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AFAB II > Lecture 5 (test 2): Hip Arthrology > Flashcards

Lecture 5 (test 2): Hip Arthrology Flashcards

1
Q

where is the femoral head located

A

just inferior to mid 1/3 of inguinal ligament

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2
Q

describe the femoral head

A

2/3 is nearly a perfect sphere

just posterior to center = the fovea

covered by articular cartilage except fovea

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3
Q

describe ligamentum teres

A

tubular

synovial lined connective tissue

houses acetabular artery

contains mechanoreceptors

runs from transverse acetabular ligament to fovea

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4
Q

describe the acetabulum of the hip

A

deep and cuplike socket

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5
Q

how deep is the acetabular notch

A

60-70 degree opening

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6
Q

describe the acetabular fossa floor

A

floor of fossa

no cartilage

no contact

filled with fat, blood vessels, synovial membrane, and ligament

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7
Q

where does the femoral head generally contact (describe this surface)

A

normally contacts along lunate surface

lunate surface is covered in articular cartilage and is thickest along the superior anterior region which is where there is the highest joint force when walking

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8
Q

describe the forces (%BW) generated at the acetabulum during swing and mid stance

A

13% at swing and 300% BW at midstance

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9
Q

what all occurs at the hip joint during midstance

A

notch widens

lunate deforms

increase contact area

decrease pressure

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10
Q

how much compression forces (% BW) occur during the stance and swing phases

A

stance = 0-60%

swing = 60-100%

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11
Q

how does the area of joint contact increase from swing to stance

A

increases from about 20% of the lunate surface during swing to 98% during mid stance

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12
Q

describe the hip labrum

A

string flexible ring of fibrocartilage rim of acetabulum

provides mechanical stability “grip” and deepens socket

mechanical seal keeps neg pressure, and fluid sealed to reduce friction/contact stress and lubrication

poor vascularization but well innervated

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13
Q

where does the transverse acetabular ligament span

A

the acetabular notch

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14
Q

the internal labrum blends with what to form what

A

blends with articular cartilage of acetabulum to form labro-chondral junction

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15
Q

how does hip joint project

A

laterally, inferior and anterior inclincation

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16
Q

what is dyplastic acetabulum

A

malformed and does not fully cover the femoral head

chronic dislocation/OA/pain

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17
Q

what measures define dyplastic acetabulum

A

center edge (CE)=degree acetabulum covers the femoral head

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18
Q

what is the acetabular anteversion angle

A

extent to which the femur faces anteriorly

NLs is 20 degrees

19
Q

what is femoral version (ante/retro)

A

defined as the angular difference between axis of femoral neck and transcondylar axis of the knee (craig’s test)

20
Q

what is acetabular anteversion

A

measurement used on a cross section imaging especially pelvic CT for the assessment of acetabular morphology

21
Q

what is femoral torsion

A

relative RT between the bones shaft and neck

normal = 15 degrees

22
Q

what is consdiered excessive anteversion or retroversion

A

ante = >15

retro = < 15

23
Q

what is the femoral torsion of an infant

A

originally around 40 degrees anteversion

it derotates to about 15 degrees by 16 years old

24
Q

excessive anteversion can cause what issues

A

dislocation

OA

increase contact stress

“in-toeing”

25
Q

what ligaments reinforce the external capsule, iliocapsularis, gluteus min, and rectus femoris

A

iliofemoral
pubofemoral
ischiofemoral

26
Q

describe the iliofemoral ligament

A

thick

strong upside down Y

medial and lateral

from AIIS to rim of acetabulum to the intertrochanteric line

elongated with full hip ext and full ER

27
Q

when is the pubofemoral ligament taut

A

hip ABD
hip EXT
some in hip ER

28
Q

describe the ischiofemoral ligament and when its taut

A

posterior

spirals

taught in IR and ABD

29
Q

what is closed packed of the hip

A

greatest simultaneous stretch to many structures

full ext (20 deg) and slight IR and ABD

for hip this is NOT position of max congruency

30
Q

what is the posiiton of max congruency for the hip

A

90 flexion and mod ABD/ER

31
Q

femoral on pelvic bs pelvic on femoral

A

femoral on pelvic = femur moves around fixed pelvis

pelvic on femoral = RT of pelvis over fixed humerus

32
Q

amount of femoral on pelvic hip flexion

A

120-140 deg

after this usually leads to post pelvic tilt + lumbar flexion

33
Q

how much femoral on pelvic hip ext

A

18-30 deg

34
Q

how much ABD/ADD occurs with femoral on pelvic movement

A

abd = 40-55 deg limited by pubofemoral and adductor muscles

add = 20-25 deg limited by abd, piriformis, and ITB

35
Q

how much femoral on pelvic IR and ER are present

A

IR = 30-45

ER = 32-50

36
Q

what is ipsidirectional lumbopelvic rhythm

A

lumbar spine and pelvis move in same direction

maximizes angular displacement of the entire trunk

37
Q

what is contradirectional lumbopelvic rhythm

A

lumbar spine and pelvis move in opposite direction

supralumbar (above L1) can stay nearly stationary

used in walking where the head and eyes need to be still

L/S is a decoupler

38
Q

describe the sagittal plane pelvic RT in contradirectional lumbopelvic rhythm

A

hip flexion/ant tilt/lumbar spine ext

39
Q

describe the frontal plane pelvic RT in contradirectional lumbopelvic rhythm

A

ABD of support hip (standing)/opp iliac crest hikes/opposite side spine lateral flexion

add is opposite

40
Q

describe the spine/pelvic movement with IR and ER of hip

A

IR = non support LE rotates fwd and spine twists opposite

ER = non support LE side rotates bwd and spine twists opposite

41
Q

describe the arthrokinematics of NWB/open chain flexion and ext of hip

A

Flexion = rolls anterior and slides posterior/inferior

ext = rolls posterior and slide anterior superior

42
Q

describe the arthrokinematics of IR and ER in open chain hip movements

A

IR = roll anterior and slide posterior

ER = roll posterior and slide anterior

43
Q

describe the arthrokinematics of ABD and ADD in open chain hip movements

A

abd = roll superior, slide inferior

add = roll inferior, slide superior

AFAB II (14 decks)

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