Hip Flashcards

1
Q

What are the functions of the pelvic girdle?

A
  • supports body weight
  • site for muscle attachment
  • supports and protects the pelvic organs
  • provides bony support for the birth canal
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2
Q

What 3 bones fused together make up the innominate?

A
  • ilium
  • pubis
  • ischium
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3
Q

When does fusion of the 3 bones in the acetabulum occur?

A

between 16-18 years old

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4
Q

Name the cartilaginous joint between the medial surface of the bodies of the 2 pubic bones.

A

pubic symphysis

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5
Q

What are the bony articulations of the sacroiliac joint?

A

ilium & sacrum

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6
Q

What completely surrounds the sacroiliac joint?

A

a fibrous capsule

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7
Q

What are (2) sacroiliac joint ligaments?

A
  • anterior sacroiliac ligament
  • posterior sacroiliac ligaments
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8
Q

What are (3) distinct bands of the posterior sacroiliac ligaments?

A
  • interosseous sacroiliac ligament
  • long posterior sacroiliac ligament
  • short posterior sacroiliac ligament
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9
Q

What are (2) accessory ligaments of the sacroiliac joint?

A
  • Sacrospinous ligament
  • Sacrotuberous ligament
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10
Q

Where does the sacrospinous ligament attach to + from?

A

sacrum to ischial spine

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11
Q

Where does the sacrotuberous ligament attach to + from?

A

sacrum to ischial tuberosity

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12
Q

What type of joint is the hip joint?

A

synovial, ball & socket joint

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13
Q

What are the bony landmarks of the proximal femur?

A
  • Head
  • Neck
  • Intertrochanteric line
  • Greater trochanter
  • Lesser trochanter
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14
Q

Where does the joint capsule on the femur attach?

A

Anteriorly:
- to the intertrochanteric line

Posteriorly:
- to the neck of the femur

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15
Q

What are (3) hip joint ligaments?

A
  • Iliofemoral ligament
  • Pubofemoral ligament
  • Ischiofemoral ligament
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16
Q

During hip flexion does the iliofemoral ligament become relaxed or taut?

A

relaxed

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17
Q

During hip flexion does the pubofemoral ligament become relaxed or taut?

A

relaxed

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18
Q

During hip flexion does the ischiofemoral ligament become relaxed or taut?

A

relaxed

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19
Q

During hip extension does the iliofemoral ligament become relaxed or taut?

A

taut

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20
Q

During hip extension does the pubofemoral ligament become relaxed or taut?

A

taut

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21
Q

During hip extension does the ischiofemoral ligament become relaxed or taut?

A

taut

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22
Q

What happens to the (3) hip joint ligaments when standing?

A

they’re under moderate tension

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23
Q

What muscles are involved in hip flexion?

A
  • Iliopsoas
  • Sartorius
  • Rectus Femoris
  • Tensor Fascia Lata
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24
Q

What muscles are involved in hip extension?

A
  • Gluteus Maximus
  • Semimembranosus
  • Semitendinosus
  • Biceps Femoris
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25
Q

What muscles are involved in hip abduction?

A
  • Gluteus Medius
  • Gluteus Minimus
  • Tensor Fascia Lata (in hip flexion)
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26
Q

What muscles are involved in hip adduction?

A
  • Pectineus
  • Adductor Magnus
  • Adductor Longus
  • Adductor Brevis
  • Gracilis
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27
Q

What muscles are involved in medial rotation of the hip?

A

No prime movers but those anterior to hip axis can produce medial rotation
(i.e.: anterior part of gluteus medius and minimus, tensor fascia lata)

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28
Q

What muscles are involved in lateral rotation of the hip?

A
  • Obturators
  • Gemelli
  • Quadratus Femoris
  • Piriformis
  • Posterior Gluteus Medius
  • Superior Gluteus Maximus
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29
Q

What happens to a patient’s position when standing if they have femoral anteversion?

A

their feet and knees turn in (closed gait)

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30
Q

What happens to a patient’s position when standing if they have femoral retroversion?

A

their feet and knees turn out (opened gait)

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31
Q

Where does the hip joint receive its blood supply from?

A
  • the medial + lateral circumflex femoral arteries
  • obturator artery
  • the superior + inferior gluteal arteries
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32
Q

What are common pathologies of the hip?

A
  • Hip fractures and trauma
  • Rheumatological conditions (Osteoarthritis & Rheumatoid arthritis)
  • Osteonecrosis
  • Infections in the bones and joints
  • Bursitis
  • Legg-Calve-Perthes disease
  • Developmental hip dysplasia
  • Femoroacetabular impingements (FAI)
  • Greater trochanteric pain syndrome (GTPS)
  • Adductor related groin pain (ARGP)
  • Proximal neuropathy
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33
Q

What is sacroiliac nutation?

A

the anterior-inferior movement of the sacrum while the coccyx moves posteriorly relative to the ilium

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34
Q

What is sacroiliac counternutation?

A

a posterior-superior movement of the sacrum while the coccyx moves anterior, relative to the ilium

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35
Q

How does nutation and counternutation work in the sacroiliac joint?

A

when one side is in nutation, the opposite side is in counternutation, and muscular activity will match

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36
Q

Describe osteitis pubis pathology of the pelvic region?

A

One pubic body slips, causing inflammation of the pubic symphysis and surrounding muscle insertions

  • affects some females after childbirth
  • common in footballers
  • may appear as unevenness of the pubic arch
  • unknown aetiology
  • linked to stresses across the symphysis pubis
  • can present as referred pain to the hip joint
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37
Q

What are avulsion factures of the hip often caused by?

A

sports injuries (especially kicking)

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38
Q

Who are avulsion fractures of the pelvic region common in?

A

adolescents + young adults

(as it particularly happens at unfused ossification centres)

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39
Q

What is an avulsion fracture?

A

a fracture occurring when a piece of bone tears away from the site where the muscle attaches to the bone

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40
Q

What are some common examples of avulsion fractures in the pelvic region?

A

ASIS - sartorius muscle

AIIS - rectus femoris muscle

Ischial tuberosity - hamstring muscles

Iliac crest - oblique abdominal + tensor fasciae latae muscles

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41
Q

What is ankylosing spondylitis?

A

a long-term condition in which the spine and other areas of the body become inflamed

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42
Q

What is the origin of the tensor fasciae latae muscle?

A

anterior superior iliac spine + anterior 1/3 of outer lip of iliac crest

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43
Q

Where is the insertion of the tensor fasciae latae muscle?

A

tubercle of iliotibial tract on the tibia (via iliotibial tract)

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44
Q

What action is produced by the tensor fascia latae muscle?

A
  • medial rotation
  • abduction
  • flexion (of thigh at hip joint)
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45
Q

What is the innervation of the tensor fasciae latae muscle?

A

superior gluteal nerve (L4-S1)

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46
Q

What is the arterial supply of the tensor fasciae latae muscle?

A
  • ascending branch of lateral circumflex femoral artery
  • superior gluteal artery
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47
Q

What is the origin of the psoas major muscle?

A
  • transverse processes of L1-L5 vertebrae
  • vertebral bodies of T12-L5 vertebrae
  • adjacent intervertebral discs
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48
Q

Where is the insertion of the psoas major muscle?

A

lesser trochanter of femur

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49
Q

What action is produced by the psoas major muscle?

A
  • flexion of thigh (hip joint)
  • flexes trunk
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50
Q

What is the innervation of the psoas major muscle?

A

anterior rami of 1st, 2nd + 3rd lumbar nerves

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51
Q

What is the arterial supply for the psoas major muscle?

A
  • lumbar arteries
  • lumbar branch of iliolumbar artery
  • obturator artery
  • external iliac artery
  • femoral artery
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52
Q

What is the origin of the iliacus muscle?

A
  • iliac crest
  • superior 2/3 of iliac fossa
  • ala of sacrum
  • anterior sacroiliac ligaments
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53
Q

Where is the insertion of the iliacus muscle?

A

lesser trochanter of femur (via tendon of psoas major)

54
Q

What action is produced by the iliacus muscle?

A
  • flexion of thigh (hip joint)
  • flexes trunk
55
Q

What is the innervation of the iliacus muscle?

A

femoral nerve (L2-L3)

56
Q

What is the arterial supply of the iliacus muscle?

A
  • iliac branch of iliolumbar artery
  • deep circumflex iliac artery
  • obturator artery
  • femoral artery
57
Q

Where does the iliotibial band attach to & from?

A
  • from the anterolateral portion of the iliac crest
  • to the tubercle of iliotibial tract (on the lateral condyle of the tibia)
58
Q

What is the origin of the pectineus muscle?

A

superior pubic ramus

59
Q

Where is the insertion of the pectineus muscle?

A

pectineal line of femur

60
Q

What action is produced by the pectineus muscle?

A
  • adduction (hip joint)
  • flexion (hip joint)
61
Q

What is the innervation of the pectineus muscle?

A
  • femoral nerve (L2-L3)
  • obturator nerve (L2-L3)
62
Q

What is the arterial supply of the pectineus muscle?

A
  • medial circumflex femoral artery
  • obturator artery
63
Q

What is the origin of the adductor magnus muscle?

A
  • inferior pubic ramus
  • ramus of ischium
  • ischial tuberosity
64
Q

Where is the insertion of the adductor magnus muscle?

A
  • gluteal tuberosity
  • linea aspera
  • medial supracondylar line
  • adductor tubercle
65
Q

What action is produced by the adductor magnus muscle?

A
  • adduction (hip joint)
  • flexion (hip joint)
  • extends (hip joint)
66
Q

What is the innervation of the adductor magnus muscle?

A
  • obturator nerve (L2-L4)
  • tibial division of sciatic nerve (L4)
67
Q

What is the arterial supply of the adductor magnus muscle?

A
  • deep femoral artery
  • obturator artery
  • femoral artery
68
Q

What is the origin of the adductor longus?

A

anterior surface of body of pubis

69
Q

Where is the insertion of the adductor longus muscle?

A

middle 1/3 of linea aspera of femur

70
Q

What action is produced by the adductor longus?

A

adduction (hip joint)

71
Q

What is the innervation of the adductor longus muscle?

A

anterior branch of obturator nerve (L2-L3)

72
Q

What is the arterial supply of the adductor longus muscle?

A
  • deep femoral artery
  • medial circumflex femoral artery
73
Q

What is the origin of the adductor brevis muscle?

A
  • body of pubis
  • inferior pubic ramus
74
Q

Where is the insertion of the adductor brevis muscle?

A

proximal 1/3 of medial lip of linea aspera of femur

75
Q

What is the action produced by the adductor brevis muscle?

A

adduction (hip joint)

76
Q

What is the innervation of the adductor brevis muscle?

A

anterior branch of obturator nerve (L2-L3)

77
Q

What is the arterial supply to the adductor brevis muscle?

A

deep femoral artery

78
Q

What is the origin of the gracilis muscle?

A
  • body of pubis
  • inferior pubic ramus
79
Q

Where is the insertion of the gracilis muscle?

A

medial aspect of proximal part of tibia

80
Q

What action is produced by the gracilis muscle?

A
  • adduction of thigh (hip joint)
  • flexion of leg (knee joint)
  • medial rotation of leg (knee joint)
81
Q

What is the innervation of the gracilis muscle?

A

obturator nerve (L2-L3)

82
Q

What is the arterial supply of the gracilis muscle?

A
  • deep femoral artery
  • medial circumflex femoral artery
83
Q

What is the origin of the sartorius muscle?

A

anterior superior iliac spine (ASIS)

84
Q

Where is the insertion of the sartorius muscle?

A

medial aspect of proximal part of tibia

85
Q

What action is produced by the sartorius muscle?

A
  • flexion (hip joint)
  • abduction (hip joint)
  • lateral rotation (hip joint)
  • flexion (knee joint)
  • medially rotates (knee joint)
86
Q

What is the innervation of the sartorius muscle?

A

femoral nerve (L2-L3)

87
Q

What is the arterial supply of the sartorius muscle?

A

femoral artery

88
Q

What is the origin of the gluteus maximus muscle?

A
  • area of ilium located posterior to its posterior gluteal line
  • posterior aspects of sacrum + coccyx
  • sacrotuberous ligament
89
Q

Where is the insertion of the gluteus maximus muscle?

A

tubercle of iliotibial tract on tibia (via iliotibial tract)
- gluteal tuberosity of femur

90
Q

What action is produced by the gluteus maximus muscle?

A
  • extension (hip joint)
  • lateral rotation (hip joint)
  • abduction (hip joint)
91
Q

What is the innervation of the gluteus maximus muscle?

A

inferior gluteal nerve (L5-S2)

92
Q

What is the arterial supply of the gluteus maximus muscle?

A

superior + inferior gluteal arteries

93
Q

What is the origin of the gluteus minimus muscle?

A

area of ilium located between anterior + inferior gluteal lines

94
Q

Where is the insertion of the gluteus minimus muscle?

A

anterolateral aspect of greater trochanter of femur

95
Q

What is the action produced by the gluteus minimus muscle?

A
  • medial rotation (hip joint)
  • abduction (hip joint)
96
Q

What is the innervation of the gluteus minimus muscle?

A

superior gluteal nerve (L5-S1)

97
Q

What is the arterial supply of the gluteus minimus muscle?

A

deep branch of superior gluteal artery

98
Q

What is the origin of the gluteus medius muscle?

A

area of ilium located between anterior + posterior gluteal lines

99
Q

Where is the insertion of the gluteus medius muscle?

A

lateral aspect of greater trochanter of femur

100
Q

What action is produced by the gluteus medius muscle?

A
  • medial rotation (hip joint)
  • abduction (hip joint)
101
Q

What is the innervation of the gluteus medius muscle?

A

superior gluteal nerve (L5-S1)

102
Q

What is the arterial supply of the gluteus medius muscle?

A

deep branch of superior gluteal artery

103
Q

What is the origin of the piriformis muscle?

A
  • pelvic surface of sacrum
  • sacrotuberous ligament
104
Q

Where is the insertion of the piriformis muscle?

A

superior border of greater trochanter of femur

105
Q

What is the action produced by the piriformis muscle?

A
  • lateral rotation (hip joint)
  • transverse abduction (hip joint)
106
Q

What is the innervation of the piriformis muscle?

A

nerve to piriformis (S1-S2)

107
Q

What is the arterial supply of the piriformis muscle?

A
  • superior + inferior gluteal arteries
  • internal pudendal artery
  • lateral sacral artery
108
Q

What is the origin of the quadratus femoris muscle?

A

lateral margin of ischial tuberosity

109
Q

Where is the insertion of the quadratus femoris muscle?

A

quadrate tubercle of femur

110
Q

What action is produced by the quadratus femoris muscle?

A

lateral rotation (hip joint)

111
Q

What is the innervation of the quadratus femoris muscle?

A

nerve to quadratus femoris (L5-S1)

112
Q

What is the arterial supply of the quadratus femoris muscle?

A
  • medial circumflex femoral artery
  • inferior gluteal artery
113
Q

What is the origin of the obturator internus muscle?

A

internal surface of obturator membrane & adjacent bones

114
Q

Where is the insertion of the obturator internus muscle?

A

medial aspect of greater trochanter of femur

115
Q

What is the action produced by the obturator internus muscle?

A
  • lateral rotation (hip joint)
  • transverse abduction (hip joint)
116
Q

What is the innervation of the obturator internus muscle?

A

nerve to obturator internus (L5-S1)

117
Q

What is the arterial supply to the obturator internus muscle?

A
  • internal pudendal
  • obturator artery
118
Q

What is the origin of the obturator externus muscle?

A

external surface of obturator membrane & adjacent bones

119
Q

Where is the insertion of the obturator externus muscle?

A

trochanteric fossa of femur

120
Q

What action is produced by the obturator externus muscle?

A

lateral rotation (hip joint)

121
Q

What is the innervation of the obturator externus muscle?

A

posterior branch of obturator nerve (L3-L4)

122
Q

What is the arterial supply of the obturator externus muscle?

A
  • obturator artery
  • medial circumflex femoral artery
123
Q

What is the origin of the superior gemellus muscle?

A

ischial spine

124
Q

Where is the insertion of the superior gemellus muscle?

A

medial aspect of greater trochanter of femur

125
Q

What is the action produced by the superior gemellus muscle?

A
  • lateral rotation (hip joint)
  • transverse abduction (hip joint)
126
Q

What is the innervation of the superior gemellus muscle?

A

nerve to obturator internus (L5-S2)

127
Q

What is the arterial supply of the superior gemellus muscle?

A
  • internal pudendal
  • inferior gluteal artery
128
Q

What is the origin of the inferior gemellus muscle?

A

ischial tuberosity

129
Q

Where is the insertion of the inferior gemellus muscle?

A

medial aspect of greater trochanter of femur

130
Q

What action is produced by the inferior gemellus muscle?

A
  • lateral rotation (hip joint)
  • transverse abduction (hip joint)
131
Q

What is the innervation of the inferior gemellus muscle?

A

nerve to quadratus femoris (L5-S1)

132
Q

What is the arterial supply of the inferior gemellus muscle?

A

medial circumflex femoral artery