1. Hip (Iliofemoral) Joint
PTA Students Curtis, Tonya, Emilee, & Zeke

2. Them Bones….. …Of the iliofemoral joint. And one extra.

3. Os Coax: The Pelvic Trifecta
Bones
Os Coax: The Pelvic Trifecta

4. Bones
Medial View

5. Lateral View, with a side of landmarks
Bones
Lateral View, with a side of landmarks

6. Bones
Find the Angry Bird

7. The Femur: Foreplay for cave men
Bones
The Femur: Foreplay for cave men

8. Tibia- Not part of the hip, but it was on the list, so here goes….
Bones
Tibia- Not part of the hip, but it was on the list, so here goes….

9. Ligaments
Iliofemoral ligament
Pubofemoral ligament

10. Ligaments
Ischiofemoral ligament

11. Ligaments
Sacrotuberous ligament

12. Ligaments & Cartilage Transverse acetabular ligament Acetubular labrum
Articular cartilage of head of femur
Ligament of head of femur

13. Articular Capsule
Synovial membrane
Fibrous layer

14. Ligaments
Zona orbicularis

15. Bursae
Trochanteric bursa
Deep
Superficial

16. Bursae
Gluteofemoral bursa Ischial Bursa

17. Muscles Anterior Compartment Thigh Muscles
Pectineus
Innervation:
Femoral Nerve, also fibers from obturator nerve
Origin:
Superior Ramus of Pubis
Insertion:
Pectineal line inferior to lesser trochanter of femur
Action:
Flexes, adducts and assists with medial rotation
Synergist:
Flexion = Rectus Femoris and Iliopsoas
Adduction = Adductors (all 3) and gracilis
Medial Rotation = Gluteus Minimus
Antagonist:
Extension = Gluteus Maximus, Semimembranosus, Semitendinosus, and Biceps Femoris
Abduction = Gluteus Medius and Minimus
Lateral Rotation = Gluteus Maximus

18. Muscles Anterior Compartment Thigh Muscles
Sartorius
Innervation:
Femoral Nerve
Origin:
Anterior superior iliac spine
Insertion:
Upper medial surface of body of tibia
Action:
Flexes knee
Flexes, abducts and laterally rotates hip
Synergist:
Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Hip Abduction = Gluteus Medius and Minimus
Antagonist
Knee Extension = Quadriceps muscles
Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps Femoris
Hip Adduction = Adductors (all 3), Pectineus & Gracilis

19. Muscles Anterior Compartment Thigh Muscles
Iliopsoas
Psoas Major & Iliacus
Innervation:
Lumbar Nerves
Femoral Nerves
Origin:
Transverse Process of T12-L5
Iliac Crest, Iliac Fossa, Anterior Sacroiliac Ligament
Insertion:
Lesser Trochanter
Action:
Hip/Thigh Flexion
Synergist:
Hip Flexion = Rectus Femoris & Pectineus
Antagonist:
Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris

20. Muscles Anterior Compartment Thigh Muscles
Quadriceps Femoris: Rectus Femoris
Innervation:
Femoral Nerve
Origin:
Anterior inferior iliac spine
Insertion:
Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action:
Knee Extension and Hip Flexion
Synergist:
Knee Extension = Vastus Medialis, Intermedialis & Lateralis
Hip Flexion = Iliopsoas & Pectineus
Antagonist:
Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris

21. Muscles Anterior Compartment Thigh Muscles
Quadriceps Femoris: Vastus Medialis
Innervation:
Femoral Nerve
Origin:
Linea Aspera of the femur
Insertion:
Patella via the quadriceps tendon and then tibial tuberosity via the patellar ligament
Action:
Knee Extension
Synergist:
Knee Extension = Rectus Femoris, Vasus Lateralis and Intermedius
Antagonist:
Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris

22. Muscles Anterior Compartment Thigh Muscles
Quadriceps Femoris: Vastus Lateralis
Innervation:
Femoral Nerve
Origin:
Intertrochanteric line and linea aspera of the femur
Insertion:
Patella via the quadriceps tendon and then tibial tuberosity via the patellar ligament
Action:
Knee Extension
Synergist:
Knee Extension = Rectus Femoris, Vastus medialis and intermedialis
Antagonist:
Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris

23. Muscles Anterior Compartment Thigh Muscles
Quadriceps Femoris: Vastus Intermedius
Innervation
Femoral Nerve
Origin
Anterior 2/3 and lateral shaft of femur
Insertion
Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action
Knee Extension
Synergist
Knee Extension = Rectus Femoris, Vastus Lateralis and Medialis
Antagonist
Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris

24. Muscles Medial Thigh Muscles
Adductor Brevis
Innervation:
Obturator Nerve
Origin
Anterior surface of the inferior ramus of the pubis
Insertion
Superior half of linea aspera of femur
Action
Adducts, flexes and helps to laterally rotate the hip
Syngerist
Hip Adduction = Adductors longus and magnus, Gracilis & Pectineus
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Lateral Rotation = Gluteus Maximus
Antagonist
Hip Abduction = Gluteus medius and minimus
Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps Femoris
Medial Rotation = Gluteus Minimus

25. Muscles Medial Thigh Muscles
Adductor Longus
Innervation:
Obturator Nerve
Origin:
Body of pubis inferior to pubic crest and lateral pubic symphysis
Insertion:
Middle 1/3 of linea aspera of the femur
Action:
Adducts, flexes & laterally rotates the hip
Synergist:
Hip Adduction = Adductors longus and magnus, Gracilis & Pectineus
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Lateral Rotation = Gluteus Maximus
Antagonist:
Hip Abduction = Gluteus medius and minimus
Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps Femoris
Medial Rotation = Gluteus Minimus

26. Muscles Medial Thigh Muscles
Adductor Magnus
Innervation:
Obturator and Tibial Nerves
Origin:
Inferior ramus of pubis and ischium to ischial tuberosity
Insertion:
Linea aspera of the femur and medial supracondylar line
Action:
Adducts thigh, superior horizontal fibers flex the thigh and posterior portion extends thigh at hip joint
Syngerist:
Hip Adduction = Adductors longus and brevis, Gracilis & Pectineus
Hip Flexion = Rectus femorus, Iliopsoas & Pectineus
Antagonist:
Hip Abduction = Gluteus medius and minimus
Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris

27. Muscles Medial Thigh Muscles
Gracilis
Innervation:
Obturator Nerve
Origin:
Body and inferior ramus of pubis
Insertion:
Anterior medial proximal tibis
Action:
Adducts and medial rotates hip
Knee Flexion
Synergist:
Hip Adduction = Adductors Brevis, Longus & Magnus, Pectineus
Medial rotation of hip = Gluteus Minimus
Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Antagonist:
Hip Abduction = Gluteus Medius and Minimus
Lateral rotation of hip = Gluteus Maximus
Knee Extension = Rectus Femoris & Vastus medialis, lateralis & intermedius

28. Muscles Gluteal Region
Tensor Fasciae Latae
Innervation:
Superior Gluteal Nerve
Origin:
Anterior superior iliac spine and anterior iliac crest
Insertion:
Tibia by way of the iliotibial tract
Action:
Flexes and abducts the thigh at the hip joint and helps to stabilize and stead the hip and knee joints by putting tension on the iliotibial band of fascia
Synergist:
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Hip Abduction = Gluteus medius and minimus
Antagonist:
Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris
Hip Adduction = All 3 Adductors, Gracilis & Pectineus

29. Muscles Gluteal Region
Gluteus Maximus
Innervation:
Inferior Gluteal Nerve
Origin:
Iliac crest, Sacrum, Coccyx & Aponeurosis of Sacrospinalis
Insertion:
Iliotibial tract of fascia lata and lateral part of linea aspera under greater trochanter (gluteal tuberosity) of the femur
Action:
Extends the thigh at the hip and laterally rotates thigh – middle fibers abduct the hip
Synergist:
Hip Extension = Semimembranosus, Semitendinosus & Biceps Femoris
Hip Abduction = Gluteus medius and minimus
Antagonist:
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Hip Adduction = Adductors longus and brevis, Gracilis & Pectineus
Medial Rotation of Hip = Gluteus Minimus

30. Muscles Gluteal Region
Gluteus Medius
Innervation:
Superior Gluteal Nerve
Origin:
Dorsal ilium inferior to the iliac crest
Insertion:
Greater Trochanter of the Femur
Action:
Abducts and medially rotates the hip
Synergist:
Gluteus Minimus (for both)
Antagonist:
Hip Adduction = All 3 Adductors, Gracilis & Pectineus
Lateral Rotation of the Hip = Gluteus Maximus

31. Muscles Gluteal Region
Gluteus Minimus
Innervation:
Superior Gluteal Nerve
Origin:
Dorsal Ilium between inferior and anterior gluteal lines
Insertion:
Greater trochanter of the femur
Action:
Abducts and medially rotates the hip
Synergist:
Gluteus Medius (for both)
Antagonist:
Hip Adduction = All 3 Adductors, Gracilis & Pectineus
Lateral Rotation of the Hip = Gluteus Maximus

32. Muscles Gluteal Region
Piriformis
Innervation:
Piriformis Nerve
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 the greater trochanter
Action:
Laterally rotates and abducts the thigh at the hip joint
Synergist:
Hip Abduction = Gluteus medius and minimus
Lateral Rotation of Hip = Gluteus Maximus
Antagonist:
Hip Adduction = All 3 Adductors, Gracilis & Pectineus
Medial Rotation of Hip = Gluteus medius and minimus

33. Muscles Posterior Thigh Muscles
Biceps Femoris
Innervation:
Tibial Nerve
Origin:
Long Head: Ischial Tuberosity
Short Head: Linea aspera of the femur
Insertion:
Head of fibula and lateral condyle of the tibia
Action:
Long Head: Extends hip and flexes knee
Short Head: Flexes knee and laterally rotates hip
Synergist:
Hip Extension = Gluteus Maximus
Extension of Hip and Flexion of Knee = Semitendinosus and semimembranosus
Lateral Rotation of Hip = Gluteus Maximus
Antagonist:
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Knee Flexion = Vastus (lateralis, medialis & intermedialis)
Medial Rotation = Gluteus Minimus

34. Muscles Posterior Thigh Muscles
Semitendinosus
Innervation:
Tibial Nerve
Origin:
Ischial Tuberosity
Insertion:
Proximal part of medial surface of shaft
Action:
Knee Flexion
Extends and medially rotates hip
Synergist:
Knee Flexion = Biceps Femoris, Semimembranosus
Hip Extension = Gluteus Maximus, Biceps Femoris & Semimembranosus
Medial Rotation of Hip = Gluteus Minimus
Antagonist:
Knee Extension = Rectus Femoris, Vastus (medialis, lateralis & intermdialis)
Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
Lateral Rotation of Hip = Gluteus Maximus

35. Muscles Posterior Thigh Muscles
Semimembranosus
Innervation:
Tibial Nerve
Origin:
Ischial Tuberosity
Insertion:
Posterior medial condyle of tibia
Action:
Knee Flexion
Extends and medially rotates the hip
Synergist:
Knee Flexion = Biceps femoris & Semitendinosus
Medial Rotation = Gluteus minimus
Antagonist:
Knee Extension = Rectus Femoris & Vastus (medialis, lateralis & intermedialis)
Lateral Rotation of Hip = Gluteus maximus

36. Nerves
Femoral Nerve
Obturator Nerve

37. Nerves Sciatic Nerve Superior Gluteal nerve Inferior gluteal nerve
Common peroneal nerve

38. Arteries Femoral artery Lateral circumflex artery Obturator artery
Deep femoral
(Profunda) artery

39. Arteries
Superior Gluteal Artery
Inferior Gluteal Artery

40. Veins
Femoral Vein
Profunda
(Deep Femoral) Vein
Great Saphenous Vein

41. Surface Anatomy
-Gluteal fold/Gluteal Sulcus -Sacrum -Posterior superior iliac spine -Tip of Greater trochanter -Intergluteal cleft -Iliac crest

42. Surface Anatomy -Supracristal plane -Anterior superior iliac spine
-Inguinal ligament

43. Clinical Concern – Piriformis Syndrome
Piriformis Syndrome-is a neuromuscular disorder that occurs when the sciatic nerve is compressed or otherwise irritated by the Piriformis muscle causing pain, tingling and numbness in the buttocks and along the path of the sciatic nerve descending down the lower thigh and into the leg.