HIP AND PELVIS PELVIS
- 4 Bones
ANATOMY AND KINESIOLOGY OF THE • Sacrum
BONES • 2 hip bones
• Coccyx
HIP FLEXORS - Made up of right and left innominate
- Sartorious (nameless) bone aka “COXA” which are
- Iliopsoas joined to the sacrum and coccyx posteriorly
- Rectus femoris - Other name “Os Coxa”
- Pectineus. - Coxa (Hip Bone) is formed by the union of the
- Tensor fascia latte following:
• Illium
HIP EXTENSORS • Ischium
- Gluteus Maximus • Pubis
- Hamstrings
• Semitendinosous ILIUM
• Semimembrenosous - LARGEST of the innominate bone
• Bicep Femoris - Is the more ANTERIOR and SUPERIOR of
the three pelvic bones
HIP EXTERNAL ROTATOR - Contributes to approximately 40% to the
- Piriformis formation of the acetabulum
- Obturator internus - Bony landmarks:
- Obturator externus • Iliac Crest
- Gemellus superior - Tensor Fascia Latae
- Gemellus inferior • Iliac fossa
- Quadratus femoris - Iliacus
• Anterior Superior Iliac Spine
HIP INTERNAL ROTATORS - Sartorius
- Pectineus • Anterior Inferior Iliac Spine
- Gracilis - Straight Head of Rectus Femoris
- Tensor fascia latae • *Reflected Head of Rectus Femoris
- Piriformis originates at ILIUM ABOVE
- Adductor ACETABULUM
• PSIS
HIP ABDUCTOR • PIIS
- Gluteus Minimus
- Tensor Fascia Latae *SACRUM
- Gluteus Medius - Anterior Piriformis
- Posterior Gluteus Maximus
HIP ADDUCTORS • *pwede din mag originate sa posterior iliac
- Gracilis wing
- Ad. Brevis
- Ad. Longus ISCHIUM
- Ad. Magnus - STRONGEST of the three innominate bone
- Pectineus - Is the more POSTERIOR and INFERIOR of
the three pelvic bones
- Contributes to approximately 40% of the
formation of the acetabulum
- Bony landmarks:
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• Ischial Ramus - Obturator foramen
• Ischial Tuberosity • Passageway of obturator nerve, artery and
- Hamstrings vein
• Semitendinosous - Obturator Membrane
• Semimenbranosous • Obturator internus
• Long head of Bicep Femoris • Obturator Externus
- Adductor Magnus
- Gemellus inferior FEMUR
- Quadratus Femoris - LONGEST, HEAVIEST and STRONGEST
• Ischial Spine bone in the body
- Gemellus Superior - Contributes to the 25% of the height
- Average length of neck of femur: 5cm (norkin)
PUBIS - Bony Landmarks
- SMALLLEST of the three innominate bone • Head of femur
- Is the more ANTERIOR and INFERIOR of the • Neck of femur
three pelvic bones • Greater trochanter
- Contributes to approximately 20% of the - Gluteus Medius
formation of acetabulum - Gluteus Minimus
- Bony landmarks: - POOGG except Q
• Superior Ramus • Lesser trochanter
- Pectineus - Iliopsoas
• Body of Pubis • Gluteal tuberosity
- Adductor Longus - Gluteus Maximus
• Inferior Ramus • Iliotibial Band
- Ad. Magnus • Linea aspera
- Gracilis - Ad. Longus
- Ad. Brevis - Ad. Brevis
• Symphysis Pubis - Ad. Magnus
• Pectineal line
GENDER DIFFERENCES OF PELVIS - Pectinous
PUBIC BONE MALE FEMALE • Shaft of femur
• Adductor tuberosity
PELVIC INTLET Heart Shape Oval Shape - Adductor magnus
P E L V I C Smaller, Ischial Larger, Ischial
OUTLET tuberosities are tuberosities are BIOMECHANICAL ANGULATION
INVERTED EVERTED - At the Acetabulum
SACRUM L o n g e r , shorter, wider,
• Center edge angle
narrower, less flatter • Acetabular Anteversion Angle
flat - At the Femur
PUBIC ARCH <90 degrees -90 degrees
• Angle of inclination
• Angle of torsion
ISCHIUM AND Ischium longer P u b i s l o n g e r
PUBIS than pubis than ischium B I O M E C H A N I C A L A N G U L AT I O N O F
ACETABULUM
OTHER STRUCTURES
- Acetabulum Center edge
• Articulates with the head of femur - AKA angle of Wiberg
- Greater sciatic notch - Angle between the lateral rim of acetabulum
• Passageway of sciatic nerve and center of femoral head
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- Measure of the amount of coverage or “roof” - Little to no movement
is over the femoral head
- 35-40 degrees (38 deg. In men; 35 deg. In SACROCOCCYGEAL
women) - CARTILAGINOUS joint
- <20-25 Hip dysplasia - Last sacral vertebra + first coccygeal vertebra
- Little to no movement
Acetabular Anteversion Angle
- Pertains to the magnitude of anterior SYMPHYSIS PUBIS
orientation of acetabulum - CARTILAGINOUS joint
- Describes the extent to which the acetabulum - Midline between bodies of the pubic bones
surrounds the femoral head within the - Little to no movement
horizontal plane - Sliding and gliding, separation and
- Normal Angle: 15-20 deg. compression
- Angle > 20 deg. - Absorbs shock during walking
• Less containment of femoral head - Increase ROM for delivery of child
- Angle <15 deg
• Excessive containment of femoral head ACETABULOFEMORAL
- AKA hip joint
BIOMECHANICAL ANGULATION OF FEMUR - Ball-and-socket joint
- Head and femur and acetabulum
Angle of Inclination - Stability and weight bearing
- Occurs. In the frontal plane between the axis - Much more stable than GH joint
through the femoral head and neck and and Resting position
axis through the distal femoral condyles - 30 deg. Flexion, 30 deg abduction, slight ER
- Normal values: 125 deg. Closed packed position
- Coxa Valga > 130 deg. - Extension, abduction
• Leg appears longer Capsular patterns
- Coxa Vara < 125 deg.
• Leg appears shorter SACROILIAC
- Strong SYNOVIAL joint
Angle of Torsion - Auricular surface of the sacrum and iliac
- Occurs in transverse plane between an axis bones
through the femoral head and neck through - Small and limited amount of movement
the distal femoral condyles - Transmits weight of body from vertebral
- Normal: 10-15 deg. column to the bony pelvis
- Angle > 20 deg = Anteroversion/ In Toeing
- Angle <20 deg = Retroversion/ Out Toeing Closed- Open-
packed packed
ANATOMY AND KINESIOLOGY OF THE SACRAL Anterior + Posterior +
PROMONTORY Inferior Superior
JOINTS
- Lumbosacral - 1 COCCYX Posterior Anterior
- Sacrococcygeal -1
- Symphysis pubis - 1 ILIAC Approximate Separate
- CREST
Acetabulofemoral -2
- Sacroiliac -2 ISCHIAL Separate Approximate
TUBEROSIT
LUMBOSACRAL Y
- CARTILAGINOUS joint NUTATION COUNTER
- Fifth lumbar vertebra + base of sacrum NUTATION
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LIGAMENTS OF THE HIP - Formed by acetabular labrum as it bridges the
- Iliofemoral acetabular notch
- Ischiofemoral - Converts the notch into a tunnel that serves
- Pubofemoral as a passageway for blood vessels and nerve
- Acetabular labrum as they enter the joint
- Transverse acetabular ligament
- Ligament of the head of femur LIGAMENT AT THE HEAD OF FEMUR
• Ligamentum teres - AKA ligamentum teres
- Proximal attachment - transverse ligament
ILIOFEMORA Limists Limits ER Limits AD and margins of acetabular notch
L Extension - Distal attachment - fovea capitis
ISCHIOFEMO Limists Limits IR Limits AB
- Passageway of blood vessels
RAL Extension
PUBOFEMOR Limists Limits ER Limits AB OSTEOKINEMATICS AND
AL Extension ARTHROKINEMATICS
ILIOFEMORAL LIGAMENT PELVIC-ON-FEMORAL OSTEOKINEMATICS
- Inverted Y- shaped - SAGITTAL PLANE
- STRONGEST ligament of the hip • Anterior pelvic tilt
- Proximal attachment - AIIS • Posterior pelvic tilt
- Distal attachment - upper and lower parts - FRONTAL PLANE
intertrochanteric line of femur • Lateral tilt
- Limits extension, adduction, external rotation - TRANSVERSE PLANE
- Prevents overextension during standing • Protraction
• Retraction
ISCHIOFEMORAL LIGAMENT
- Spiral shaped ANTERIOR POSTERIOR
- Proximal attachment - body of ischium, near PELVIC TILT PELVIC TILT
acetabular margin ASIS Anterior + Posterior +
- Distal attachment- greater trochanter Inferior Superior
- Limits extension, abduction, internal rotation ACTION Hip Flexion Hip Extension
- Primary ligament that limits IR
MUSCLES Iliopsoas Gluteus
PUBOFEMORAL LIGAMENT Maximus
- Triangular LORDOSIS Increase Decrease
- Proximal attachment- superior rams of pubis
- Distal attchment- lower part of
intertrochanteric line of femur Lateral Tilt
- Limits extension, abduction, and external - Reciprocal motion between 2 hips
rotation - Contralateral hip acts as an axis
- Primary ligament that limits abduction
ACETABULAR LABRUM
- Fibrocartilaginous ring around the acetabulum
- Increase depth of acetabulum
- C- connected by transverse acetabular lig.
TRANSVERSE ACETABULAR LIGAMENT
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