Pelvis, Hip, and Leg

Regions of the lower limb

-Thigh (femoral)

-Patellar

-Crural (leg)

-Tarsal/ tarsus (ankle)

-Pedal/ pes (foot)

Sacrum

Extension of spinal column with 5 fused vertebrae

Extending inferiorly is the coccyx

Pelvic bone

Illium, ischium, and pubic bone/ pubis

-Innominate bones (fused bones)

Differences in female pelvic bones

-Wider

-Flatter

-Tilted forward

-Thinner bones

-Acetabular care smaller and farther apart

What originates on the anterior pelvis

Hip flexors

-Tensor fasciae latae, sartorius, rectus femoris

What originates medially on the pelvis

Hip adductors

-Adductor magnus, adductor longus, adductor brevis, pectineus, and gracilis

What originates laterally on the pelvis

Hip abductors

-Gluteus medius and minimus

What originates posteriorly on the pelvis

Hip extensors

-Gluteus maximus

What originates postinferiorly on the pelvis

Hip extensors

-Hamstrings

Illium structures

Anterior Superior Iliac Spine (ASIS)

Posterior Superior Iliac Spine (PSIS)

Iliac Crest

Anterior Inferior Iliac Spine

Posterior Inferior Iliac Spine

Greater Sciatic Notch

Ischium structures

Spine of the Ischium

Lesser Sciatic (ischial) Notch

Ischial Tuberosity

What do you sit on

Ischial tuberosity

Pubic bone structures

Pubic Symphysis

Public Tubercle

Sacroiliac articulation

Amphiarthrodial

Ilium articulation with sacrum posteriorly

Pubic symphysis articulation

Amphiarthrodial

Pubic bones articulate with each other anteriorly

Acetabulum

Deep socket for hip joint

Iliolumbar Ligament

Connects the 5th lumbar vertebrae to crest of ilium

Anterior sacroiliac ligamant

Connects the sacrum to the ilium

Posterior sacroiliac ligament

Connects the ilium to the sacrum

3 sections (short sacroiliac, long sacroiliac, and interosseous)

Pelvis Ligaments

Inguinal ligament

Sacrospinous

Sacrotuberous

Inguinal ligament

Connects the ASIS to the pubic tubercle

Sacrospinous ligament

Connects the sacrum and the coccyx to ischial spine

Sacrotuberous ligament

Connects the ilium, sacrum, and coccyx to the ischial tuberosity

Pelvis ligaments

Anterior pubic

Inferior (arcuate) pubic

Superior pubic

Posterior pubic

Interpubic fibrocartilage disc

Anterior pelvic tilt

Anterior movement of the upper pelvis; iliac crest tilts forward in the sagittal plane; anterior tilt, downward rotation

-Sagittal/ anteroposterior plane

-Hip flexion/ lumbar flexion

Posterior pelvic tilt

Posterior movement of upper pelvis; iliac crest tilts backward in a sagittal plane; posterior tilt, upward rotation

-Sagittal/ anteroposterior plane

-Hip extension/ lumbar flexion

Left lateral pelvic rotation

Frontal plane left pelvis moves inferiorly in relation to right pelvis; either left pelvis rotates downward or right pelvis rotates upward; left lateral tilt

-Left hip abduction, right hip adduction, and right lumbar lateral flexion

Right lateral pelvic rotation

Frontal plane right pelvis moves inferiorly in relation to left pelvis; either right pelvis rotates downward or left pelvis rotates upward; right lateral tilt

-Right hip abduction, left hip adduction, and left lumbar lateral flexion

Left transverse pelvic rotation

Horizontal plane pelvis rotates to body's left; right iliac crest moves anteriorly in relation to left iliac crest, which moves posteriorly

-Right hip external rotation, left hip internal rotation, and right lumbar rotation

Right transverse pelvic rotation

Horizontal plane pelvis rotates to body's right; left iliac crest moves anteriorly in relation to right iliac crest, which moves posteriorly

-Left hip external rotation, right hip internal rotation, and left lumbar rotation

Femur (and articulations)

Longest, strongest, and heaviest bone in the body

-Head (fovea)

-Neck

-Greater/ lesser trochanters

-Intertronchanteric ridge

-Gluteal tuberosity

-Linea aspera

Acetabulofemoral Joint (hip joint)

Diarthrotic ball and socket joint between head of femur and acetabulum of pelvis

Most mobile after glenohumoral (3DoF)

Capsular ligament of the hip

Connects acetabulum to neck of femur

Glenoid lip

-Deepens socket

-Enhances stability

-Provides shock absorption

-Torn with injury

Ligamentum capitis femoris (ligamentum teres)

-Runs between transverse acetabular ligament (inferior region of acetabulum) and femoral fovea

-Loosely connects head of femur to acetabulum

-Slightly limits adduction

-Contains an artery that supplies head of femur

Transverse acetabular ligament

-Creates foramen for nerves and blood vessels

-Transverses small (acetabular) notch in lower portion of glenoid lip

Iliofemoral ligament

-Y ligament

-Attaches ilium to neck of femur

-Prevents hyperextension

Ischiofemoral ligament

-Attaches ischium to neck of femur

-Limits internal rotation

Pubofemoral ligament

-attaches pubic bone to the neck of the femur

-Limits extension and abduction

Hip Movements

Flexion/extension, abduction/adduction, internal/external rotation

Iliopsoas

Psoas major and iliacus

Psoas major origin

L1-L5 transverse processes, T12 and L1-L5 intervertebral discs and bodies

Psoas major insertion

Lesser trochanter of femur

Psoas major action

Flexion of lumbar, hip flexion, adduction, and external rotation of hip

Iliacus origin

Iliac fossa, iliolumbar, and sacroiliac ligaments

Iliacus insertion

Lesser trochanter of femur

Iliacus action

Hip flexion, adduction, and internal rotation

Sartorius origin

ASIS (anterior superior iliac spine)

Sartorius insertion

Proximal medial end of the tibia

Sartorius action

Hip flexion, abduction, and external rotation

Sartorius facts

-Longest muscle

-"Tailors" muscle (named after palpation in crisscross applesauce)

Quadriceps femoris

-Rectus femoris (only one that crosses the hip)

-Vastus lateralis

-Vastus medialis

-Vastus intermedius

Rectus femoris origin

AIIS (anterior inferior iliac spine)

Rectus femoris insertion

Tibial tuberosity

Rectus femoris action

Hip flexion and knee extension

Pectineus origin

Anterior superior pubic bone

Pectineus insertion

Femur (distal to lesser trochanter)

Pectineus action

Hip flexion, adduction, and external rotation

Anterior hip muscles

Primary action is hip flexion

-Iliacus

-Psoas Major

-Pectineus

-Rectus femoris

-Sartorius

Gluteal muscles

Primary action is extension and rotation of the hip

-Gluteus maximus

-Gluteus medius

-Gluteus minimi

-Tensor fascia latae

-Deep external rotators (piriformis, obturator externs, obturator internus, gemellus superior, gemellus inferior, ad quadrates femoris)

Posterior hip and thigh muscles

Primary action is hip extension

-Gluteus maximus

-Biceps femoris

-Semitendinosus

-Semimembranosus

Gluteus maximus origin

Iliac crest, sacrum, and coccyx

Gluteus maximus insertion

Gluteal lines femur and blends with tensor fasciae later to form IT band

Gluteus maximus action

Hip extension, adduction, and external rotation

Hamstrings

-Biceps femoris

-Semitendinosus

-Semimembranosus

Biceps femoris origin

Long head: ischial tuberosity

Short head: linea aspera

Biceps femoris insertion

Head of fibula

Biceps femoris action

Hip extension, adduction, and knee flexion

Semitendinous origin

Ischial tuberosity

Semitendinous insertion

Medial aspect of tibia

Semitendinous action

Hip extension, adduction, internal rotation, and knee flexion

Semimembranosus origin

Ischial tuberosity

Semimembranosus insertion

Medial condyle of tibia

Semimembranosus action

Hip extension, adduction, internal rotation, and knee flexion

Deep posterior muscles

Primary action is external hip rotation

-Superior gemellus

-Inferior gemellus

-External obturator

-Piriformis

-Quadratus femoris

Superior gemellus origin

Ischial spine

Superior gemellus insertion

Greater trochanter

Superior gemellus action

Hip external rotation

Internal obturator origin

Obturator foramen

Internal obturator insertion

Greater trochanter

Internal obturator action

Hip external rotation

Inferior gemellus origin

Ischial tuberosity

Inferior gemellus insertion

Greater trochanter

Inferior gemellus action

Hip external rotation

External obturator origin

Ischium and pubic bone around obturator foramen

External obturator insertion

Trochanter fossa of femur

External obturator action

Hip external rotation

Piriformis origin

Upper sacrum

Piriformis insertion

Greater trochanter

Piriformis action

Hip external rotation, extension and abduction

Quadratus femoris origin

Ischial tuberosity

Quadratus femoris insertion

Intertrochanteric ridge or femur

Quadratus femoris action

Hip external rotation, adduction, and extension

Lateral hip muscles

Primary action is hip abduction

-Gluteus medius

-Gluteus minimus

-External rotators

-Tensor fascia latae

Gluteus medius origin

Middle surface of ilium to iliac crest

Gluteus medius insertion

Greater trochanter

Gluteus medius action

Hip abduction

Gluteus minimus origin

Middle of lateral surface of ilium to iliac crest

Gluteus minimus insertion

Greater trochanter

Gluteus minimus action

Hip abduction and internal rotation