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Endocrine > Joints of the hip complex > Flashcards

Joints of the hip complex Flashcards

1
Q

Is all of the acetabulum articular?

A

No

Lunate surface is weight bearing

Acetabular notch and fossa are non-articular

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2
Q

Describe the shape of the epiphysis in the acetabulum until puberty?

A

Y shaped

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3
Q

What crosses the actebular notch?

A

Ligament

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4
Q

What fills in the space in the acetabulum?

A

Potential space filled with fat pad

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5
Q

Describe the location of the fat pads within the hip joint?

A

Intra-articular

Extra-synovial

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6
Q

What is the anatomical neck of the femur?

A

Line of growth plate

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7
Q

Where is the fovea in the femur?

A

Head

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8
Q

Where can traction epiphyses occur in the femur?

A

Greater and lesser trochanters

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9
Q

Where is the intertrochanteric line/crest?

What is its significance?

A

Between greater and lesser trochanter

Line is anterior, crest is posterior

Ligament attaches here

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10
Q

Where do blood vessels that supply the head of the femur enter the bone?

A

Enter growth plate just below anatomical neck

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11
Q

What is the significance of pressure and traction epiphyses in the femur?

A

Pressure epiphyses are weight bearing

Traction epiphyses can form where ligaments or muscles attach

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12
Q

Describe the orientation of the head of the femur?

What is the significance of this for the joint?

A

Directed upwards, medially and forwards

So, anterior part of head lies outside socket

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13
Q

How is the anterior part of the head of femur that lies outside the acetabulum protected?

A

Psoas bursa

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14
Q

What is the function of the psoas bursa?

A

Protects head of femur that lies outside acetabulum and tendon

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15
Q

What in the acetabulum does the head of the femur articulate with?

Why?

A

Roof of acetabulum

Thickest cartilage here

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16
Q

List the intra-articular structures in the hip joint?

Describe the function of each?

A

Labrum: deepens cup and increases SA

Ligament of head of femur: directs artery to femoral head

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17
Q

Describe the bony architecture of the femur?

A

Two trabecular systems that intersect: superior (vertical and arcuate) and inferior (medial and lateral)

18
Q

Compare the functions of the vertical and arcuate bundles in the bony structure of the femur?

A

Arcuate bundle: resist bending forces on neck of femur

Vertical bundle: for weight bearing in stance

19
Q

Where is the site of weakness in the bony architecture of the femur?

Why?

A

Arcuate bundles

Degenerate with ageing

20
Q

Where does the line of gravity lie in relation to the hip joint?

A

Behind centre of joint

21
Q

Describe the position of greatest stability in the hip joint?

Why?

A

Extension

Abduction

Medial rotation

This is the close packed position where the ligaments are most taught

22
Q

Describe the ligamentous supports of the hip joint?

A

Iliofemoral ligament (strong, anterior)

Ischiofemoral ligament, Pubofemoral ligament (weaker, posterior)

23
Q

Describe the attachment of the ligaments of the hip joints?

A

Iliofemoral: ileum to femur (2 attachments)

Ischiofemoral: from ischeum, blends with capsule (no attachment to femur)

Pubofemoral: from pubis, blends with capsule (no attachment to femur)

24
Q

Describe the shape and function of the iliofemoral ligament?

A

Inverted V shape

Tighten and spiral medially when joint is in extension

Resist extension, prevent us from falling backwards

25
Q

What are the retinacular fibres in the hip joint?

What is their function?

A

Reflections of fibrous tissue from capsule to femoral neck

Contain vessels which supply head of femur

26
Q

Describe the movements that occur at the hip joint?

A

Flexion/extension

Abduction/adduction

Medial/lateral rotation

27
Q

Describe the rotation that occurs at the hip joint during locomotion?

A

Medial rotation in stance

Lateral rotation in swing

28
Q

Which muscles stabilise the head of femur in the acetabulum?

A

Cuff of fixator muscles

Dynamic support

29
Q

Describe the actions of gluteus medius and minimus?

A

Maintain position of pelvis in coronal plane (stop pelvis from falling to unsupported side)

Abduct hip

30
Q

Describe the effect of injury to the gluteus medius and minimus?

A

Trendellenberg gait

31
Q

Which muscles are associated with the development of osteitis pubis?

A

Adductor muscles

32
Q

Describe the nerve supply to the hip joint?

A

Innervated by articular branches of femoral and obturator nerve

Hilton’s law: joint receives pain and proprioceptive fibres from branches to muscles that move the joint (also pass to overlying skin)

33
Q

Where does pain referred to the hip originate from?

A

Lumbar spine and SIJ

34
Q

Describe the blood supply to the hip joint?

A

Via anastamoses between branches of medial and lateral femoral circumflex arteries (normally from profunda femoris)

35
Q

Describe the structures that lie posterior to the hip joint that may be damaged in dislocation?

A

Sciatic nerve

36
Q

Describe traumatic dislocations of the hip joint?

A

Head of femur slips out back of joint

Usually associated with fractured posterior lip of acetabulum

37
Q

Why is re-artculation important in traumatic dislocations of the hip joint?

A

To maintain blood supply

Must be within 5-6 hours

38
Q

Describe the appearance of a leg with a fractured neck of femur?

Why?

A

Muscle spasm causes external rotation and shortening of limb

39
Q

How can congenital dislocation of the hip joint be identified and treated?

A

Test in adduction

Treat by putting hip into abducted posture > adductor magnus pulls along line of femur and pulls head back into socket

40
Q

Which fracture leaves the hip joint particularly susceptible to disruption of blood supply?

A

Fractured neck of femur

Endocrine (17 decks)

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