Anatomy: Hip lecture part 1 Flashcards
Osteology: innominate
Ilium, ischium, pubis, acetabulum
General function of hip joint
Support the body weight
Center of gravity of the Hip joint passes posterior to the hip anterior to the knee and anterior to the ankle
Osteology: acetabulum
Lunate, fossa, notch
Osteology: proximal femur
Femoral head, fovea, femoral neck, greater trochanter, lesser trochanter, intertrochanteric crest, Linea aspera
Support for the acetabulum
U-shaped cartilage: open part is covered by transverse acetabular ligament
Transverse acetabular ligament: Provide shock absorption, Protects neurovascular supply to the head of the Femur
Fibroelastic fat
Ligament to the head of the femur
Hip joint classification
Diarthrodial, ball and socket, multi axial, simple, complex
Angle of inclination
Definition: angle formed between the femoral neck and the shaft of the femur
Normal: 125 to 135°
Coxa valga: greater than 135°
Coxa Vara: less than 125°
Angle of inclination: Coxa valga
Coxa valga: greater than 135°
Associated with structurally long leg
Abductors less effective due to decreased moment arm
Angle of inclination: coxa Vara
Coxa Vara: less than 125°
Associated with structurally short leg
Abductors more effective due to increased moment arm
Transverse plane alignment
Definition: angle in transverse plane between femoral neck and femoral condyle’s
Normal: 12 to 15°
Normal in children: up to 30°
Angle of torsion
Definition: amount of twist in the bone that occurred during fetal development
Anterior portion of the head and neck of the femur
Normal: 12 to 15°
Transverse plane deformity: anteversion
Greater than 15° of rotation
Symptoms: compensatory hip internal rotation, decreased in hip external rotation, in toeing
Transverse plane deformity: retroversion
Less than 8° of anterior rotation
Symptoms: compensatory hip external rotation, decrease in hip internal rotation, out toeing
Trabecular system of the femur
Zones of weakness: superior and lateral to neck of femur
Common fracture site
Hip joint capsule
Fibrous sleeve like structure covering the synovial membrane
Proximally attaches to the labrum and distally attaches to the neck of the femur
Hip joint: open packed position
30° of flexion, 30° of abduction, slight external rotation
Ligaments and tendons are not on stretch
Bony structures are not fully congruent
Hip joint: close packed position
Ligamentous: extension, internal rotation, and abduction
Tony congruency: full flexion, abduction, external rotation
Normal range of motions of the hip joint
Flexion: 120° Extension: 30° Abduction: 45° Adduction: 30° Internal rotation: 45° External rotation: 45°
2-joint limiters of hip range of motion
Flexion: hamstrings
Extension: rectus femoris
Abduction: gracilis
Adduction: TFL
Effects of hip motion on pelvis and lumbar spine
Hip flexion: causes posterior pelvic tilt and extreme may cause lumbar flexion
Hip extension: causes anterior pelvic rotation and extreme may cause lumbar extension
Closed chain motion of the hip
Described as innominate moving on Femur
Motions: posterior pelvic tilt, anterior pelvic tilt, pelvic rotation, lateral tilt
Effects of Anterior pelvic tilt on hip
Produces hip flexion
Effects of posterior pelvic tilt on hip
Produces hip extension
Effects of pelvic rotation on the hip
Pelvic rotation: causes ipsilateral internal rotation and contralateral exhortation
Pelvic rotation to the left: left hip internal rotation and right hip external rotation
Pelvic rotation to the right: right hip internal rotation and left hip external rotation
Effects of lateral pelvic tilt on the hip
Causes ipsilateral adduction and contralateral abduction
Left pelvic tilt: left adduction and right abduction
Right pelvic tilt: right adduction and left abduction
Arthrokinematic motions of the hip joint
Direction of glide = direction of capsular limitation
Flexion: anterior roll and posterior glide
Extension: posterior roll and anterior glide
Abduction superior roll and Inferior glide
Adduction: inferior roll and superior glide
External rotation: posterior roll and anterior glide
Internal rotation anterior roll and posterior glide
Ligaments of the hip joint capsule
Pubofemoral ligament, iliofemoral ligament, ischiofemoral ligament
Transverse acetabular ligament
Provide shock absorption
Protects neurovascular supply to the head of the Femur
Iliofemoral ligament
Strongest ligament of the hip joint
Proximal attachment: iliac portion of the rim of the acetabulum and AIIS
Distal attachment: anterior capsule and intertrochanteric line
Limits hip hyper extension and lateral rotation. It’s superior fibers limits hip adduction.
Pubfemoral ligament
Attaches to pubic portion of acetabular rim and blends on to inferior hip joint capsule and iliofemoral ligament
Limits hip extension and hip abduction
Ischiofemoral ligament
Proximal Attachment: ischial portion of the rim of the acetabulum and blends onto the posterior capsule
Distally attachment: intertrochanteric crest and medial aspect of the greater trochanter
Restricts excessive hip extension
posterior fibers restrict internal rotation
Limits adduction of the thigh when the hip is flexed
Ligament of head of femur (Ligamentum teres)
On slack during most hip movements, therefore it is not a stabilizer
Attaches to acetabular notch and fossa and runs to the fovea
Contains an artery that gives blood to the head of the femur
Bursa of the hip
Iliopectineal bursa: Between iliopsoas and anterior aspect of the hip
Ischiogluteal bursa
Greater trochanteric bursa: between gluteus max and posterolateral aspect of greater trochanter
Compressed during flexion and internal rotation
Compartments of the thigh
Anterior compartment: separate from posterior compartment by lateral IMS
Posterior compartment: separated from anterior compartment by the lateral IMS
Medial compartment: separated from anterior compartment by the medial IMS
Anterior compartment of the thigh
Separated from posterior compartment by the lateral intramuscular septum
Separated from medial compartment of the side by the medial intramuscular septum
Muscles: Sartorius, quadriceps
Posterior compartment of the thigh
Separated from anterior compartment by the lateral intramuscular septum
Separated from your compartment by the medial intramuscular septum
Muscles: biceps femoris, semitendinosus, semimembranosus
Medial compartment of the thigh
Separated from the anterior compartment by the medial intramuscular septum
Separated from the posterior Compartment by the special plane between the adductor magnus and the hamstrings
Muscles: pectineus obturator externus, gracilis, adductors
