Chapter 8: Hip Joint and Pelvic Girdle

Muscles innervated by inferior gluteal nerve

gluteus maximus

Posterior muscles of hip joint (extensors)

gluteus maximus biceps femoris semitendinosus semimembranosus external rotators

Muscles innervated by superior gluteal nerve

gluteus medius, gluteus minimus, tensor fasciae latae

Lateral muscles of hip joint

gluteus medius, gluteus minimus, tensor fasciae latae, external rotators

Anterior muscles of hip joint (flexors)

iliopsoas pectineus rectus femoris sartorius

right lateral pelvic rotation

in frontal plane right pelvis moves inferiorly in relation to left pelvis; either right pelvis rotates downward or left pelvis rotates upward; right lateral tilt

left lateral pelvic rotation

in frontal plane, left pelvis moves inferiorly in relation to right pelvis; either left pelvis rotates downward or right pelvis rotates upward

left transverse pelvic rotation

in horizontal plane pelvis rotates to body's left; right iliac crest moves anteriorly in relation to left iliac crest, which moves posteriorly

right transverse pelvic rotation

in horizontal plane pelvis rotates to body's right; left iliac crest moves anteriorly in relation to right iliac crest, which moves posteriorly

tensor fasciae latae

acts solely at the hip, not the knee

Hip joint

(acetabulum fibular joint) is relatively stable due to: - bony architecture - strong ligaments - large supportive muscles Ball and socket joint

Muscles innervated by obturator nerve

**medial thigh** adductor longus adductor brevis adductor magnus obturator externus gracilis pectineus

Range of motion of hip joint

-0 to 130 degrees of flexion -0 to 30 degrees of flexion -0 to 35 degrees of abduction -0 to 30 degrees of adduction -0 to 45 degrees of internal rotation -0 to 50 degrees of external rotation

Anterior, posterior, medial compartment of thigh muscles

Anterior Rectus femoris (RF) Vastus Lateralis (VL) Vastus intermedius (VI) Vastus medialis (VM) Sartorius Posterior Biceps femoris Semitendinosus Semimembranosus Medial Adductor brevis Adductor longus Adductor magnus Pectineus Gracilis

Bony Landmarks of the Pelvic Girdle and Their Corresponding Muslces

Anterior Pelvis (Flexors) -Anterior Iliac Crest: Tensor Fascia Latae -Anterior superior iliac spine: Sartorius -Anterior inferior iliac spine: Rectus Femorus Medially (adductors) -Pubis and inferior ramus: adductor magnus, adductor longus, adductor brevis, pectineus, and gracilis Posteriorly (extensors) - Posterior iliac crest, posterior sacrum, and coccyx: gluteus maximus Posteroinferiorly (extensors) -ischial tuberosity: hamstrings

Joints

Anteriorly -symphysis pubis (amphiarthrodial joint) Posteriorly -sacroiliac joints Acetabulofemoral joint -Bony architecture provides stability -Enarthrodial joint -Reinforced by extremely strong and dense ligamentous capsule, especially anteriorly

ligaments of the acetabulofemoral joint (anterior)

Iliofemoral ligament ("Y" ligament of Bigelow): located anteriorly and prevents hyperextension Pubofemoral ligament: located anteromedially and inferiorly, limits excessive extension and adduction

Pelvic muscles acting on hip joint

Iliopsoas muscle Iliacius Psoas major Psoas minor Gluteal region (extend and rotate hip) Gluteus maximus, minimus, and medius Tensor fascia latae Six deep external rotators: piriformus, obturator externus, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris

Muscles innervated by femoral nerve

Pectineus; Sartorius; Iliacus; Rectus Femoris; Vastus Lateralis; Vastus Medialis; Vastus Intermedius

Bony Landmarks of Femur

Proximal Thigh (insertion for short muscles of the hip) - greater and lesser trochanter Origin for 3 knee extensors Adductors -Linea aspera Patella (insertion for all quadriceps muscles) Proximal tibia and fibula -medial tibial condyle: sartorius, gracilis, -posteriorly on medial tibial condyle: semimembranosus -fibula head, tibial condyle, and gerdy's tubercle: biceps femorus (laterally, primarily on fibula head with some fibers attaching on lateral tibial condyle) -Iliotibial tract of Tensor fascia latae: anterolaterally on gerdy's tubercle of tibia

What bones comprise the acetabulum?

Pubis, ilium, and ischium

ligaments of the acetabulofemoral joint (posterior)

Teres ligament: attaches from deep in acetabulum to a depression in femoral head, slightly limits addcution Ischiofemoral ligament: located posteriorly, extends from ischium to trochanteric fossa of femur, limits internal rotation.

Anterior view of pelvic girdle

The pelvic girdle consists of the sacrum, the coccyx, and the two hip (coxal) bones. The femur proximally articulates with acetabulum to form the hip joint.

Muscles innervated by sciatic nerve

Tibial division: Semimembranosus, semitendinosus, biceps femoris long head, adductor magnus extensor head (HAMSTRING MUSLCES) Peroneal (fibular) division: sensation to anterolateral lower leg and dorsum of foot

Medial muscles of hip joint (adductors)

adductor brevis adductor longus adductor magnus gracilis

anterior pelvic rotation

anterior movement of upper pelvis; iliac crest tilts forward in a sagittal plane; anterior tilt

What plexuses innervate hip and pelvic girdle muscles?

lumbar and sacral plexus

Iliopsoas

made up of the iliacus and psoas major, minor

Motions Accompanying Pelvic Rotation

movements of the pelvis around 20 minutes in chapter 8 lecture

posterior pelvic rotation

posterior movement of upper pelvis; iliac crest tilts backward in a sagittal plane; posterior tilt; upward rotation