Lower limb (hip joint) Flashcards
What are the structures at the hip joint contributing to stability?
- Deep acetabulum, so the head of femur is well supported in it.
- Many ligaments and muscles extending across the joint contribute to its stability.
- The labrum further deepens the acetabulum.
What are the structures at the hip joint contributing to mobility?
- Long femoral neck.
- Narrow femoral neck so wider range of movements facilitated before neck collides with acetabulum.
What are the attachments of the joint capsule?
- Proximal: Acetabular labrum, transverse ligament
- Distal: Neck of femur
- Anterior: Intertrochanteric line
- Posterior: Femoral neck
What are the ligaments of the hip joint?
- Iliofemoral ligament
- Pubofemoral ligament
- Ischiofemoral ligament
- Ligamentum teres
- Transverse acetabular ligament
What are the relations, attachments and shape of the iliofemoral ligament?
Relations: Anterior
Attachments:
- Proximal: AIIS
- Distal: Superior/inferior intertrochanteric line
Shape: Inverted Y-shape
What are the relations, attachments and shape of the pubofemoral ligament?
Relations: Anteroinferior
Attachments:
- Proximal: Iliopubic eminence
- Distal: Fibrous membrane of joint capsule + iliofemoral ligament
Shape: Triangular
What are the relations and attachments of the ischiofemoral ligament?
Relations: Posterior
Attachments:
- Proximal: Ischium (posterior to acetabulum)
- Distal: Greater trochanter deep to iliofemoral ligament
What are the relations and attachments of the ligamentum teres?
Relations: Intracapsular
Attachments:
- Proximal: Acetabular fossa
- Transverse acetabular ligament
- Acetabular notch
What are the relations and attachments of the transverse acetabular ligament?
Relations: Intracapsular
Attachments:
Betweem the tips of the horseshoe-shaped labrum
What are the 2 anastomoses around the hip joint?
- Trochanteric anastomosis
- Cruciate anastomosis
What are the vessels of the trochanteric anastomosis?
- Superior gluteal artery
- Inferior gluteal artery
- Branches from medial/lateral circumflex femoral artery
What are the vessels of the cruciate anastomosis?
- Inferior gluteal artery
- Branches of the medial/lateral circumflex femoral artery
- Ascending branch of 1st perforating artery
What is the blood supply to the hip joint?
- Retinacular arteries: Running along the neck of the femur, arising from the anastomoses. These are the main blood supply to the hip joint.
- Arteries in ligamentum teres: Blood vessel in ligamentum teres (branch of obturator artery) present in children, but insignificant in adults.
What is the clinical significance of the blood supply to the hip joint?
- Intertrochanteric fractures do not affect the blood supply to the hip joint.
- Subcapital fractures damage the retinacular arteries and may lead to avascular necrosis of the neck of femoral head.
What are the muscles involved in flexion of the hip joint?
- Psoas major
- Iliacus
- Rectus femoris
- Tensor fascia latae
- Sartorius
- Pectineus
