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ANATOMY > HIP ARTHOLOGY > Flashcards

HIP ARTHOLOGY Flashcards

1
Q

Identify the bones in articulation at the hip joint

A
  1. Acetabulum - socket
  2. Head of femur - ball

Both covered in hyaline cartilage

Reciprocally curved the articular surfaces are incongruent (don’t fit well)
resulting in limited S.A contact at low loads and increases as load increase

This distributes load and protects the underlying cartilage and bone from excessive stress

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2
Q

Shape + extent of articulating surfaces

head of femur

A

Head of femur

  • 2/3 of a sphere slightly compressed anteroposteriorly
  • small depression on the head= fovea capitis for attachment of ligament teres
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3
Q

Describe arrangement of articular cartilage at hip joint

Acetabulum

A

Acetabulum
* hemispherical socket (concave) deficient interiorly prominent rim = (acetabular notch)

  • central part is thin walled non- articular acetabular fossa formed by the ischium
  • Lateral (outer) surface of the innominate bone

*Formed of 3 bones
2/5th Ilium
2/5th Ischium
1/5th Pubis

*Semilunar articular surface

*Thin-walled, central part (acetabular fossa) non-articular
Articular surface covered in Articular Hyaline Cartilage

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4
Q

Describe attachments of fibrous capsule of hip joint (joint capsule)

A

Strong fibrous capsule thicker anteriorly and superiorly

Acetabulum superiorly and posteriorly

Acetabulum and acetabulum labrum anteriorly and inferiorly and transverse ligament

Intertrochanteric line and neck anteriorly and posteriorly to medial 2/3 to neck of femur

Longitudinal fibres: acetabulum to femur
Oblique fibres: acetabulum to femur
Arcuate: one part of acetabulum to other
Zona obicularis: deepest no boney attachments wrap round capsule

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5
Q

Where are the areas that the capsule is thickest

A

Anteriorly+Superiorly

Strengthened anteriomedially by the reflected head of rectus femoris + laterally by gluteus minimums

Capsule thicker anterosuperiorly where maximal stress occurs

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6
Q

Special features/ direction of fibre of capsule

A

Majority of capsule fibre run from the innominate to femur

The capsule is a mix of connective tissue fibres of different arrangements and orientation

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7
Q

4 fibres of capsule

A
  1. Longitudinal
  2. Oblique
  3. Arcuate
  4. Zona Orbicularis
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8
Q

Longitudinal fibres

A

Run parallel to axis of the cylinder pass from acetabular to femoral attachments (straight line between femoral head and acetabulum)

Main longitudinal capsular fibre form thickened bands which resist tensile stress which the capsule is subjected

Deeper fibres upon reaching the femoral neck turn upwards towards articular margin

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9
Q

Oblique fibres

A

Spiral around the cylinder between their attachments unite articular surfaces

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10
Q

Arcuate fibres

A

Arch from one part of the acetabular rim to the other helps femoral head within acetabulum

Deeper fibres run circularly around capsule and have no bones attachments

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11
Q

Synovial membrane overview, function

A

Function: lines joint capsule and non articulating bones inside capsule

Membrane accumulates adipose tissue, larger accumulations= articular fat pads

Fat pads= form flexible cushions which fill potential spaces and irregularities of joint

Internal synovial surface= synovial vile increase S.A

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12
Q

Structure synovial membrane

A

2 layers

1.Cellular Intima Supported by ⬇️

Cells lining cellular intima =SYNVIOCYTES

  1. Fibrovascular Subintimal lamina
    Contains some elastic component which prevents redundant folds
    being formed during joint movement
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13
Q

Cellular Intima (synoviocytes)

A

Two types = A + B

A: removal of debris , form part of macrophage system

B: production of synovial fluid

> some can produce antigens immune response in joint

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14
Q

Bursa

A

A sack of fluid naturally occurring

Main role is to improve the efficiency how a joint moves or a muscle/tendon acts around a joint

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15
Q

Function ligaments

A

Prevent excessive or abnormal movement occurring at joint but offer no resistance to normal movement

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16
Q

Capsular ligaments of HIP

[extracapsular]

A

ILIOFEMORAL
PUBOFEMORAL
ISCHIOFEMORAL

17
Q

ILIOFEMORAL ligament

Shape,attachments, position,role

A

Shape: Y shaped , thick 🔺ular ligament

Attachments: *Apex attaches to the lower part of anterior inferior iliac spine and adjacent acetabular rim+ base to intertrochantic line of femur

*Outer bands attach the upper / lower parts of the intertrochanteric line= strongest parts and central part is thinner and weaker

Position: anterior to joint between lower part of anterior inferior iliac spine adjacent to acetabular rim and intertrochanteric line

Role: prevents hyper extension of the hip strongest of 3 ligaments

Limits: lateral rotation, extension adduction - (upper band) abduction-( lower band)

18
Q

PUBOFEMORAL ligament

Shape,attachments, position, role

A

Shape: 🔺ular, strong narrow ligament, inferiorly
situated

Attachments: runs from the iliopubic eminence, superior pubic ramus to lower part of intertrochanteric line blending with the inferior band of the iliofemoral ligament

Position: Anterior and inferior to the joint between the iliopubic eminence and superior pubic ramus and lower intertrochanteric line

Role: strengthens the anteroinferior aspect of joint
limits extension lateral rotation and abduction

19
Q

ISCHIOFEMORAL ligament

Shape,attachments, position, role

A

Shape: less well defined spiral ligament, spirals superolaterally around capsule

Attachments: runs between the body of the ischium, superior part of neck of femur and root of greater trochanter

Position: Posterior of the hip.

Role: limits extension, medial rotation, adduction and prevents hyper-extension holds femoral head in acetabulum

20
Q

Intra-articular structures - (4)

(Structures other than ligaments in joints)

[inracaspular]

A
  1. Transverse acetabular ligament
  2. Acetabular labrum
  3. Ligamentum teres
  4. Acetabular fat pad
21
Q

Intra and extra capsular

A

INTRACAPSULAR

  1. Transverse acetabular ligament
  2. Acetabular labrum
  3. Ligamentum teres
  4. Acetabular fat pad

EXTRA CAPSULAR

  1. ILIOFEMORAL
  2. PUBOFEMORAL
  3. ISCHIOFEMORAL
22
Q

Transverse acetabular ligament

Position, attachments, function

A

Position: inferior deficiency in the acetabular rim is completed by the transverse acetabular ligament (portion of acetabular labrum)

Attachments: bridges the acetabular notch and joins the 2 ends of the acetabular labrum forming complete rim connected with he ligament of the head of femur and articular capsule

Function: supports part of the acetabular labrum

23
Q

Acetabular labrum

Shape,extent/nature,function

A

Shape:🔺ular in cross section

Extent/nature: fibrocartilage rim attaches to the outer surface of the acetabulum and transverse ligament which enhances depth of acetabulum

Function: enhances depth of acetabulum which means dislocation is rare.
Cups round head of femur holding it firmly socket

24
Q

Ligamentum teres (ligament of the head of the femur)

Position,Attachments , function

A

flat 🔺ular band primarily a synovial fold

Position: extends from fossa of acetabulum to fovea capitis of head of femur

Attachments: attached to adjacent margins of the acetabular notch and transverse ligament narrowing as it passes to insert into fovea capitis

Function: contains small artery that supplies head of femur appears to be of little importanance in strengthening hip

25
Q

Acetabular fat pad

Position, function

A

Position: lies within acetabular fossa where femoral head is not

Function: cushion prevent friction

fibroelastic fat pad contains numerous proprietary receptive nerve endings so when compressed or partially extruded
from acetabular fossa beneath the transverse ligament additional proprioreceptive info about hip movement is provided

26
Q

Close packed position of hip

A

Due to the hip ligaments tightening in extension, this is the point of highest joint stability, and therefore the close pack position (extension, adduction, medial rotation).

27
Q

Open packed position

A

The hip joint is different from most joints in the fact that it’s open pack position (flexion, abduction, lateral rotation) is actually where the joint surfaces are in least contact with each other.

It is more often the close pack position where the is the case in other joints.

28
Q

Blood and nerve supply (general)

A

All synovial joints have a rich blood supply especially synovial membrane and capsule = derived from branches of main blood vessels in vicinity of joint

29
Q

Hilton’s law

A

Branches of nerves which supply the muscles acting on the joint

Most articular nerves end in sensory receptors in capsule+ ligaments - synovial membrane has few nerve endings= insensitive to pain

30
Q

Nerve supply to hip

A

Primarily : sciatic, femoral and obturator

31
Q

Blood supply to hip

A

Receive a blood from medial+lateral circumflex femoral, obturator, superior and gluteal arteries forming a periorticular anastomosis around joint

32
Q

Hip stability is determined by

A
  1. shape/angle of bone
  2. Strong reinforcing ligament
  3. acetabular labrum
  4. muscles crossing joint
33
Q

Movements at HIP

A

Flexion/extension x2
Abduction/adduction
Medial/lateral rotation

34
Q

Angle of inclination

A

Normal Between 120-125^

In frontal plane the angle between head neck and shaft of femur

Greater than 130^ = reduced stability

35
Q

angle of anteversion

A

Normal 15^

In the horizontal plane outward rotation of head and neck of femur against the shat

Greater 15^= reduced stability

36
Q

Classifying Hip

A

Classification:
Synovial: Synovial membrane, capsule, hyaline cartilage

Simple: There are no intervening structures between the bones; there are only two bones articulating at this joint (innominate bone and femur)

Multi-axial: The hip undertakes movement in three planes;
Sagittal (Flexion/Extension);
Frontal/coronal (Abduction/Adduction);
Transverse (Medial Rotation/Lateral Rotation)

Shape: Ball (head of femur) and socket (acetabulum)

37
Q

Shape and extent of articulating surface

acetabulum

A

Acetabulum
* hemispherical socket (concave) deficient interiorly prominent rim = (acetabular notch)

  • central part is thin walled non- articular acetabular fossa formed by the ischium
  • Lateral (outer) surface of the innominate bone

*Formed of 3 bones
2/5th Ilium
2/5th Ischium
1/5th Pubis

*Semilunar articular surface

*Thin-walled, central part (acetabular fossa) non-articular
Articular surface covered in Articular Hyaline Cartilage

38
Q

Zona Orbicularis

A

Deep (innermost) part of the capsule. No bony attachment. Run in a circular fashion around the capsule, strengthening it

ANATOMY (11 decks)

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