Hip
ANTERIOR ANATOMY
The superficial and most palpable muscle on the medial thigh is the adductor longus. Its proximal tendon, the common adductor tendon, is attached to the pubis. Pectineus is medial to this, and the obturator nerve and artery is beneath it The psoas muscle/tendon lies lateral to pectineus the fleshy iliacus component adjacent to the tendinous psoas portion. Vastus intermedius is a little more distal The hip joint lies deep to these The acetabulum is deepened by the labrum which is deficient inferiorly The defect is filled by the transverse ligament The ligamentum teres runs from this ligament to the fovea of the femoral head. Overlying the hip joint a little tothe lateral side is the main or direct of the two origins of rectus femoris The indirect/reflected head arises from the superior margin of the acetabulum. Above the hip joint is the anterior superior iliac spine (ASIS). The oval-shaped tendon of Sartorius can be seen to arise from it. Medial to this are the muscles of the abdominal wall. These form three layers from superficial they are • obturator externus, • obturator internis and • transversus abdominis The ilioinguinal nerve can be located between the second and third muscle layers. The inguinal ligament passes from the ASIS to a small tubercle on the pubic bone. T The lateral cutaneous nerve of thigh lies beneath it, close to its lateral attachment surrounded by a small cuff of fat. The nerve passes distally on the superior surface of sartorius.
LATERAL ANATOMY
The lateral cortex of the femur is pointed superiorly forming three facets the anterior, middle and superior The gluteus minimus tendon inserts on the anterior facet The lateral portion of the gluteus medius insertion inserts on the middle facet. The remainder of the gluteus medius tendon inserts onto the superior facet, w The gluteus medius has a short tendon below the MTJ The gluteus minimus bursa lies deep to its tendon, but inflammation often involved the paratenon more than the bursa The medial bursa lies deep to the tendon. The trochateric bursa is the most superficial deep to the ITB
POSTERIOR ANATOMY
In the space between the posteromedial margin of the tip of the greater trochanter and the ischial tuberosity lies the • hamstring origin medially • Sciatic nerve just lateral to it • the quadratus femoris muscle centrally and, deep to this • the tendon of obturator externus • The gemelli muscles proximally overlying the • Hip joint and posterior labrum The quadratus femorus and obturator externus occupy the ischiofemoral fossa