis within sagittal plane about a medial-lateral axis of rotation Reduces distance between posterior aspect of pelvis and posterior surface of femurs

Hip Flexion

Movement between femur and pelvis within sagittal plane about a medial-lateral axis of rotation Reduces distance between anterior aspect of pelvis and anterior surfaces of femurs

Most nerves exit pelvis via the greater sciatic foramen to innervate posterior hip muscles

Nerve to piriformis (S1-2) Nerve to the obturator internus (L5-S2) Nerve to quadratus femoris (L4-S1) Superior gluteal nerve (L4-S1) Inferior gluteal nerve (L5-S2)

What's the innervation of Adductor Longus Muscle?

Obturator nerve L3, L4

People sit on their ischial tuberosities

Often the site of pressure ulcers occurring in persons who lack normal sensation

Ischium

On posterior-inferior aspect of innominate

Each of six motions can use three different kinematic strategies

Open-chain hip motion (Femoral on Pelvic Motion) Maximizing trunk displacement through closed-chain hip motion (Long Arc Pelvic on Femoral Motion) Short-arc closed-chain hip motion (Short Arc Pelvic on Femoral Motion)

Functional Considerations: Force-Couple and Posterior Pelvic Tilt

Posterior pelvic tilt is produced by a force-couple created by abdominal muscles and hip extensors Posterior pelvic tilt reduces lordosis in lumbar spine Exercises involving posterior pelvic tilt are often used clinically to address low back problems such as spondylolisthesis

Ischial spine

Posterior projection of bone marking inferior aspect of greater sciatic notch

Posterior-superior iliac spine (PSIS)

Posterior tip of the iliac crest

Greater trochanter

Projection of bone that extends laterally from near junction of femoral neck and shaft Distal attachment for numerous muscles of hip

Adductor tubercle

Raised portion of bone located just proximal to medial epicondyle marking distal attachment of adductor magnus muscle

Functional Considerations: Sagittal Plane Function of Adductor Muscles

Regardless of hip position, extensor head of adductor magnus is an extensor Remaining hip adductors can function as flexors or extensors, depending on hip position, and can flexion and extension torque Switching from flexion to extension may explain adductors' susceptibility to injuries while running

Intertrochanteric crest

Ridge of bone connecting posterior aspects of greater and lesser trochanters

Acetabular labrum

Ring of fibrocartilage surrounding outer rim of acetabulum Provides increased hip stability by deepening socket and gripping femoral head

Greater sciatic notch

Semicircular space between PIIS and ischial spine providing space for sciatic nerve to exit pelvis Sacrospinous and sacrotuberous ligaments convert this notch to sciatic foramen

Lesser trochanter

Sharp posterior-medial projection of bone Distal attachment for iliopsoas muscle

Posterior-inferior iliac spine (PIIS)

Small bony prominence located inferior to PSIS, marking superior tip of greater sciatic notch

Pectineal line

Small crest of bone running from lesser trochanter to superior aspect of linea aspera Distal attachment for pectineus muscle

Trochanteric fossa

Small pit on posterior-medial side of greater trochanter; many of the hip external rotators attach on or near it

Iliac fossa

Smooth, concave, anterior surface of ilium Provides proximal attachment of iliacus muscle

Transverse acetabular ligament

Spans acetabular notch, completing "cup" of acetabulum

Ligamentum teres

Tubular sheath of connective tissue running from transverse acetabular ligament to femoral head fovea Obturator artery branch travels through, providing some of femoral head blood supply

Sacral Plexus:

Ventral Rami of L4-S4

Ilium

Wing-shaped superior portion of innominate

pubis

_____ forms the anterior inferior portion of the hip. divided into three parts - the body and its two rami

posterior inferior iliac spine

abbreviated as PIIS; located just abolve the PSIS.

posterior superior iliac spine

abbreviated as PSIS. It is the posterior projection on the iliac crest.

What's the origin of Psoas Major Muscle?

anterior and lateral surfaces of T12 through L5

What's the origin of rectus femoris muscle?

anterior inferior iliac spine

What's the origin of Sartorius muscle?

anterior superior iliac spine

What's the origin of tensor fascia latae muscle?

anterior superior iliac spine

What's the insertion of Gluteus Minimus Muscle?

anterior surface of the greater trochanter

What's the action of tensor fascia latae muscle?

combined hip flexion and abduction

ischiofemoral ligament

cover the capsule posteriorly. attached on the ischial portion of the acetabulum, crosses the joint in the lateral and superior direction and attaches on the femoral neck. LIMITS HYPEREXTENSION AND MEDIAL ROTATION.

Ischial ramus

extends anteriorly from ischial tuberosity to join with inferior pubic ramus

ilium

fan shaped ___________ makes up the superior portion of the hip bone

What's the innervation of Sartorius muscle?

femoral nerve (L2, L3)

What's the innervation of rectus femoris muscle?

femoral nerve L2, L3, L4

lesser trochanter

femur: a smaller projection located medially and posteriorly just distal to the greater trochanter, providing attachment for the iliopsoas muscle

lateral condyle

femur: distal lateral end.

medial condyle

femur: distal medial end.

greater trochanter

femur: large projection located laterally between the neck and the body of the femur, providing attachment for the gluteus medius and minimus and for most deep rotator muscles

patellar surface

femur: located between the medial and lateral condyle anteriorly. it articulates with the posterior surface of the patella.

lateral epicondyle

femur: projection proximal to the lateral condyle.

medial epicondyle

femur: projection proximal to the medial condyle.

linea aspera

femur: prominent longitudinal ridge or crest running most of the posterior length

pectineal line

femur: runs form below the lesser trochanter diagonally toward the linea aspera. it provides attachment for the adductor brevis

adductor tubercle

femur: small projection proximal to the medial epicondyle to which a portion of the adductor magnus muscle attaches.

body

femur: the long, cylindrical portion between the bone ends; also called the shaft. it is bowed slightly anteriorly

neck

femur: the narrower portion located between the head and the trochanters

head

femur: the rounded portion covered with articular cartilage articulating with the acetabulum

What's the action of Gluteus Medius Muscle?

hip abduction

What's the action of Gluteus Minimus Muscle?

hip abduction, medial rotation

What's the action of Adductor Longus Muscle?

hip adduction

What's the action of Adductor Magnus muscle?

hip adduction

What's the action of Gluteus Maximus Muscle?

hip extension, hyperextension, lateral rotation

What's the action of Iliopsoas Muscle?

hip flexion

What's the action of rectus femoris muscle?

hip flexion, knee extension

flexion

hip joint has 120° of ____________

hyperextension

hip joint has 15° of ___________

abduction

hip joint has 45° of __________

internal and external rotation

hip joint has 45° of rotation in ____________________________

adduction

hip joint has an additional 25° of motion in __________ beyond return to anatomical position

obturator foramen

hip: a large opening surrounded by the bodies and rami of the ischium and the pubis and through which pass blood vessels and nerves

acetabulum

hip: deep, cup shaped cavity that articulates with the femus, it is made up of nearly equal portions of the ilium, ischium, and pubis

greater sciatic notch

hip: large notch just below the PIIS that is actually made into a foramen but the sacrospinous and sacrotuberous ligaments. the sciatic nerve, piriformis muscle, and other structures pass through this opening.

What's the origin of Iliacus muscle?

iliac fossa

What's the innervation of Iliopsoas Muscle?

iliacus portion: femoral nerve L2,L3, psoas major portion: L2 & L3

anterior inferior iliac spine

ilium: abbreviated as AIIS: the projection is just inferior to the ASIS, to which the rectus femoris muscle attaches

Anterior Superior Iliac Spine

ilium: abbreviated as ASIS. the projections on the anterior end of the iliac crest. the tensor fascia latae, sartorius, inguinal ligament attach here.

iliac crest

ilium: bony part that your hands rest on when you put your hands on your hips. its borders are the anterior superior iliac spine (ASIS) and the posterior superior iliac spine (PSIS)

iliac fossa

ilium: large, smooth concave area on the internal surface to which the iliac portion of the iliopsoas muscle attached

What's the innervation of Gluteus Maximus Muscle?

inferior gluteal nerve L5, S1, S2

Proximal femur

is composed of head, neck, and shaft

Pubis

is composed of two rami, superior pubic ramus and inferior pubic ramus, that coalesce anteriorly to form pubic crest

hip bone

is known as the os coxae and is irregularly shaped and actually consists of three bones, the ilium, the ischium and the pubis.

hip joint

is made up of the hip bone and femur.

ischium

is the posterior inferior portion of the hip bone

What's the origin of Adductor Magnus muscle?

ischium and pubis

ramus

ischium: extends medially form the body to connect with the inferior ramus of the pubis. the adductor magnus, obturator externus, and the obturator internus muscles attach here.

spine

ischium: located on the posterior portion of the body between the greater and lesser sciatic notches. it provides attachment for the sacrospinous ligament.

body

ischium: makes up about 2/5 of the acetabulum

ischial tuberosity

ischium: rough, blunt projection of the inferior part of the body, which is weight-bearing when you are sitting. it provides attachment for the hamstring and adductor magnus muscles

ischial tuberosity

ischium: rough, blunt projection of the inferior part of the body, which is weight-bearing when you are sitting. it provides attachment for the hamstring and adductor magnus muscles.

What's the insertion of tensor fascia latae muscle?

lateral condyle of tibia

What's the origin of Gluteus Minimus Muscle?

lateral ilium

What's the insertion of Gluteus Medius Muscle?

lateral surface of the greater trochanter

What's the insertion of Iliopsoas Muscle?

lesser trochanter

femur

longest, strongest, heaviest bone in the body; person's height can roughly be estimated to be 4x the length of the femur. articulates with the hip bones to form the hip joint

triaxial joint

moves in all three planes

What's the innervation of Adductor Magnus muscle?

obturator and sciatic nerve L3, L4

Arthrokinematics

of hip joint are based on a convex femoral head moving within concave acetabulum of pelvis Accessory motions: Distal traction, lateral, dorsal and ventral glides During hip flexion, the femoral head spins posteriorly During hip extension, the femoral head spins anteriorly

What's the origin of Gluteus Medius Muscle?

outer surface of the ilium

What's the insertion of Gluteus Maximus Muscle?

posterior femur distal to greater trochanter and to iliotibial band

What's the origin of Gluteus Maximus Muscle?

posterior sacrum and ilium

What's the insertion of Sartorius muscle?

proximal medial aspect of tibia

What's the origin of Adductor Longus Muscle?

pubis

symphysis pubis

pubis: a cartilaginous joint connecting the bodies of the two pubic bones at the anterior midline

body

pubis: externally forms about one-fifth of the acetabulum and internally provides attachment for the obturator internus muscle

inferior ramus

pubis: lies posterior, inferior, and lateral to the body. provides attachement for the adductor magnus and brevis and gacilis muscles

superior ramus

pubis: lies superior between the acetabulum and the body and provides attachment for the pectineus muscle.

pubic tubercle

pubis: projects anteriorly on the superior ramus near the symphysis pubis and provides attachment for the inguinal ligament

iliofemoral ligament

reinforces the capsule anteriorly by attaching proximally to the anterior inferior iliac spine and crossing the joint anteriorly. splits into two parts distally to attach to the intertrochanteric line of the femur. resembles and inverted Y often called Y ligament. Known as ligament of Bigelow. MAIN FUNCTION IS TO LIMIT HYPEREXTENSION.

pubofemoral ligament

spans the hip joint medially and inferiorly. attached form the medial part of acetabular rim and superior ramus of the pubis and runs down and back to attach on the neck of the femur. LIMITS HYPEREXTENSION AND ABDUCTION

What's the innervation of tensor fascia latae muscle?

superior gluteal nerve L4, L5

What's the innervation of Gluteus Medius Muscle?

superior gluteal nerve L4, L5, S1

What's the innervation of Gluteus Minimus Muscle?

superior gluteal nerve L4, L5, S1

convex on concave

the femoral head fits into and articulates with the concave shaped acetabulum. convex femoral head slides in the direction opposite the movement of the thigh.

tibial tuberosity

tibia: large projection at the proximal end in the midline. it provides attachment for the patellar tendon.

What's the insertion of rectus femoris muscle?

tibial tuberosity

pelvis or pelvic girdle

two hip bones, sacrum and coccyx make up the _______________

pubis is Covered by obturator membrane

which serves as proximal attachment for obturator internus and obturator externus muscles

B. valgus; increase

2. When the angle of inclination of the hip increases, this is called coxa ____________. The change in alignment (shorter distance between femoral head and greater trochanter) results in a ____________ in muscular demand to overcome gravitational adduction moments to maintain hip abduction. A. valgus; decrease B. valgus; increase C. varus; decrease D. varus; increase

A. anteversion; decreases

3. A newborn has approximately 30° to 40° of femoral neck ____________. This ____________ about 1.5° per year until skeletal maturity. A. anteversion; decreases B. anteversion; increases C. retroversion; decreases D. retroversion; increases

B. Right pelvis backward rotation

3. A person is standing with both of his legs equally weight-bearing. The person then rotates the entire body to the left. What is occurring at the pelvis? A. Left pelvis backward rotation B. Right pelvis backward rotation C. Options 1 and 2 D. None of the above

A. In the left hand

3. In order to stop the left pelvic drop, where should the patient hold the cane? A. In the left hand B. In the right hand C. Does not matter which hand the patient holds it in

C. convex; concave

3. The head of the femur is _____ and the acetabulum is _____. A. concave; concave B. concave; convex C. convex; concave D. convex; convex

A. gluteus medius and piriformis

4. The greater trochanter is the attachment for the: A. gluteus medius and piriformis B. iliopsoas and vastus medialis C. piriformis and adductor longus D. semimembranosus and gluteus minimus

A. It attaches to the anterior superior iliac spine.

4. Which of the following statements is NOT correct about the iliofemoral ligament of the hip? A. It attaches to the anterior superior iliac spine. B. It is known as the "Y" ligament. C. It limits hip internal rotation in hip extension. D. It limits hip external rotation in hip flexion.

C. hip flexors; hamstrings

5. If an individual has an increased anterior pelvic tilt, stretching the __________ or strengthening__________, may help reduce the tilt. A. hamstrings; hip flexors B. hamstrings; quadriceps C. hip flexors; hamstrings D. hip flexors; quadriceps

B. iliopsoas

5. The lesser trochanter is the attachment for the: A. abductor longus B. iliopsoas C. rectus femoris D. sartorius

D. pelvic drop on the right with compensatory hip hiking right

6. During ambulation, poor force development of the left hip abductors may result in: A. pelvic drop on the left with compensatory hip hiking left B. pelvic drop on the left with compensatory hip hiking right C. pelvic drop on the right with compensatory hip hiking left D. pelvic drop on the right with compensatory hip hiking right

A. Iliofemoral ligament

6. Which of the following hip ligaments is known as the "Y" ligament? A. Iliofemoral ligament B. Ischiofemoral ligament C. Pubofemoral ligament

A. lateral rotator in hip extension and a medial rotator in 90° of hip flexion

7. Based on the study by Delp et al., the piriformis muscle was determined to be a: A. lateral rotator in hip extension and a medial rotator in 90° of hip flexion B. lateral rotator throughout all hip motions C. medial rotator in hip extension and a lateral rotator in 90° of hip flexion D. medial rotator throughout all hip motions

B. internal rotation

7. If a person is standing erect and rotates the trunk to the right, the right hip is in: A. external rotation B. internal rotation

A. frontal plane

8. Hip abduction occurs in the: A. frontal plane B. horizontal plane C. sagittal plane

A. active; rectus femoris

8. When performing a seated knee extension exercise with a very heavy weight, one might attempt to extend the hip to avoid __________ insufficiency of the __________. A. active; rectus femoris B. active; sartorius C. passive; rectus femoris D. passive; sartorius

B. gracilis

9. An individual is lying prone and the hip is taken to end range abduction. The range is limited to 30° with the knee in extension. When the knee is flexed, the leg can be abducted further. Thus, the limiting structure is most likely the ___________. A. biceps femoris B. gracilis C. iliotibial band D. vastus medialis

D. hip flexion and knee extension

9. The rectus femoris muscle contributes to: A. hip abduction and knee extension B. hip adduction and knee flexion C. hip extension and knee flexion D. hip flexion and knee extension

Pubofemoral ligament

Arises from anterior-inferior rim of acetabulum and attaches distally to lower half of intertrochanteric line of femur Limits abduction and extension of hip

Ischiofemoral ligament

Arises from ischial portion of acetabular rim, spirals around femoral neck and attaches near apex of greater trochanter Limits extension and internal rotation of hip

Gluteal tuberosity

Arises from superior-lateral portion of linea aspera; serves as distal attachment for gluteus maximus

Ischial tuberosity

Bumpy projection from posterior-inferior aspect of ischium, serving as proximal attachment of hamstring muscles

Hip Joint

Capsular Pattern: Flexion, abduction, IR (equal limitations) Resting Position (loose packed): 30 deg flexion, 30 deg abd, slight lateral rotation (starting point for mobilization) Close Packed Position: Full extension, IR, and abduction End Feel

Trendelenburg Sign

Classic indicator of hip abduction weakness Patients assumes SLS and lifts the contralateral LE. If the pelvis drops toward the unsupported leg, the test is positive and indicative of hip abductor weakness Watch for ipsilateral trunk lean*** Termed gluteus medius limp for gait analysis

What's the action of Sartorius muscle?

Combination of hip flexion, abduction, lateral rotation, and knee flexion

Femur neck

Connects head to shaft, bordered superior-laterally by greater trochanter

Femur head

Contains depression called fovea, which accepts ligamentum teres

Intertrochanteric line

Courses anteriorly between greater and lesser trochanters; marks distal attachment for anterior capsule of hip

Articular cartilage

Covers lunate surface of acetabulum and acts as shock absorber within joint; thickest at superior pole of femoral head

Acetabulum

Cup-shaped structure enclosing head of femur, formed by combination of all three pelvis bones

Acetabular fossa

Depression deep within floor of acetabulum

What's the insert of Adductor Magnus muscle?

Entire linea aspera and adductor tubercle

Functional Considerations: Cane in Hand Opposite Affected Hip

Therapeutic measures (principles of joint protection) are often employed to reduce large forces crossing a painful or weakened hip One way to protect hip is to use cane in hand opposite affected hip Reduces demand on hip abductor muscles and therefore reduces compression forces on the unstable hip Cane produces an abduction torque about the affected hip Cane force is good substitute for much of the torque that must be produced by hip abductors

Iliofemoral ligament "Y ligament"

Thick, strong ligament resembling an inverted Y Attaches proximally to anterior-superior aspect of acetabular rim, and distally to intertrochanteric line of femur Limits excessive extension of hip