Ithaca College Department of Physical Therapy Human Anatomy Review Site

The Hip

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Follow the dissection manual closely for instructions on skinning the thigh and observation of the superficial features of the thigh.

FIG. 1-1 : ASIS & HIP FLEXORS (back to top)

To begin, observe the most proximal muscles of the hip on the anterior apesct of the iliacus, primarily used in hip flexion. These should be exposed following the dissection of the lower trunk and perineum. Observe the iliacus and psoas major and minor muscles as they join to form the iliopsoas muscle attaching to the lesser trochanter. In this illustration, the sartorius and tensor fascia lata muscles have already been exposed, but will not appear on your specimen until the next step of your dissection.

After carefully skinning the thigh you will have exposed the deep fascia of the thigh called the fascia lata. This strong, dense tissue encases the tensor fascia lata muscle. You will notice that on the lateral thigh the fascia thickens and forms a longitudinal , straplike band called the iliotibial band or IT band. Once you have identified the IT band, you will slit the fascia lata and reflect the It band to see the muscles of the anterior thigh.

FIG. 1-3 : SUPERFICIAL ANTERIOR THIGH (back to top)

There are four muscles which make up the anterior thigh (vastus medialis, intermedialis, lateralis, and rectus femoris) which together compose the quadriceps femoris muscle commonly known as "the quad". These four muscles form one common tendon called the patellar tendon which inserts intothe patella and continues to the tibial tuberosity.

FIG. 1-4 : SUPERFICIAL POSTERIOR HIP (back to top)

The gluteal (buttock) region lies on the posterior aspect of the pelvis. It is found by the large gluteus maximus muscle and other other smaller gluteal muscles. Carefully clean and define the borders of the gluteus maximus muscle and note its rhomboidal shape and oblique direction of its fibers. A portion of the gluteus medius muscle is visible superior to the gluteus maximus fibers.

FIG. 1-5 : SUPERFICIAL LATERAL HIP (back to top)

Familiarize yourself with the attachments of gluteus maximus. Proximally it attaches to the dorsal surface of the ilium, sacrum, as well as the sacrotuberous ligament. Reflect gluteus maximus laterally. Now the deeper strucures of the gluteal region are expose. Also note the gluteus medius and minimus muscles, which lie deep to the gluteus maximus, respectively. We will discuss the attachments of these muscles on a later picture. One of the most prominent features of the gluteal region is the sciatic nerve, which is located between the ischial tuberosity and the greater trochanter of the femur. Following the nerve proximally, you will notice that it enters the gluteal region just inferior to the piriformis muscle. Be aware of possible variations, in most cases both tibial and fibular divisions of the nerve pass together inferior to the piriformis; however, in some cases they emerge separately as indicated in fig. 1-6.

FIG. 1-6 : DEEP GLUTEAL REGION (back to top)

The piriformis passes through the greater sciatic foramen and is a good landmark from which to identify other structures in this region. Inferior to the piriformis you will see the obturator internus muscle, which traverses the lesser sciatic foramen and attaches on the medial surface of the greater trochanter. It's tendon splits the two gemelli muscle; superior gemellus attaching proximally to the ischial spine, inferior gemellus attaching proximally to the ischial tuberosity. Inferior to the inferior gemellus muscle, wou will note the quadratus femoris muscle, which runs from the ischial tuberosity to the intertrochanteric crest of the femur. Between the fibers of inferior gemellus and quadratus femoris, you will see the tendon of the obturator externus muscle as it inserts into the trochanteric fossa.

FIG. 1-7 : POSTERIOR HIP JOINT (back to top)

To see bony features and muscular attachments of the hip, click here.

FIG. 1-8 : SUPERFICIAL POSTERIOR THIGH (back to top)

Viewing the posterior thigh, you can see the three large muscles collectively known as the hamstrings. Two of the three muscles, the semitendinosus and semimembranosus muscles, run medially along the thigh. The third, biceps femoris muscle, runs laterally. The hamstring group all share a common proximal attachment, the ischial tuberosity.

FIG. 1-9 : ISCHIAL TUBEROSITY (back to top)

Figure 1-9 illustrates the hamstring attachment on the ischial tuberosity as it would appear if all musculature was removed.

FIG. 1-10 : DEEP LATERAL HIP (back to top)

Figure 1-10 illustrates bony attachments of the musculature of the anterior, lateral and gluteal regions of the thigh as it would appear if all musculature were removed.

FIG. 1-11 : MAGNIFIED POSTERIOR HIP (back to top)

Dissection of the hip joint requires removal and reflection of all the muscles, nerves and vessels of the hip. Surrounding the head and neck of the femur, observe the fibrous joint capsule of the hip joint (reflected in illustration). An important part of the joint capsule is the iliofemoral ligament, which can be seen from an anterior view (see fig. 1-10).

FIG. 1-12 : DISTRACTED HIP (back to top)

Once you have removed the joint capsule, you will be able to distract the head of the femur from the acetabulum. Following the distraction, you will be able to see the smooth shiny cartilage surface of the head of the femur. Also in the head of the femur, note the small indentation, or fovea, where the ligament of the head of the femur attaches. This ligament is a synovial tube which attaches within the acetabular fossa. This ligament is important to movement in that it becomes taught with hip adduction. Observe the acetabular ligament, a dense fibrous structure forming a concentric ring around the acetabulum by completing the "C" shaped acetabular labrum.

FIG. 1-13 : HIP SOCKET (back to top)

Within the acetabulum, identify the lunate articular surface. Also, you can observe that the acetabular fossa contains a fatpad that is lined with synovial membrane. Note that in our specimen, the hyaline cartilage of the lunate articular surface is shiny and smooth, characteristic of healthy, painfree cartilag. If this person had been affected by degenerative joint disease or another joint pathology, you may see rough or pitting surfaces in place of these smooth, healthy surfaces.

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This page created by Jennfier Biviano, Todd Mitchell, & David Orenstein. © 2000, Stephen P. Lahr
The text has been adapted from Grant's Dissector, 11th edition
Maintained by Stephen Lahr. Last updated: 3/21/03