The Hip Joint and Pelvic Gateways

The Hip Joint is a typical synovial joint that is a •Ball and socket joint•It may also be described as a multi-axial, spheroidal joint that permits an extensive range of movement

The Hip Joint is formed by an articulation between the •Head of the Femur•Acetabulum of the Hip Bone

The Acetabulum is a deep cup-shaped bony depression on the lateral aspect of the hip bone and is formed by the union of the three constituent bony parts• Ilium• Pubis• Ischium

lateral view, left hip bone

Acetabular Labrum

Is a rim of fibro-cartilaginous tissue that is attached to the periphery of the Acetabulum. It helps to deepen the cup thereby improving joint stability.

lateral view, left hip bone

Acetabular Labrum

Is a rim of fibro-cartilaginous tissue that is attached to the periphery of the Acetabulum. It helps to deepen the cup thereby improving joint stability.

lateral view, left hip bone

The Hip Joint is covered in a thick fibrous capsule which attaches

Anterior View

Intertrochanteric Line

• Proximally to the rim of the Acetabulum

The Hip Joint is covered in a thick fibrous capsule which attaches

Anterior View

Intertrochanteric Line

Distally to the • Intertrochanteric Line of

Femur anteriorly

The Hip Joint is covered in a thick fibrous capsule which attaches

Posterior View

Intertrochanteric Crest

Distally to the • Intertrochanteric Line of

Femur anteriorly

• Femoral neck superior to the Intertrochanteric Crest posteriorly

capsule

Anterior View Posterior View

Hip Joint Capsule

The capsule of the hip joint is reinforced by 3 strong ligaments that are thickenings or condensations of the capsule on the anterior, inferomedial and posterior aspects

Ligaments of the Hip Joint

Ligaments of the Hip Joint

Iliofemoral Ligament

Is the strongest of the hip joint ligaments

An inverted Y-shaped ligament

Anterior aspect of the Hip Joint

Ligaments of the Hip Joint

Pubofemoral Ligament

Triangular shaped ligament

Inferomedial aspect of the Hip Joint

Ligaments of the Hip Joint

Ischiofemoral Ligament

Spiral arrangement of fibres

Posterior aspect of the Hip Joint

Ligaments of the Hip Joint

Transverse Acetabular Ligament

Is continuous peripherally with the labrum

The fibres bridge the Acetabular Notch

labrum

Transverse Acetabular Ligament

lateral view, left hip bone

Ligaments of the Hip Joint

Ligamentum Teres

Triangular flattened ligament

Runs from -Fovea on the head of the Femur to-Edges of the Acetabular Notch and Transverse Acetabular Ligament

Labrum

Transverse Acetabular Ligament

Ligamentum Teres

left hip joint, disarticulated

Labrum

Transverse Acetabular Ligament

Ligamentum Teres

Ligaments of the Hip Joint

1. Iliofemoral Ligament

2. Pubofemoral Ligament

3. Ischiofemoral Ligament

4. Transverse Acetabular Ligament

3. Ligamentum Teres

left hip joint, disarticulated

Pelvic Gateways

There are two major pelvic gateways that transmit vessels from the pelvis to the lower limb •Myopectineal Orifice•Greater Sciatic Foramen

FemurFemur

IliumIlium

Greater Greater TrochanterTrochanter

Lesser TrochanterLesser TrochanterIschiumIschium

PubisPubis

Inguinal Inguinal LigamentLigament

Anterior Aspect Pelvis

The Myopectineal Orifice

Inferior Aspect Pelvis

Myopectineal Orifice

The Inguinal Ligament is the continuation of the lower edge of the

External Oblique Aponeurosis

Inguinal Ligament

It forms the upper boundary

of the Myopectineal Orifice

Pubis

The inferior boundary of the Myopectineal Orifice is the superior ramus of the pubis

and adjacent Ilium

Inguinal LigamentIlium

Pubis

The Femoral Nerve, Artery and Vein pass

through the Myopectineal Orifice

from the Iliac Fossa to enter the Lower Limb

Inguinal Ligament

Ilium

Femoral Nerve

Femoral Vein

Femoral Artery

Inguinal Ligament

Greater Trochanter

Ilium

Femoral Vessels are a direct continuation of External Iliac Vessels

found in the pelvis

External Iliac Vessels

Femoral Vessels

One of the major gateways between the abdomino-pelvic cavity

and the lower limb

The Greater Sciatic Foramen

One of the major gateways between the abdomino-pelvic cavity

and the lower limb

The Greater Sciatic Foramen

Sacrotuberous Ligament

Formed by the greater Sciatic Notch and the

Sacrospinous ligament attaching to the Ischial Spine

One of the major gateways between the abdomino-pelvic cavity

and the lower limb

The Greater Sciatic Foramen

Formed by the greater Sciatic Notch and the

Sacrospinous ligament attaching to the Ischial Spine

Sacrotuberous Ligament

Greater Sciatic Greater Sciatic ForamenForamen

Lateral View of Pelvis

SacrumSacrum

FemurFemurGreater TrochanterGreater Trochanter

Myopectineal

Orifice Sacrospinous Sacrospinous LigamentLigament

Sacrotuberous Sacrotuberous LigamentLigament

left hip region

A number of

− Muscles− Arteries − Nerves

pass through the Greater Sciatic Foramen

The Greater Sciatic Foramen

Sacrotuberous Ligament

Nerves that cross the Greater Sciatic Foramen

Sciatic NerveSuperior Gluteal NerveInferior Gluteal NerveNerve to Quadratus FemorisNerve to Obturator InternusPosterior Cutaneous Nerve of ThighPudendal NervePerforating Cutaneous Nerve

Nerves that cross the Greater Sciatic Foramen

See the Gluteal Region for further details

Vessels that cross the Greater Sciatic Foramen

Superior Gluteal ArteryInferior Gluteal ArteryInternal Pudendal Artery

(All of the above are branches of the Internal Iliac Artery)

See the Gluteal Region for further details