Hip Flashcards
What are the functions of the pelvic girdle?
- supports body weight
- site for muscle attachment
- supports and protects the pelvic organs
- provides bony support for the birth canal
What 3 bones fused together make up the innominate?
- ilium
- pubis
- ischium
When does fusion of the 3 bones in the acetabulum occur?
between 16-18 years old
Name the cartilaginous joint between the medial surface of the bodies of the 2 pubic bones.
pubic symphysis
What are the bony articulations of the sacroiliac joint?
ilium & sacrum
What completely surrounds the sacroiliac joint?
a fibrous capsule
What are (2) sacroiliac joint ligaments?
- anterior sacroiliac ligament
- posterior sacroiliac ligaments
What are (3) distinct bands of the posterior sacroiliac ligaments?
- interosseous sacroiliac ligament
- long posterior sacroiliac ligament
- short posterior sacroiliac ligament
What are (2) accessory ligaments of the sacroiliac joint?
- Sacrospinous ligament
- Sacrotuberous ligament
Where does the sacrospinous ligament attach to + from?
sacrum to ischial spine
Where does the sacrotuberous ligament attach to + from?
sacrum to ischial tuberosity
What type of joint is the hip joint?
synovial, ball & socket joint
What are the bony landmarks of the proximal femur?
- Head
- Neck
- Intertrochanteric line
- Greater trochanter
- Lesser trochanter
Where does the joint capsule on the femur attach?
Anteriorly:
- to the intertrochanteric line
Posteriorly:
- to the neck of the femur
What are (3) hip joint ligaments?
- Iliofemoral ligament
- Pubofemoral ligament
- Ischiofemoral ligament
During hip flexion does the iliofemoral ligament become relaxed or taut?
relaxed
During hip flexion does the pubofemoral ligament become relaxed or taut?
relaxed
During hip flexion does the ischiofemoral ligament become relaxed or taut?
relaxed
During hip extension does the iliofemoral ligament become relaxed or taut?
taut
During hip extension does the pubofemoral ligament become relaxed or taut?
taut
During hip extension does the ischiofemoral ligament become relaxed or taut?
taut
What happens to the (3) hip joint ligaments when standing?
they’re under moderate tension
What muscles are involved in hip flexion?
- Iliopsoas
- Sartorius
- Rectus Femoris
- Tensor Fascia Lata
What muscles are involved in hip extension?
- Gluteus Maximus
- Semimembranosus
- Semitendinosus
- Biceps Femoris
What muscles are involved in hip abduction?
- Gluteus Medius
- Gluteus Minimus
- Tensor Fascia Lata (in hip flexion)
What muscles are involved in hip adduction?
- Pectineus
- Adductor Magnus
- Adductor Longus
- Adductor Brevis
- Gracilis
What muscles are involved in medial rotation of the hip?
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)
What muscles are involved in lateral rotation of the hip?
- Obturators
- Gemelli
- Quadratus Femoris
- Piriformis
- Posterior Gluteus Medius
- Superior Gluteus Maximus
What happens to a patient’s position when standing if they have femoral anteversion?
their feet and knees turn in (closed gait)
What happens to a patient’s position when standing if they have femoral retroversion?
their feet and knees turn out (opened gait)
Where does the hip joint receive its blood supply from?
- the medial + lateral circumflex femoral arteries
- obturator artery
- the superior + inferior gluteal arteries
What are common pathologies of the hip?
- 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
What is sacroiliac nutation?
the anterior-inferior movement of the sacrum while the coccyx moves posteriorly relative to the ilium
What is sacroiliac counternutation?
a posterior-superior movement of the sacrum while the coccyx moves anterior, relative to the ilium
How does nutation and counternutation work in the sacroiliac joint?
when one side is in nutation, the opposite side is in counternutation, and muscular activity will match
Describe osteitis pubis pathology of the pelvic region?
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
What are avulsion factures of the hip often caused by?
sports injuries (especially kicking)
Who are avulsion fractures of the pelvic region common in?
adolescents + young adults
(as it particularly happens at unfused ossification centres)
What is an avulsion fracture?
a fracture occurring when a piece of bone tears away from the site where the muscle attaches to the bone
What are some common examples of avulsion fractures in the pelvic region?
ASIS - sartorius muscle
AIIS - rectus femoris muscle
Ischial tuberosity - hamstring muscles
Iliac crest - oblique abdominal + tensor fasciae latae muscles
What is ankylosing spondylitis?
a long-term condition in which the spine and other areas of the body become inflamed
What is the origin of the tensor fasciae latae muscle?
anterior superior iliac spine + anterior 1/3 of outer lip of iliac crest
Where is the insertion of the tensor fasciae latae muscle?
tubercle of iliotibial tract on the tibia (via iliotibial tract)
What action is produced by the tensor fascia latae muscle?
- medial rotation
- abduction
- flexion (of thigh at hip joint)
What is the innervation of the tensor fasciae latae muscle?
superior gluteal nerve (L4-S1)
What is the arterial supply of the tensor fasciae latae muscle?
- ascending branch of lateral circumflex femoral artery
- superior gluteal artery
What is the origin of the psoas major muscle?
- transverse processes of L1-L5 vertebrae
- vertebral bodies of T12-L5 vertebrae
- adjacent intervertebral discs
Where is the insertion of the psoas major muscle?
lesser trochanter of femur
What action is produced by the psoas major muscle?
- flexion of thigh (hip joint)
- flexes trunk
What is the innervation of the psoas major muscle?
anterior rami of 1st, 2nd + 3rd lumbar nerves
What is the arterial supply for the psoas major muscle?
- lumbar arteries
- lumbar branch of iliolumbar artery
- obturator artery
- external iliac artery
- femoral artery
What is the origin of the iliacus muscle?
- iliac crest
- superior 2/3 of iliac fossa
- ala of sacrum
- anterior sacroiliac ligaments