Anatomy of the Hip and Knee Flashcards

1
Q

What kind of joint is the hip joint?

A
  • Diarthrodial joint (movable type of joint characterised by presence of fibrocartilage or hyaline cartilage that lines opposing bony surfaces)
  • Ball and socket synovial joint
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2
Q

Can the hip joint be decribed as stable?

A
  • Stable joint, with stability being enhanced by static (ligaments) and dynamic stabilisers (muscles)
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3
Q

Descibe the normal angles of the hip joint?

A
  • Neck shaft about 130o
  • Femoral anteversion 15o
  • Acetabular anteeversion 20o
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4
Q

What is B?

A

Coxa valga (>140 degrees)

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5
Q

What is C?

A

Coxa vara (<125 degrees)

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6
Q

What are some static hip stabilisers?

A
  • Bony morphology
    • Ball and socket provides good stability
  • Labrum
  • Negative intra-articular pressure
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7
Q

What are the dynamic hip stabilisers?

A

Musculature

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8
Q

What are the hip flexors?

A
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9
Q

What are the hip extensors?

A
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10
Q

What is the illio-psoas: origin, insertion, innervation?

A
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11
Q

What is the rectus femoris: origin, insertion, innervation?

A
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12
Q

What is the sartorius: origin, insertion, innervation?

A
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13
Q

What is the pectineus: origin, insertion, innervation?

A
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14
Q

What is the glut max: origin, insertion, innervation?

A
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15
Q

What is the semitinosus: origin, insertion, innervation?

A
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16
Q

What is the semimembranosus: origin, insertion, innervation?

A
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17
Q

What is the bicep fem: origin, insertion, innervation?

A
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18
Q

What is the glut. med: origin, insertion, innervation?

A
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19
Q

What is the glut. min: origin, insertion, innervation?

A
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20
Q
A
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21
Q

What is the tensor fascia latae: origin, insertion, innervation?

A
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22
Q

What is the adductor longus: origin, insertion, innervation?

A
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23
Q

What is the adductor brevis: origin, insertion, innervation?

A
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24
Q

What is the adductor magnus: origin, insertion, innervation?

A
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25
Q

What is the gracilis: origin, insertion, innervation?

A
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26
Q

What is the tensor fascia latae: origin, insertion, innervation?

A
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27
Q

What is the sup. gemellus: origin, insertion, innervation?

A
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28
Q

What is the psoas: origin, insertion, innervation?

A
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29
Q

What is the piriformis: origin, insertion, innervation?

A
30
Q

What is the inferior gemellus: origin, insertion, innervation?

A
31
Q

What is the obturator internus: origin, insertion, innervation?

A
32
Q

What is the obturator externus: origin, insertion, innervation?

A
33
Q

What is the quadratus femoris: origin, insertion, innervation?

A
34
Q

What are the hip abductors?

A
35
Q

What are the hip adductors?

A
36
Q

What are the hip internal rotators?

A
37
Q

What are the hip external rotators?

A
38
Q

What are indicators that pathology is from the hip?

A
  • “C” sign
  • Exacerbating factors
    • Weight bearing, difficulty flexing hip such as tying shoes
  • Site of pain
    • Trochanteric
    • Buttock
    • Groin
    • Referred
39
Q

What is the “C” sign indicating a normal hip?

A

Called Shenton’s line

40
Q

What is Shenton’s line formed by?

A

Medial edge of femoral neck

Inferior edge of superior pubic ramus

41
Q

Loss of contour of Shenton’s line is indicative of what?

A

Fracture of neck of femur

42
Q

Blood supply of femoral head comes via what?

A

Blood supply of femoral head comes in via a capsule from medial and lateral femoral circumflex arteries:

  • Also intramedullary and ligamentum teres blood supply
43
Q

Fractures can be extra-capsular or intra-capsule which changes what blood supply is disrupted, describe this?

A
  • Extra-capsular
    • Always fix
    • Blood supply intact
  • Intra-capsular
    • Blood supply compromised
    • Management based on age of patient and displacement
      • Undisplaced – fixed
      • Displaced and young – fix
      • Displaced and elderly – replace (hemiarthroplasty or THR)
44
Q

What is the mangement of an intra-capsular femoral neck fracture?

A
  • Management based on age of patient and displacement
    • Undisplaced – fixed
    • Displaced and young – fix
    • Displaced and elderly – replace (hemiarthroplasty or THR)
45
Q

What is hemiarthroplasty?

A

Surgical procedure which replaces one half of the hip joint (the head of femur)

46
Q

What kind of joint is the knee?

A

Hinge synovial joint

47
Q

What movements occur at the knee?

A
  • Flexion/extension
  • Small amount of rotation
48
Q

How does stability of the knee compare to the hip?

A

Less stable than hip and more reliant on soft tissue constrains

49
Q

What are the 3 articulating surfaces at the knee?

A
  • Fibula, tibia and patella
50
Q

What is the normal ROM of the knee?

A
  • -5 to 130 degrees
51
Q

What kind of bone is the patella?

A
  • Sesamoid bone (a bone placed within a tendon)
52
Q

What is a sesamoid bone?

A

Bone placed within a tendon

53
Q

What is the function of the patella?

A
  • Role in increasing extensor lever arm
54
Q

Where is the thickest hyaline cartilage in the body found?

A

Patella

55
Q

How does the knee angle (tibio-femoral angle) compare to the mechanical axis?

A

Is 6 degrees of valgus relative to mechanical axis

56
Q

What are the soft tissue constraints of the knee?

A
  • Static
    • Collateral ligamnets
    • ACL/PCL
    • Capsule
    • ITB
    • Meniscii
  • Dynamic
    • Quadriceps
    • Hamstrings
    • Medial and lateral gastrocnemius
    • Popliteus
57
Q

What are the knee extensors?

A
58
Q

What are the knee flexors?

A
59
Q

What is the rectus femoris: origin, insertion, innervation?

A
60
Q

What is the vastus medialis: origin, insertion, innervation?

A
61
Q

What is the vastuls lateralis: origin, insertion, innervation?

A
62
Q

What is the vastus intermedius: origin, insertion, innervation?

A
63
Q

What is the biceps femoris: origin, insertion, innervation?

A
64
Q

What is the semimembranosus: origin, insertion, innervation?

A
65
Q

What is the semitendinosus: origin, insertion, innervation?

A
66
Q

What is the gastrocnemius: origin, insertion, innervation?

A
67
Q

What are meniscii?

A
  • Crescent of fibrocartilage between surfaces
68
Q

Describe the shape of meniscii?

A
  • Avascular centrally
  • Medial C-shaped
    • Less mobile
    • Firmly attached to tibia
  • Lateral circular
    • More mobile
    • Unattached at popliteus hiatus
69
Q

What is the function of meniscii?

A
  • Load transmission
  • Stability
  • Proprioception
  • Shock absorption
70
Q

What are examples of knee injuries?

A
  • Meniscal tears
  • Ligament injuries
    • Example is ACL injury
      • Knee buckles during pivot
      • Unable to play on
      • Immediate haemarthrosis
      • Recurrent instability
      • X-ray – hamerthrosis, segond fracture
  • OCD lesions
  • Loose bodies
  • Fractures
    • Open or classed
  • Quads/patellar tendon ruptures
  • Knee dislocation
    • Ligaments need to be compromised for this to occur