Hip and Pelvis Flashcards
What are the primary functions of the hip and pelvis?
Anchor the axial and appendicular skeleton.
Support body weight.
Facilitate locomotion.
Name the bones that make up the pelvis.
Ilium
Ischium
Pubis
Sacrum
Coccyx
What are the key bony landmarks of the pelvis (anterior view)?
Iliac crest
Anterior Superior Iliac Spine (ASIS)
Anterior Inferior Iliac Spine (AIIS)
Pubic tubercle
Pubic symphysis
What are the bony landmarks of the femur?
Femoral head
Femoral neck
Greater trochanter
Lesser trochanter
Intertrochanteric line (anterior)
Linea aspera (posterior)
Describe the hip joint and its movement.
Type: Synovial, polyaxial, ball-and-socket.
Movements:
Flexion/Extension (Sagittal plane)
Abduction/Adduction (Frontal plane)
Medial/Lateral rotation (Transverse plane).
What are the features of the acetabulum?
Lunate surface of hyaline cartilage (horseshoe-shaped).
Non-articular region of acetabular fossa filled with fat.
Acetabular labrum (fibrocartilaginous rim).
List the ligaments of the hip joint.
Iliofemoral ligament (anterior)
Pubofemoral ligament (anterior)
Ischiofemoral ligament (posterior)
Ligamentum Teres (internal)
What is the function of the iliofemoral ligament?
Superior band: Limits extension and adduction.
Inferior band: Limits extension and abduction.
Describe the pubofemoral ligament.
Base: From the pubic eminence.
Apex: To the capsule, medial iliofemoral ligament, and intertrochanteric line.
Limits extension and abduction.
What are the stability factors of the hip joint?
Strong surrounding ligaments.
Cup-shaped acetabulum, deepened by the labrum.
Strong capsule.
Vacuum effect of the ball-and-socket structure.
Arrangement of surrounding muscles.
What are the ligaments of the sacroiliac joint?
Anterior sacroiliac ligament
Interosseous sacroiliac ligament
Posterior sacroiliac ligament
What is the function of the sacrotuberous ligament?
Limits nutation of the sacrum.
Prevents posterior rotation of the ilium.
What is the function of the symphysis pubis?
Classification: Secondary cartilaginous joint.
Contains an interpubic disc.
Supported by the superior and inferior pubic ligaments.
Allows minimal movement.
Define femoral neck inclination and its clinical relevance.
Angle between the femoral shaft and neck.
Variations (e.g., coxa vara or coxa valga) can affect biomechanics and stability.
What is acetabular anteversion and retroversion?
Anteversion: Acetabulum faces forward, increasing mobility but decreasing stability.
Retroversion: Acetabulum faces backward, enhancing stability but reducing mobility.
What is nutation and counter-nutation at the sacroiliac joint?
Nutation: Anterior tilting of the sacrum.
Counter-nutation: Posterior tilting of the sacrum.
What is the clinical relevance of the neck of the femur (NOF)?
Common site for fractures, especially in elderly individuals due to falls.
What are the active movements of the hip joint and their range of motion?
Flexion: 120-130°
Extension: 10-15°
Abduction: 45°
Adduction: 20-30°
External Rotation: 40-50°
Internal Rotation: 30-40°
What are the factors limiting the range of motion in the hip joint?
Tension of antagonists.
Soft tissue apposition.
Tension of ligaments.
Relative congruency of articular surfaces.
Define the close-packed and open-packed positions of the hip joint.
Close-packed position: Maximum extension, internal rotation, and abduction.
Open-packed position: Slight flexion, abduction, and external rotation.
What muscles act as hip flexors, and what are their primary innervations?
Iliopsoas: Anterior rami (L1-L3).
Pectineus: Femoral nerve (L2-L3).
Rectus Femoris: Femoral nerve (L2-L4).
Sartorius: Femoral nerve (L2-L3).
Which muscles are responsible for hip extension, and what limits this movement?
Muscles:
Gluteus Maximus
Adductor Magnus (hamstring part)
Biceps Femoris
Semimembranosus
Semitendinosus
Limits: All ligaments and close-pack position.
What are the primary hip abductors, and what is their clinical relevance?
Muscles:
Gluteus Medius
Gluteus Minimus
Tensor Fascia Lata (TFL)
Clinical Relevance: Weak abductors may result in a Trendelenburg sign or gait.
Name the hip adductors and their nerve supply.
Adductor Longus: Obturator nerve (L2-L4).
Adductor Magnus:
Adductor part: Obturator nerve (L2-L4).
Hamstring part: Sciatic nerve (L4).
Adductor Brevis: Obturator nerve (L2-L3).
Pectineus: Femoral nerve (L2-L3).
Gracilis: Obturator nerve (L2-L3).
What are the deep lateral rotators of the hip?
Piriformis
Obturator Internus
Obturator Externus
Gemellus Superior
Gemellus Inferior
Quadratus Femoris
Describe the boundaries of the femoral triangle.
Base: Inguinal ligament.
Medial border: Adductor longus.
Lateral border: Sartorius.
Floor: Pectineus, adductor longus, and iliopsoas.
Apex: Points inferiorly and continues with the adductor canal.
What are the contents of the femoral triangle (lateral to medial)?
Femoral nerve
Femoral artery
Femoral vein
Lymphatic vessels
Which muscles perform internal rotation of the hip?
Gluteus Medius (anterior fibres).
Gluteus Minimus (anterior fibres).
Tensor Fascia Lata (TFL).
Adductor Magnus.
Limit: Ischiofemoral ligament and posterior capsule.
Which muscles perform external rotation of the hip?
Gluteus Maximus
Piriformis
Obturator Internus/Externus
Gemellus Superior/Inferior
Quadratus Femoris
Sartorius
Limit: Iliofemoral ligament (lateral band).
What are the clinical implications of weak hip flexors?
Weak hip flexors may result in a circumducting gait.
What is the function of the Tensor Fascia Lata (TFL)?
Stabilizes the knee joint.
Weak abductor and internal rotator of the hip.
What is the clinical relevance of the Trendelenburg sign?
A positive Trendelenburg sign indicates weak hip abductors, leading to a pelvic drop on the opposite side during walking.
