r
Chapter 1: Bones of the lower limb 1
The bones of the lower limb form pelvic girdle & 3 segments. The girdle is complete as the 2 hip
bones articulate together anteriorly (at symphysis pubis) and posteriorly with the sacrum.
The 3 segments are: - First segment: Femur (the skeleton of the thigh).
- Second segment: Tibia and fibula (bones of leg).
- Third segment: Bones of the foot.
r
The Hip Bone
The hip consists of three bones artlculatlnq by Y-shaped articulation at the acetabulum.
These bones are (Fig.2):
- Ilium: The upper 2/5 of the hip bone. "1fl •• ~~~-lIiac tubercle
Iliac crestL-4~'liV'!::
- Ischium: The lower posterior 2/5 of the hip. It
Iliac ala
is formed of body, tuberosity and a ramus. ===~~--7.(wing)
- Pubis: The lower anterior 1/5 of the hip. It is
formed of superior, inferior rami and body. Body OIL---li~=-"-'~'-¥-~
ilium
The hip bone has 4 borders:
1. Upper border (iliac crest) is formed of:
- Anterior 2/3:
- It is thick, convex outwards with outer, inner Body of
Inferiorpubic
ramus
lips & intermediate rough part. Ischium
Conjoint ramus
- Has iliac tubercle 5 cm from the anterior
FII.2: hl1:l of tIhle
superior iliac spine.
hip bone Ischial Obturator
tuberosity foramen
- Post er ior 1/3: - Is thin and concave "
outwards.
,;.r·---';';;;"'~~--lIiac crest
N.B.: The highest point of the iliac crest (a little
behind its midpoint) is in level of L31 L4 ---~~k--- Iliacfossa
vertebrae.
''':'~~I-- Iliactuberosity
2- Lower border: Is formed of the inferior pubic
ramus and ischial ramus (conjoint rami).
3- Anterior border: Has the following features
from above downwards (Fig.3):
1. Anterior superior iliac spine (A.S.I.S.). t-----Arcuate line
2. Anterior inferior iliac spine.
Ant.inf. iliac lIiopubic(iliopectineal)
3. lliopubic (iliopectineal) eminence.
4. Pectineal border & surface of superior pubic
ramus.
spine emirience
~-Ischial spine
-
5. Pubic crest, tubercle.
4. Posterior border: From above downwards, it
presents the following features:
1. Posterior superior iliac spine. Flg.3: Rt. hip bone
2. Posterior inferior iliac spine. (anterior view)
, ~hapter 1: Bones of the lower ilmb 2 I
I 3. Greater sciatic notch. 4. Ischial spine. 5. Lesser sciatic notch.
6. Ischial tuberosity: Anterior (middle)gluteal line Inferior gluteal line
Iliac crest
It is divided by a transverse ridge
into upper quadrangular and lower
r triangular parts.
The upper quadrangular part is
divided by an oblique ridge into
upper lateral and lower medial Posterior
superior iliac
areas. spine
The lower triangular part is divided
Posterior inferior
by a longitudinal ridge into lateral iliac spine
and medial areas.
The hip bone has 2 surfaces
(Figs 4 & 5):
",
r~1_ Outer surface: Has the following Lesser sciatic notch --"'\
features. Upper lupper lat. area
quarangular Lower med. area
r A. Three gluteal lines: Posterior, /part
middle (anterior) and inferior. Ishial L~wer ILat. area
~ triangular Med area-~QIi~~_
tuberosity part
B. Acetabulum: Is the socket of the
hip joint, it has: Flg.4: Rt hip bone (lateral view)
Horse - shoe articular surface
(Iunate surface).
- Rough non articular (acetabular fossa) in the concavity of lunate surface.
r=: - Acet abular not ch: A deficiency on
the inferior aspect of the acetabulum.
C. Obturator foramen:
Iliac crest-_-f
Iliac fossa
Sacropelvic surface
Iliac tuberosity
Auricular
surface
j
It lies below and slightly anterior to
the acetabulum.
r The obturator membrane fills this
foramen except superiorly (obturator
canal). ASIS
The obturator canal allows passage
of obturator nerve & vessels. .....--Greater sciatic notch
Ischial spine
"2_ Inner surface: Contains the following
=features:
A. Iliac fossa: Is the internal concavity
of the ilium.
B. Sacropelvic surface: Shows:
-Rough iliac tuberosity.
-Auricular surf ace for articulation Pig": Rt. hip
with the sacrum. • •• (m •••••
-Pelvic surface of the hip bone. vieW)
, Chapter 1: Bones of the lower limb 3
C. Arcuate line: Separates the sacropelvic surface from the iliac fossa.
The pubis has the following parts and features:
1. Body: Has: - 3 surfaces: Anterior, posterior and medial symphyseal surfaces.
I - Upper border (pubic crest), its lateral extremity is the pubic tubercle.
2. Superior ramus: Has 3 surfaces:
I A. Pectineal surface, bounded behind by the pectineal line (pecten pubis).
B. Pelvic surface. C. Obturator surface.
I 3. Inferior ramus:
How to determine the side:
Has internal and external surfaces.
We put the hip bone in anatomical position with:
I - Iliac crest (above). - Ischial tuberosity (below & behind). - Acetabulum (lateral).
NB: The position of the hip bone in the erect posture may be demonstrated by holding it so that the
I anterior superior iliac spine and the top of pubic symphysis are in the same vertical plane.
NB: In the sitting posture, the body rests on the medial and lower parts of the ischial tuberosities.
I Subcutaneous parts of hip bone:
1. Anterior superior iliac spine. 2. The whole of iliac crest. 3. Ischial tuberosity.
I 4. Pubic tubercle, to feel it abduct, flex and laterally rotate the thigh. The rounded tendon of
adductor longus is felt. The bony prominence just above it is the pubic tubercle.
Ossification of hip bone:
I - The junction between pubic and ischial rami ossifies at 8 years.
- The tri-radiate cartilage of the acetabulum ossifies at 15 years.
I - Both ischial tuberosity and ossification centres of iliac crest fuse at 25 years.
Nerves related to the hip bone:
I - The sciatic nerve lies at the inferior margin of the greater sciatic notch.
- The obturator nerve runs in the obturator groove.
- The pudendal nerve runs in the pudendal canal along the inner surface of ischial tuberosity.
I Sex differences of the hip bone'
Differences Male Female
I 1. Subpubic angle. Acute (50-60 degrees). 80-85 degrees.
2. Edge of pubic arch. More everted. Less everted.
I 3. Distance from symphysis pubis
to anterior margin of acetabulum
Equals transverse
acetabulum.
diameter of More than transverse
diameter of acetabulum
I 4. Greater sciatic
5. Obturator foramen.
notch. Deep and narrow.
Oval.
Wide and shallow.
Triangular
I 6. Iliac fossa.
7. Auricular surface.
Shallow.
Articulates with 21/2 sacral
More concave.
Articulates with 2 sacral
pieces. pieces.
I
I
I
, Chapter 1: Bones of the lower limb 4
Particular features of the hip bone
A. Muscles attached
I Site
Iliac crest
Muscle attached
Tensor fascia lata
o or
OriQin
I Exact site of attachment
Outer lip of iliac crest bet. ASIS & iliac tubercle.
Latissimus dorsi Origin Outer lip of iliac crest behind the highest point.
I Gluteus maximus Oricin Outer surface of the posterior part.
Anterior Sartorius Oriqin Lower part of the ASIS.
I border
Straight
femoris
head of rectus Origin Upper part of the anterior inferior iliac spine.
Outer Gracilis Oriqin Body of pubis & inferior pubic ramus.
I surface of
the body of
Adductor longus Oriqin Outer surface of the body of the pubis.
the pubis & Adductor brevis Origin Outer surface of body of pubis & inferior pubic
I conjoint
ramus Adductor magnus (pubic Origin
ramus.
Outer surface of conjoint ramus.
part)
I Obturator externus
Pectineus
Origin
Origin
Outer margin of obturator foramen.
Pectineal surface & line of the superior pubic
ramus.
I Ischial
tuberosity
Semimembranosus Origin Upper
part.
lateral area of the upper quadrangular
I Semitendinosus
head of biceps
& long Origin Lower
part.
medial area of the upper quad rangular
Adductor magnus (ischial Origin Medial area of the lower triangular part.
I part)
Quad ratus fern oris Oriqin Lateral border.
Lesser Gemellus superior Origin Upper rnarqin of the lesser sciatic notch.
I sciatic
notch
Gemellus inferior Origin Lower marg in of the lesser sciatic notch.
Gluteal Gluteus maximus Origin Gluteal surface of ilium behind the posterior
I surface
the ilium
of
Gluteus medius Origin
gluteal line.
Gluteal surface of ilium between the posterior &
middle gluteal lines.
I Gluteus minimus Origin Gluteal surface of ilium between the middle &
inferior gluteal lines.
I Inner
Reflected
femoris
Iliacus
head of rectus Origin
Oriqln
Area above the acetabulum.
Floor of the iliac fossa.
I surface
hip bone
of
Obturator internus Origin Inner margin of the obturator foramen & pelvic
surface of ilium till the qreater sciatic notch.
Levator ani Origin Body of pubis & ischial spine.
I Psoas minor Insertion lIiopubic eminence.
I
I
I
Chapter 1: Bones of the lower limb 1
The bones of the lower limb form pelvic girdle & 3 segments. The girdle is complete as the 2 hip
bones articulate together anteriorly (at symphysis pubis) and posteriorly with the sacrum.
The 3 segments are: - First segment: Femur (the skeleton of the thigh).
- Second segment: Tibia and fibula (bones of leg).
- Third segment: Bones of the foot.
r
The Hip Bone
The hip consists of three bones artlculatlnq by Y-shaped articulation at the acetabulum.
These bones are (Fig.2):
- Ilium: The upper 2/5 of the hip bone. "1fl •• ~~~-lIiac tubercle
Iliac crestL-4~'liV'!::
- Ischium: The lower posterior 2/5 of the hip. It
Iliac ala
is formed of body, tuberosity and a ramus. ===~~--7.(wing)
- Pubis: The lower anterior 1/5 of the hip. It is
formed of superior, inferior rami and body. Body OIL---li~=-"-'~'-¥-~
ilium
The hip bone has 4 borders:
1. Upper border (iliac crest) is formed of:
- Anterior 2/3:
- It is thick, convex outwards with outer, inner Body of
Inferiorpubic
ramus
lips & intermediate rough part. Ischium
Conjoint ramus
- Has iliac tubercle 5 cm from the anterior
FII.2: hl1:l of tIhle
superior iliac spine.
hip bone Ischial Obturator
tuberosity foramen
- Post er ior 1/3: - Is thin and concave "
outwards.
,;.r·---';';;;"'~~--lIiac crest
N.B.: The highest point of the iliac crest (a little
behind its midpoint) is in level of L31 L4 ---~~k--- Iliacfossa
vertebrae.
''':'~~I-- Iliactuberosity
2- Lower border: Is formed of the inferior pubic
ramus and ischial ramus (conjoint rami).
3- Anterior border: Has the following features
from above downwards (Fig.3):
1. Anterior superior iliac spine (A.S.I.S.). t-----Arcuate line
2. Anterior inferior iliac spine.
Ant.inf. iliac lIiopubic(iliopectineal)
3. lliopubic (iliopectineal) eminence.
4. Pectineal border & surface of superior pubic
ramus.
spine emirience
~-Ischial spine
-
5. Pubic crest, tubercle.
4. Posterior border: From above downwards, it
presents the following features:
1. Posterior superior iliac spine. Flg.3: Rt. hip bone
2. Posterior inferior iliac spine. (anterior view)
, ~hapter 1: Bones of the lower ilmb 2 I
I 3. Greater sciatic notch. 4. Ischial spine. 5. Lesser sciatic notch.
6. Ischial tuberosity: Anterior (middle)gluteal line Inferior gluteal line
Iliac crest
It is divided by a transverse ridge
into upper quadrangular and lower
r triangular parts.
The upper quadrangular part is
divided by an oblique ridge into
upper lateral and lower medial Posterior
superior iliac
areas. spine
The lower triangular part is divided
Posterior inferior
by a longitudinal ridge into lateral iliac spine
and medial areas.
The hip bone has 2 surfaces
(Figs 4 & 5):
",
r~1_ Outer surface: Has the following Lesser sciatic notch --"'\
features. Upper lupper lat. area
quarangular Lower med. area
r A. Three gluteal lines: Posterior, /part
middle (anterior) and inferior. Ishial L~wer ILat. area
~ triangular Med area-~QIi~~_
tuberosity part
B. Acetabulum: Is the socket of the
hip joint, it has: Flg.4: Rt hip bone (lateral view)
Horse - shoe articular surface
(Iunate surface).
- Rough non articular (acetabular fossa) in the concavity of lunate surface.
r=: - Acet abular not ch: A deficiency on
the inferior aspect of the acetabulum.
C. Obturator foramen:
Iliac crest-_-f
Iliac fossa
Sacropelvic surface
Iliac tuberosity
Auricular
surface
j
It lies below and slightly anterior to
the acetabulum.
r The obturator membrane fills this
foramen except superiorly (obturator
canal). ASIS
The obturator canal allows passage
of obturator nerve & vessels. .....--Greater sciatic notch
Ischial spine
"2_ Inner surface: Contains the following
=features:
A. Iliac fossa: Is the internal concavity
of the ilium.
B. Sacropelvic surface: Shows:
-Rough iliac tuberosity.
-Auricular surf ace for articulation Pig": Rt. hip
with the sacrum. • •• (m •••••
-Pelvic surface of the hip bone. vieW)
, Chapter 1: Bones of the lower limb 3
C. Arcuate line: Separates the sacropelvic surface from the iliac fossa.
The pubis has the following parts and features:
1. Body: Has: - 3 surfaces: Anterior, posterior and medial symphyseal surfaces.
I - Upper border (pubic crest), its lateral extremity is the pubic tubercle.
2. Superior ramus: Has 3 surfaces:
I A. Pectineal surface, bounded behind by the pectineal line (pecten pubis).
B. Pelvic surface. C. Obturator surface.
I 3. Inferior ramus:
How to determine the side:
Has internal and external surfaces.
We put the hip bone in anatomical position with:
I - Iliac crest (above). - Ischial tuberosity (below & behind). - Acetabulum (lateral).
NB: The position of the hip bone in the erect posture may be demonstrated by holding it so that the
I anterior superior iliac spine and the top of pubic symphysis are in the same vertical plane.
NB: In the sitting posture, the body rests on the medial and lower parts of the ischial tuberosities.
I Subcutaneous parts of hip bone:
1. Anterior superior iliac spine. 2. The whole of iliac crest. 3. Ischial tuberosity.
I 4. Pubic tubercle, to feel it abduct, flex and laterally rotate the thigh. The rounded tendon of
adductor longus is felt. The bony prominence just above it is the pubic tubercle.
Ossification of hip bone:
I - The junction between pubic and ischial rami ossifies at 8 years.
- The tri-radiate cartilage of the acetabulum ossifies at 15 years.
I - Both ischial tuberosity and ossification centres of iliac crest fuse at 25 years.
Nerves related to the hip bone:
I - The sciatic nerve lies at the inferior margin of the greater sciatic notch.
- The obturator nerve runs in the obturator groove.
- The pudendal nerve runs in the pudendal canal along the inner surface of ischial tuberosity.
I Sex differences of the hip bone'
Differences Male Female
I 1. Subpubic angle. Acute (50-60 degrees). 80-85 degrees.
2. Edge of pubic arch. More everted. Less everted.
I 3. Distance from symphysis pubis
to anterior margin of acetabulum
Equals transverse
acetabulum.
diameter of More than transverse
diameter of acetabulum
I 4. Greater sciatic
5. Obturator foramen.
notch. Deep and narrow.
Oval.
Wide and shallow.
Triangular
I 6. Iliac fossa.
7. Auricular surface.
Shallow.
Articulates with 21/2 sacral
More concave.
Articulates with 2 sacral
pieces. pieces.
I
I
I
, Chapter 1: Bones of the lower limb 4
Particular features of the hip bone
A. Muscles attached
I Site
Iliac crest
Muscle attached
Tensor fascia lata
o or
OriQin
I Exact site of attachment
Outer lip of iliac crest bet. ASIS & iliac tubercle.
Latissimus dorsi Origin Outer lip of iliac crest behind the highest point.
I Gluteus maximus Oricin Outer surface of the posterior part.
Anterior Sartorius Oriqin Lower part of the ASIS.
I border
Straight
femoris
head of rectus Origin Upper part of the anterior inferior iliac spine.
Outer Gracilis Oriqin Body of pubis & inferior pubic ramus.
I surface of
the body of
Adductor longus Oriqin Outer surface of the body of the pubis.
the pubis & Adductor brevis Origin Outer surface of body of pubis & inferior pubic
I conjoint
ramus Adductor magnus (pubic Origin
ramus.
Outer surface of conjoint ramus.
part)
I Obturator externus
Pectineus
Origin
Origin
Outer margin of obturator foramen.
Pectineal surface & line of the superior pubic
ramus.
I Ischial
tuberosity
Semimembranosus Origin Upper
part.
lateral area of the upper quadrangular
I Semitendinosus
head of biceps
& long Origin Lower
part.
medial area of the upper quad rangular
Adductor magnus (ischial Origin Medial area of the lower triangular part.
I part)
Quad ratus fern oris Oriqin Lateral border.
Lesser Gemellus superior Origin Upper rnarqin of the lesser sciatic notch.
I sciatic
notch
Gemellus inferior Origin Lower marg in of the lesser sciatic notch.
Gluteal Gluteus maximus Origin Gluteal surface of ilium behind the posterior
I surface
the ilium
of
Gluteus medius Origin
gluteal line.
Gluteal surface of ilium between the posterior &
middle gluteal lines.
I Gluteus minimus Origin Gluteal surface of ilium between the middle &
inferior gluteal lines.
I Inner
Reflected
femoris
Iliacus
head of rectus Origin
Oriqln
Area above the acetabulum.
Floor of the iliac fossa.
I surface
hip bone
of
Obturator internus Origin Inner margin of the obturator foramen & pelvic
surface of ilium till the qreater sciatic notch.
Levator ani Origin Body of pubis & ischial spine.
I Psoas minor Insertion lIiopubic eminence.
I
I
I
