anatomy Flashcards
- How do the hip and GH joint compare?
a. GH trades joint congruency and less stability for increased mobility
b. Acetabulum of the hip is not completely covered in cartilage
c. Acetabulum is more round versus pear shaped
d. Both a fibrocartilaginous labrum
- How is the stability of the hip joint maintained?
“a. close fit of the femoral head in the acetabulum
b. strong capsule and supporting ligaments
c. massive muscle groups
d. acetabular labrum increase depth and congruency
e. orientation of zona obicularis and ligaments creates a screw home mechanism with full extension
“
- What impact does the stability of the hip have on the surrounding joints?
a. high increase of stability means less mobility
b. SI and Lumbar spine facilitate greater motion hip the pelvis and hip
- What bones make up the pelvis and why is important to the hip?
“a. they fuse together at the hip
b. ilium- upper acetabulum
c. ischium- lower posterior acetabulum
d. pubic- lower anterior acetabulum
- What anatomic features connect the trochanters of the hip?
“a. posteriorly the trochanteric crest
b. anteriorly the trochanteric line
- How is the femoral shaft shaped?
“a. cylindrical shape
b. bowed forward slightly (ie an anterior convexity)
- What does the synovial membrane cover in the hip?
“a. starts at the margins of the articular cartilage of the femoral head
b. covers the neck of the femur within the capsule
c. turns up on to the capsule
d. travels to cove the acetabulum and labrum
e. surrounds the ligamentum teres and PA
f. some time it can communicate with the subtendonus iliac bursa
- What is the capsular pattern of the hip?
“a. internal rotation
b. abduction
c. extension
d. flexion
e. external rotation
- What is the neuromuscular guarding pattern?
“a. increased tone in the external rotators
b. adductors
c. flexors
- What makes up the femoral triangle?
“a. superiorly- lower border of the inguinal ligament
b. laterally- medial border of the sartorius
c. medially- adductur longus
d. apex- bound by pecineus, adductor longus, illiacus and psoas muscle
- What is found in the femoral triangle?
“a. psoas
b. femoral nerve
c. femoral artery and most of its branches
d. femoral vein
- How is the acetabulum shaped?
a. prominent superior and posterior margins to compensate for weight bearing
- Where is the acetabulum located on the pelvis?
a. at the intersection of the the three bone of the pelvis
- How is the acetabulum oriented?
“a. inferior
b. lateral
c. anterior
- Describe the articular surface of the acetabulum
“a. Only the perimeter has cartilage due to the acetabular notch
b. Acetabular notched is filled with the pulvinar acetabulum
What passes through the acetabular notch?
a.PA, nutrient arteries and viens, nerve
What is found in the acetbular fossa?
PA, ligament of the head of the femur
- What are the attachments of the acetabular labrum?
“a. boney rim of the acetabulum
b. continues across the acetabular notch as the transverse ligament
- What is the function of the acetabular labrum?
“a. increase depth of acetabulum
b. increase joint stability
- How is the labrum shaped?
“a. it completely surrounds the joint
b. triangular shaped with the apex a free floating edge
c. it is thicker superiorly
- How doe the labrum relate the synovial lining of the hip?
a. both sides of the free floating edge of the labrum are lined with synovium
- How is the femoral head shaped?
“a. it forms about 2/3 of a sphere
b. average diameter of 4-5cm
- What is the subcapital sulcus?
a. the dividing line between the femoral head and neck
- Describe the articular surface of the femoral head?
“a. completely covered in articular cartilage
b. largest superiorly
c. surface is broken up by the fovea capitis where the ligamentum teres attaches
- How is the femoral head situated on the neck?
a. it overhangs the neck in all planes, but is greatest posteriorly
- How is the femoral neck oriented?
“a. anterior about 10-30 degrees
b. medial
c. superior about 115-140 degrees
- Describe the shape of the femoral neck
“a. it has a curve appearance created by the posterior overhangs of the femoral head and trochanteric crest
b. it is about 5 cm in length
c. 2.5 cm in the horizontal plane
d. 3-3.5 cm in the vertical plane
- What are the coxal side attachments of the capsule?
“a. superiorly- margin of the acetabulum and labrum and up 5-6cm
b. anteriorly- outer margins of the labrum
c. inferiorly- edge of acetabulum, transverse ligament down to the obturator foramen
- What are the femoral attachments of the hip capsule?
“a. anteriorly- trochanteric line
b. superiorly- base of the neck
c. posteriorly- about 1 cm above the trochanteric crest
d. inferiorly- lower neck close to less trochanter
- Describe the fiber orientation of the hip joint capsule
“a. Longitudinal- bone to bone and blend with the iliofemoral ligament
b. zone obicularis- oriented to faciliatate screw home of the capsule with extension, do not go bone to bone, but can blend with the pubofemoral and ishiofemoral
- What are the attachments of the ligamentum teres?
“a. fovea capitus of femoral head
b. acetabular notch- three bands one to each side and transverse ligament
- What are the attachments of the iliofemoral ligament?
“a. blends with the capsule
b. apex- lower part of the AIIS
c. base attaches to the trochanteric line
- What are the different parts of the iliofemoral ligament?
“a. medial band- strong
b. central band- weak
c. Lateral band- strong
- What is the function of the iliofemoral ligament?
“a. Primarily checks hip extension and external rotation
b. adduction tension lateral band
c. abbuction tensions medial band
- What are the attachments of the pubofemoral ligament?
“a. base- iliopectineal eminence, superior rami of os pubis, obturator crest, and obturator memebrane
b. inferiorly blends with capsule and iliofemoral ligament into the trochanteric line
- What is the function of the pubofemoral ligament?
“a. Limits extension
b. limits external rotation
c. limits abduction
- Where is the hip capsule weakest and how is the compensated for?
“a. its weakest between the iliofemoral and pubofemoral ligaments
b. tendon of the iliopsoas crosses at this point
- Where is the iliopecintial bursa located and why is this significant?
“a. under the iliopsoas tendon between the iliofemoral pubofemoral ligaments
b. often times the capsule is in communication with the bursa
- What are the attachments of the ishiofemoral ligament?
“a. inferiorly on the ischium
b. posteriorly on the acetabulum
c. travels up and over blending with zona obicularis and iliofemoral ligament
d. attaches to greater trochanter
- What are the functions of the ishiofemoral ligament?
“a. limits extension
b. limits internal rotation
- How is the inguinal ligament different than other ligaments?
a. internally-folded lower border of the aponeurosis of the external oblique
- What are the attachments of the inguinal ligament?
“a. ASIS
b. Pubic tubercle
c. continuous with fascia latae
d. oblique muscles
- What is the pulvinar acetabulum?
a. visco-elastic fat pad in the acetabular notch of the hip
- What is the function of the PA?
“a. help lubricate the hip joint
b. provide shock absorption
c. protect the ligamentum teres and the artery
- How does the PA relate to the labrum?
it passes under the transverse ligament which the labrum lies on top of
- How does the PA relate to the articular cartilage?
a. it fills the gap where the articular cartilage does not cover the acetabulum
- How does the PA relate to the transverse ligament?
it passes under the transverse ligament into subtendonous illiac bursa
- What bursa does the PA relate to?
subtendonuous illiac bursa
- What other structure is the PA similar to?
a. meniscoid fat pad of the spinal facet joints in that it dampens force and travels in and out of the joint
- How does the PA move?
“a. during weight bearing it is pressed out of the hip
b. with distraction it is pulled back in
- What are the primary blood vessels of the hip?
“a. deep femoral
b. medial circumflex
c. lateral circumflex
d. inferior gluteal
e. superior gluteal
f. obturator
- What is the pathway of the deep femoral artery?
“a. comes off the lateral side of the femoral artery in the femoral triangle
b. passes between adductor longus and brevis
c. descends between adductor longus and magnus
d. pierces the adductor magnus to go to hamstrings
- What is the pathway of the medial circumflex artery?
“a. comes off posteriormedial deep femoral artery in the femoral triangle
b. sinks deep into triangle to run between pectineus and psoas major
c. travels backward under the femoral neck
d. deep to adductor brevis an acetabular branch passes under transverse ligament
e. divides into ascending and descending branches
- What is pathway of the lateral circumflex artery?
“a. comes lateral side of deep femoral
b. deep to sartorius and rectus femoris
c. divides into three branches ascending, transverse, descending
i. ascending- pass up and along intertrochanteric line to lateral hip to anstamose with superior gluteal
ii. transverse- winds around the greater trochanter
iii. descending- runs behind rectus femoris and runs along border of vastus lateralis
- What is the pathway of the inferior gluteal?
“a. travels over sacral rami to go between piriformis and coccygeus muscle
b. passes through the greater sciatic foramen
c. follows sciatic nerve between greater trochanter and ischial tuberosity running back of thigh
- What is the pathway of the superior gluteal artery?
“a. Large largest branch of internal iliac
b. dives between the lumbosacral trunk and first sacral ram
c. leaves the pelvis via greater sciatic foramen
d. divides into superficial and deep branches
i. superficial- enters gluteus maximus
ii. deep- lies between glut medius and bone dividing further into superior and inferior
1. superior- goes up to ASIS
2. inferior- anasomes with lateral cirumflex
- What is the pathway of the obturator artery?
“a. first branch of the anterior division of the internal iliac artery
b. passes forward and downward the upper part of the obturator foramen
c. branches supply iliach fossa, vesical branch and pubic brand
d. leaves pelvic cavity through obturator canal and divides into anterior and posterio brahcnes
i. anterior- muscular branches to obturator externus, pecitineus, adductor, and gracilis
ii. posterior- follows ischial ramus then anastomses with anterior
