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MSK > Hip joint > Flashcards

Hip joint Flashcards

1
Q

What type of synovial joint is the hip

A

Ball and socket

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2
Q

Where is the articular cartilage thickest

A

Places of weight bearing

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3
Q

What makes up the hip bone

A

Ilium
Ischium
Pubis

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4
Q

What structures strengthen the hip joint

A

Acetabular labrum,
Joint capsule,
Ligaments,
Muscles

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5
Q

What is the Acetabular labrum

A

Fibrocartilaginous collar attached to margin of acetabulum and increases its depth

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6
Q

Where does the joint capsule attach

A

Intertrochanteric line (anteriorly)

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7
Q

What part of femur is extra capsular

A

Posterior lateral neck of femur

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8
Q

What is the intracapsular ligament

A

Ligament of head of femur

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9
Q

Attachments of ligament of head of femur

A

Acetabular fossa to fovea of femur

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10
Q

Which artery does the ligament of head of femur enclose

A

Branch of obturator artery

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11
Q

What are the extra capsular ligaments

A

Iliofemoral (anterior and superior protection, strongest in body)
Pubofemoral (anterior and inferior protection )
Ischiofemoral (posterior protection, weakest)

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12
Q

What’s the advantage of the orientation of the extra capsular ligaments

A

Spiral orientation so becomes tighter when joint is extended which increases stability and requires less energy to maintain standing position

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13
Q

Origin of iliofemoral ligament

A

Ilium, inferior to ASIS

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14
Q

Attachment of iliofemoral ligament

A

Intertrochanteric line in 2 places (Y shaped)

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15
Q

What does iliofemoral ligament prevent

A

Hyperextension

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16
Q

What does pubofemoral ligament prevent

A

Excessive abduction

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17
Q

Attachment of pubofemoral ligament

A

Iliopubic eminence and obturator membrane

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18
Q

What does ischiofemoral ligament limit

A

Extension at hip

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19
Q

Origin of ischiofemoral

A

Ischium

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20
Q

Attachment of ischiofemoral ligament

A

Greater trochanter

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21
Q

What is the strength of muscles and ligaments anteriorly

A

Ligaments are strongest

Medial flexors are fewer and weaker

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22
Q

What is the strength of muscles and ligaments posteriorly

A

Ligaments weakest

Medial rotators are greater in number and stronger

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23
Q

Muscles performing flexion

A

Iliopsoas,
Rectus femoris,
Sartorius

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24
Q

Muscles performing extension

A

Gluteus maximus,
Semimembranosus,
Semitendinosus,
Long head of biceps femoris

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25
Q

What determines degree of hip flexion

A

Whether knee is flexed - flexed increases range of hip flexion

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26
Q

Muscles performing abduction

A

Gluteus medius and minimus

Deep gluteals

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27
Q

Muscles performing adduction

A

Adductor longus, brevis and Magnus
Pectineus
Gracilis
Obturator externus

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28
Q

Muscles performing lateral rotation

A

Biceps femoris,
Gluteus maximus,
Deep gluteals

29
Q

Muscles performing medial rotation

A

Gluteus medius and medialis
Semimembranosus
Semitendinosus

30
Q

Articulation

A

Head of femur and acetabulum of pelvis

31
Q

Innervation of HJ

A

Femoral nerve,
Obturator nerve,
Superior gluteal nerve,
Nerve to quadratus femoris

32
Q

Blood supply to HJ

A

Majority by medial circumflex femoral artery,
Lateral circumflex femoral artery,
Obturator artery via ligament of head of femur (not enough to keep hip alive on own)

33
Q

What separates the hip bones before age 15

A

Tri-radiate cartilage

34
Q

When is fusion of hip bones complete

A

20-25

35
Q

Where do the hip bones converge

A

Acetabulum

36
Q

What are the extra capsular ligaments continuous with

A

Outer surface of joint capsule

37
Q

Where do the medial and lateral circumflex femoral arteries anastomose

A

Base of femoral neck

38
Q

What does the lateral circumflex femoral artery have to penetrate to reach the hip joint

A

Iliofemoral ligament

Therefore medial circumflex femoral artery provides most blood supply to HJ

39
Q

What happens in hip replacement surgery

A

Plastic socket is cemented to hip bone to replace acetabulum
Stainless steel femoral stem and head to replace femur

40
Q

When do surgical hip replacement take place

A

After traumatic injury

Degenerative diseases of joint

41
Q

What are the bursae of hip joint

A

Trochanteric
Iliopsoas
Ischiogluteal

42
Q

When do the bursa of hip joint become inflamed

A

repetitive strain or direct trauma

43
Q

Where is the trochanteric bursa

A

Between gluteus maximus and greater trochanter

44
Q

When can the trochanteric bursa be inflamed

A

In arthritis

45
Q

What percentage of people have iliopsoas bursa communicating with HJ

A

15%

46
Q

Where is the ischiogluteal bursa

A

Near ischial tuberosity

47
Q

When can the ischiogluteal bursa become inflamed

A

Sitting down e.g. Horse riding and cycling

48
Q

What are the types of hip dislocation

A

Acquired

Congenital

49
Q

What percentage of congenital dislocations are bilateral

A

50%

50
Q

How common are congenital hip dislocations

A

1.5 per 1000 births

8x more likely in girls

51
Q

Cause of congenital hip dislocation

A

During development the femoral head is not placed within the acetabulum

52
Q

Symptoms of congenital hip dislocation

A

Inability to abduct at hip
Affected limb is shorter
Positive trendelenburg sign

53
Q

Consequence of congenital hip dislocation

A

Predisposes patient to arthritis of hip later in life

54
Q

How common are acquired hip dislocations

Why

A

Uncommon

Joint is very strong and stable

55
Q

Common cause of acquired hip dislocation

A

Traumatic accidents

56
Q

Types of acquired hip dislocation

A

Anterior

Posterior

57
Q

How are hip dislocations named

A

Position of femoral head in relation to acetabulum

58
Q

What happens in posterior acquired hip dislocation

A

Femoral head tears through inferior and posterior part of joint capsule (weakest part)

59
Q

Appearance of affected limb in posterior hip dislocation

Why does this occur

A

Shortened - extensors and adductors

Medially rotated - gluteus medius and minimus

60
Q

Risk of posterior hip dislocation

A

Sciatic nerve can be damaged

Paralysis of hamstrings and muscles distal to knee

61
Q

How do anterior hip dislocations occur

A

Excessive:
extension
abduction
lateral rotation

62
Q

What often occurs in anterior hip dislocations

A

Femoral head pulls Acetabular labrum with it (anterior and inferior to acetabulum)

63
Q

Where is margin of acetabulum incomplete

What strengthens this portion

A

Inferiorly (Acetabular notch)

Strengthened by transverse Acetabular ligament

64
Q

What is a slipped upper femoral epiphysis

A

Fracture through epiphyseal growth plate

65
Q

What age does a slipped upper femoral epiphysis usually occur

A

10-16

66
Q

Displacement of fragments in slipped upper femoral epiphysis

A

Distal femur displaced superiorly and anteriorly in relation to growth plate

67
Q

Location of iliopsoas bursa

A

Deep to iliopsoas

68
Q

How does iliopsoas bursitis present

A

Swelling under inguinal ligament

MSK (87 decks)

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