Movements of the hip joint + clinical

Question 1

What does the degree of flexion at the hip depend on?

Answer 1

whether the knee is flexed

when the knee is flexed, the hamstrings are relaxed and increases the range of flexion

Question 2

What is extension of the hip joint limited by?

Answer 2

joint capsule esp. iliofemoral ligament (antierior superior one)
they become taut during extension to limit further movement

Question 3

Which muscles are responsible for flexion of the hip joint?

Answer 3

iliopsoas, rectus femoris, sartorius

Question 4

Which muscles are responsible for extension of the hip joint?

Answer 4

gluteus maximus, semimembranosus, semitendinosus, biceps femoris

Question 5

Which muscles are responsible for abduction of the hip?

Answer 5

gluteus medius, gluteus minimus, deep gluteals (piriformis, gemellus superior + inferior, obturator externus + internus, quadratus femoris)

Question 6

Which muscles are responsible for adduction of the hip?

Answer 6

adductor longus, adductor brevis, adductor magnus, pectineus, gracillis

Question 7

Which muscles are responsible for lateral rotation of the hip?

Answer 7

biceps femoris
gluteus maximus
deep gluteals (piriformis, gemelli etc.)

Question 8

Which muscles are responsible for medial rotation of the hip?

Answer 8

gluteus medius + minimus
semitendinosus
semimembranosus

Question 9

Fracture to the neck of femur

Answer 9

in 40yrs, femoral neck fractures from falls - more likely in women (have brittle necks from osteoporosis)
affected limb laterally rotated, arteries from medial circumflex femoral artery usually torn, disrupting blood supply –> avascular necrosis of femoral head + neck

Question 10

what are the movements that can be carried out at the hip joint?

Answer 10

flexion, extension, abduction, adduction, medial / lateral rotation

Question 11

Surgical hip replacement

Answer 11

PLASTIC SOCKET is cemented to the hip bone to replace the Acetabulum
STAINLESS STEEL femoral stem and head replaces the FEMUR
usually performed after traumatic injury, or DEGENERATIVE disease of the joint

Question 12

What are the 2 ways of obtaining a hip dislocation?

Answer 12

acquired and congenital

Question 13

How does congenital dislocation occur? What does it predispose the patient to?

Answer 13

more common in girls, during development, femoral head is not placed within the acetabulum

predispose to arthritis of the hip in later life

Question 14

What are the common symptoms of congenital dislocation of femoral head?

Answer 14

1. inability to ABduct at the hip joint
2. affected limb is shorter
3. positive Trendelenburg sign

Question 15

How do acquired dislocation of the hip occur?

Answer 15

uncommon due to strength and stability of joint

usually in traumatic accidents

Question 16

What are the 2 types of acquired dislocations that can occur?

Answer 16

posterior and anterior dislocation

Question 17

What is posterior dislocation?

Answer 17

more common
femoral head is forced posteriorly
tears through the inferior and posterior part of the joint capsule
affected limb becomes SHORTened and MEDIALLY rotated

Question 18

What can be damaged in posterior dislocation? Why? What does it cause?

Answer 18

sciatic nerve as it runs posteriorly to the hip joint

can cause paralysis of the hamstrings + muscles distal to the knee

Question 19

What is anterior dislocation of the hip?

Answer 19

far more rare
consequence of extension, ABduction + lateral rotation
femoral head ends up anterior + inferior to acetabulum
often pulls acetabular labrum (steepen socket) with it