Fragments from the book Gray H. Anatomy, descriptive and surgical (1918; 20th ed.). The selected passages on the anatomy of the ligamentum capitis femoris (LCF) and color illustrations.
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| Fig. 235. — Right hip bone. External surface. |
Quote p. 237
The Acetabulum (cotyloid cavity). — The acetabulum is a deep, cup-shaped, hemispherical depression, directed downward, lateralward, and forward. It is formed medially by the pubis, above by the ilium, laterally and below by the ischium; a little less than two-fifths is contributed by the ilium, a little more than two-fifths by the ischium, and the remaining fifth by the pubis. It is bounded by a prominent uneven rim, which is thick and strong above, and serves for the attachment of the glenoidal labrum (cotyloid ligament), which contracts its orifice, and deepens the surface for articulation. It presents below a deep notch, the acetabular notch, which is continuous with a circular non-articular depression, the acetabular fossa, at the bottom of the cavity: this depression is perforated by numerous apertures, and lodges a mass of fat. The notch is converted into a foramen by the transverse ligament; through the foramen nutrient vessels and nerves enter the joint; the margins of the notch serve for the attachment of the ligamentum teres. The rest of the acetabulum is formed by a curved articular surface, the lunate surface, for articulation with the head of the femur.
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| Fig. 243. — Upper extremity of right femur viewed from behind and above. |
Quote p. 243
The Head (caput femoris). — The head which is globular and forms rather more than a hemisphere, is directed upward, medialward, and a little forward, the greater part of its convexity being above and in front. Its surface is smooth, coated with cartilage in the fresh state, except over an ovoid depression, the fovea capitis femoris, which is situated a little below and behind the center of the head, and gives attachment to the ligamentum teres.
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| Fig. 244. — Right Femur. Anterior Surface. [fragment] |
Quote p. 333
I. Coxal Articulation
or Hip-joint (Articulatio Coxae).
This articulation
is an enarthrodial or ball-and-socket joint, formed by the reception of the head
of the femur into the cup-shaped cavity of the acetabulum. The articular cartilage
on the head of the femur, thicker at the center than at the circumference, covers
the entire surface with the exception of the fovea capitis femoris, to which the
ligamentum teres is attached; that on the acetabulum forms an incomplete marginal
ring, the lunate surface. Within the lunate surface there is a circular depression
devoid of cartilage, occupied in the fresh state by a mass of fat, covered by synovial
membrane. The ligaments of the joint are:
The Articular
Capsule.
The Iliofemoral.
The Ischiocapsular.
The Pubocapsular.
The Ligamentum
Teres Femoris.
The Glenoidal
Labrum.
The Transverse Acetabular.
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| Fig. 339. — Right hip-joint from the front. (Spalteholz.) |
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| Fig. 340. — Right hip-joint from behind. (Quain.) |
Quote p. 336
The Ligamentum Teres Femoris (Fig. 341), — The ligamentum teres femoris is a triangular, somewhat flattened band implanted by its apex into the antero-superior part of the fovea capitis femoris; its base is attached by two bands, one into either side of the acetabular notch, and between these bony attachments it blends with the transverse ligament. It is ensheathed by the synovial membrane, and varies greatly in strength in different subjects; occasionally only the synovial fold exists, and in rare cases even this is absent. The ligament is made tense when the thigh is semiflexed and the limb then adducted or rotated outward; it is, on the other hand, relaxed when the limb is abducted. It has, however, but little influence as a ligament.
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| Fig. 341. — Left hip-joint, opened by removing the floor of the acetabulum from within the pelvis. |
Quote p. 338
Synovial Membrane (Fig. 343). — The synovial membrane is very extensive. Commencing at the margin of the cartilaginous surface of the head of the femur, it covers the portion of the neck which is contained within the joint; from the neck it is reflected on the internal surface of the capsule, covers both surfaces of the glenoidal labrum and the mass of fat contained in the depression at the bottom of the acetabulum, and ensheathes the ligamentum teres as far as the head of the femur. The joint cavity sometimes communicates through a hole in the capsule between the vertical band of the iliofemoral ligament and the pubocapsular ligament with a bursa situated on the deep surfaces of the Psoas major and Iliacus.
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| Fig. 343. — Capsule of hip-joint (distended). Posterior aspect. |
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| Fig. 344. — Structures surrounding right hip-joint. |
Quote p. 338-339
Movements.
— The movements of the hip are very extensive, and consist of flexion, extension,
adduction, abduction, circumduction, and rotation.
The length of
the neck of the femur and its inclinations to the body of the bone have the effect
of converting the angular movements of flexion, extension, adduction, and abduction
partially into rotatory movements in the joint. Thus when the thigh is flexed or
extended, the head of the femur, on account of the medial inclination of the neck,
rotates within the acetabulum with only a slight amount of gliding to and fro. The
forward slope of the neck similarly affects the movements of adduction and abduction.
Conversely rotation of the thigh which is permitted by the upward inclination of
the neck, is not a simple rotation of the head of the femur in the acetabulum, but
is accompanied by a certain amount of gliding.
The hip-joint
presents a very striking contrast to the shoulder-joint in the much more complete
mechanical arrangements for its security and for the limitation of its movements.
In the shoulder, as has been seen, the head of the humerus is not adapted at all
in size to the glenoid cavity, and is hardly restrained in any of its ordinary movements
by the capsule. In the hip-joint, on the contrary, the head of the femur is closely
fitted to the acetabulum for an area extending over nearly half a sphere, and at
the margin of the bony cup it is still more closely embraced by the glenoidal labrum,
so that the head of the femur is held in its place by that ligament even when the
fibers of the capsule have been quite divided. The iliofemoral ligament is the strongest
of all the ligaments in the body, and is put oi) the stretch by any attempt to extend
the femur beyond a straight line with the trunk. That is to say, this ligament is
the chief agent in maintaining the erect position without muscular fatigue; for
a vertical Une passing through the center of gravity of the trunk falls behind the
centers of rotation in the hip-joints, and therefore the pelvis tends to fall backward,
but is prevented by the tension of the iliofemoral ligaments. The security of the
joint may be provided for also by the two bones being directly united through the
ligamentum teres; but it is doubtful whether this ligament has much influence upon
the mechanism of the joint. When the knee is flexed, flexion of the hip-joint is
arrested by the soft parts of the thigh and abdomen being brought into contact,
and when the knee is extended, by the action of the hamstring muscles; extension
is checked by the tension of the iliofemoral ligament; adduction by the thighs coming
into contact; adduction with flexion by the lateral band of the iliofemoral
ligament and the lateral part of the capsule; abduction by the medial band of the
iliofemoral ligament and the pubocapsular ligament ; rotation outward by the lateral
band of the iliofemoral ligament; and rotation inward by the ischiocapsular ligament
and the hinder part of the capsule. The muscles which flex the femur on the pelvis
are the Psoas major, Iliacus, Rectus femoris, Sartorius, Pectineus, Adductores longus
and brevis, and the anterior fibers of the Glutaei medius and minimus. Extension
is mainly performed by the Glutseus maximus, assisted by the hamstring muscles and
the ischial head of the Adductor magnus. The thigh is adducted by the Adductores
magnus, longus, and brevis, the Pectineus, the Gracilis, and lower part of the Glutseus
maximus, and abducted by the Glutaei medius and minimus, and the upper part of the
Glutseus maximus. The muscles which rotate the thigh inward are the Glutseus minimus
and the anterior fibers of the Glutajus medius, the Tensor fascise latae and the Iliacus and Psoas major; while those which rotate it outward are the posterior fibers
of the Glutseus medius, the Piriformis, Obturatores externus and internus, Gemelli
superior and inferior, Quadratus femoris, Glutseus maximus, the Adductores longus,
brevis, and magnus, the Pectineus, and the Sartorius.
External links
Gray H. Anatomy, descriptive and surgical; 20th ed. Philadelphia, New York: Lea & Febiger, 1918. [archive.org]
Authors & Affiliations
Henry Gray (1825-1861) was a British anatomist and surgeon. [wikipedia.org]
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| Henry Gray Author: H. Pollock, unknown date; original in the wikimedia.org collection (CC BY 4.0, no changes). |
Keywords
ligamentum capitis femoris, ligamentum teres, ligament of head of femur, anatomy, functions
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