ATTR 219 1st Edition Lecture 10Anatomy of the Hip-hip and pelvis are not the same-hip is actually articulation of femur with the pelvis-typically hip issues are not common in athletes, more often seen in the elderlyPelvis-consists of sacrum, coccyx and two large hip bones on each side-these hip bones are called innominatesInnominates:- protect reproductive organs - Serve as part of birth canal- Serve as stable platform which supports body weight- Consists of 3 separate bones joined by hyaline cartilageo Iliumo Ischiumo Pubis-females have lighter, thinner and smoother bones in the hip and pelvic region (makes for more effective child delivery)Ilium- largest part of innominates-posterior is called the ala, or wings-anterior is the iliac fossa-lots of muscular attachment on iliac fossaThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.-bones are more flared in females, leading to broader/wider hips-iliac crest is thickened superior ridge- it serves as muscular attachmentSpines of Ilium-anterior superior iliac spine (ASIS)-anterior inferior iliac spine (AIIS)-posterior superior iliac spine (PSIS)-posterior inferior iliac spine (PIIS)-most are easily palpated and serve as muscular attachment for hip, trunk and thighOther Structures of IliumGreater sciactic notch- deep indentation inferior to PIIS-serves as passageway for sciatic nerve and some tendonsAuricular surface- large roughened area on iliac fossa-articulates with sacrum for sacroiliac joint (SI)-iliacus muscle originates on iliac fossaIschium-lower posterior portion of innominate and marked by several structuresischial spine- between great and lesser sciatic notches- Attachment for sacrospinous ligament- Physician will measure to determine the size and width of pelvic outlet (further apart in women)- When it is too small, women must deliver by C-sectionLesser sciatic notch- indentation between ischial spine- passageway for blood vessels and nervesIschial tuberosity- large rough inferior portion of ischium-inferior to lesser sciatic notch-inferior to lesser sciatic notch-origin for hamstrings-farther apart in womenPubis-most anterior part of innominatesPubic symphysis- anterior midline where two pubic bones meet-this articulation is held together by fibrocartilage-fibrocartilage is cartilage containing collagen fibersPubic rami- arm-like projection from pubic symphysis Superior pubic rami- from body of pubis and goes superior, posterior and laterally to form anterior portion of acetabulumPubic tubercles- most prominent portion of pubic bonesInferior pubic rami- goes posterior, inferior and lateral to unite with ischial tuberosityIlliopectineal (arcuate) line- sharp curved line at inferior margin of iliac fossa- point of muscular attachmentPubic arch- v-shaped and is inferior to pubic symphysis- formed by inferior pubic ramiObturator foramen- opening between pubis and ischium- passageway for blood vessels, nerves and tendonsAcetabulum-sits at fusion site of all 3 sections of innominate-deep socket/depression on lateral surface of innominate-socket to articulate with head of femur-acetabulum slopes slightly inferiorly and anteriorlyAnterior Thigh Muscles-primary flexor of hip and trunk is the iliopsoas-iliopsoas consists of 2 muscles-psoas major and iliacusIliacusOrigin: upper 2/3 of iliac fossa, iliac crest, base of sacrumInsertion: tendon of psoas major, joint capsule, lesser trochanterAction: flexes hip/thighNerve: femoralArtery: iliac branch of iliolumbar and glutealPsoas MajorOrigin: transverse processes, intervertebral discs, bodies of all lumbar vertebraeInsertion: lesser trochanter of femurAction: flexes hip/thigh, and when thigh is lifted it will flex vertebral column on pelvisNerve: 2nd and 3rd lumbar plexusArtery: iliolumbarMedial Thigh MusclesAdductor longusOrigin: anterior portion of pubis and pubic symphysisInsertion: middle portion of medial lip of linea asperaAction: adducts hip/thighNerve: anterior branch of obturatorArtery: medial femoral circumflex and obturatorAdductor BrevisOrigin: inferior pubic ramiInsertion: line from lesser trochanter to linea asperaAction: adduct hip/thigh, assists in flexion of hipNerve: anterior branch of obturatorArtery: medial femoral circumflex and
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