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Rania Gabr Hip Joint. Objectives Know the type and formation of hip joint. Differentiate the stability and mobility between the hip joint and shoulder.

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Presentation on theme: "Rania Gabr Hip Joint. Objectives Know the type and formation of hip joint. Differentiate the stability and mobility between the hip joint and shoulder."— Presentation transcript:

1 Rania Gabr Hip Joint

2 Objectives Know the type and formation of hip joint. Differentiate the stability and mobility between the hip joint and shoulder joint. Identify the muscles that act at the hip joint.

3 Type & Articular Surfaces  Type: Synovial, ball & socket joint.  Articular Surfaces: Acetabulum of hip (pelvic) bone Head of femur The lunate surface and the head of the femur(except for the fovea) are covered by hyaline cartilage The nonarticular acetabular fossa contains loose connective tissue.

4 Acetabular labrum: C-shaped fibro- cartilaginous collar attached to margins of acetabulum, increases its depth for better retaining of head of femur.

5 The hip joint is enclosed within strong fibrous capsule lined by synovial membrane. Proximally: it is attached to the acetabulum, and to the transverse acetabular ligament. Distally:  Anteriorly: covers the neck & is attached to intertrochanteric line  Posteriorly: covers medial half of the neck of femur Capsule

6 Intertrochanteric line ANTERIOR POSTERIOR

7 The synovial membrane lines the capsule and the nonarticular surfaces. It reflects along the femoral neck to the edge of the femoral head Synovial Membrane

8 The arteries that supply the femoral head and neck course within the synovial folds. They are called retinacular vessels

9 Pubofemoral ligament: Located antero-inferior to joint Limits abduction & lateral rotation Iliofemoral ligament: Y-shaped Located anterior to joint Limits extension Ligaments: 3 Extracapsular Ischiofemoral ligament: Located posterior to joint Limits medial rotation

10 Ligaments: 2 Intracapsular (Extrasynovial) Transverse acetabular ligament: formed by the acetabular labrum as it bridges the acetabular notch converts acetabular notch into foramen through which pass acetabular vessels Ligament of femoral head: carries vessels to head of femur

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12 Flexion. Extension, Movements of the hip

13 Abduction. Adduction.

14 Medial and lateral rotation. Circumduction.

15 Iliopsoas(composite muscle) Chief flexor of HIP:  Psoas major  iliacus Origin: 1- Anterior surfaces of the transverse processes of T12-L5 vertebrae 2- Upper two thirds of the iliacus Insertion: Lesser trochanter of the femur after being joined by the iliacus Action: 1-Flexion of thigh at hip 2- Assists in extension of the lumbar spine 3. Lateral Flexion of the spine when acting unilaterally Innervation: Lumbar plexus (L2,3,4) Hip Flexion Psoas Major

16 Origin Iliac fossa within abdomen Insertion Lowermost surface of lesser trochanter of femur, after joining psoas Action Flexes &laterally rotates hip Nerve Femoral nerve in abdomen (L2,3) Iliacus

17 Gluteal region: -Gluteus maximus (most powerful extensor, also lateral rotator) Insertion: Gluteal tuberosity + Iliotibial tract (band) gluteus maximus iliotibial tract Tensor Fasciae Latae Gluteus maximus Gluteus Maximus and Tensor Fascia Lata insert into Iliotibial Tract - Iliotibial tract is a thickening of the deep fascia (fascia lata) that extends from the ilium to the tibia. - Tension from contraction of gluteus maximus and tensor fasciae latae stabilizes the lower limb as a weight-bearing column. Hip extension

18 Medial Compartment main function = adduction  Obturator externus  Adductor brevis  Adductor longus  Adductor magnus  Gracilis Most innervated by: Obturator nerve (L2-L4) (lumbar plexus) Exception: -Hamstring component of adductor magnus (extensor) (tibial division of sciatic nerve) obturator nerve adductor longus adductor brevis Adductor magnus gracilis obturator externus Hip Adduction

19 Deep to gluteus maximus: -Abductors: gluteus medius gluteus minimus (anterior fibres medially rotate) -Lateral (external) rotators: piriformis obturator internus (associated gemelli) quadratus femoris [obturator externus is also a lateral rotator] inferior gamellus superior gamellus gluteus medius gluteus minimus piriformis obturator internus quadratus femoris gluteus maximus Lateral Rotation of the hip

20 Flexion - Anterior + medial compartments of thigh (iliopsoas, sartorius, rectus femoris, adductor) group) Extension - Gluteal region /posterior compartment of thigh (gluteus maximus, hamstrings, adductor magnus) Adduction - Medial (adductor) compartment of thigh Abduction - gluteus medius & minimus, Tensor Fascia Lata Rotation: Lateral - Gluteus maximus, lateral rotators Medial - anterior parts of gluteus medius & minimus, + Tensor Fascia Lata Summary Movements of the Hip Joint (ball and socket)

21 1- Obturator artery. 2-Medial & 3-Lateral circumflex femoral arteries. 4- Superior and inferior gluteal arteries. 5- First perforating branch of the deep artery of the thigh. The articular branches of these vessels form a network(anatomosis) around the joint. Vascular supply to the hip joint

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23 The hip joint is innervated by articular branches (Hilton’s Law) from: Femoral. Obturator. Superior gluteal nerves Nerve to the quadratus femoris. Sciatic nerve. Nerve Supply of the hip joint

24 Perthes' disease is a condition where the top of the thigh bone in the hip joint (the femoral head) softens and breaks down. It occurs in some children and causes a limp and other symptoms. The bone gradually heals and reforms as the child grows. The aim of treatment is to make sure the femoral head reforms back into its normal shape so that the hip joint can work well. Applied anatomy Perthes disease

25 Coxa vara and Coxa Valga

26 Avascular Necrosis of the Head of the Femur

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