thighs and pelvis

what bones make up the hip bone made

ilium

ischium

pubis

symphysis pubis

• not much movement unless during birth/ breast feeding

cartilaginous joint

Sacroiliac Joint

• very strong

Function: transmit weight

 Nerve supply: Sacral spinal nerves

Sacrococcygeal Joint

 Cartilaginous joint

- Movements of flexion and extension

◦Labor

Defecation

femur

Largest and heaviest bone in the body

COXA VARA

 Decreased angle

 Mild shortening of the lower limb

 Limits hip ABD, may see a limp

COXA VALGA

 Increased angle

 Hip muscle weakness

Pectinous

◦Origin: superior ramis of the pubis

◦Insertion: pectineal line of the femur

◦Innervation: femoral n.

◦Action: ADD, √ thigh, medial rotation

Iliopsoas

Origin:

Iliacus: upper two-thirds of the iliac fossa and the lateral parts of the wing of the sacrum.

Psosas Major: The transverse processes and lateral surfaces of the vertebral bodies of L1 - L4

Psoas Minor- T12 and L1 and lies anteriorly to the psoas major

Insertion:

Iliacus and Psoas Major-  join together, pass under the inguinal ligament onto the femoral lesser trochanter

Psoas Minor- iliopectineal eminence

Innervation:

 L4-L5, Femoral nerve

Action:

chief flexor of the thigh, √ trunk at hip

 Tensor of fascia lata

◦Origin: iliac spine and crest

◦Insertion: iliotibial tract

◦Innervation: superior gluteal n.

◦Action: ABD, medially rotates, √ thigh

 Sartorius

◦Origin: iliac spine

◦Insertion: superior tibia

◦Innervation: femoral n.

◦Action: √, ABD, laterally rotates thigh, and √ knee

rectus femoris

◦Origin: iliac spine, ilium

◦Insertion: base of patella

◦Innervation: femoral n.

◦Action: / knee, steadies hip joint, and assists with thigh √

vastus lateralis

◦Origin: greater trochanter, lateral lip of linea aspera

◦Insertion: base of patella

◦Innervation: femoral n.

◦Action: / knee, steadies hip joint, and assists with thigh √

vastus medialis

◦Origin: intertrochanteric line, medial lip of linea aspera

◦Insertion: base of patella

◦Innervation: femoral n.

◦Action: / knee, steadies hip joint, and assists with thigh √

vastus intermedius

◦Origin: anterior and lateral surfaces of the femur

◦Insertion: base of patella

◦Innervation: femoral n.

◦Action: / knee, steadies hip joint, and assists with thigh √

medial thigh

◦Adductor longus

◦Adductor brevis

◦Adductor magnus

◦Gracililis

◦Obturator externus

adductor longus

◦Origin: pubis

◦Insertion: linea aspera

◦Innervation: obturator n.

◦Action: ADD thigh

adductor brevis

◦Origin: pubis

◦Insertion: pectineal line and linea aspera

◦Innervation: obturator n.

◦Action: ADD thigh, some thigh √

adductor Magnus

◦Origin: pubis and ischium

◦Insertion: gluteal tuberosity, linea aspera, medial supracondylar line

◦Innervation: obturator n.

◦Action: ADD and √ thigh

gracilis

◦Origin: pubis and ischium

◦Insertion: gluteal tuberosity, linea aspera, medial supracondylar line

◦Innervation: obturator n.

◦Action: ADD and √ thigh

obturator externus

◦Origin: obturator foramen

◦Insertion: trochanteric fossa of femur

◦Innervation: obturator n.

◦Action: lateral rotation of thigh, steadies head of femur in acetabulum

femoral nerve

◦Originates from the lumbar plexus

◦Supplies anterior thigh muscles and skin, hip and knee joints

obturator nerves

◦Originates from the lumbar plexus

◦◦Supplies anterior and posterior thigh muscles

 Rider’s strain

◦Strain of the adductor longus

◦Usually occurs with horseback riders due to the need to actively ADD thighs to stay on the horse.

 Pulled groin

◦Flexor and ADD thigh muscles

◦Usually occurs in sports that require a quick start

◦Strain, stretching, and/ or tearing of the muscles

 Varicose veins

◦Valvular insufficiency

◦Treatment with compression, elevation, surgery

 Gluteal fold

◦If uneven in children can be a sign of hip dysplasia

 Gluteal sulcus 

◦The boundary between the buttocks and the thigh

gluteal ligaments

sacrotuberous

sacrospinous

glute maximus

◦Origin: ilium, sacrum, coccyx, sacrotuberous ligament

◦Insertion: iliotibial tract, gluteal tuberosity of femur

◦Innervation: inferior gluteal n.

◦Action: / thigh, lateral rotation

◦Rising from the seated position

◦Straightening from a bending position

◦Walking upstairs

◦Running

gluteus medius

◦Origin: ilium

◦Insertion: lateral surface of the greater trochanter of the femur

◦Innervation: superior gluteal n.

◦Action: ABD,  medial rotation of the thigh

gluteus minimus

◦Origin: ilium

◦Insertion: anterior surface of the greater trochanter

◦Innervation: superior gluteal n.

◦Action: ABD,  medial rotation of the thigh

piriformis

•Origin:

•Anterior aspect of the sacrum at the level of about S2 through S4

•Sacrotuberous ligament

•Periphery of the greater sciatic notch

Insertion: Superior and medial aspects of the greater trochanter.

Innervation: S1-S2 Rami

Action:

◦laterally rotate the extended thigh; ABD the flexed thigh; steadies the femoral head in the acetabulum

obturator internus

 Action: laterally rotate the extended thigh; ABD the flexed thigh; steadies the femoral head in the acetabulum

gemellus superior

◦Origin: ischial spine

◦Insertion: medial surface of the greater trochanter

◦Innervation: nerve to the obterator internus

◦Action: laterally rotate the extended thigh; ABD the flexed thigh; steadies the femoral head in the acetabulum

gemellus inferior

◦Origin: ischial tuberosity

◦Insertion: medial surface of the greater trochanter

◦Innervation: nerve to the quadratus femoris

◦Action: laterally rotate the extended thigh; ABD the flexed thigh; steadies the femoral head in the acetabulum

quadratus femoris

◦Origin: lateral border of the ischial tuberosity

◦Insertion: intertrochanteric crest

◦Innervation: nerve to the quadratus

◦Action: laterally rotates the thigh, steadies the femoral head in the acetabulum

sciatic nerve

largest nerve in the body

• supplies the skin of the foot, most of the leg, posterior thigh muscles, all leg and foot muscles, and lower limb joints

what are the 3 hamstring muscles

◦Semitendinosus

◦Semimembranosus

◦Biceps femoris (long head)

• Originate from the ischial tuberosity

femoral fractures

◦“broken hip”= fracture neck of the femur or intertrochanteric fracture

◦Higher incidence in individuals over 60 years old, and women= osteoporosis

 what provides relief for Osteoarthritis

◦Hip replacements

◦Metal prosthesis replaces the head and neck of the femur

◦Plastic socket replaces the acetabulum

 Ischial Bursitis

◦Repeated stress over the ischial bursae

◦Pressure sores from bearing body weight

 Sciatic nerve

◦Pain in the buttocks

◦Athletes with excessive glut muscle use and women

 Hamstring strains

◦Injury caused by excessive stretching movements

◦Most likely due to not stretching enough