Anatomy and clinical of hip and knee Flashcards
What is meant by a diarthrodial joint?
moveable joint with cartilage on articulating surfaces
hip joint type
synovial ball and socket
neck shaft normal angle
130
femoral anteversion angle
15
acetabular anteversion angle
20
static hip stabilisers
bony morphology - congruence
anteversion of ball and socket
labrum
negative intra-articular pressure
dynamic hip stabilisers
muscles
4 hip flexor muscles
iliopsoas
rectus femoris
sartorius
pectineus
innervation of hip flexors
femoral nerve
4 hip extensor muscles
gluteus maximus
semitendinosus
semimembranosus
biceps femoris
innervation of hip extensors
glut max = inferior gluteal
others = sciatic
3 hip abductor muscles and innervation
gluteus med. and min
tensor fascia latae
superior gluteal nerve
4 hip adductors and innervation
adductor longus, brevis and magnus (sciatic aswell)
gracillis
obturator nerve
2 hip internal rotators and innervation
anterior fibres - glut med
TFL
superior gluteal
7 hip external rotators
gluteus maximus piriformis sup and inf gemellus obturator internus obturator externus quadratus femoris
hip external rotators innervation
obturator
inferior gluteal nerve
Diagnosing hip pathology
C sign
exacerbating factors - tying shoe laces
4 sites of pain in hip pathology
trochanteric
buttock
groin
referred
blood supply to femoral head
capsule via medial and lateral femoral circumflex
ligamentum teres via acetabular branch of obturator
Fixing extra-capsular femoral head
always - blood supply intact
blood supply in intra-capsular femoral head fracture
compromised
Management of intra-capsular femoral head pathology depends on
age and displacement
When to replace femoral head?
old and displaced
movements of knee
flexion and extension
rotation, varus and valgus
Normal ROM knee
-5 to 130 degrees
Largest sesamoid bone in the body
patella
Mechanical axis in males and females
M = 14 F = 17
5 static soft tissue constraints of knee
collateral ligaments ACL/PCL capsule ITB menisci
4 dynamic soft tissue constraints knee
quadriceps
hamstrings
medial and lateral gastroc
popliteus
4 knee extensor muscles
rectus femoris
vastus medialis, lateralis and intermedialis
innervation of the knee extensor muscles
femoral nerve
4 knee flexor muscles
biceps femoris
semimembranosus
semitendinosus
gastrocnemius
innervation of the knee flecors
sciatic nerve
S1 for the gastrocnemius
medial menisci knee
less mobile and c shaped
attached to tibia
lateral menisci knee
more mobile and circular
unattached at popliteus hiatus
4 roles of menisci
load transmission
stability
proprioception
shock absorption
List some knee injuries
meniscal tears ligament injuries OCD lesions loose bodies fractures quads/patellar tendon ruptures
ACL injury cause
knee buckles during pivot and cannot play on
What happens immediately in ACL injury/?
haemarthrosis
x-ray 2 findings for ACL injury
haemarthrosis and segond fracture
what helps to deepen the hip joint?
labrum acetabulare
ililofemoral ligament
Y shaped
strongest ligament in body
6 stabilisers of hip
labrum congruity capsule ligaments ligamentum teres muscles
4 notes on hip dislocation
short leg
posteriorly
internally rotated
high energy
3 compartments of knee joint
medial tibiofemoral
lateral tibiofemoral
patellofemoral
Where does the articular cartilage in knee receive nutrition?
synovial fluid
capsule in knee
large, uneven thickness and lined by synovial membrane
medial or lateral menisci more commonly damaged?
medial
symptoms of meniscal tear
rotation, flexion, weightbearing knee pop or crack delayed swelling locked knee tender
medial collateral ligament
flat, broad, blends with capsule
often damaged
lateral collateral ligament
discrete, round, extra-articular
