Pelvic and Hip Anatomy Notes

Ilium and Pubic Bones:

The ilium is the uppermost part of the pelvic bone.

As it comes down, it transitions into the pubic bones, also referred to as the pubis.

Pubic Symphysis:

The pubic symphysis is where the two pubic bones meet.

It is located at the front of the hips, just above the genitalia, and can be palpated as a protruding bump.

The symphysis consists of cartilage which offers slight shock absorption, but its primary role is stability.

Separation may occur during pregnancy but is stable otherwise.

Posterior Structures:

Posteriorly, two prominent bones known as ischial bones are located, also referred to as "butt bones".

Ischial Tuberosity:

• The ischial tuberosity is a bony prominence in the buttock area where the hamstrings attach.
• Hamstring strains or avulsion fractures can occur due to excessive force, often resulting from activities involving knee flexion.

Muscle Connections:

The hamstring originates at the ischial tuberosity and assists with knee flexion and hip extension.

The glutes are the primary extensor muscles for hip movements.

Pelvic Structures:

The ilium, sacrum, and pubis collectively form the pelvis with the SI (Sacroiliac) Joint forming between the sacrum and ilium.

Acetabulum:

• It is the socket where the femoral head sits.
• The hip joint is scientifically referred to as the acetabulofemoral joint.

Femur Bones:

Important landmarks include:

• Femoral head
• Femoral neck
• Greater and lesser trochanters

These points serve as attachment areas for muscles involved in movement.

Hip Musculature:

Gluteus Maximus: Major extensor of the hip joint.

Gluteus Medius: Assists in abduction and stabilization of the hip.

Iliopsoas: A major hip flexor consisting of the iliacus and psoas muscles.

Hip Flexors:

Four primary hip flexors: iliopsoas, sartorius (longest muscle), pectineus, and rectus femoris (part of the quadriceps).

Rectus femoris assists with both knee extension and hip flexion.

Adductor Muscles:

Major adductors include adductor longus, adductor brevis, and adductor magnus, with gracilis being the longest muscle involved in adduction.

Common Injuries:

Hip Pointer: Bruising at the iliac crest due to trauma.

Piriformis Syndrome: Involves tightness or swelling in the piriformis muscle affecting the sciatic nerve.

Bursitis: Inflammation of the bursa can occur, particularly at the hip near the greater trochanter.

AVULSION FRACTURES: When muscles like the hamstrings exert enough force to pull off portions of the ischial tuberosity.

Bony Landmarks:

Anterior Superior Iliac Spine (ASIS): Easily palpated at the front of the pelvis.

Iliac Crest: The upper border of the ilium, often associated with hip pointers.

Bony Injury Types and Treatments:

After multiple contusions in muscles, myositis ossificans can develop, creating bone in muscle tissue.

Fractures, especially in the femoral neck, are common sites for hip injuries due to their structure being vulnerable to forces.

Treatments can vary from rest to surgical intervention, depending on the severity of the injury.

Hip Movement Review:

Understanding muscle roles helps in diagnosing injuries.

Determining whether pain is due to hip flexors or quadriceps involves specific testing and positions to target pain accurately.

Functional Movement:

Adductor strains often occur during rapid direction changes in sports.

Opportune stretching techniques can isolate specific muscle groups for rehabilitative purposes.