hip

Question 1

what is the inguinal ligament

Answer 1

strong tight band that forms the lower part of the lower abdominal wall

Question 2

what is the superior and inferior place of attachment of the inguinal ligament

Answer 2

superior = ASIS
inferior = pubic tubercle

Question 3

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

Question 4

what is situated in the gap between the inguinal ligament and the superior pubic ramus

Answer 4

psoas muscles
femoral artery, nerve, vein
inguinal lymph nodes

Question 5

what is the femoral triangle and what structures border this triangle

Answer 5

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

Question 6

at what point does the common / external illiac artery/vein become the femoral artery/vein

Answer 6

once it passes the inguinal ligemant

Question 7

explain how to long saphenous vein runs along the leg

Answer 7

• branches off the femoral vein
• runs down the medial side of leg all the way to the ankle

Question 8

what is the main artery that supplies the thigh

Answer 8

the deep femoral artery

Question 9

what are the 2 branches that the deep femoral artery gives off

Answer 9

lateral and medial circumflex artery

Question 10

what 2 arteries supply the glutes with blood supply and where does it branch from

Answer 10

• branching from the internal iliac artery
• inferior and superior gluteal artery

Question 11

all the nerves of the lower extremities come from which 2 structure/places

Answer 11

anterior rami of the 2-5th lumbar nerves
and
1-2nd sacral nerves

Question 12

describe the position of the femoral nerve and obturator nerve in relation to the psoas muscle

Answer 12

femoral nerve emerges lateral to the posas major

obturator nerve emerges medial to psoas major

Question 13

what body parts does the sciatic nerve affeft

Answer 13

posterior compartment of thigh and everything below the knee

Question 14

what type of joint is the hip

Answer 14

ball and socket

Question 15

what movements can occur at the hip

Answer 15

flexion, extension, abduction, adduction, circumduction, and hip rotation.

Question 16

what movements are the anterior, posterior and medial compartments of leg do

Answer 16

anterior = flex leg at hip,

posterior = extension of hip, flexion of knee

medial = adduction at hip

Question 17

what are the 2 main ligaments at the acetabulum and femoral head area

Answer 17

• illiofemoral lig
• pubofemora lig

Question 18

in total, how many ligaments connect the femur to the pelvis

Answer 18

4

Question 19

what is the name of the fibrocartilage ring that extends out of the acetabulum fosssa

Answer 19

acetabulum labrum

Question 20

what is the name given to the curved area of the cartilage by with the femoral head articulates with the acetabulum

Answer 20

lunate surface

Question 21

what is a ligament of the hip that does no directly attach to the femur from the pelvis

Answer 21

• ligamentous of the head of femur (comes through the acetabulum fossa)
• also known as roud ligament
• ligamentum teres femoris
• foveal ligament

Question 22

which part of the femur does the distal end of the anterior hip capsule attach to

Answer 22

intertrochanteric line

Question 23

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

Answer 23

anterior or posterior dislocation of the femur

Question 24

how can you tell the difference between anterior or posterior dislocation of femur

Answer 24

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

Question 25

what line is used to analyse pelvic/hip injuries

Answer 25

shentons line

Question 26

what is the purpose of the acetabulum labrum and how

Answer 26

adds to stability of hip joint by deepening the acetabulum

Question 27

what is the fovea found on the head of femur

Answer 27

• dip in the femoral head where the ligament of femur attaches

Question 28

why is the free edge of the labrum, narrower than the base

Answer 28

to help grip the head of femur keeping it in place and increasing joint stability

Question 29

the acetabular fossa usually contains fat and is where the artery travels along the ligament of the head of femur to supply it

Question 30

the produnda femoris / deep femoral artery is a branch of the femoral artery that travels in which direction

Answer 30

posteriorly

Question 31

we know that the deep femoral artery / profunda femoris splits into the medial and lateral circumflex artery, at what structure is this done

Answer 31

• in the area of where the deep femoral artery is on the iliopsoas tendon ,
• the deep femoral artery splits into 2

Question 32

besides the lateral and medial circumflex arteries, what other 2 arteries contribute to the blood supply of the hip

Answer 32

• foveal artery
• branch of posterior division of obturator artery

Question 33

how can the foveal artery prevent avascular necrosis of hip

Answer 33

• if the medial and lateral circumflex artery get disrupted, the foveal artery maintains a blood supply to prevent necrosis

Question 34

what are 2 significant anastomoses in the hip and what do they supper

Answer 34

• cruciate anastomosis (supper upper thigh)
• trochanteric anastomosis (supports head of femur)

Question 35

hip fractures are separated into what 2 categoris

Answer 35

intracapsula (within joint capsule)

extracapsula (outside joint capsule)

Question 36

hip fractures can be described in what 5 ways

Answer 36

• capital ( head)
• sub capital (below head)
• transcervial (across neck)
• inter trochanteric (between greater and lesser trochanter)
• subtrochanteric (below trochanters)

Question 37

how does the position of fracture in the proximal femur affect bloody supply which may or may not cause avascular necrosis

(intra/extra capsula)

Answer 37

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

Question 38

in cases of a neck of femur fracture, why is it completely likely for the head to undergo avascular necrossi

Answer 38

• 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

Question 39

what is shentons line

Answer 39

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

Question 40

identify what the deep femoral artery, medial and lateral circumflex flex artery and foveal artery look like

Question 41

what 2 ligaments does the femoral head dislocate between

Answer 41

illiofemoral
pubofemoral ligament

Question 42

what 3 movements of the hip occur in a frog leg view

Answer 42

hip flexion , abduction and lateral rotation

Question 43

what is SUFE and how does this happen

Answer 43

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