Hip Joint Flashcards
What is a fibrous joint? Describe the characteristics of a fibrous joint.
simplest joint structure, just two bones connected by fibrous tissue
What is a cartilaginous joint? describe the characteristics of a primary and secondary cartilaginous joint
primary = bone & cartilage - doesn’t allow movement secondary = bone, cartilage, then fibrous tissue
What is a synovial joint?
most complex joint structure = articular cartilage, joint cavity, articular (fibrous) capsule, synovial membrane and synovial fluid.
Identify the following part of the hip joint
- pubis, ilium and ischium
- lunate surface
- acetabular fossa
- acetabular notch
- fibrous labrum
- transverse ligament
Identify these parts of the femur
- fovea of head
- head
- neck
- lesser trochanter
- greater trochanter
- intertrochanteric line
- intertrochanteric crest
What are the articulating surfaces in the hip joint?
The head of the femur and the acetabulum in the pelvis
What is the purpose of the fovea of the head of the femur?
the fovea ( a little depression in the head of the femur) is not actually a part of the joint, but is where the ligament attaches.
Describe the blood supply to the head of the femur during fetal development
The artery of the ligament of the head of the femur supplies the head of the femur during development b/c the head of the femur grows seperately to the body of the femur -
However, this artery is not big enough in an adult to give an adequate blood supply to the head of the femur so it’s relatively unimportant later in life.
What are the ligaments of the hip joint?
Iliofemoral ligament (AIIS to the intertrochanteric line)
pubofemoral ligament
Ischiofemoral (posterior margin of acetabulum to capsule at zona orbicularis)
ligament of head (ligamentum teres) from transverse ligament of acetabulum to fovea.
What are the stabilizing factors of the hip joint?
The gluteus minimus and medius
The three ligaments (iliofemoral, ischiofemoral, pubofemoral) which are ‘spiraled’ in nature, so when the hip is extended and in a ‘vulnerable’ position, these tendons actually tighten b/c of the spiral shape.
Describe the blood supply to the hip joint
Most important = medial and lateral circumflex arteries
which form a ‘trochanteric anastomosis’ with the superior and inferior gluteal arteries
retinacular arteries (beneath capsule around neck of femur)
Artery of the ligament of the head of the femur
What is the real danger of a hip fracture of the neck of the femur?
The real risk is severing the retinacular arteries below the capsule - which supply the head of the femur -
If these arteries are severed, there is a potential for necrosis of the head of the femur - requires a total hip joint replacement.
What are the possible movements at the hip joint?
Extension (glute maximus, hamstrings)
Flexion (psoas)
Abduction (Gluteus med and min)
Adduction (medial compartment of thigh)
Lat rotation (glute max, piriformis, obturator internous)
Med rotation ( psoas, iliacus, glut. min, pectineus)
What is the clinical presentation for a broken hip?
You’ll see a shortened leg and lateral rotation
Lateral rotation is caused by the psoas major muscle which changes from a medial rotator to a lateral rotator when you change its axis of rotation in a break.
Which nerves supply the hip joint?
Hilton’s law- the nerves that supply the muscles which act on the joint, also supply the joint itself
Femoral, sciatic, and obturator
*clinically this means that there is a potential for referred pain from the hip to the knee*
Hip dislocations in a car accident - what is the clinical relevance?
Potential sciatic nerve damage
describe the process of femur ossification in development
primary centre = shaft at 8 weeks fetus
secondary cetre = lower end at birth (unites at 20 weeks)
Head of femur= 1 year old
greater trochanter = 3 years old
lesser trochanter = appears at 12 years old (fusion at 18)
Where do you find the sciatic nerve on surface anatomy?
halfway between the greater trochanter and the ischial tuberosity
What are the borders of the greater sciatic foramen?
Greater sciatic notch and the sacrospinous ligament
What are the borders of the lesser sciatic foramina?
the lesser sciatic notch and the sacrotuberous ligament
Why are the hamstrings commonly injured?
They are often flexed while seated- so they are easily pulled during exercise.
What is the relationship between the obtruator nerve and the adductor brevis?
It innervates it
What is a pudendal nerve block?
Can be given through the rectum or vagina during childbirth to numb the perineum.
How would the leg appear in the case of a hip fracture?
It would appear shorter with a lateral rotation due to the iliopsoas muscle
What nerves send branches to the hip and why is that clinically relevant?
Obturator, Femorl and Sciatic nerve branches -
Relevant because we may experience refered pain
Where is the obturrator canal?
Where is the adductor/subsartorial canal?
Obturator canal is a passage way through the obturator foramen
the adductor/subsartorial canal is below the sartorius muscle ending at the adductor hiatus in the distal thigh but beginning at the femoral triangle
What are the borders of and the contents of the adductor canal?
Anteriorly - sartorius.
Posteromedially - adductor longus and adductor magnus.
Laterally - vastus medialis.
it contains superficial femoral artery, femoral vein, and branches of the femoral nerve (specifically, the saphenous nerve, and the nerve to the vastus medialis)
