MI3 Arthokinematics/Osteokinematics

Question 1

Name the type, structure and functional characterstics of the hip joint

Answer 1

Simple, Synovial, unmodified ovid

Formed by ellipsoid, convex head of the femur articulating with the concave hemispheric surface of the acetabulum

Femoral head projects superiorly, Anteriorly, medially

covered by hyaline carilage, apart from fovea which is attachment of ligament teres

Acetabulum is rough, concave hemispheric surface that projects in anteriolateral inferior direction, broadest superiorly to resist body weight

Question 2

Define the characteristics and function of the joint capsule of the hip ?

Answer 2

Acetabulum is deepened by a TFC rim - ie: Acetabulum labrum and attaches to the rim of the Acetabulum except the inferiorly

Joint capsule is strong and dense and is thickest anteriorly and superiorly where femoral head is positioned at heel strike, lax and thin postero-inferiorly

Question 3

Define the charactersitics and functions of the 3 Hip ligaments

Answer 3

made up of 2 Anterior Ligaments -

1) Illiofemoral ligament

Made up of medial/inferior band and a lateral/superior band - both start at AIIS.

Provide static stability in stance that prevents hyperextension when muscle are inactive

Medial band - attaches to medial portion of the inter-trochanteric line

Lateral bands - attach to lateral portion of the trochanteric line

2) Pubofemoral ligament

Attaches from the superior ramus of the pubis to

capsule of femoral neck

It is taut in extension and restricts abduction in the hip joint

1 Posterior Ligament -

Ischiofemoral ligament

Arises from the ischial component of the acetabulum, fibres pass horizontally to hip joint and converge on lateral aspect of femoral neck

Prevents medial rotation

Question 4

Name the 5 common bursae of the hip?

Answer 4

1. Greater trochanteric
2. Gluteofemoral
3. Ischiogluteal
4. Illiopectinal
5. Illiopsoas

Question 5

Discuss the anatomical location and divisions of the Femoral Nerve

Answer 5

Passes between Psoas Major and Iliacus and runs beneath the inguinal ligament, into the thigh and splits into anterior and posterior divisions

Lateral Femoral cutaneous nerve (L2-L3) runs towards the ASIS - passing below the inguinal ligament to supply skin of lateral thigh

Genitofemoral nerve (L1-2) supplies scotum/Labia and skin of the greater trochanteric triangle

Question 6

Hip Flexion

Answer 6

Iliopsoas- Femoral (L2-4), Lumbar (L1-3)

Rectus Femoris - Femoral (L2-4)

Pectineus - Femoral +- Obturator (L2-4)

Question 7

Extension

Answer 7

Glute Max - Inf. Gluteal (L5-S2)

Semitend/Memb - Tibial (L5-S3)

Biceps Fem - Tibial (L5-S3)

Question 8

Abductors

-

Adductors

Answer 8

Glute Med - Sup. Gluteal (L4-S1)

-

Add Magnus - Obturator and Tibial (L2-5)

**Add Long/Brevis - **Obturator (L2-4)

Gracilis - Obturator (L2-4)

Pectineus - Obturator, Acc. Ob, Femoral (L2-4)

Question 9

External Rotators

Answer 9

Glute Max - Inf. Gluteal (L5-S2)

Gem I/S - Sacral Plexus

Obturator I/E - Sacral Plexus (Obturator for Externus)

Piriformis - Sacral Plexus

Quadratus Femoris - N. to Quadratus Femoris

Question 10

Internal rotation

Answer 10

Glute Minimus - Sup. Gluteal (L4-S1)

**TFL - ** Sup. Gluteal (L4-S1)

Question 11

Mechanical Axis

Answer 11

Transverse Axis through the neck of femur

Question 12

Flexion/Extension

Answer 12

Pure spin about a Transverse axis in a Sagittal plane

90-100 degrees Flexion with knee extended, 110-120 degrees with knee flexed

10-24 degrees extension

Spin

Question 13

Abduction/Adduction

Answer 13

Near pure swing about a Sagittal axis in a Frontal plane

Impurity comes from the slightly ovoid shape of the

Femoral head

30-57o abduction

30-45o adduction

Arthrokinematics:

Abduction – Inferior Glide

Adduction – Superior Glide

Question 14

Internal/ External Rotation

Arthrokinematics

Answer 14

Near pure swing about a Vertical axis in a Transverse plane

40-60degrees ER

Varies with age and sex

Internal Rotation – Posterior Glide

External Rotation – Anterior Glide