Hip Anatomy Flashcards
angle of inclination of the femur
- Normal → 135 (125-140)
- Coxa Vara <120
- Coxa Valga →140
Angle of Anteversion of the femur
defined by neck and posterior borders of femoral condyles (in the transverse plane)
- Normal → 10-15
- Excessive → 40
- anterior dislocation risk
- more exposed femoral head
- Retroversion
describe hip vascularture
- Medial and Lateral Circumflex Arteries
- ascending branches pierce capsule
- ascend the neck
- minor contributions from inferior and superior gluteal arteries
osseous structures of the pubis
- pubis
- superior pubic ramus
- inferior pubic ramus
- pubic tubercle
osseous structures of the ilium
- iliac crest
- anterior, posterior, medial borders
- gluteal surfaces
- iliac fossa
- sacropelvic surface
osseous structures of the ishium
- ischial ramus
- ischial tuberocity
- ischial spine
innominate angles
- inclincation of the acetablum → 45
- acetabular angle of anteversion
- men → 14
- women → 19
pelvic spaces, canals, and foramens
- gap between inguinal ligament and pelvis
- greater sciatic foramen (above and below piriformis)
- lesser sciatic foramen
- obturator canal
what contributes to stability at the hip?
- contact area of articulating surfaces > 1/2 sphere
- labrum
- vacuum effect
- thick capsule
- strong ligamentous structures
- transverse ligament of acetabulum
- joint angles
- muscular stability
arthrology of the femoral head
- spheroidal (or slightly ovoid)
- covered by AC (except ligamentum teres)
- contacts anteriolateral surface
arthrology of the acetabular surface
- Lunate surface
- incomplete ring (transverse acetabular ligament)
- contacts on anteriosuperior margin
- deficient inferiorly (opposite acetabular notch)
- acetabular fossa contains acetabular fat
Vascular supply and Innervation of the Labrum
- Vascularized in outer 1/3
- blood vessels enter peripheral labrum from the capsule
- inner 2/3 avascular
- Innervation
- branches from nerve to quads and obturator nerve
- nociception
- proprioception
where is the hip capsule strongest?
thickest anteriosuperiorly
List the ligaments of the hip
- Iliofemoral ligament
- Pubofemoral ligament
- Ischiofemoral ligament
- Transverse Acetabular ligament
- Ligamentum Teres
describe the iliofemoral ligament
- strong, inverted Y
- anterior hip → between AIIS and acetabular rim to intertrochanteric line
describe the pubofemoral ligament
- triangular
- base → iliopubic eminence, superior pubic ramus, obturator crest, obturator membrane
- distal → deep fibers of medial iliofemoral ligament
describe the ishiofemoral ligament
- posterior
- three parts:
- central (greater trochanter to ishium just posterioinferior acetabulum)
- lateral and medial wind around femoral neck
ligaments of the hip during → flexion
ischiofemoral, pubofemoral and iliofemoral are all slackened
ligaments of the hip during extension
all ligaments taut (wind around femoral neck)
inferior band of iliofemoral ligament most taut (checks posterior tilt of pelvis)
ligaments of the hip during Adduction
- superior band of IF is sig tightended, inferior band of IF slightly taut
- PF relaxes
- IsF stretched
ligaments of the hip during Abduction
- superior band of IF is loosened, inferior band of IF taut
- PF taut
- IsF tenses
ligaments of the hip during External/Internal Rotation
- External Rotation → anterior ligaments become taut
- IsF becomes slackened
- Internal Rotation → opposite
Anterior Hip musculature paired with nerve roots
- Psoas Major → L1-3
- Psoas Minor → L1
- Iliacus → L1-4
- Sartorius → L2, 3
- Quadriceps Femoris → L2-4
- TFL → L4-5
- Gracilis → L2, 3
- Adductors → L2-4
- Pectineus → L2-4
Posterior Hip musculature paired with nerve roots
- Glut Max → L5-S2
- Semitendinosus and Semimembranous → tibial division L5-2
- Biceps femoris
- long head → tibial portion L5-S2
- short head → fibular portion L5-S2
- Glute Medius → L5/S1
- Glut Min → L5/S1
Resting and Closed Packed position of the Hip
- Resting → ~30 flexion, abduction and slight ER
- Closed pack → full extension with abduction and IR
