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Year 3 - MSK > Anatomy of the Hip and Knee - Clinical > Flashcards

Anatomy of the Hip and Knee - Clinical Flashcards

1
Q

the hip is a diarthrodial joint, what does this mean?

A

A diarthrodial joint is one in which the adjoining bone ends are covered with a thin cartilaginous sheet and joined by a joint capsule lined by a synovial membrane, which secretes synovial fluid

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2
Q

the hip is a ______-bearing joint

A

weight

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3
Q

what type of synovial joint is the hip?

A

Ball and Socket

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4
Q

the hip is a stable joint enhanced by what?

A

Enhanced by static and dynamic stabilisers

Static stabilisers– ligaments and shape of the hip

Dynamic stabilisers - muscles

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5
Q

what is the normal angles of the hip?

A

Neck Shaft ~130deg

Fem Anteversion 15deg

Acet Anteversion 20deg

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6
Q

cover the labels and name the different parts of the pelvis

A
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7
Q

what bones make up the hip?

A
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8
Q

name the different labels of the surface anatomy

A
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9
Q

name the ligaments of the hip

A

Inguinal ligament connects anterior superior iliac spine to pubic tubercle

The iliofemoral ligament is a ligament of the hip joint which extends from the ilium to the femur in front of the joint. It is also referred to as the Y-ligament - most important one

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10
Q

picture showing anatomy of the hip joint

A

Head of the femur and the acetabulum covered in hyaline cartilage and if damaged it doesn’t repair itself, and if bone exposed you start to get arthritis process

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11
Q

what are the static hip stabilisers?

A

Bony morphology:

  • Congruence
  • Anteversion of ball and socket

Labrum

-ve intra-articular pressure

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12
Q

what are the dynamic stabilisers of the hip?

A

Musculature (never truly NWB-ing)

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13
Q

what are the Hip Flexors, their origin, insertion and invervation?

A
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14
Q

whats the storngest muscle that flexes the hip?

A

Psoas muscles is strongest muscles that flexes the hip

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15
Q

what are the Hip extensors, their origin, insertion and invervation?

A
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16
Q

a

A

gluteus maximus

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17
Q

b

A

biceps fomoris

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18
Q

c

A

semitendinosus

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19
Q

d

A

semimembranosus

20
Q

what muscles make up the hamstring?

A

biceps femoris

semimembranosus

semitendinosus

21
Q

what are the Hip abductors, their origin, insertion and invervation?

A
22
Q

name a and b

A

a = gluteus medius

b = gluteus minimus

23
Q

what are the Hip adductors, their origin, insertion and invervation?

A
24
Q

cover the labels and name the hip adductors

A
25
Q

what are the Hip Internal Rotators, their origin, insertion and inervation?

A
26
Q

what are the Hip external Rotators, their origin, insertion and inervation?

A
27
Q

Diagnosing Hip Pathology is done how?

A
  • “C” sign
  • Exacerbating Factors
  • Worse WB-ing (weight bearing)
  • Difficulty tying shoe laces
  • Site of pain:
  • Trochanteric
  • Buttock
  • Groin
  • Referred
28
Q

what is shentons line?

A

If shentons line is disrupted then points to hip pathology

29
Q

Blood Supply to Femoral Head is done by what?

A
  • Capsule via Medial and Lateral Fem. Circumflex
  • Intramedullary
  • Ligamentum Teres via acetabular branch of Obturator Artery
30
Q

how is a extra-capsilar injury managed?

A
  • Always fix
  • Blood supply intact
31
Q

how is a intra-capsular injury managed?

A
  • Blood supply (to femoral head) compromised
  • Management based on age of patient, and displacement:
  • Undisplaced-Fix
  • Displaced and Young – Fix
  • Displaced and Old – Replace (either hemiarthroplasty or THR)
32
Q

what type of joint is the knee and what movements does it do?

A

• Sophisticated hinge

  • Flexion extension primary plane of motion
  • But also rotation, varus/valgus, AP translation
33
Q

is the knee:

  • Weightbearing
  • diarthrodial
A

Weightbearing - yes

diarthrodial - yes

34
Q

is the knee more or less stable than the hip and what does this mean?

A
  • Less stable than hip, more reliant on soft tissue constraints
  • Prone to injuries
35
Q

Bony anatomy of th eknee:

how. many articulating surfaces and what is the ROM?

A
  • 3 Articulating surfaces
  • Relatively unconstrained
  • Normal ROM -5 – 130deg

Femur, tibia and fibula

36
Q

what is the patella and its role?

A
  • Largest sesamoid bone in body (Sesamoid bone is a bone placed within a tendon)
  • Thickest hyaline cartilage
  • 3x body weight through PFJ on stairs, 7x during squats
  • Role in increasing extensor lever arm
37
Q

what is the Knee Alignment?

A
38
Q

what are some static some tissue constraints?

A

Collateral ligaments

ACL/PCL (cruciate ligament)

Capsule

ITB

Meniscii

39
Q

what are some dynamic tissue constraints?

A

Quadriceps

Hamstrings

Medial and lateral gastroc.

Popliteus

40
Q

what is the soft tissue anatomy of the knee

A
41
Q

what muscles make up the knee extensors, what is their origin, insertion and inervation?

A

All are parts/make up the quadriceps

42
Q

what muscles make up the knee flexors, what is their origin, insertion and inervation?

A
43
Q

what muscles make up your hamstrings?

A

Semitendinosus

Semimembranosus

Biceps femoris

44
Q

what ar ethe Meniscii?

A
  • Crescent of fibrocartilage
  • Avascular centrally
  • Medial C-shaped - Less mobile and Firmly attached to tibia
  • Lateral “Circular” - More mobile and Unattached at popliteus hiatus

A meniscus is a piece of cartilage found where two bones meet (joint space). Menisci (plural of meniscus) protect and cushion the joint surface and bone ends. In the knee, the crescent-shaped menisci are positioned between the ends of the upper (femur) and lower (tibia) leg bones

45
Q

what is the role of meniscii?

A
  • Load Transmission
  • Stability - Esp AP translation
  • Proprioception
  • Shock absorbtion
46
Q

what are different knee injuries that may occur?

A
  • Meniscal tears
  • Ligament injuries
  • OCD lesions (osteochondral defects)
  • Loose bodies
  • Fractures
  • Quads/Patellar tendon ruptures
47
Q

How do ACL injuries occur, how do they present and what investigation is required?

A
  • Knee buckles during pivot
  • Unable to play on
  • Immediate haemarthrosis (haemorrhage into a joint space )
  • Recurrent instability
  • X-ray - Haemarthrosis, Segond fracture (a type of avulsion fracture (soft tissue structures pulling off fragments of their bony attachment) from the lateral tibial plateau of the knee, immediately below the articular surface of the tibia)

Year 3 - MSK (45 decks)

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