Clinical anatomy of the hip and knee Flashcards
what are the hip extensors? ?
gluteus maximus hamstrings; - semitendinous - semimembranous - biceps femoris
what is the nerve supply of the gluteus maximus and what is its action?
hip extensor, abductor and externally rotates hip
inferior gluteal nerve
what is the nerve supply of the semitendinous muscle and what is its function?
hip extensor
sciatic nerve
what is the nerve supply of the semimembranous muscle and what is its function?
hip extensor
sciatic nerve
what is the nerve supply of the biceps femurs and what is its function?
hip extensor
sciatic nerve
what are the hamstring muscles and what is their nerve supply?
semitendinous
semimembranous
biceps femoris
- sciatic nerve
what are the hip flexors?
psoas major iliac rectus femoris sartorius pectineus
what is the nerve supply of the psoas major and what is its function?
hip flexor
femoral nerve - L1 ventral ramus
what is the nerve supply of the rectus femoris and what is its function ?
femoral nerve
hip flexor
what is the nerve supply of the sartorius and what is its function?
hip flexor
femoral nerve
what is the nerve supply of the pectineus and what is its function?
hip flexor
femoral nerve
what are the hip abductors and what is their nerve supply?
gluteus medius gluteus minimus gluteus maximus tensor fascia latae - all superior gluteal nerve
what is a clinical sign of damage to the gluteus medius and how does this occur?
gluteus medius is the most important hip abductor
- Trendelenberg sign
when you stand on one leg, if G.M. isn’t working then the hip with the pathology will drop and you have to physically swing your body over to the opposite side to prevent from falling over
what are the hip adductors and what is their blood supply?
adductor longus
adductor brevis
adductor magnus (+ sciatic nerve)
graciali
- all obturator nerve
what are the hip internal rotators and their nerve supply?
anterior fibres of gluteus medius
tensor fascia latae
- superior gluteal nerve
what are the hip external rotators?
gluteus maximus piriformis superior gemellus inferior gemellus obturator internus obturator externus obturator femoris
what is a sign on x-ray of a fractured neck of femur?
loss of shenton’s line
- but not all fractures of the neck of femur cause loss of shentons line
what is the most common location of dislocation of the hip?
posterior
what is the blood supply to the head of the femur?
capsule; medial and lateral circumflex femoral arteries (branch of profunda femoris)
ligamentum teres via acetabular branch of obturator artery
intramedullary
in what type of fracture is the blood supply to the head of the femur compromised?
intra capsular
what is the angle of the neck shaft of the femur?
130 degrees
126-139
what is the acetubular ante version and femoral ante version angle of the femur?
20 degrees - acetabular
15 degrees - femoral
what factors help to stabilise the hip joint?
- Deep socket for joint
- Anteversion of ball and socket
- Acetubular Labrum
- Negative intra articular pressure
- Musculature
what is the difference in the management of someone with an intra-capsular fracture compared to someone with an extra-capsular fracture?
with an extra articular fracture the blood sup will still be intact therefore always fix
if its intra capsular then the blood supply is compromised treat on an individual basis: undisplayed = fix displaced and young = fix displaced and old = replace
what type of bone is the patella?
sesamoid
are people more prone to getting arthritis in the medial or lateral side of the knee joint and why?
medial
when weight bearing 60% goes to the medial side and only 40% to the lateral
what ligaments are found within the knee joint ?
anterior and posterior cruciate ligaments
medial and lateral collateral ligaments
medial and lateral menisci
what is responsible for shock absorption in the knee joint?
medial and lateral menisci
fibrocartilage
what are the extensors of the knee?
(quadriceps) rectus femoris vastus medialis vastus lateralis vastus intermedius
what are the flexors of the knee?
hamstrings:
- biceps femoris
- semitendinosus
- semimembranosus
- gastrocnemius (S1 nerve innervation)
what is the functions of the menisci of the knee joint?
shock absorption
proprioception
load transmission
stability
give examples of knee injuries.
meniscal tears ligament injuries Oosteochondral defect lesions loose bodies fractures quadriceps/patellar tendon ruptures
what is an evulsion fracture?
when soft tissues tear off bit of their bony attachment
what would you see on an X-ray of an anterior cruciate ligament (ACL) injury?
haemarthrosis (bleeding into joint space)
segond fracture
what is a second fracture?
a type of avulsion fracture
occurs at the lateral epicondyle of the tibia
usually due to ACL injuries
how does an ACL injury typically occur?
knee buckles during pivot
what are the 4 signs of osteoarthritis on x-ray?
reduced joint space
sub chondral sclerosis
sub chondral cysts
osteophytes
with a knee dislocation what are you most worried about and what is the immediate actions?
worried about damage to the popliteal artery and neurological impairment
reduce it first then x-ray (don’t wait to reduce the dislocation)
