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MSK > 10 - Hip Joint > Flashcards

10 - Hip Joint Flashcards

1
Q

What muscles do hip/thigh flexion and what is the nerve supply and what is the MYOTOME?

A 
Anterior Thigh Muscles
- Rectus Femoris
- VM
- VI
- VL
- Sartorius 
- Iliopsoas (psoas major and iliacus) strongest hip flexion
> Femoral Nerve
> L2/L3
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2
Q

What movements can the hip joint do?

A

Strong and stable but can move in every direction. Usually one or the other. Flex/ext and abd/add, circumduction and rotation (multiaxial)
The large head and thin neck allows this movement

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3
Q

What muscles do hip extension, what is the nerve supply and what is the myotome?

A
  • Gluteus Maximus
  • Hamstring Muscles
    > Inferior Gluteal Nerve
    > Tibial Nerve
    > L4/L5
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4
Q

What is the myotome for hip flexion and hip extension?

A

L2/L3

L4/L5

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5
Q

What muscles do hip adduction, what is the nerve supply and what is the myotome?

A 
Adductor Magnus
Adductor Brevis
Adductor Longus
Pectineus (sometimes femoral)
Gracillis 
> Obturator Nerve
> L4
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6
Q

What muscles do hip abduction, what is the nerve supply and what is the myotome?

A

Gluteus Medius
Gluteus Minimus
> Superior Gluteal Nerve
> L5/S1

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7
Q

What is the myotome for hip adduction and abduction?

A

L4

L5/S1

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8
Q

What is the hip joint proper?

A

Femur head articulates with the pevlic bone (acetabulum) forming a ball in socket joint

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9
Q

What is the acetabulum?

A

The part of the pelvis that articulates with the femur. It is where the ilium, ischium and pubis fuse (until puberty these are separated by cartilage). Means little cup

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10
Q

What is the lunate surface of the acetabulum?

A

It is the articular surface of the acetabulum so is covered in cartilage

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11
Q

What is the hip designed for?

A

Both movement as stability as the body weight is transferred through the hip joint through to the legs

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12
Q

What is the acetabular fossa and what does it contain?

A

Is the non-articulating area of the acetabulum as it is deep to the lunate surface. It contains a fat pad and a ligament (used to contain an artery)

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13
Q

What is the transverse acetabular ligament?

A

The acetabulum forms 3/4 of a circle - this ligament completes the circle for the femoral head inferiorly but is NOT articular

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14
Q

What completes the acetabular circle for the femoral head?

A

The transverse acetabular ligament

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15
Q

What is the acetabular labrum?

A

The acetabular labrum is a thick lip of fibrocartilage around the external/lateral surface of the acetabulum. It’s function is to increase the depth and so articular surface area of the joint by 10% and stabilises the joint

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16
Q

Which way does the femoral head point?

A

Superomedially and slightly anteriorly

17
Q

What is the shape of the femoral had and how much of it is covered by the acetabulum?

A

2/3 of a sphere and more than 50% and this makes it a stable joint

18
Q

The head of the femur is covered in cartilage except for…

A

Where the Ligament of the Head of the Femur inserts

19
Q

What is the ligament in the Acetabular Fossa? Describe it.

A

The Ligament of the Head of the Femur.
Is between the acetabular fossa and the femoral head
In childhood this ligament is arterial (has an artery in it) to supply the femoral head with blood as it is developing
In your 20s this stops being patent and becomes a ligament

20
Q

What is the ridge down the posterior aspect of the femur?

A

Superiorly: Gluteal Tuberosity
Inferiorly: Linea Aspera

21
Q

What is the course of the arteries that supply the hip?

A

Aorta > CIA > Ext. Iliac Artery > Femoral A > Profunda Femoris > Medial and Lateral Femoral Circumflex Arteries

22
Q

What do the medial and lateral femoral circumflex arteries supply?

A

Medial Circumflex Femoral Artery > Posterior Femoral Neck
Lateral Circumflex Femoral Artery > Anterior Femoral Neck
Encircle the femoral neck and the meet laterally around the greater trochanter

23
Q

What arteries anastomose to supply the hip/femoral neck?

A
  • ## once the Superior and Inferior Gluteal Arteries supply the gluteal muscles they then anastomose with each other and the Medial and Lateral Femoral Circumflex Arteries
24
Q

What is the purpose of an anastomosis?

A

Acts as security. If one vessel doesn’t supply enough there is overlap so the region will still get some blood supply

25
Q

What vessels supply the femoral HEAD?

A

Profunda femoris gives off the medial and lateral femoral circumflex arteries that supply the femoral neck. These vessels then give off the retinacular vessels that supply the femoral head

26
Q

Where do the medial and lateral femoral circumflex arteries run?

A

They run along the intertrochanteric line and crest before meeting laterally around the femoral neck

27
Q

Where do they retinacular vessels run?

A

Deep INTO the joint capsule and into the head and neck of the femur

28
Q

When may you do an angiogram in the thigh?

A
  • put in a contrast in vessels
  • often do if you break your femur to see if there is blood coming out of just the bone or also the arteries
  • you can dump your entire blood volume out of your femur in hours
29
Q

Hip Dislocation

A

Usually occurs posteriorly

Often in car crashes with thigh flexed, adducted, internally rotated

30
Q

Hip Fracture - how do you know if you should fix it or not?

A
  • if the bone WILL heal then you can fix the bone with screws and plates
  • if the bone WONT heal then you may need to replace the bone with metal
  • need to know if the bone will heal to do the right surgery
31
Q

Intertrochanteric (extracapsular) Fracture (#)?

A
  • is a fracture between the 2 trochanters
  • the blood supply to the hip joint (circumflex) goes around the femoral neck which is more superior so is NOT damaged
  • the BONE will heal
  • do a Dynamic Hip Screw which is a plate down the side of the femur with a screw in the femoral head to hold it in place
32
Q

Where is iliopsoas attached and what does it tend to pull off?

A

The LESSER trochanter

33
Q

What is a Subcapital # (intracapsular)?

A
  • Subcapital means below the head
  • fracture is immediately below the head at the femoral neck
  • damage is right where the bloody supply (circumflex and retinacular vessels) are
  • bone/fracture won’t heal as no blood supply and bone will break down
  • take the broken bone out and replace the femoral head with a metal ball and a stem goes down the femoral shaft (half hip replacement)
  • may also replace the bony acetabulum in a full hip replacement
34
Q

What is triradiate cartilage?

A

The Y shaped epiphyseal plate between the ilium, ischium and pubis. At 15-17 these bones fuse.

MSK (29 decks)

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