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Locomotor > Hip > Flashcards

Hip Flashcards

1
Q

what does the pelvic girdle do

A
  • Forms a stable ring

- Foundation of the lower limb

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2
Q

what is the pelvic girdle formed of

A
  • Ischium – sit on the ischium tuberosities
  • Ileum
  • Pubis
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3
Q

where do the ischium, ileum, and pubci meet

A
  • acetabulum
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4
Q

what is the difference in the acetabulum of children versus adults

A

there is an epipsymphial joint in children therefore allows for more movement
- don’t have much movement in adult skeleton therefore forms a nice foundation to have a stable base for the lower limb

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5
Q

what does the sacroiliac joint do

A
  • Connects ileum to the sacrum
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6
Q

what does the pubic symphysis do

A
  • Connects hemi-pelvis anteriorly
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7
Q

what kind of joint is the hip

A
  • Ball and socket synovial joint
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8
Q

what is the hip designed for in comparison to the glenohumeral joint

A
  • Designed for stability whereas the glenohumeral joint is designed for motility
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9
Q

what does the acetabular do

A

cup shape and covers all of the femoral head

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10
Q

why is the hip stable

A
  • there is deep insertion of the femoral head into the acetabulum
  • there is a strong tight articular capsule that extend to the femoral neck this limits movement
  • ligaments are around the joint capsules - ligament teres
  • power muscles that are tonically active
  • fat pads fills central region and adds cushioning for thinnest part of acetabulum, this is where the acetabulum might break - pushes femur head into the acetabulum without damaging it
  • acetabular labrum is not complete in the hip joint but adds 10% surface area
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11
Q

why is the ligament teres important in children

A

in adults don’t really need it but in children they might not have the same articulalation and this stops the separation of the head of the femur

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12
Q

what happens when you stand up and sit down to the ligaments in the hip

A

– When hip extended (for example when you stand up)ligament fibres become twisted and tighten (shorten) articular capsule pulling acetabulum and femur together\
– When hip sat down and flexed the ligament fibres are horizonal and looser, prevent the articular capsule from tearing

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13
Q

what rotators push he femur into the acetabulum

A

• Medial and lateral rotators reciprocal pull, they both pull from the anterior and posterior side and these pull the head of the femur deeper into the acetabulum

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14
Q

describe the structure of the acetabular

A
  • fibrocartilage

- horse shoe ring - therefore it is incomplete

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15
Q

why is the acetabular incomplete

A

– Have a horseshow rather than a complete ring because the Blood vessels that pass into joint through notch and via ligament of head of femur – there is blood vessel running down the centre of the ligament of the head of the femur

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16
Q

what parts of the femur are in the articular capsules

A

• Anterior surface and medial half of posterior surface of the femoral neck

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17
Q

where are the articular capsule and ligaments at there thickest

A

• Strongest and thickest over upper and anterior parts, thinner over lower and posterior parts

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18
Q

what do the ligaments do to the articular capulse

A

• Ligaments around joint blend with articular capsule, strengthening it further

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19
Q

what ligament is the strongest

A

• Anterior Iliofemoral ligament strongest – runs along the front of the joint capsule

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20
Q

what does the anterior Lilofemoral ligament do

A
  • Prevent excessive extension of the hip – this is because it becomes tight and taut it prevents you over extending the hip
  • Relaxed in flexion
  • When it becomes taut in extension it pulls the head of the femur in the acetabulum
21
Q

why are the posterior ligaments weaker

A
  • This is because the do not cover the whole of the femoral neck, doesn’t need to become all the way back because there is a big muscle
22
Q

where is the hip most likely to disclose

A
  • posteriorly due to lack of ligaments

- Often happens with acetabulum fractures as well, this is with chips breaking off the posterior rim

23
Q

what happens during a posterior dislocation

A
  • The head of the femur goes behind the pelvis so the leg is shortened and medially rotated
24
Q

what is affected in a hip disocloation

A
  • blood vessels are all anterior to the joint so therefore they are not effected
  • sciatica nerve is posterior therefore is more likely to be effected
  • Discloation can compress or stretch the sciatic nerve
25
Q

what is the sciatic nerve

A
  • biggest nerve in the body

- it innervates the hamstrings and everything below the knee

26
Q

what does the femoral nerve innervate

A

the quadriceps

27
Q

what are the hip flexors and what is its innervation

A
  • Innervation = femoral nerve
  • Iliopsoas (it is made by these muscles iliacus and psoas major, attaches to the lesser tronchater)
  • Sartorius assist flexion
  • Pectineus assist flexion
    – Quadriceps (rectus femoris)
28
Q

what does sartoirus also do

A

abducts and laterally rotates hip

29
Q

what does pectineous also do

A

adducts and medially rotates

30
Q

what does psoas minor do

A

– Helps stabilise psoas major

31
Q

what are the main hip abductors

A

– Gluteus medius

– Gluteus minimus

32
Q

what are the muscles that make up the gluteus muscle group

A

– There are 3 muscles in the gluteus muscle group these are gluteus medius, minimus and maximus

33
Q

what muscles cause lateral rotation

A

– Piriformis – this comes from the sacrum, goes from the sciatic notch and onto the back of the greater tronchater

34
Q

what muscles do hip enxteion

A
  • Gluteus maximus (basically does all of extension on its own) – helps lift the limb up, comes from the sacroiliac joint up to the iliac crest, inserts into the greater trochanter
  • It is assisted by the hamstrings, work as a functional group, these are the hamstring group and these assist in hip extension
35
Q

what nerve innervates hip extension

A

inferior gluteal nerve

- - innervation by tibial division of sciatic

36
Q

what nerves and muscles do hip adbuction

A 
o	gluteus medius and minimus
	Innervation = superior gluteal nerve
o	Tensor fasciae lata
	Innervation superior gluteal nerve
	This also helps gluteal maximus to tense ilotibial tract
37
Q

where does the iliotibial tract come from

A
  • Comes from the iliac crest to the tibia
38
Q

what does the iliotibial tract do

A
  • When it tightens all the muscles get pushed towards the femur
  • Stops the muscles on the lateral side of the leg pressing out and pushing agains the skin, pushes them against the femur
  • Stablisie the knee and hip join
39
Q

describe the structure of the iliotibial tract

A
  • Acts as a long aponeurosis (tendon sheet) inserting into the iliotibial tract is the tensor fasciae latae and superficial and anterior parts of gluteus maximus
  • thickening of the deep fascia but acts like a tendon
40
Q

what is the muscles and innervation of hip adduction

A
  • This is the adductor group of muscles medial thigh adductor longus, brevis and magnus, gracilis, pectineus and obturator externus
  • Innervation = obturator nerve
41
Q

what muscles do hip lateral rotation

A
  • Gluteus maximus

- Adductor group

42
Q

what muscles do hip medial rotation

A
  • Gluteus medius/minimus

- Tensor fasciae latae

43
Q

muscles overlap …

A
  • Muscels overlap depending on what they do, so adductors can also be flexors
  • For example gluteus medium and minimus do abductors and medial rotators
44
Q

where do hip fractures occur

A

– High in femoral neck, subcapital
– Across the neck, cervical
– Trochanteric region
– Pretrochanteric

45
Q

what is the symptoms of hip fractures

A
  • Shortening of the leg
  • Lateral external rotation
  • Shentons line is disrupted by the fracture – shentons line is always disrupted good way to diagnose this
46
Q

what is the treatments of hip fractures

A
  • Depends on the age of the individual and the shape of the bone pelvis
  • For young people – pinned and this is healed in 6 months and then you can remove the screws
    in older
  • Usually linked to osteoporosis
  • Use screws and total hip replacement
47
Q

what re the complications of hip fractures

A
  • Fracture to the neck of the femur may disrupt blood supply to the femoral head – avascular necrosis
  • The blood supply comes in more distally and moves proximally up to the head therefore if you fracture the neck you disrupt this blood supply
  • Femoral head becomes avascular and dies
  • The circumflex branches can get broken
  • There is collapse of the bone, loss of rounded profile and loss of surface of the joint, the bone cracks and collaspes
  • Articular cartilage separates so you get a gap and the pressure causes it to collaspse and break
48
Q

why is the hip prone to developing osteoarthritis

A
  • Carry’s the weight of the body therefore it is more prone developing osteoarthritis
  • If you lose it then you expose the bone

Locomotor (22 decks)

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