hip Flashcards
what is the inguinal ligament
strong tight band that forms the lower part of the lower abdominal wall
what is the superior and inferior place of attachment of the inguinal ligament
superior = ASIS
inferior = pubic tubercle
be aware that the inguinal ligament is not a singular structure, it is the lower edge of the large sheet of tendon known as the external oblique aponeurosis
what is situated in the gap between the inguinal ligament and the superior pubic ramus
psoas muscles
femoral artery, nerve, vein
inguinal lymph nodes
what is the femoral triangle and what structures border this triangle
a subfascial space that appears as a triangular depression inferior to the inguinal ligament;
- lateral border = sartorius muscle
- medial border = adductor longus
- superior border = inguinal ligament
at what point does the common / external illiac artery/vein become the femoral artery/vein
once it passes the inguinal ligemant
explain how to long saphenous vein runs along the leg
- branches off the femoral vein
- runs down the medial side of leg all the way to the ankle
what is the main artery that supplies the thigh
the deep femoral artery
what are the 2 branches that the deep femoral artery gives off
lateral and medial circumflex artery
what 2 arteries supply the glutes with blood supply and where does it branch from
- branching from the internal iliac artery
- inferior and superior gluteal artery
all the nerves of the lower extremities come from which 2 structure/places
anterior rami of the 2-5th lumbar nerves
and
1-2nd sacral nerves
describe the position of the femoral nerve and obturator nerve in relation to the psoas muscle
femoral nerve emerges lateral to the posas major
obturator nerve emerges medial to psoas major
what body parts does the sciatic nerve affeft
posterior compartment of thigh and everything below the knee
what type of joint is the hip
ball and socket
what movements can occur at the hip
flexion, extension, abduction, adduction, circumduction, and hip rotation.
what movements are the anterior, posterior and medial compartments of leg do
anterior = flex leg at hip,
posterior = extension of hip, flexion of knee
medial = adduction at hip
what are the 2 main ligaments at the acetabulum and femoral head area
- illiofemoral lig
- pubofemora lig
in total, how many ligaments connect the femur to the pelvis
4
what is the name of the fibrocartilage ring that extends out of the acetabulum fosssa
acetabulum labrum
what is the name given to the curved area of the cartilage by with the femoral head articulates with the acetabulum
lunate surface
what is a ligament of the hip that does no directly attach to the femur from the pelvis
- ligamentous of the head of femur (comes through the acetabulum fossa)
- also known as roud ligament
- ligamentum teres femoris
- foveal ligament
which part of the femur does the distal end of the anterior hip capsule attach to
intertrochanteric line
remember that between the illiofemoral lig and pubofemoral lig is an area of weakness where the joint is not supported by a ligament, hence in a car crash , what is likely to happen
anterior or posterior dislocation of the femur
how can you tell the difference between anterior or posterior dislocation of femur
anterior = head of femur inferior to acetabulum, lesser trochanter more visible due to rotation
posterior = head of femur superior to acetabulum, lesser trochanter not visible due to medial rotation
what line is used to analyse pelvic/hip injuries
shentons line
what is the purpose of the acetabulum labrum and how
adds to stability of hip joint by deepening the acetabulum
what is the fovea found on the head of femur
- dip in the femoral head where the ligament of femur attaches
why is the free edge of the labrum, narrower than the base
to help grip the head of femur keeping it in place and increasing joint stability
the acetabular fossa usually contains fat and is where the artery travels along the ligament of the head of femur to supply it
the produnda femoris / deep femoral artery is a branch of the femoral artery that travels in which direction
posteriorly
we know that the deep femoral artery / profunda femoris splits into the medial and lateral circumflex artery, at what structure is this done
- in the area of where the deep femoral artery is on the iliopsoas tendon ,
- the deep femoral artery splits into 2
besides the lateral and medial circumflex arteries, what other 2 arteries contribute to the blood supply of the hip
- foveal artery
- branch of posterior division of obturator artery
how can the foveal artery prevent avascular necrosis of hip
- if the medial and lateral circumflex artery get disrupted, the foveal artery maintains a blood supply to prevent necrosis
what are 2 significant anastomoses in the hip and what do they supper
- cruciate anastomosis (supper upper thigh)
- trochanteric anastomosis (supports head of femur)
hip fractures are separated into what 2 categoris
intracapsula (within joint capsule)
extracapsula (outside joint capsule)
hip fractures can be described in what 5 ways
- capital ( head)
- sub capital (below head)
- transcervial (across neck)
- inter trochanteric (between greater and lesser trochanter)
- subtrochanteric (below trochanters)
how does the position of fracture in the proximal femur affect bloody supply which may or may not cause avascular necrosis
(intra/extra capsula)
intracapsular fractures can lead to necrosis femoral head due to ascending blood supply being cut off from deep femoral artery
extracapsula fractures usually protected from necrosis as they dont interfere with blood supply to femoral head
in cases of a neck of femur fracture, why is it completely likely for the head to undergo avascular necrossi
- majority branches originate from medial and lateral circumflex arteries and hence from deep femoral arteryies
- these arteries are situated in the neck of femur so if it is fractured the head will not be supplied anymore
what is shentons line
imaginary curved line drawn along the inferior border of the suerior pubic ramps and along the inferomedial border of neck of femur
- should be continuous and smooth
identify what the deep femoral artery, medial and lateral circumflex flex artery and foveal artery look like
what 2 ligaments does the femoral head dislocate between
illiofemoral
pubofemoral ligament
what 3 movements of the hip occur in a frog leg view
hip flexion , abduction and lateral rotation
what is SUFE and how does this happen
slipped upper femoral epiphysis
- during growth spurt, there widening of epiphyseal plate
- angle of epiphysis alters during growth and moves from being horizontal to being oblique
- this results in increased risk of fracture and slippage