THE HIP-JOINT 145 



The pubofemoral ligament may be described in three parts 

 at its origin: The first is a continuation of the fascia over 

 the pectineus muscle, and goes from the iliopectineal eminence 

 down between the iliopsoas and pectineus muscles to the 

 lowest part of the capsule; a second fasciculus (pubofemoral 

 of Barkow) comes beneath the pectineus from the whole length 

 of the obturator crest, and joins the first set outside that muscle; 

 a third set comes from the upper ramus of the pubis and upper 

 obturator spine and joins the others; it gives origin to some 

 fibers of the obturator externus. 



The ischiocapsular ligament rises from the lower part of 

 the edge of the acetabulum and neighboring portion of the 

 ischium, and ends in the lower and outer portion of the orbicular 

 zone. 



The ischiofemoral ligament (Macalister) rises from the 

 upper part of the ischial tuberosity, passes over the groove 

 between this tuberosity and the acetabulum, and is attached 

 to the back of the neck at a point midway between the two 

 trochanters. It is often fused with the capsule. 



Synovial processes occupy the joint outside the fatty pad of 

 the fossa acetabuli and in the region of the neck of the femur; 

 broad flaps hang from the capsular covering of the neck, or 

 thin tufts give a velvety appearance to the inner surface of 

 the capsule. 



The iliopsoas bursa opens into the joint anteriorly, and is 

 analogous to the subscapular bursa of the shoulder; it may act 

 as an accessory pouch for synovial supply as needed. Where 

 the capsule is thin, muscles strengthen it; in front is the ilio- 

 psoas; above, the rectus and glutens minimus; internally, the 

 obturator externus and pectineus; behind, the pyriformis, two 

 obturators, two gemelli, and quadratus femoris. 



Nerves are from the sacral plexus, great sciatic, nerve to 

 quadratus femoris muscle, obturator, accessory obturator, 

 and anterior crural. 



The arteries are from the obturator, sciatic, gluteal, internal 

 and external circumflex. 



Movements are in every possible direction. Flexion and 

 extension pass through 139 degrees on the dead subject, about 

 SO degrees on the living; abduction or adduction through 90 

 decrees, and rotation through 51 degrees. Flexion is checked 

 by soft parts and by hamstring muscles (with knee extended), 

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