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ESA 2- Musculoskeletal System > Hip Joint > Flashcards

Hip Joint Flashcards

1
Q

What kind of joint is the hip?

A

Ball and socket synovial type joint

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2
Q

What is the hip joint between?

A

The head of the femur and acetabulum of the pelvis

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3
Q

What does the hip joint join?

A

The lower limb to the pelvic girdle

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4
Q

What is the hip joint designed to be?

A

A stable weight bearing joint

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5
Q

What is the result of the hip being a stable weight bearing joint?

A

A large range of movement is sacrificed for stability

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6
Q

What does the hip joint consist of?

A

An articulation between the head of the femur and the acetabulum of the pelvis

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7
Q

What is the acetabulum?

A

A cup-like depression in the lateral side of the pelvis

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8
Q

What shape is the head of the femur?

A

Hemispherical

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9
Q

How does the head of the femur fit into the acetabulum?

A

Fits completely into the concavity

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10
Q

What are the acetabular and head of femur covered in?

A

Articular cartilage

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11
Q

Where is the articular cartilage on the acetabulum and head of femur thicker?

A

At places of weight bearing

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12
Q

What do the ligaments of the hip joint act to do?

A

Increase stability

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13
Q

How can the ligaments of the hip joint be divided?

A

Into two groups, intracapsular and extracapsular

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14
Q

What is the intracapsular ligament?

A

The ligament of the head of the femur

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15
Q

Where does the ligament of the head of the femur run?

A

From the acetabular fossa to the fovea of the femur

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16
Q

What does the ligament of the head of the femur enclose?

A

A branch of the obturator artery

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17
Q

What does the branch of the obturator artery comprise?

A

A small proportion of the hip joint blood

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18
Q

What are the extracapsular ligaments?

A

Iliofemoral
Pubofemoral
Ischiofemoral

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19
Q

What are the extracapsular ligaments continuous with?

A

The outer surface of the hip joint capsule

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20
Q

Where is the iliofemoral ligament located?

A

Anteriorly

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21
Q

What does the iliofemoral ligament originate from?

A

The ilium, immediately inferior to the anterior inferior iliac spine

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22
Q

Where does the iliofemoral ligament attach?

A

To the intertrochanteric line in two places

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23
Q

What does the attachment of the iliofemoral ligament give?

A

The Y shaped appearance of the ligament

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24
Q

What does the iliofemoral ligament prevent?

A

Hyperextension of the hip joint

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25
Q

Where is the pubofemoral ligament located?

A

Anteriorly and inferiorly

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26
Q

Where does the pubofemoral ligament attach?

A

At the pelvis, to the iliopubic eminance and obturator membrane

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27
Q

What does the pubofemoral ligament blend with?

A

The articular capsule

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28
Q

What does the pubofemoral ligament do?

A

Prevents excessive abduction and extension

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29
Q

Where is the ischiofemoral ligament located?

A

Posteriorly

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30
Q

Where does the ischiofemoral ligament originate from?

A

The ischium of the pelvis

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31
Q

What does the ischiofemoral ligament attach to?

A

The greater trochanter of the femur

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32
Q

What does the ischiofemoral ligament prevent?

A

Excessive extension of the femur at the hip joint

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33
Q

How is vascular supply to the hip joint achieved?

A

Via the medial and lateral circumflex femoral arteries, and the artery to the head of the femur

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34
Q

What are the circumflex arteries branches of?

A

The profunda femoris artery

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35
Q

Where do the circumflex arteries anastomose?

A

At the base of the femoral neck

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36
Q

What is formed when the circumflex arteries anastomose?

A

A ring, from which smaller arteries arise to supply the joint itself

37
Q

What is responsible for the majority of the arterial supply to the hip joint?

A

The medial circumflex femoral artery

38
Q

Why is it the medial, rather than lateral, circumflex femoral artery that provides the majority of the arterial supply to the hip joint?

A

The lateral circumflex femoral artery has to penetrate through the thick iliofemoral ligament to reach the hip joint

39
Q

What can damage to the medial circumflex artery result in?

A

Avascular necrosis of the femoral head

40
Q

What is the hip joint innervated by?

A

The femoral nerve, the obturator nerve, superior gluteal nerve, and the nerve to the quadratus femoris

41
Q

What is the primary function of the hip?

A

To bear weight

42
Q

What structures increase the stability of the hip joint?

A

Acetabulum
Acetabular labrum
Ligaments
Muscles

43
Q

How does the acetabulum of the hip increase its stability?

A

It is deep, encompasses nearly all of the head of the femur, decreasing the probability of the head slipping out of the acetabulum and causing dislocation

44
Q

What is the acetabular labrum?

A

The fibrocartilaginous collar around the acetabulum

45
Q

What does the acetabular labrum do?

A

Increases its depth

46
Q

What does the increase in depth produced by the acetabular labrum do?

A

Provides a large articular surface, thus improving the stability of the joint

47
Q

What ligaments stabilise the hip joint?

A

Iliofemoral, pubofemoral and ischiofemoral

48
Q

What do the hip ligaments stabilise the joint in conjunction with?

A

The thickened joint capsule

49
Q

What features of the ligament contribute to their role of strengthening the hip?

A

Very strong

Spiral orientation

50
Q

What is the result of the spiral orientation of the ligaments stabilising the hip?

A

It causes them to become tighter when the joint is extended, which adds stability to the joint and means less energy is needed to maintain a standing position

51
Q

How do muscles and ligaments work at the hip joint?

A

In a reciprocal fashion

52
Q

How do the muscles and ligaments of the hip joint work anteriorly?

A

Here the ligaments are strongest, and the medial flexors (located anteriorly) are fewer and weaker

53
Q

How do the muscles and ligaments of the hip joint work posteriorly?

A

Here the ligaments are weakest, and the medial rotators are greater and stronger- they effectively ‘pull’ the head of the femur into the acetabulum

54
Q

What movements can be carried out at the hip?

A 
Flexion
 Extension
 Abduction
 Adduction
 Medial/lateral rotation
55
Q

What does the degree to which flexion at the hip can occur depend on?

A

Whether the knee is flexed

56
Q

Why does hip flexion depend on knee flexion?

A

Because knee flexion releases the hamstrings, and so increases the range of flexion

57
Q

What is extension at the hip joint limited by?

A

The joint capsule and, in particular, the iliofemoral ligament

58
Q

How do the joint capsule and iliofemoral ligament limit hip extension?

A

They become taut during extension to limit further movement

59
Q

What produces flexion at the hip?

A

Iliosoas
Rectus femoris
Sartorius

60
Q

What produces extension at the hip?

A

Gluteus maximus
Semimembranosus
Semitendinosus
Biceps femoris

61
Q

What produces abduction at the hip?

A

Gluteus medius
Gluteus minimis
Deep gluteals (piriformis, gemelli etc)

62
Q

What produces adduction at the hip?

A

Adductors longus, brevis and magnus, pectineus and gracillis

63
Q

What produces lateral rotation at the hip?

A

Biceps femoris
Gluteus maximus
Deep gluteals (piriformis, gemelli etc)

64
Q

What produces medial rotation at the hip?

A

Gluteus medius and minimus
Semitendinosus
Semimembranosus

65
Q

How do fractures to the neck of the femur occur?

A

In 40 year olds, more likely to occur from balls

66
Q

Who are fractures to the neck of the femur more likely to occur in?

A

Women

67
Q

Why are fractures to the femoral neck more likely to occur in women?

A

They generally have more brittle necks from osteoporosis

68
Q

What often happens to the affected limb in a femoral neck fracture?

A

It is often laterally rotated

The arteries arising from the medial circumflex artery are usually torn, disrupting the blood supply

69
Q

What can the disruption of the blood supply in femoral neck fractures cause?

A

Avascular necrosis of the femoral head and neck

70
Q

What happens in a surgical hip replacement?

A

A plastic socket is cemented to the hip bone to replace the acetabulum, while a stainless steel femoral stem and head replaces the femur

71
Q

When are hip replacements usually performed?

A

After traumatic injury or in degenerative disease of the joint

72
Q

What are the types of hip dislocation?

A

Acquired and congenital

73
Q

Who is congenital dislocation of the hip joint more common in?

A

Girls (8x more likely)

74
Q

How common is congenital dislocation of the hips?

A

Relatively common

75
Q

What causes congenital dislocation of the hip?

A

During development, the femoral head is not placed within the acetabulum, resulting in a dislocated joint

76
Q

What are the common symptoms of congenital hip dislocation?

A

Inability to abduct at the hip joint
Affected limb is shorter
Positive Trendelenburg sign

77
Q

What does having congenital displacement of the hip predispose to?

A

Arthritis of the hip later in life

78
Q

How common are acquired dislocations of the hip joint?

A

Quite uncommon

79
Q

Why are acquired dislocations of the hip joint quite uncommon?

A

Because of the strength and stability of the joint

80
Q

What are acquired dislocations of the hip usually due to?

A

Traumatic accidents

81
Q

What are the types of acquired hip dislocation?

A

Posterior and anterior

82
Q

What is the more common type of acquired hip dislocation?

A

Posterior

83
Q

What happens in a posterior hip dislocation?

A

The femoral head is forced posteriorly (backwards), and tears through the inferior and posterior part of the joint capsule, where it is at its weakest

84
Q

What are the signs of a posterior hip dislocation?

A

The limb becomes shortened and medially rotated

85
Q

What can be damaged in a posterior hip dislocation?

A

The sciatic nerve

86
Q

Why can the sciatic nerve be damaged in a posterior hip dislocation?

A

Because it runs posteriorly to the hip joint

87
Q

What would sciatic nerve damage cause?

A

Paralysis of hamstrings, and muscles distal to the knee

88
Q

What are anterior hip dislocations a consequence of?

A

Extension, abduction and lateral rotation

89
Q

What is the result of an anterior hip dislocation?

A

The femoral head ends up anterior and inferior to the acetabulum, and often pulls the acetabular labrum with it

ESA 2- Musculoskeletal System (69 decks)

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