1. The Hip (Iliofemoral) Joint
Heather Friedland, Liz Huisman, Josh McCoy

2. Iliac Crest! (and Inguinal Ligament)
Surface Anatomy
Iliac Crest?
Iliac Crest! (and Inguinal Ligament)
Josh McCoy

3. Surface Anatomy, continued
Gluteal Fold/Sulcus
Intergluteal Cleft
Sacrum
Iliac Crest
Josh McCoy

4. Surface Anatomy, continued
Anterior Superior Iliac Spine
Iliac Crest
Tip of Greater Trochanter
Josh McCoy

5. Surface Anatomy, continued
Posterior Superior Iliac Spine
Josh McCoy

6. Surface Anatomy, continued
Supracristal Plane
Inguinal Ligament
Josh McCoy

7. The Hip Joint
Liz Huisman

8. Iliofemoral Ligament (red)
Prevents hyperextension
Pubofemoral Ligament (green)
Prevents overabduction.
Liz Huisman

9. Ishiofemoral ligament
Slackens during adduction, tenses during abduction
Liz Huisman

10. Ligaments that support walking
posterior
anterior
Inguinal ligament
Sacrotuberous ligament
Liz Huisman

11. Bursae Trochanteric bursa Gluteofemoral bursa Ischial bursa
Liz Huisman

12. Bones of the Hip Joint
Heather Friedland

13. Os Coxa Pubis Inferior ramus Acetabulum Ischial tuberosity Iliac fossa
Lesser sciatic notch
Superior pubic ramus
Pubic (or suprapubic) arch
Obturator foramen
Superior ramus
Obturator foramen
Ischium
Iliac crest
Ischial spine
Symphysis pubis
Inferior pubic ramus
Pubic crest
Greater sciatic notch
Heather Friedland

14. Heather Friedland
Click to add text

15. Iliac Spines Anterior superior Anterior Inferior Posterior superior
Posterior inferior
Heather Friedland

16. Femur Head Neck Greater Trochanter Lesser Trochanter Linea Aspera
Pectineal line
Adductor tuberacle
Condyles (medial and lateral)
Epicondyles (medial and lateral)
Heather Friedland

17. Bones: Tibia Lateral and Medial Condyles Intercondylar Eminence
Tibial Tuberosity
Crest
Josh McCoy

18. Muscles of the Hamstrings
Heather Friedland
A&P 106
11/18/2015

19. Muscles Semitendinosus Semimembranosus Gracilis Pectinius
Biceps Femoris
Piriformis
Heather Friedland

20. Semitendinosus Nerve: Tibial Nerve Roots: L5, S1 & S2
Origin: Ischial tuberosity
Insertion: Proximal medial shaft of the tibia
at Pes Anserinus tendon
Heather Friedland

21. Semitendinosus Synergist:
Knee Flexion: Biceps femoris, Semimembranosus, gracilis, sartorius, gastrocnemius, popliteus
Hip extension: Gluteus Maximus, Biceps femoris, semimembranosus
Medial rotation: semimembranosus, gracilus, Sartorius, popliteus, Semimembranosus
Antagonist:
Knee extension: Rectus femoris, Vastus (medialis, lateralis, and intermedialis)
Hip Flexion: Rectus femoris, iliopsoas, pectineus, Sartorius
Lateral rotation: Biceps femoris
Action: Flexes knee. Medially rotates knee. Extends the knee
Heather Friedland

22. Semimembranosus
Heather Friedland

23. Semimembranosus Nerve: Tibial Nerve Roots: L5, S1 & S2
Origin: Ischial tuberosity
Insertion: Posterior medial condyle of the tibia
Synergist: Same as Semitendinosis
Antagonist: Same as Semitendinosis
Action: Flexes knee. Medially rotates flexed knee
and extends the hip
Heather Friedland

24. Gracilis Nerve: Obturator nerve Roots: L2 and L3
Origin: Body and inferior ramus of pubis
Insertion: Anterior medial proximal tibia
Heather Friedland

25. Gracilis Synergist: Antagonist:
Adduction: Adductor(magnus, brevis, and longus), Gracilis, pectineus
Medial rotation: Gluteus (medius and minimus), adductor (all 3), Pectinius, TFL, Gracilis
Knee flexion: Semimembranosus, Semiteninosis, biceps femoris, gracilis, gastrocnemius, Popliteus, Sartorius
Antagonist:
Abduction: Gluteus (maximus, medius, and minimus), TFL, Sartorius
Lateral Rotation: Gluteus maximus, Sartorius, piriformis, iliopsoas
Knee extension: Rectus femoris, Vastus (medialis, lateralis, and intermedialis)
Action: Adducts and medially rotates hip. Flexes the knee
Heather Friedland

26. Pectineus
Heather Friedland

27. Pectinius Nerve: Femoral Nerve, also fibers from the Obturator nerve
Roots: L2 - L4
Origin: Superior ramus of the pubis
Insertion: Pectineal line inferior to lesser trochanter of femur
Heather Friedland

28. Pectineus
Synergist:
Flexion: Rectus femoris, Iliopsoas, TFL, Sartorius, Adductor (longus & brevis)
Adduction: Adductor (longus, brevis, and magnus), Gracilis, Pectineus
Medial rotation: Gluteus(medius & minimus), Adductor (longus and brevis), Gracilis
Antagonist:
Extension: Gluteus maximus, Semimembranosus, Semitendinosis, Biceps femoris, Adductor magnus
Abduction: Gluteus(medius and minimus), TFL, Sartorius
Lateral Rotation: Gluteus maximus, Piriformis, Sartorius
Action: Flexes, adducts, and assists with medial rotation of the hip
Heather Friedland

29. Biceps Femoris
Heather Friedland

30. Biceps Femoris Nerve: Tibial nerve (LH) and Fibular nerve (SH)
Roots: L5, S1 & S2
Origin: Long head: Ischial tuberosity
Short Head: Linea aspera of femur
Insertion: Head of fibula and lateral condyle of tibia
Heather Friedland

31. Biceps Femoris Synergist:
Hip Extension: Gluteus maximus, Semitendinosis, Semimembranosis, Adductor
Lateral Rotation: Gluteus Maximus, Piriformis, Iliopsoas, Sartorius
Knee Flexion: Semitendinosis, Semimembranosis, Gastrocnemius, Gracilis, Sartorius
Antagonist:
Hip Flexion: Rectus femoris, Iliopsoas, Pectinus, TFL, Sartorius
Medial Rotation: Gluteus(medius and minimus), TFL, Adductor (magnus, longus, and brevis), pectineus, Gracilis
Knee Extension: Vastus (medialis, lateralis, and intermedialis), Rectus femoris
Action:
Long head: Extends hip and flexes knee
Short Head: Flexes knee and laterally rotates hip
Laterally rotates flexed knee
Heather Friedland

32. Piriformis
Heather Friedland

33. Piriformis Nerve: Piriformis Nerve Roots: L5, S1 & S2
Origin: Anterior Surface of lateral process of sacrum and gluteal surface of ilium at the margin of the greater sciatic notch
Insertion: Superior border of greater trochanter
Heather Friedland

34. Piriformis Synergist:
Abduction: Gluteus (medius, minimus), TFL, Sartorius
Lateral rotation: Gluteus maximus, Iliopsoas, piriformis, Sartorius
Medial rotation: Glutues (minimus, medius), TFL, Adductor (all 3), Gracilis
Antagonist:
Adduction: adductors (all 3), Gracilis, Pectinius, Gluteus maximus
Medial rotation: Gluteus (Minimus and medius), TFL, Adductor (all 3), Pectinius, Gracilis
Action: Laterally rotates and abducts thigh when hip is flexed
Heather Friedland

35. Adductors Brevis & Longus
Actions:
Adduction
Flexion
Assists in medial hip rotation
Liz Huisman

36. Adductors Brevis Origin: Insertion: Nerve: Roots:
Anterior surface of the inferior ramus of the pubis
Insertion:
Pectineal line, medial lip of linea aspera of femur.
Nerve:
Obturator nerve
Roots:
L2-L4
Liz Huisman

37. Adductor Brevis Synergists Antagonists Adduction:
Adductor (longus & magnus), gracilis, pectineus
Medial Rotation:
Gluteus (minimus & medius), adductor (longus & magnus), pectineus, tensor fascaie latae, gracilic
Flexion:
Rectus femoris, Iliopsoas, pectineus, TFL, sartorius
Abduction:
Gluteus (all 3), TFL, Sartorius
Lateral Rotation:
Gluteus maximus, Sartorius, piriformis, Iliopsoas
Extension:
Gluteus maximus, semimembgranosus, semitendinosus, biceps femoris, adductor magnus
Liz Huisman

38. Adductor longus Origin: Insertion: Nerve: Roots:
Body of pubis inferior to pubic crest & lateral pubic symphysis.
Insertion:
Middle 1/3 of linea aspera of the femur
Nerve:
Obturator nerve
Roots:
L2-L4
Liz Huisman

39. Adductor Longus Synergists Antagonists Adduction:
Adductors (brevis & magnus), gracilis, pectineus
Medial Rotation:
Gluteus (minimus &medius), adductor (brevis & magnus), pectineus, TFL, gracilis
Flexion:
Rectus femoris, Iliopsoas, pectineus, TFL, sartorius
Abduction:
Gluteus (all 3), TFL, Sartorius
Lateral Rotation:
Gluteus maximus, Sartorius, piriformis, Iliopsoas
Extension:
Gluteus maximus, semimembranosus, semitendinosus, biceps femoris, adductor magnus
Liz Huisman

40. Adductor Magnus Origin:
Inferior ramus of pubis and ischium to ischial tuberosity.
Insertion:
Linea aspera of femur. Medial supracondylar line and adductor tubercle.
Nerve:
Obturator and tibial nerve
Roots:
L2-L4
Actions: Adducts thigh, superior horizontal fibers flexes thigh, posterior portion extends thigh at hip joint
Liz Huisman

41. Adductor Magnus Synergists Antagonists Adduction:
Adductor (longus & brevis), gracilis, pectineus
Hip Flexion:
Rectus femorus, Iliopsoas, pectineus, TFL, gluteus (medius & minimus), adductor (longus & brevis)
Abduction:
Gluteus (all 3), TFL, Sartorius
Hip Extension:
Gluteus maximus, semimembranosus, semitendinosus, biceps femoris
Liz Huisman

42. The Glutes Actions Gluteus medius & minimus Hip abduction
Medial rotation of hip
Gluteus maximus
Extends the hip
Liz Huisman

43. Gluteus Minimus Origin:
Dorsal ilium between inferior and anterior gluteal lines
Insertion:
Greater trochanter of femur
Nerve:
Superior gluteal nerve
Roots:
L4 & L5, S1
Liz Huisman

44. Gluteus Minimus Synergists Antagonists Abduction: Adduction:
Gluteus medius, tensor fasciae latae, Sartorius
Medial Rotation:
Gluteus medius, tensor fasciae latae, Adductor (all 3)
Adduction:
Adductors (all3), gracilis, pectineus, gluteus maximus
Lateral Rotation:
Gluteus maximus, piriformis, iliopsoas, sartorius
Liz Huisman

45. Gluteus Medius Origin: Dorsal ilium inferior to iliac crest Insertion:
Greater trochanter of femur
Nerve:
Superior Gluteal nerve
Roots:
L4 & L5, S1
Liz Huisman

46. Gluteus Medius Synergists Antagonists Abduction: Adduction:
Gluteus (maximus & minimus), tensor fasciae latae, Sartorius
Medial Rotation:
Gluteus minimus, tensor fasciae latae, adductors (all 3), pectineus, gracilis
Adduction:
Adductors (all 3), gracilis, pectineus
Lateral Rotation:
Gluteus maximus, piriformis, iliopsoas, sartorius
Liz Huisman

47. Gluteus Maximus Origin:
Iliac crest, sacrum, coccyx and aponeurosis of sacrospinalis
Insertion:
Lateral part of linea aspera under greater trochanter (gluteal tuberosity) of femur
Nerve:
Inferior gluteal nerve
Roots:
L5, S1 & S2
Liz Huisman

48. Gluteus Maximus Synergists Antagonists Extension: Flexion:
Semimembranosus, semitendinosus, biceps femoris, adductor magnus
Lateral Rotation:
Piriformis, iliopsoas, sartorius
Flexion:
Gluteus (medius & minimus), rectus femoris, iliopsoas, pectineus, TFL, Sartorius
Medial Rotation:
Gluteus (medius & minimus), TFL, adductors (all 3), pectineus, gracilis
Liz Huisman

49. Psoas Major (of Iliopsoas)
Action: Hip/Thigh Flexion
Origin: Transverse Processes of T12-L5
Insertion: Lesser Trochanter
Nerve: Lumbar Nerves (L1-L3)
Josh McCoy

50. Iliacus (of Iliopsoas)
Action: Hip/Thigh Flexion
Origin: Iliac Crest, Fossa, Anterior Sacroiliac Ligament
Insertion: Lesser Trochanter
Synergist (Iliopsoas): Rectus Femoris, Pectineus
Antagonist (Iliopsoas): Gluteus Maximus, Semimembranosus, Semitendinosus, Biceps Femoris
Josh McCoy

51. Rectus Femoris Action: Extension at Knee, Flexion at Hip
Origin: Anterior Inferior Iliac Spine
Insertion: Patella via Quadriceps Tendon and then Tibial Tuberosity via Patellar Ligament
Nerve: Femoral
Roots: L2-L4
Josh McCoy

52. Rectus Femoris, continued
Synergist:
Hip Flexion: Iliopsoas (Psoas Major and Iliacus), Pectineus
Knee Extension: Vastus (Medialis, Lateralis, and Intermedialis)
Antagonist:
Hip Extension: Gluteus Maximus, Semimembranosus, Semitendinosus, Biceps Femoris
Knee Flexion: Semimembranosus, Semitendinosus, Biceps Femoris
Josh McCoy

53. Sartorius
Action: Flexes Knee; Flexes, Abducts, and Laterally Rotates Hip
Origin: Anterior Iliac Spine
Insertion: Upper Medial Surface of Body of Tibia
Nerve: Femoral
Roots: L2-L3
Josh McCoy

54. Sartorius, continued Synergist: Antagonist:
Hip Flexion: Rectus Femoris, Iliopsoas, Pectineus
Knee Flexion: Semimembranosus, Semitendinosus, Biceps Femoris
Hip Abduction: Gluteus Minimis and Medius
Antagonist:
Hip Extension: Gluteus Maximus, Semimembranosus, Semitendinosus, Biceps Femoris
Knee Extension: Quadriceps Muscles
Hip Adduction: Adductor (Longus, Brevis, and Magnus), Pectineus, Gracillis
Josh McCoy

55. Tensor Fascia Latae (TFL)
Action: Flexes and Abducts Thigh at Hip Joint; Helps stabilize and steady the Hip and Knee Joints by putting tension on the Iliotibial Band of Fascia
Origin: Anterior Superior Iliac Spine and Anterior Iliac Crest
Insertion: Tibia by way of Iliotibial Tract
Josh McCoy

56. Tensor Fascia Latae (TFL), continued
Nerve: Superior Gluteal Nerve
Roots: L4, L5, S1
Synergist:
Flexion: Rectus Femoris, Iliopsoas, Pectineus
Abduction: Gluteus Medius and Minimis
Antagonist:
Extension: Gluteus Maximus, Semimembranosus, Semitendinosus, Biceps Femoris
Adduction: Gracillis, Pectineus, Adductors (All Three)
Josh McCoy

57. Nerves Obturator and Femoral Superior and Inferior Gluteal, Sciatic
Josh McCoy

58. More Nerves (are we getting on yours yet?)
Common Peroneal
Josh McCoy

59. What are Pirate’s favorite vessels? ARRRRteries! Har har har
Femoral
Deep Femoral (Profundus)
Obturator
Medial Circumflex Femoral
Lateral Circumflex Femoral
Josh McCoy

60. Posterior Arteries
Superior Gluteal
Inferior Gluteal
Josh McCoy

61. You’re so VEIN, you probably think this slide is about you
You’re so VEIN, you probably think this slide is about you! Don’t you, don’t you?
Femoral
Great Saphenous
Profunda (Deep) Femoral
Josh McCoy

62. Clinical Concerns: Total Hip Replacement
Josh McCoy

63. Clinical Concerns: Total Hip Replacement, continued
According to “A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a ‘cup- shaped’ component of the pelvis called the acetabulum.”
Josh McCoy