Hip joint

Question 1

What forms the trochanteric anastomosis?

Answer 1

Ascending branches of lateral and medial circumflex femoral arteries
Descending branch of superior gluteal artery
Infeior gluteal artery (ocassionally)

Question 2

What is coxa valga?

Answer 2

An increase in the neck-shft angle of the femur to more than 139 degrees

Question 3

What is the normal neck-shaft femoral angle in children?

Answer 3

135-145 degrees

Question 4

What is the normal neck-shaft femoral angle in adults?

Answer 4

125 degrees

Question 5

State the attachments of the joint capsule of the hip joint.

Answer 5

Anteriorly: intertrochanteric line, bases of greater and lesser trochanters
Posteriorly: 0.5 in above intertronchanteric crest
Superomedially: outer aspect of acetabular margin
Inferiorly: transverse acetabular ligament

Question 6

Which ligaments are extracapsular?

Answer 6

Iliofemoral
Pubofemoral
Ischiofemoral

Question 7

Which ligamens are intracapsular?

Answer 7

Ligamentum teres femoris

Question 8

What forms the cruciate anastomosis?

Answer 8

Tranverse branches of medial and lateral femoral circumflex arteries
Descending branch of gluteal artery
Ascending branch of first perforating artery

Question 9

What is the strongest ligament in the body?

Answer 9

Iliofemoral ligament

Question 10

What do the extracapsular ligaments do?

Answer 10

Prevent hyperextension of hip joint.

Question 11

What forms the retinacular anastomosis?

Answer 11

Branches of medial circumflex with some contribution from lateral circumflex femoral artery.

Question 12

State two difference between the retinacular and cruciate/trochanteric anastomosis?

Answer 12

Retinacular anastomosis has no contribution from gluteal arteries
Retinacular anastomosis located closer to femoral head

Question 13

What is the clinical relevance of the cruciate anastomosis?

Answer 13

If there is blockage between femoral artery and internal iliac artery, blood can still reach popliteal artery by going from internal iliac artery –> inferior gluteal artery –> first perforating branch –> lateral circumflex femoral artery descending branch –> superior lateral genicular artery –> popliteal artery

Question 14

What are the anterior relations of the hip joint?

Answer 14

From deep to superficial, medial to lateral;

1. Pectineus, Psoas, Rectus femoris
2. Femoral vein, femoral artery, femoral nerve, Iliacus

Question 15

State the lateral relations of the hip joint.

Answer 15

From deep to superficial;

1. Gluteus minimus
2. Gluteus medius

Question 16

True or false: The hip is the largest joint in the body.

Answer 16

True

Question 17

What is another name for the iliofemoral ligament?

Answer 17

Y-shaped ligament of Bigelow

Question 18

What is the origin of the iliofemoral ligament?

Answer 18

Anterior inferior iliac spine

Question 19

Hilton’s law states that…

Answer 19

The nerves passing across a joint supply the muscles that act on it, the skin over the joint, and the joint itself

Question 20

What is referred pain?

Answer 20

Because the hip and knee joint are supplied by the same nerves, pain originating from the hip can be felt in the knee or vice versa and it easy to misdiagnose.

Question 21

What causes the tredelendburg gait?

Answer 21

Damage to gluteus medius and/or minimus so that when walking, the unsupported side sags as the pelvis leans towards the healthy side, since the damaged muscles on the other side don’t pull on the pelvis to stabilize it.

Question 22

What is the nerve supply to the hip joint?

Answer 22

1. Femoral nerve (via nerve to rectus femoris)
2. Anterior division of obturator nerve
3. Twig from sciatic nerve
4. Branch from nerve to quadratus femoris

Question 23

What are the immediate posterior relations of the hip joint?

Answer 23

From deep to superficial;

1. Tendon of obturator externus
2. Sciatic nerve, Quadratus femoris
3. Gluteus maximus

Question 24

State the superior relations of the hip joint.

Answer 24

1. Gluteus minimus and medius
2. Head of rectus femoris
3. Gluteus maximus

Question 25

What is the difference between a femoral and inguinal hernia?

Answer 25

A femoral hernia lies below and lateral to the pubic tubercle.
An inguinal hernia lies above and medial to the pubic tubercle.

Question 26

Which nerve segments innervate the hip joint?

Answer 26

L2 - L5