Hip Introduction Bones, Ligaments and Other Structures -Mr. Brewer

Bones of the Hip

Bones of the Hip - The Hip joint is comprised of the femur distally inserting into the Pelvis. - Also the sacrum joins both pelvic bones to form the pelvic girdle, and attaches to the most distal aspect of the spine.

Sacrum and Coccyx The Sacrum attaches the distal spinal to the hip, BUT the sacrum is actually comprised of 5 fused vertebrae. The distal aspect of the Sacrum is the Coccyx. The Coccyx is also known as your “Tail Bone” The Coccyx too is a compilation of 4 more fused vertebrae. Foramen or “holes” in the sacrum are present to allow nerves and blood vessels to exit and form all over the lower extremity.

Sacrum and Coccyx

Ilium, Ischium and the Pubis

Ilium The Ilium is the largest aspect of the pelvic girdle and is the most superior of the bones that make up the pelvic girdle. The Ilium is broken down into two portions. The Body: The lower part of the Ilium which joins with both the pubis and ischium to form the acetabulum. The “Ala”: Latin for “wing”, the superior and wide aspect of the Ilium. The Ilium allows for several insertion points for muscles such as: The Gluteals IT Band 6 Lateral Rotators of the hip

Ilium Ilium Landmarks: Iliac Crest ASIS and PSIS AIIS and PIIS The upper rim or edge of the ilium. Also the insertion point for a few ASIS and PSIS Anterior Superior Iliac Spine & Posterior Superior Iliac Spine Located at both the most anterior and posterior portions of the Iliac Crest. AIIS and PIIS Anterior inferior iliac spine & Posterior inferior iliac spine.

Ischium Ischium: Broken into 3 parts  Ischium Landmarks: Ischial Tuberosity AKA the “Sit Bone” The part of your pelvis that takes the greatest amount of force from sitting down. Ischial Tuberosity

Pubis The Pubis is the final bone that comes together to form the Pelvic Girdle. Both the left and right pubis bones of each hip are joined together by a thick piece of cartilage known as the pubic symphysis. Sacrum Ilium Ischium Pubis Pubic Symphysis Acetabulum Obturator Foreman

Joints Hip Joint The hip joint is the common term for the union of the Femur and the Pelvis bone. The hip joint is the strongest major joint in the body because of the thick capsular ligaments and strong musculature.

Joints Sacroiliac Joint

SacroIliac Joint The Sacro-Iliac joint is the name of the location in which the Sacrum meets the Ilium. Imbalances in muscle strength (Mostly Hamstrings and Quadriceps) can result in a SacroIliac condition.

Other Important Landmarks Acetabulum: The acetabulum is made up of 3 bones joining together. (Ischium, Pubis, and Ilium) The Acetabulum is “cup-like” in formation and this allows the head of the femur to comfortably fit in and join with the pelvis to form the hip joint.  Acetabulum

Acetabulum On the surface of the acetabulum sits the acetabular labrum. Just like the Meniscus of the knee and the labrum of the shoulder joint, the acetabular labrum is a piece of cartilage that acts a cushion to absorb shock and to prevent bone-to-bone contact.

Acetabulum The function of the acetabulum and the acetabular labrum on the head of the Femur. https://www.youtube.com/watch?v=qlCvKEOZtpo *First 3-4 minutes*

Ligamentum Teres This ligament is attached at the fovea capitis of the femur and inserts itself through the acetabulum. The ligamentum teres plays a large role, especially in development of younger people such as children into adolescense. The ligament is one of the very few ligaments that have been innovated with blood flow. At a young age, this blood flow is vital for keeping the head of your femur healthy and supplied with necessary nutrients.

A view of the Ligament from inside of the hip. Ligamentum Teres A view of the Ligament from inside of the hip.

Other Ligaments The hip is held together by some of the strongest ligaments in the body. These ligaments are named for their insertion/origin points and encapsulate the head of the femur for additional strength and stability with movement.

Obturator Foramen The obturator foramen is a “hole” formed by the ischium and pubis bones. The space is a “throughway” for some important blood vessels, nerves and other important structures.

Resource for Personal Use http://www.healthline.com/human-body-maps/iliacus-muscle : This resource allows you to visualize the layers of the hip area from muscles, nerves and blood vessels, down to the bones in isolation. *Intended for more of a visual tool*