Hip To Knee Flashcards
Parts of hip bone
▪️develops as 3 bones but by 8 they fuse together for stability
▪️ilium
▪️pubis
▪️ischium
▪️acetabulum- articulates with head of femur
Features of hip bone
▪️iliac fossa
▪️iliac crest
▪️ischial tuberosity
▪️anterior superior iliac spine (ASIS)- most anterior part of iliac crest, can be palpated on front of hip.
▪️posterior superior iliac spine (PSIS)- most posterior part of the iliac crest articular surface of sacro-iliac joint- where sacrum lies
▪️obturator foramen- large gap filled with muscle and fascia
▪️ischial spine- posterior, separates GSN and LSN
▪️greater sciatic notch-superior to spine, where sciatic nerve passes through
▪️lessor sciatic north, inferior to spine, smaller than GSN
Male vs Female pelvises
▪️male (adapted for bipedalism) -longer iliac crest -narrower pelvic inlet -subpublic angle-70 degrees ▪️female (adapted for bipedalism and child birth) -shorter iliac crest -wider pelvic inlet -subpubic angle- 90-100 degrees
Proximal femur
▪️head-articulates with pelvis
▪️fovea-hole at centre of head (ligament)
▪️neck-below head
▪️greater trochanter-lateral side for muscles
▪️lesser trochanter-posterior side for muscles
▪️intertrochanteric crest- inbetween trochanters
▪️pectineal line- diagonally on medial side for muscles
Hip joint
▪️more stable than shoulder joint
- larger and deeper socket
▪️synovial joint
▪️acetabulum labrum- articular cartilage of acetabulum, gap in meddle of labrum which allows ligament to attach from acetabulum to head of femur.
▪️ synovial membrane- has slack around the joint (folds on itself)
Ligaments of the hip joint
▪️iliofemoral ligament- ilium to femur (anterior superior)
▪️pubofemeral ligament- pubis to femur (anterior inferior)
▪️ischiofemoral ligament- ischium to femur (posterior superior)
- gaps between ligaments: any dislocations are likely to happen when head slips out of the gaps- mostly posteriorly through ischial-pubo femoral ligaments
Action of the hip joint ligaments
▪️closed packed position- when ligaments are at their tightest- most stable- muscles around can relax as ligaments doing work (injuries most likely to occur)
▪️closed packed when standing up
▪️when hip is flexed ligaments stretch out straight.
▪️when hip is extended ligaments twist around each other- screw head of femur into acetabulum (passive process)- stabilised
Movements of hip
▪️medial rotation-toes inwards ▪️lateral rotation-toes outwards ▪️extension-foot at normal position ▪️flexion-foot forward ▪️abduction-foot out to the side ▪️adduction-foot at normal position ▪️rotation- forwards and backwards when walking
Mechanical axis vs anatomical axis
▪️mechanical axis- straight down (180 degrees from hip to knee to foot)
-most ideal for bearing weight
▪️anatomical axis-through evolution femur shaft has been shifted laterally and created a neck- allows legs more space to move and rotate, also allows for more muscle attachments (174 degrees)
Extrinsic hip muscles
▪️from outside the hip and attach to the hip
▪️iliopsoas
▪️Psoas major- attached to spinous process of lumbar vertebrae and joins illiacus and travels through inguinal ligament and attach to lesser trochanter
▪️illacus- sits in illiac fossa and joins psoas major to attached to lesser trochanter
▪️flexion of hip
▪️helps walk down hill
Gluteus maximus
▪️attaches to posterior part of illiac and inserts at posterior of femur
- extension, adduction, abduction, lateral rotation
- fibres above point of rotation of demure abduct the demure, fibres below adduct femur
Tensor fasciae latae
▪️attaches to illiac crest and tenses iliotibial tract (stabilising knee)
-can flex and extend the knee depending on the position of the knee due to where it is positioned around axis of rotation.
Gluteus medius and gluteus minimus
▪️underneath GMaximus, attach to ilium and inserts at greater trochanter
-abduction of the femur, prevents pelvic drop
4 Muscles posterior to hip
▪️periformis muscle- through greater sciatic nocth
▪️gemellus superior
▪️obturator internus- covers up obturator foramen
▪️gemellus inferior
-laterally rotates and abducts hip and insert at greater trochanter
▪️quadratus femoris -laterally rotate only
Trendelenburg gait
▪️normally when you lift your leg, the other sides gluteus medius contracts pulling the hip straight to make it parallel to the ground.
▪️if this does not happen, if you stand on one leg, the pelvis on the other side would drop due to centre of gravity.
▪️to compensate for this, they would move their centre of gravity to the other side- lean their body over the leg that is standing.
