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Year 2 > Hip Joint > Flashcards

Hip Joint Flashcards

1
Q

What is the hip joint?

A

Multiaxial ball and socket joint which is very mobile and stable due to deep acetabulum, strengthened by ligaments. The joint consists of the femur and the pubis, ischium and ilium of the pelvis.

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2
Q

What are the ligaments of hip joint?

A

Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament

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3
Q

How do the ligaments of the hip stabilise?

A

The ligaments connect the femur to the hip; when the hip is flexed, the ligaments are parallel for the attachment to femur. In extension, the femur moves further away relative to the acetabulum so the ligaments tighten in an oblique position to bring femur closer to acetabulum, preventing hyper extension and increasing joint stability.

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4
Q

What is the strongest hip ligament?

A

Iliofemoral ligament

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5
Q

What is the weakest hip ligament?

A

Ischiofemoral ligament

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6
Q

What are the gluteal muscles?

A

Gluteus maximus
Gluteus medius
Gluteus minimis
Tensor fascia latae

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7
Q

What is the gluteus maximus?

A

Arises from the ilium and saccrum to the
1)iliotibial band and
2) gluteal tuberosity of femur
Innervated by the inferior gluteal nerve from (L5, S1,S2) which moves below the piriformis muscle.

Important for hip extension from a flexed position.

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8
Q

What is the gluteus medius?

A

Origin is from the ilium to the greater trochanter of the femur, innervated by the superior gluteal nerve (L4, L5, S1)

—> Stabilishes the pelvis and for hip abduction.

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9
Q

What is the gluteus minimis?

A

Origin is from the ilium to the greater trochanter of the femur, innervated by the superior gluteal nerve (L4, L5, S1) for hip abduction and pelvis stabilisation.

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10
Q

What is the tensor fascia latae?

A

Origin is the ilium to the iliotibial band for hip , innervated by the superior gluteal nerve (L4, L5, S1) for hip abduction, stabilisation of pelvis and internal rotation.

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11
Q

What is the role of the gluteus medius, minimis and tensor fasciae latae?

A

Hip abduction and stabilisation of the pelvis.
-> Innervated by the superior gluteal nerve

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12
Q

What is the role of the gluteus maximus?

A

Hip extension from a flexed position.
External rotation of the hip,

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13
Q

Which muscles are involved in hip flexion?

A

Iliopsoas muscle
Rectus femoris, Sartorius and Pectineus of anterior thigh, which are also involved in rotation.

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14
Q

Which muscles are involved in hip extension?

A

Gluteus maximum
Hamstrings

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15
Q

Which muscles are involved in hip abduction?

A

Gluteus medius
Gluteus minimis
Tensor fasciae latae
-> These muscles are innervated by the superior gluteal nerve.

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16
Q

Which muscles are involved in hip adduction?

A

Medial compartment thigh muscles such as adductor longus, adductor brevis, adductor Magnus

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17
Q

Which muscles are involved in internal rotation of hip?

A

Gluteus medius and minimis

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18
Q

Which muscles are involved in external rotation of the hip?

A

Piriformis
Quadratics femoris
Obturator internus
Superior and inferior gemelli
-> these are innervated by the sacral plexus branches

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19
Q

What is the role of iliopsoas muscle?

A

Consists of the iliacus muscle and psoas major muscle which are responsible for hip flexion.

20
Q

What is the deep femoral artery?

A

AKA profounda femoris artery, it is the largest branch of the femoral artery that arises in the femoral triangle. It gives off the medial circumflex artery and lateral circumflex artery, the major blood supply to the femoral head.

21
Q

What is the major blood supply to the head and neck of femur?

A

Extracapsular arterial ring, formed of ascending branches of the medial circumflex arteries and the lateral circumflex arteries that give off retinacular branches. These give off the epiphyses arteries for the ligament of femoral head

Eg LCF → ascending → retinacular —> epiphyseal

Most major is the Medial circumflex artery via its posterior-superior retinacular branches. Damage to the MCF results in avascular necrosis .

22
Q

What are the branches of the medial circumflex artery?

A

Transverse branch (involved in cruciate anastomosis)
Ascending branch (involved in trochanter anastomosis)
Posterior retinacular branch

23
Q

What are the branches of the Lateral circumflex artery?

A

Ascending branch -> anterior reticular branch
Transverse branch
Descending branch

24
Q

Which part of lateral circumflex is involved in the cruciate anastomosis?

A

Transverse branch.

25
Q

What is the blood supply to the ligament of femoral head?

A

Initially by the obturator artery which transitions to the lateral epiphyseal branch of MCF

26
Q

What are the components of the trochanteric anastomosis?

A

Ascending branches of MCF and LCF
Descending branch of superior gluteal artery

27
Q

What are the components of the cruciate anastomosis?

A

Transverse branch of MCF and LCF
Descending branch of inferior gluteal artery

28
Q

What is the purpose of the trochanteric and cruciate anastomosis?

A

Provide alternative blood supply to femur head when there is blockage of the externalities or femoral artery to prevent avascular necrosis.

29
Q

What is the superior gluteal nerve?

A

From L4-S1, it is superior to the piriformis muscle and innervates the gluteus medius, gluteus minimis and tensor fasciae latae.

30
Q

What is the inferior gluteal nerve?

A

From L5-S2, it is inferior to the piriformis muscle and innervates the gluteus maximus. It exits through the sciatic foramen.

31
Q

What is Trendelenburg gait?

A

Waddling gait due to injury to superior gluteal nerve which causes weakness of the adductor muscles, important in walking stance phase. Caused by superior gluteal nerve injury, affects the muscles on the leg being stood on.

32
Q

What are the deep hip rotators?

A

Piriformis
Quadratus femoris
Superior gemellus
Obturator internus
Inferior gemellus
Obturator externus
These are responsible for external hip rotation and are commonly inserted into the greater trochanter.

33
Q

What is the piriformis?

A

Arises from the saccrum to leave through greater sciatic notch and attach to the greater trochanter of femur for external hip rotation.

Innervated by piriformis nerve from S1-S2.

34
Q

What is the superior gemellus?

A

Origin is the ischial spine to insert into the greater trochanter of femur, innervated by the nerve to the obturator internus from L5-S1 for external hip rotation.

35
Q

What is the obturator internus?

A

Arises from the obturator membrane to attach to greater trochanter of femur, between superior and inferior gemellus innervated by the nerve to the obturator internus from L5-S1 for external hip rotation.

36
Q

What is the obturator externus?

A

Arises from obturator membrane to attach to the greater trochanter, part of the medial thigh muscles innervated by the obturator nerve from L2-L4.

37
Q

What is the inferior gemellus?

A

Arises from the ischium to attach to the greater trochanter of the femur, innervated by the nerve to quadratus femoris from L5-S1 for external hip rotation.

38
Q

What is the quadratus femoris?

A

From the ischium to the intertrochanteric crest of femur, innervated by the nerve to quadratus femoris from L5-S1 for external hip rotation.

39
Q

What is the piriformis nerve?

A

S1-S2 nerve root to innervate the piriformis muscle.

40
Q

What is the obturator internus nerve?

A

L5-S1 nerve root to innervate the superior gemellus and obturator internus muscle.

41
Q

What is the quadratus femoris nerve?

A

L5-S1 nerve root to innervate the quadratus femoris and inferior gemellus.

42
Q

What is the role of the iliofemoral ligament?

A

Limits hyperextension of hip

43
Q

What is the role of the pubofemoral ligament?

A

Limits abduction and extension of hip.

44
Q

What is the role of the ischial femoral ligament?

A

Limits internal rotation of the hip.

45
Q

What is the iliacus muscle innervation?

A

Arises from the iliac crest to the lesser trochanchter of the femur, innervated by the femoral nerve (L2-L4) for hip flexion.

46
Q

What is the psoas major muscle innervation?

A

Arises from the vertebrae to attach the lesser trochanter innervated by the L2 spinal cord level.

Year 2 (247 decks)

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