Hip Joint Flashcards
Joint classification, how the joint achieve stability, movements and muscles, innervation and blood supply, what can go wrong and how to tell on examination.
Classify the hip joint structurally and functionally.
Synovial, ball and socket.
What are the articulating surfaces of the hip joint?
Pelvic acetabulum and head of femur.
How does the hip joint achieve stability?
Acetabuluar labrum, intracapsular ligamnets, extracapsular ligaments, muscles.
What is the role of the acetabular labrum?
Deepens the acetabulum so the hemispherical head of femur fits completely.
Where is the intracapsular ligament?
From acetabular fossa to fovea of the femur.
What is enclosed within the intracapsular ligament?
Artery to the head of the femur, minor arterial supply to the joint.
What are the extracapsular ligaments?
Iliofemoral, pubofemoral, ischiofemoral.
Where does the iliofemoral ligament run?
From anterior inferior iliac spine to intertrochanteric line of femur.
What is the role of the iliofemoral ligament?
Prevents hyperextension of the hip.
Where does the pubofemoral ligament run?
From superior pubic rami to intertrochanteric line of the femur.
What is the role of the pubofemoral ligament?
Anterior and inferior support to prevent excessive abduction and extension.
Where does the ischiofemoral ligament run?
From the body of the ischium to the greater trochanter of the femur.
What is the role of the ischiofemoral ligament?
Supports posteriorly, prevents hyperextension and holds femoral head in place.
What are the movements of the hip?
Flexion, extension, abduction, adduction, internal rotation, external rotation.
Which muscles power flexion of the hip?
Iliopsoas, rectus femoris, sartorius, pectineus.
Which muscles power extension of the hip?
Gluteus maximus, semimembranosus, semitendinosus, biceps femoris.
Which muscles power abduction of the hip?
Gluteus minimus, gluteus medias, piriformis, tensor fascia lata.
Which muscles power adduction of the hip?
Adductor longus, adductor brevis, adductor magnus, pectineus, gracilis.
Which muscles power internal rotation of the hip?
Anterior fibres of gluteus medius and minimus, tensor fascia lata.
Which muscles power external rotation of the hip?
Biceps femoris, gluteus maximus, piriformis.
What are the arteries supplying the hip?
Medial and lateral circumflex arteries, artery to the head of the femur, intramedullary arteries, superior and inferior gluteal arteries.
Which nerves innervate the hip?
Sciatic, femoral, obturator.
What is developmental dysplasia of the hip?
Congenital hip dislocation due to a shallow acetabulum. .
What are the signs of DDH?
Limited abduction at hip joint, limb length discrepancy, asymmetrical gluteal or thigh skin folds.
What is the management of DDH?
Pavlik harness to hold femoral head in place or surgery if no repsonse.
What can cause dislocation of the hip?
Trauma, complications of THR or hemiarthroplasty.
What is the usual direction of hip dislocation?
Posterior dislocation, femoral head goes posteriorly and through the inferior and posterior parts of the capsule.
What is the clinical appearance of hip dislocations?
Shortened and medially rotated, sciatic nerve injury in 10-20% of cases.
