This PPT explain about the anatomy of pectoral girdle and femur, associated joints and muscles.

1. BY
HERMIZAN HALIHANAFIAH

2. OBJECTIVES
Explain the bony structure of pelvic girdle and femur
Explain the associated joints of pelvic girdle and
femur
Explain about the muscles of pectoral girdle and
femur.

3.  Hip girdle
 Consists of :
 2 hip bones
 Pubic
symphysis
 Sacrum
PELVIC GIRDLE

4.  Known as coxal bones
 Unite anteriorly at pubic symphysis
 Unite posteriorly with the sacrum at the sacroiliac
joints
Pelvic / innominate / hip bones

5.  Hip bone consists of 3
bones separated by
cartilage in newborn :
- ilium : superior
- pubis : inferior &
anterior
- ischium : inferior &
posterior
Pelvic / innominate / hip bones

6.  Largest of the 3
components of hip bone.
 Divided into:
1. Superior ala ( = wing)
2. Inferior body – form
acetabulum
Ala

8. Superior border – iliac crest
 Ends anteriorly in a blunt - anterior superior iliacanterior superior iliac
spine (ASIS)spine (ASIS)
 Below ASIS – anterior inferior iliac spine (AIIS)
 Ends posteriorly in a sharp: posterior superior iliac
spine (PSIS)
 Below PSIS – posterior inferior iliac spine (PIIS)
 The spines - as a points of the attachment for the
tendons of the muscles of the trunk, hip and thighs.
 Below the PIIS - greater sciatic notch which allow the
passage of the sciatic nerve

9. iliac tuberosity

10.  Conspicuous marking lateral surface of ilium are 3 arched
lines :
 Posterior, anterior and inferior gluteal line
 The gluteal muscles attach to the ilium between these lines.
Medial surface of ilium:
 iliac fossa – a concave surface; attachment site for iliacus
muscle.
 Posterior to iliac fossa
iliac tuberosity – attachment site for sacroilliac
ligament.
auricular surface - which articulates with the sacrum
to form the sacroilliac joint.
 Projecting anteriorly and inferiorly from the auricular surface -
arcuate line.

11.  Inferior & posterior
portion of the hip bone
 Divided into :
 Superior body
 Inferior ramus

12. Ischial spine
Lesser sciatic notch
Ischial tuberosity

13. The apex of the angulation is blunt and rounded, forming
ischial tuberosity.
In the sitting position, the weight of the body rest on the
two ischial tuberosity.
Anteriorly the tuberosity passes upward as the ischial
ramus continuous with inferior pubic ramus, forming
ischiopubic ramus.
The body of ischium forming 2-fifth of the acetabulum.
Posterior border of the body is continuous above to form
greater sciatic notch.
Inferiorly this border end as a blunt medially projecting
called ischial spine, below which is the groove forming the
lesser sciatic notch.

14.  Anterior & inferior part
of the hip bone
 Divided into:
 Superior ramus
 Inferior ramus
 Body (between
the rami)

15.  Anterior border of the body - pubic crest
 Lateral end – a projection called the pubic tubercle
 Together ramus of ischium and ramus of pubis
surround the obturator foramen
 Pubic symphysis:
 Joint between the two pubic bones
 Consist of disc of fibrocartilage
 Ampiarthroses

16. iliopectineal
line

18.  Is a deep fossa formed by ilium, ischium and pubis
 The anterior 1/5th
of the acetabulum is formed by the
pubis, the posterosuperior 2/5th
by the body of ilium and
the posteroinferior 2/5th
by the body of ischium.
 Function – as the socket that accept head of the femur
 Together the acetabulum and head of femur  form
hip (coxal) joint / acetabulofemoral joint.
 Inferior side of the acetabulum - acetabular notch, is a
deep indentation, forms a foramen through which
blood vessels & nerves pass

19. Functions of the Pelvic Girdle
1. Supports and protects the pelvis viscera (as well lower
abdominal) ---- true pelvis and false pelvis
2. Supports the body weight transmitted through vertebra,
hence through sacrum, across the sacroilliac jt to the
innominate bones and then to the femur in standing
position or to the ischial tuberosity when sitting.
3. During walking the pelvis swings from side to side by a
rotatory movement at the lumbosacral jt, enables a patient
to walk reasonably well

20. 4. Provide muscles attachments
5. In the female it provides bony support for the birth
canal
6. Accepts the bones of the lower limbs, connecting them
to the axial skeleton
Functions of the Pelvic Girdle

21. LOWER LIMB (EXTREMITY)
30 bones
- Femur
- Patella
- Tibia and fibula
- 7 tarsal
- 5 metatarsal
- 14 phalanges

22. FEMUR
Thigh bone
Is the longest, heaviest, strongest bone
Proximal end articulates with the acetabulum of the
hip bone
Distal end articulates with tibia and patella
Body (shaft) closer to midline
The angle is greater in females - pelvis is broader

24. PROXIMAL END OF FEMUR
Rounded head which articulates
with the acetabulum of the hip
bone to form the hip (coxal)
joint
The head contains fovea capitis -
a small centered depression.
Ligament of the head of femur
(ligamentum teres) connects the
fovea capitis of femur to the
acetabulum of the hip bone
The neck of femur is constricted
distal to the head
Neck connect the head into shaft
and have 125° angle. (Normal

26. Torsion Angle
The angle of torsion
between femoral
neck and femoral
shaft on the
transverse plane.
Femoral neck
normally project
upward about 15 °.
(normal anteversion)

27. Greater and lesser trochanter - projection from the
junction of the neck and shaft  serves as points of
attachment for the tendons of some of the thigh and
buttock muscles
Greater trochanter – large quadrilateral process,
prominence felt and seen anterior to the hollow on the
intramuscular injection
Lesser trochanter – conical in shape, inferior and
medial to the greater trochanter

28. Between the anterior surface of the trochanters is a
narrow intertrochanteric line
Between the posterior surface of the trochanter is a
ridge called the intertrochanteric crest
Inferior to the intertrochanteric crest posteriorly on
the body of femur is a vertical ridge called gluteal
tuberosity
Gluteal tuberosity blends into another vertical ridge
called the linea aspera
Linea aspera serves as attachment points for the
tendons of several thigh muscle

29. DISTAL END OF FEMUR
• Expanded distal end of the femur includes the
medial condyle and the lateral condyle
• Superior to the condyle are medial epicondyle and
lateral epicondyle to which the ligament of the
knee joint attach
• The patella surface is located between the
condyles on the anterior surface
• Intercondylar fossa - depressed area between
condyles on the posterior surface

30. Figure 8.38a

31. Figure 8.38b

32. SACROILIAC JOINT
Articulation surface – auricular surface of ilium and
auricular surface of sacrum
It is a strong, weight bearing synovial joint with
irregular elevations and depressions articulating
surface that produce interlocking of the two bones
Strengthen anteriorly and posteriorly by strong
ligaments --- ant/post sacroiliac lig, sacrotuberous
lig , sacrospinous lig
At the same time strengthen by anterior (abdominal
muscles) posterior by gluteal muscles.
Less mobility, but more stability – resist high level of
forces of the pelvis during walking, running, jumping
etc.

33. Ligaments of the Sacroilliac Jt
SI jt is richly endowed with
ligaments.
Extreamly strong posterior
and slightly weaker anterior
ligaments surrounds the
capsule
And accessory ligaments
situated some distance from
the joint provide additional
stability against unwanted
movements.

34. Anterior Sacroilliac Ligament
Broad and flat
Lying anteriorly on the
pelvic side of the joint
It stretches from the ala
and pelvic brim to the
adjoining margin of the
auricular surface of the
illium.

35. Posterior Sacroiliac Ligaments
 Lying posterior and superior of the joint
 Much more thicker and stronger than anterior SI
Lig.
 Several specific bands identified as they extend
from sacrum and the tuberosity of the ilium.
1. Interosseous Sacroiliac Lig.
2. Long and short posterior SI Lig

36. Posterior Sacroiliac Ligament

37. Interosseous SI Ligament
The deepest of all the
posterior SI Lig.
Short, thick and
extremely strong.
Fills the narrow cleft
between the rough
areas on the bones
immediately behind
and above the
auricular surface.

38. Short and Long Posterior SI Ligament
Superficial to the Interosseous SI Lig
Consist of numerous bands passing between two bones
Passing horizontally on the upper part between the two
bones – short band
Passing obliquely downwards and medially between 2
bones – long band
Short Posterior SI Lig – resist anterior movement
anterior movement of sacral promontory
Long Posterior SI Lig – resist downward movement of
the sacrum

39. Short and Long Posterior SI Ligament

40. Accessory Ligaments of SI Jt
 The most accessory lig that provide stability to the
SI jt are:
1. Supraspinous lig
2. Sacrotuberous lig
 Help stabilize the sacrum on the pelvic bone by
preventing from forward tilting of the sacral
promontory.
 They also converting greater and lesser sciatic
notch into greater and lesser sciatic foramina.

41. Sacrotuberous Ligament
Flat, triangular, strong
Attached between PSIS
and PIIS, back and side of
the sacrum and coccyx
and continuously
attached to the ischial
tuberosity

42. Sacrospinous Ligament
Triangular band
Deep to the
sacrotuberous lig
Attached from the
lower edge of the
sacrum and coccyx,
continuously extends
and attached to the
ischial spine.

44. Movements of Sacroiliac Jt
Arrangement of the jt
surface and ligamentous
support given minimum
movement – low ROM
Slight gliding and
rotation between two
bones – forward tilting
and backward tilting.

46. HIP JOINT
Also known as coxal joint
The hip joint referred to as the acetabulofemoral joint
Multiaxial ball and socket joint
Articulation surface ---Head of femur and acetabulum
of hip bone
Its primary function is to ; 1. Stability -- support the
weight of the body in both static (e.g. standing) and 2.
Mobility --dynamic (e.g. walking or running) postures.

47. Movement of Hip joint
1. Flexion
2. Extension
3. Abduction
4. Adduction
5. Medial rotation of thigh
6. Lateral rotation of thigh

48. The Stability of the Hip Joint
The stability of the hip joint determined by
Shape of the articular surface
Strength of the articular capsule
Strength of the ligaments (extra and intracapsular)
Insertion muscles that crossing the joint

49. Articular Capsule
The fibrous capsule of the hip is very strong, thicker
anteriorly and superiorly
Proximally the capsule surrounds the acetabulum,
attaching directly outside the labrum
Distally attached anteriorly to the intertrochanteric
line and to the junction of the neck and trochanters.

50. Hip Joint

51. Extracapsular Ligaments
 There are three extracapsular ligaments that
stabilize and strengthen the hip joint
1. Iliofemoral ligament
2. Pubofemoral ligament
3. Ischiofemoral ligament
 Prevent an excessive range of movement in the joint.

52. Iliofemoral Ligament
Y shaped - Very strong and
consider thickness
Situated anterior to the joint
Triangular band which apex
attaching to the lower part of
the AIIS and adjacent part of
the labrum
And the base attached to the
intertrochanteric line.
Prevent hyperextension of the
hip joint especially during
standing

53. Ischiofemoral Ligament
Spiral in shape
Arises from the body of the
ischium and attached to
the superior part of the
neck and greater trochanter
of the femur.
This ligament slackens
during adduction, tenses
during abduction &
strengthens the articular
capsule.

54. Pubofemoral Ligament
Runs from the iliopubic
eminence and superior
ramus of pubic and attached
to the intertrochanteric line
(blends with iliofemoral lig)
Prevents overabduction of
the femur at the hip joint &
strengthens the articular
capsule.

55. Role of the Extracapsular
Ligaments
During standing erection – all three lig are under
moderate tension
Hip flexion – all lig become relax
Hip extension – all lig become taut (greatest tension
from iliofemoral)
Hip adduction - iliofemoral (taut), pubo and
ischiofemoral (slackens)
Hip abduction – iliofemoral (slackens), pubo and
ischiofemoral (taut)

56. Cont..
Lateral rotation – iliofemoral and pubofemoral lig
(taut), ischiofemoral (slackens)
Medial rotation – iliofemoral and pubofemoral
(slackens), ischiofemoral (taut)

57. Intracapsular ligaments
1. Ligamentum teres
Within the hip joint, weak
lig
Attacheds at one end of
fovea capitis head of femur,
and the other end to the
acetabular fossa, transverse
acetabular lig and acetabular
notch.
Little importance of
strengthening hip jt
It is only stretched when the
hip is dislocated, and may
then prevent further
displacement

58. Tranverse ligament of the acetabulum
Strong ligament that crosses
over the acetabular notch.
The inferior deficiency in the
acetabular rim (labrum)
completed by transverse
ligament.

59. Acetabular Labrum (Acetabular Rim)
The acetabulum is
deepened by the
fibrocartilaginous
acetabular labrum
Attach to the bony rim of
the acetabulum and to the
transverse ligament
The acetabular labrum cups
around the head, holding it
firmly in the acetabular
socket.

62. Muscles that Move the Hip Joint
Hip Extensor
1. Gluteus maximus
2. Hamstring
1. Biceps femoris
(long head)
2. Semitendinosus
3. semimembranosus
Hip Flexor
1. Psoas major
2. Iliacus
3. Rectus femoris
4. Sartorius
5. Pectineus

63. Muscles that Move the Hip Joint
Hip Abductor
 Gluteus maximus
 Gluteus minimus
 Gluteus medius
 Tensor fascia latae
Hip Adductor
 Adductor longus
 Adductor magnus
 Adductor brevis
 Gracilis
 pectineus

64. Muscles that Move the Hip Joint
Hip Medial Rotator
 Gluteus medius
 Gluteus minimus
 Tensor fascia latae
 Psoas major
 Iliacus
Hip Lateral Rotator
 Gluteus maximus
 Piriformis
 Obturator internus
 Obturator externus
 Superior gamellus
 Inferior gamellus
 quadratus

65. Psoas major
- Origin :transverse processes &
bodies of lumbar vertebrae
- insertion : with iliacus into
lesser trochanter of femur
- action : flexes thigh at hip
joint, flex trunk on the hip as
sitting up from the supine
position
- nerves : lumbar spinal nerves
L2-L3

66. Iliacus muscle
 Origin : Iliac fossa and
sacrum
 Insertion : with psoas major
into lesser trochanter of femur
 action : flexes thigh at hip
joint, flex trunk on the hip as
sitting up from the supine
position
 Nerves : Femoral nerve

67. Gluteus maximus
- Origin : iliac crest, sacrum,
coccyx, aponeurosis of
sacrospinalis
- Insertion : iliotibial tract of
fasiae lata and greater
trochanter of femur
- Action : Extends thigh at hip
joint & lateraly rotates thigh
- Nerve : Inferior gluteal nerve

69. Gluteus medius
- Origin : gluteal surface of
ilium
- Insertion : Greater
trochanter of femur
- Action : Abducts thigh at
hip joint and medially
rotates thigh
- Nerve : Superior gluteal
nerve

70. Gluteus minimus
- Origin : gluteal surface of
ilium
- Insertion : Greater
trochanter of femur
- Action : Abducts thigh at
hip joint and medially
rotates thigh
- Nerve : Superior gluteal
nerve

71. Figure 10.33

72. Tensor fasciae latae
- Origin : iliac crest
- Insertion : iliotibial tract
- Action : help in Flexes,
abducts and medial rotation
thigh at hip joint
- Nerve : Superior gluteal
nerve

73. Figure 7.25a

74. Piriformis
- Origin : anterior sacrum
- Insertion : superior border
of greater trochanter of
femur
- Action : laterally rotates &
abducts thigh at hip joint
- Nerve : sacral spinal nerves
S1 or S2

75. Obturator internus
Origin : inner surface of
obturator foramen, pubis,
and ischium
Insertion : medial surface
of greater trochanter of
femur
Action : laterally rotates &
abducts thigh at hip joint
Nerve : nerve to obturator
internus

76. Obturator externus
Origin : outer surface of
obturator membrane
Insertion : deep depression
inferior to greater
trochanter of femur
Action : Laterally rotates &
abducts thigh at hip joint
Nerve : obturator nerve

78. Superior gemellus
Origin : ischial spine
Insertion : medial surface
of greater trochanter of
femur
Action : Laterally rotates &
abducts thigh at hip joint
Nerve : nerve to obturator
internus

79. Inferior gemellus
Origin : ischial tuberosity
Insertion : medial surface
of greater trochanter of
femur
Action : Laterally rotates &
abducts thigh at hip joint
Nerve : nerve to quadratus
femoris

80. Quadratus femoris
Origin : ischial tuberosity
Inserton : elevation
superior to mid-portion of
intertrochanteric crest on
posterior femur
Action : lateraly rotates &
abducts hip joint
Nerve : nerve to quadratus
femoris

82. Adductor longus
Origin : pubic crest and
pubic symphysis
Insertion : linea aspera of
femur
Action : addducts and flexes
thigh at hip joint and laterally
rotates thigh
Nerve : obturator nerve

83. Adductor brevis
Origin : inferior ramus of pubis
Insertion : superior half of
linea aspera of femur
Action : addducts and flexes
thigh at hip joint and medially
rotates thigh
Nerve : obturator nerve

84. Adductor magnus
Origin : inferior ramus of
pubis and ischial tuberosity
Insertion : linea aspera of
femur
Action : adducts thigh at hip
joint and laterally rotates
thigh, anterior part flexes
thigh at hip joint & posterior
part extends thigh at hip joint
Nerve : obturator & sciatic
nerve

85. Pectineus
Origin : superior ramus of
pubis
Insertion : pectineal line of
femur, between lesser
trochanter and linea aspera
Action : flexes and adducts
thigh at hip joint
Nerve : femoral nerve

86. Figure 10.35a

87. Figure 10.34

88. Figure 10.32

89. MUSCLES THAT ACT ON THE FEMUR
(THIGH BONE) & TIBIA AND FIBULA
(LEG BONES)
Deep fascia separate the thigh muscles that act on
the thigh bone into compartment
- Medial (Adductor)
- Anterior (Extensor)
- Posterior (Flexor)

90. MEDIAL COMPARTMENT
(ADDUCTOR)
Adductor magnus
Adductor longus
Adductor brevis
Pectineus
Gracilis

91. Gracilis
- origin: body and inferior ramus
of pubis
- Insert : medial surface of body
of tibia
- action : adducts thigh at hip
joint, medially rotates thigh &
flexes le at knee joint
- Nerve : Obturator nerve

93. ANTERIOR (EXTENSOR)
COMPARTMENT
Extend leg at knee joint
Quadriceps femoris:
- largest muscle in the body
- covering the anterior surface & sides
- 4 separate muscles : rectus femoris,
vastus lateralis, vastus medialis,
vastus intermedius
Sartorius muscle – long, narrow, forms a band
across the thigh from the ilium of the hip bone to the
medial side of the tibia

94. Quadriceps femoris
Rectus femoris
Origin : anterior inferior iliac spine
vastus lateralis
Origin : greater trochanter and linea aspera of femur
vastus medialis
Origin : linea aspera of femur
vastus intermedius
Origin : anterior & lateral surfaces of body of femur

95. Quadriceps femoris
All the Quadriceps femoris muscles
insert to patella via quadriceps tendon and then
tibial tuberosity via patellar ligament.
Action : all four heads extend leg at knee joint ;
rectus femoris muscle acting alone also flexes thigh
at hip joint.
Innervation : femoral nerve

96. quadriceps superficial

97. quadriceps deep

99. Sartorius muscle
Origin : anterior superior
iliac spine
Insertion : medial surface
of body of tibia.
Action : flexes leg at knee
joint ; flexes, abducts &
laterally rotates thigh at
hip joint.
Innervation : femoral
nerve

100. POSTERIOR COMPARTMENT
(FLEXOR)
Flex the leg and extend the thigh
Hamstrings : composed of 3 muscles
a) biceps femoris
b) semitendinosus
c) semimembranosus

101. Biceps femoris
Origin : long head arises from
ischial tuberosity, short head
arises from linea aspera of
femur
Insertion : head of fibula &
lateral condyle of tibia
Action : flexes leg at knee joint
& extends thigh at hip joint
Innervation : tibial & common
peroneal nerves from the
sciatic nerve

102. Semitendinosus
Origin : ischial tuberosity
Insertion : proximal part of
medial surface of shaft of
tibia
Action : flexes leg at knee
joint & extends at hip joint
Innervation : tibial nerve
from the sciatic nerve

103. Semimembranosus
Origin : ischial tuberosity
Insertion : medial condyle of
tibia
Action : flexes leg at knee
joint & extends at hip joint
Innervation : tibial nerve
from the sciatic nerve

105. Clinical Importance
Fractures the hip joint are known as hip
fractures
Femoral head fracture:
fracture involving the femoral head
due to high energy trauma and a
dislocation of the hip joint

106. Femoral neck fracture:
fracture adjacent to the femoral head in
the neck between the head and the
greater trochanter
damage the blood supply to the femoral
head, potentially causing avascular
necrosis

107. Intertrochanteric fracture:
fracture line is between the greater and
lesser trochanter on the
intertrochanteric line
common type of hip fracture

109. Hamstring Strain / Pulled Hamstring
excessive stretch or tear
of muscle fibers and
related tissues.
Strike athletes of all
sports – runners,
footballer etc.

110. Groin Injury / Groin Pull
Injury to the muscles of
the inner thigh
Groin muscles referred
to adductor group of
muscles
Adductor muscle is
stretched too far
(muscles strain)
Groin pulls are often
seen in athletics who
participate in sports such
as ice hockey and
football.