Anatomy: Hip lecture part 1

Question 0

Osteology: innominate

Answer 0

Ilium, ischium, pubis, acetabulum

Question 1

General function of hip joint

Answer 1

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

Question 2

Osteology: acetabulum

Answer 2

Lunate, fossa, notch

Question 3

Osteology: proximal femur

Answer 3

Femoral head, fovea, femoral neck, greater trochanter, lesser trochanter, intertrochanteric crest, Linea aspera

Question 4

Support for the acetabulum

Answer 4

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

Question 5

Hip joint classification

Answer 5

Diarthrodial, ball and socket, multi axial, simple, complex

Question 6

Angle of inclination

Answer 6

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°

Question 7

Angle of inclination: Coxa valga

Answer 7

Coxa valga: greater than 135°
Associated with structurally long leg
Abductors less effective due to decreased moment arm

Question 8

Angle of inclination: coxa Vara

Answer 8

Coxa Vara: less than 125°
Associated with structurally short leg
Abductors more effective due to increased moment arm

Question 9

Transverse plane alignment

Answer 9

Definition: angle in transverse plane between femoral neck and femoral condyle’s
Normal: 12 to 15°
Normal in children: up to 30°

Question 10

Angle of torsion

Answer 10

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°

Question 11

Transverse plane deformity: anteversion

Answer 11

Greater than 15° of rotation

Symptoms: compensatory hip internal rotation, decreased in hip external rotation, in toeing

Question 12

Transverse plane deformity: retroversion

Answer 12

Less than 8° of anterior rotation

Symptoms: compensatory hip external rotation, decrease in hip internal rotation, out toeing

Question 13

Trabecular system of the femur

Answer 13

Zones of weakness: superior and lateral to neck of femur

Common fracture site

Question 14

Hip joint capsule

Answer 14

Fibrous sleeve like structure covering the synovial membrane

Proximally attaches to the labrum and distally attaches to the neck of the femur

Question 15

Hip joint: open packed position

Answer 15

30° of flexion, 30° of abduction, slight external rotation
Ligaments and tendons are not on stretch
Bony structures are not fully congruent

Question 16

Hip joint: close packed position

Answer 16

Ligamentous: extension, internal rotation, and abduction

Tony congruency: full flexion, abduction, external rotation

Question 17

Normal range of motions of the hip joint

Answer 17

Flexion: 120°
Extension: 30°
Abduction: 45°
Adduction: 30°
Internal rotation: 45°
External rotation: 45°

Question 18

2-joint limiters of hip range of motion

Answer 18

Flexion: hamstrings
Extension: rectus femoris
Abduction: gracilis
Adduction: TFL

Question 19

Effects of hip motion on pelvis and lumbar spine

Answer 19

Hip flexion: causes posterior pelvic tilt and extreme may cause lumbar flexion
Hip extension: causes anterior pelvic rotation and extreme may cause lumbar extension

Question 20

Closed chain motion of the hip

Answer 20

Described as innominate moving on Femur

Motions: posterior pelvic tilt, anterior pelvic tilt, pelvic rotation, lateral tilt

Question 21

Effects of Anterior pelvic tilt on hip

Answer 21

Produces hip flexion

Question 22

Effects of posterior pelvic tilt on hip

Answer 22

Produces hip extension

Question 23

Effects of pelvic rotation on the hip

Answer 23

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

Question 24

Effects of lateral pelvic tilt on the hip

Answer 24

Causes ipsilateral adduction and contralateral abduction

Left pelvic tilt: left adduction and right abduction
Right pelvic tilt: right adduction and left abduction

Question 25

Arthrokinematic motions of the hip joint

Answer 25

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

Question 26

Ligaments of the hip joint capsule

Answer 26

Pubofemoral ligament, iliofemoral ligament, ischiofemoral ligament

Question 27

Transverse acetabular ligament

Answer 27

Provide shock absorption

Protects neurovascular supply to the head of the Femur

Question 28

Iliofemoral ligament

Answer 28

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.

Question 29

Pubfemoral ligament

Answer 29

Attaches to pubic portion of acetabular rim and blends on to inferior hip joint capsule and iliofemoral ligament
Limits hip extension and hip abduction

Question 30

Ischiofemoral ligament

Answer 30

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

Question 31

Ligament of head of femur (Ligamentum teres)

Answer 31

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

Question 32

Bursa of the hip

Answer 32

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

Question 33

Compartments of the thigh

Answer 33

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

Question 34

Anterior compartment of the thigh

Answer 34

Separated from posterior compartment by the lateral intramuscular septum
Separated from medial compartment of the side by the medial intramuscular septum
Muscles: Sartorius, quadriceps

Question 35

Posterior compartment of the thigh

Answer 35

Separated from anterior compartment by the lateral intramuscular septum
Separated from your compartment by the medial intramuscular septum
Muscles: biceps femoris, semitendinosus, semimembranosus

Question 36

Medial compartment of the thigh

Answer 36

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