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01. hip anatomy
The hip joint is a ball and socket synovial joint formed between the femoral head and the acetabulum. It allows movements like flexion, extension, abduction, adduction, and rotation. The joint is stabilized by ligaments like the iliofemoral, pubofemoral, and ischiofemoral ligaments. It receives its blood supply from the medial and lateral femoral circumflex arteries and has nerves like the femoral and sciatic nerves passing near it.
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01. hip anatomy
- 1. HIP JOINTHIP JOINT ANATOMYANATOMY FahadzakwanFahad zakwan MD5MD5
- 2. ArticulationArticulation •The hip jointis the articulation betweenThe hip joint is the articulation between the hemisphericalthe hemispherical head of femurhead of femur and theand the cup shapedcup shaped acetabulumacetabulum of the hip boneof the hip bone •The articular surface of the acetabulum isThe articular surface of the acetabulum is horseshoe shaped and is deficienthorseshoe shaped and is deficient inferiorly at the acetabular notchinferiorly at the acetabular notch
- 4. • Synovial balland socketSynovial ball and socket joint.joint. • Femoral head: slightlyFemoral head: slightly asymmetric,asymmetric, forms 2/3forms 2/3 sphere.sphere. • Acetabulum:Acetabulum: inverted “U”inverted “U” shaped articular surface.shaped articular surface. • Ligamentum teresLigamentum teres, with, with artery to femoral head,artery to femoral head, passes through middle ofpasses through middle of inverted “U”.inverted “U”.
- 7. Joint ContactJoint Contact AreaArea ThroughoutROM:Throughout ROM: •40% of femoral head40% of femoral head is in contact withis in contact with acetabular articularacetabular articular cartilage.cartilage. •10% of femoral head10% of femoral head is in contact withis in contact with labrum.labrum.
- 8. Femoral neck angleFemoralneck angle
- 9. ACETABULUMACETABULUM Strong fibrous ringStrongfibrous ring Increases femoral head coverageIncreases femoral head coverage Contributes to hip joint stabilityContributes to hip joint stability
- 10. ArticulationArticulation • The cavityof acetabulum is deepened by theThe cavity of acetabulum is deepened by the presence of apresence of a fibrocartilaginous rimfibrocartilaginous rim calledcalled acetabular labrumacetabular labrum • The labrum bridges across the acetabularThe labrum bridges across the acetabular notch and is here called thenotch and is here called the transversetransverse acetabular ligamentacetabular ligament • The articular surfaces are covered withThe articular surfaces are covered with hyalinehyaline cartilagecartilage
- 12. Ligament and OtherLigamentand Other StructuresStructures • Joint capsuleJoint capsule • LigamentsLigaments – IliofemoralIliofemoral – PubofemoralPubofemoral – IschiofemoralIschiofemoral • Ligamentum teresLigamentum teres • Acetabular labrumAcetabular labrum • Inguinal ligamentInguinal ligament • Iliotibial band or tractIliotibial band or tract
- 13. Joint CapsuleJoint Capsule •Strong and thickStrong and thick • Covers hip cylindricallyCovers hip cylindrically • AttachesAttaches – Proximally - around lip ofProximally - around lip of acetabulumacetabulum – Distally - neck of femurDistally - neck of femur • Forms a cylindrical sleeveForms a cylindrical sleeve – Encloses the joint and mostEncloses the joint and most of the femoral neckof the femoral neck
- 14.
- 15. Iliofemoral LigamentsIliofemoral Ligaments •It is a strong, inverted Y-shapedIt is a strong, inverted Y-shaped ligamentligament • Its base is attached to theIts base is attached to the anterioranterior inferior iliac spineinferior iliac spine aboveabove • Below the two limbs of Y areBelow the two limbs of Y are attached to theattached to the upper and lowerupper and lower parts of the intertrochanteric lineparts of the intertrochanteric line ofof the femurthe femur • The strong ligament preventsThe strong ligament prevents overextension during standingoverextension during standing
- 16. PubofemoralPubofemoral LigamentLigament •It is atriangular ligamentIt is a triangular ligament •The base of the ligamentThe base of the ligament is attached to theis attached to the superior ramus of thesuperior ramus of the pubispubis •The apex is attachedThe apex is attached below to the lower part ofbelow to the lower part of the intertrochanteric linethe intertrochanteric line •This ligament limitsThis ligament limits extension and abductionextension and abduction IschiofemoralIschiofemoral LigamentLigament •It is a spiral shapedIt is a spiral shaped ligamentligament •Attached to the body ofAttached to the body of the ischium near thethe ischium near the acetabular marginacetabular margin •Fibers pass upward andFibers pass upward and laterally and attached tolaterally and attached to the greater trochanterthe greater trochanter •This ligament limits theThis ligament limits the extensionextension
- 18. Ligamentum TeresLigamentum Teres •Small intracapsular ligamentSmall intracapsular ligament • Attaches:Attaches: – Proximally in acetabulumProximally in acetabulum – Distally in fovea of the femoralDistally in fovea of the femoral headhead • Debatable importanceDebatable importance – Contains a blood vessel to supplyContains a blood vessel to supply head of femurhead of femur – ? Taut in adduction or lateral? Taut in adduction or lateral rotation when hip semiflexedrotation when hip semiflexed
- 19. Ligament of Headof FemurLigament of Head of Femur • It is flat and triangular ligamentIt is flat and triangular ligament • It is attached by its apex to the pit on the headIt is attached by its apex to the pit on the head of the femur (fovea capitis)of the femur (fovea capitis) • Attached by its base to the transverseAttached by its base to the transverse ligament and the margins of the acetabularligament and the margins of the acetabular notchnotch • It lies within the joint and is ensheathed byIt lies within the joint and is ensheathed by synovial membranesynovial membrane
- 20. TransverseTransverse Acetabular LigamentAcetabular Ligament •It isIt is formed by theformed by the acetabular labrumacetabular labrum asas it bridges theit bridges the acetabular notchacetabular notch • ItIt converts the notchconverts the notch into a tunnelinto a tunnel throughthrough which blood vesselswhich blood vessels and nerves enter theand nerves enter the jointjoint
- 21. Synovial MembraneSynovial Membrane •The synovial membraneThe synovial membrane lines the capsulelines the capsule • It is attached to the margins of the articular surfacesIt is attached to the margins of the articular surfaces • It covers the portion of the neck of the femur that lies withinIt covers the portion of the neck of the femur that lies within the joint capsulethe joint capsule • It ensheathes the ligament of the head of the femurIt ensheathes the ligament of the head of the femur • It covers the pad of fat contained in the acetabular fossaIt covers the pad of fat contained in the acetabular fossa • A pouch of synovial membrane frequently protrudes through aA pouch of synovial membrane frequently protrudes through a gap in the anterior wall of the capsulegap in the anterior wall of the capsule • Forms the psoas bursa beneath the psoas tendonForms the psoas bursa beneath the psoas tendon
- 25. Surrounding Vital Structures:SurroundingVital Structures: • Blood Vessel & Blood Supply of theBlood Vessel & Blood Supply of the JointJoint • femoral arteryfemoral artery passes by the front of the passes by the front of the hip area, and has a deep branch, called thehip area, and has a deep branch, called the profunda femorisprofunda femoris. The profunda femoris. The profunda femoris sends two vessels that go through the hipsends two vessels that go through the hip joint capsule.joint capsule. • Lateral & Medial femoral circumflexLateral & Medial femoral circumflex arteriesarteries • These vessels are the main blood supply forThese vessels are the main blood supply for the femoral head, the ligamentum teresthe femoral head, the ligamentum teres (Ligament of the head of the femur)(Ligament of the head of the femur) contains a small blood vessel hat gives acontains a small blood vessel hat gives a very small supply of blood to the top of thevery small supply of blood to the top of the femoral head.femoral head.
- 26. BLOOD SUPPLYBLOOD SUPPLY •At age 4 years, the major blood supply to the femoral head comesAt age 4 years, the major blood supply to the femoral head comes from the medial and lateral circumflex arteries .from the medial and lateral circumflex arteries . • After age 4 years, the posterosuperior and posteroinferior arterialAfter age 4 years, the posterosuperior and posteroinferior arterial branches of the medial femoral circumflex bypass the growth platebranches of the medial femoral circumflex bypass the growth plate and form the main blood supply to the femoral head.and form the main blood supply to the femoral head. • During adolescence, the growth plate fuses and the metaphysealDuring adolescence, the growth plate fuses and the metaphyseal vessels again become significant, traveling along the femoral neck.vessels again become significant, traveling along the femoral neck. • Fractures in this area can disrupt this delicate blood supply, leadingFractures in this area can disrupt this delicate blood supply, leading to AVN, the most severe complication of this fracture.to AVN, the most severe complication of this fracture.
- 28. NervesNerves:: •All of thenerves that travelAll of the nerves that travel down the thigh pass by thedown the thigh pass by the hip. The main nerves arehip. The main nerves are the the femoral nervefemoral nerve in front in front and the and the sciatic nervesciatic nerve in backin back of the hip. A smaller nerve,of the hip. A smaller nerve, called the called the obturator nerveobturator nerve,, also goes to the hipalso goes to the hip
- 30. Movements at theHipMovements at the Hip 1.1. FlexionFlexion 2.2. ExtensionExtension 3.3. AbductionAbduction 4.4. AdductionAdduction 5.5. Medial RotationMedial Rotation 6.6. Lateral RotationLateral Rotation
- 31. • Flexion =0Flexion = 0ºº - 120- 120ºº • Extension = 0Extension = 0ºº - 20- 20ºº
- 32. • Abduction =0Abduction = 0ºº - 45- 45ºº • Adduction = 0Adduction = 0ºº - 25- 25ºº
- 33. • Internal Rotation= 0Internal Rotation = 0ºº - 45- 45ºº • External Rotation = 0External Rotation = 0 ºº - 45- 45ºº