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Musculoskeletal System > Session 8 - The hip joint > Flashcards

Session 8 - The hip joint Flashcards

1
Q

What is the function of the hip joint?

A
  • Support the body weight on standing

- Joins the lower limb to the pelvic girdle

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2
Q

What are the articulations of the hip joint?

A

-Acetablum with head of femur

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3
Q

Which parts of the hip joint are covered in articular cartilage?

A

-Both head of femur and acetabulum

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4
Q

At what point do the pubis, ischium and ilium fuse?

A

-15 to 25 years

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5
Q

What stabilises the three hip bones before fusion?

A

-Triradiate cartilage

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6
Q

Where is the acetabular notch?

A

-The inferior margin of the acetabulum which is incomplete

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7
Q

What is the acetabular labrum and what is its function?

A
  • Fibrocartilaginous rim attached to the margin of acetabulum
  • Increased articular contact which increases stability
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8
Q

What is the transverse acetabular ligament and what is its function?

A

-fibrous continuation of the labrum which crosses the acetabular notch (leaves a small gap for vessels) to strengthen the joint inferiorly

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9
Q

What is the joint capsule?

A

-Fibrous coating lined with synovium surrounding the joint which attaches anteriorly at the intertrochanteric line and finishes proximally to intertrochanteric crest

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10
Q

What is the function og the joint capsule and he ligaments of the hip?

A

-Increase strength and stability

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11
Q

What are the two groups of ligaments of the hip joint?

A

-Intracapsular and extracapsular

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12
Q

Name the intracapsular ligament and its anatomical location

A
  • Ligament of head of femur

- Runs from acetabular fossa to fovea capitis

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13
Q

How does ligament of head of femur effect movement?

A

-Limits abduction

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14
Q

What is significant about the ligament of head of femur?

A

-Encloses a small branch of the obturator artery (small portion of bloodflow)

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15
Q

Name the extracapsular ligaments

A
  • Iliofemoral
  • Pubofemoral
  • Ischiofemoral
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16
Q

Describe the anatomical location of the iliofemoral ligament

A
  • Located anteriorly

- Runs from ilium, inferior to ASIS, to intertrochanteric line

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17
Q

What is the function of iliofemoral ligament?

A
  • Strongest ligament
  • Protects hip joint anteriorly and superiorly
  • Prevents hyperextension
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18
Q

Describe the anatomical location of the pubofemoral ligament

A
  • Located anterioinferiorly

- Attached atiliopubic eminence and blends with capsule

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19
Q

What is the function of pubofemoral ligament?

A
  • Protects anteriorly and inferiorly

- Prevents excessive aBduction and extension

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20
Q

Describe the anatomical location of the ischiofemoral ligament

A
  • Located posteriorly

- Originates from ischium and attaches to greater trochanter

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21
Q

What is the function of the ischiofemoral ligament?

A
  • Protects posteriorly

- Prevents excessive extension of the hip

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22
Q

Which is the weakest of the 3 extracapsular hip joint ligaments?

A

-Ischiofemoral

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23
Q

Which muscles are responsible for flexion of the hip?

A

-Iliopsoas
-Rectus femoris
-Sartorius
(-Pectineus
-Adductor magnus)

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24
Q

What nerve serves the hip flexors?

A

-Femoral nerve

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25
Q

Which muscle makes the lateral border of the femoral triangle?

A

-Sartorius

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26
Q

What artery serves the hip flexors?

A

-Medial and Lateral circumflex

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27
Q

What type of joint is the hip joint?

A

-Synovial ball and socket joint

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28
Q

Which muscles are responsible for hip aDduction?

A
  • Adductor brevis
  • Adductor longus
  • Adductor magnus
  • Pectineus
  • Obturator externus
  • Gracilis
29
Q

Whst nerve supplies the hip ADductors?

A

-Obturator nerve

30
Q

What artery predominantly serves the hip aDductors? What is the exception?

A
  • Obturator artery

- Pectineus (medial circumflex)

31
Q

Which muscles are responsible for hip extension?

A
  • Gluteus maximus
  • Long head biceps femoris
  • Semimembranosus
  • Semitendinosus
32
Q

What arteries serve the hip extensors?

A
  • Glut. max. = superior and inferior gluteal artery

- Biceps, semimembranosus and semitendinosus = perforating arteries

33
Q

What nerve serves glut max?

A

-Inferior gluteal nerve

34
Q

What nerve innervates the hamstrings?

A

-Tibial

35
Q

Which muscles are responsible for hip ABduction?

A

-Gluteus medius
-Gluteus minimus
-Tensor fascia lata
(Deep Gluteal muscles except quadratus femoris)

36
Q

What nerve/artery serves glut med and glut min?

A

-Superior gluteal nerve/artery

37
Q

What muscles are responsible for lateral rotation of the hip?

A
  • Piriformis
  • Gemelli superior
  • Obturator Internus
  • Gemelli inferior
  • Obturator externus
  • Quadratur femoris
38
Q

What does nerve of quadratus femoris innervate?

A
  • Quadratus femoris

- Gemelli inferior

39
Q

What does nerve of obturator internus innervate?

A
  • Obturator internus

- Gemelli superior

40
Q

What innervates piriformis?

A

-Sacral plexus

41
Q

What is the main arterial supply to the hip?

A

-Lateral and medial femoral circumflex arteries from deep femoral artery

42
Q

What is the minor blood supply to the hip?

A

-Branch of obturator artery in ligament head of femur

43
Q

Is the obturator blood supply to the hip enough to supply the hip if the circumflex arteries are damaged?

A

-No, avascular necrosis would occur

44
Q

How is the circumflex artery located in the hip joint?

A

-Anastomose around the femoral neck to form a ring, with smaller branches arising to supply the joint

45
Q

What is hip dysplasia?

A
  • Abnormal growth causing in-exact articulations with head of femur, predisposing to dislocations due to abnormal pressures running through the hip
  • Spectrum of severity
46
Q

What is a slipped upper femoral epiphysis?

A

-Fracture through epiphyseal growth plate, causing the remaining femur to ride up and forward in relation to epiphysis

47
Q

Are hip diclocations common?

A

-No, the joint is highly stable

48
Q

What is the most frequent cause of a hip dislocation and in which direction does it occur and why?

A
  • RTA

- Posteriorly ->Head of femur tears through inferior and posterior part of joint capsule as this is the weakest point

49
Q

If a hip id posteriorly dislocated, how will it look anatomically?

A

-Shortened and medially rotated

50
Q

Damage to what major nerve can occur during hip dislocations? What would be the consequence of this?

A
  • Sciatic nerve

- Paralysis of hamstrings and muscles distal to the knee

51
Q

Where does the femur most commonly fracture?

A

-Neck

52
Q

Who do intracapsular neck of femur fractures commonly occur in?

A

-The elderly

53
Q

What are the two types of neck of femur fracture?

A
  • Intracapsular

- Extracapsular

54
Q

Who do extracapsular neck of femur fractures most commonly effect?

A

-Young/middle-aged

55
Q

Which type of neck of femur fracture has a higher risk of avascular necrosis?

A

-Intracapsular

56
Q

What is the main cause of intracapsular neck of femur fractures?

A

-Minor trip/stumble

57
Q

What blood supply is disrupted in an intracapsular neck of femur fracture?

A

-Lateral and medial circumflex arteries

58
Q

In a extracapsular neck of femur fracture, how does the limb look anatomically?

A
  • Shortened

- Externally rotated

59
Q

What determines treatment in neck of femur fracture?

A

-Age and health of the patient determines whether a replacement is needed

60
Q

How are extracapsulr neck of femur fractures usually treated?

A

-With a dynamic hip screw

61
Q

What is arthritis?

A
  • Inflammation in the synovium of joint resulting in damage to cartilage
  • Pain from inflammation
62
Q

-What is osteoarthritis?

A
  • Wear of the articular cartilage which leads to secondary changes in the underlying bone
  • Pain from mechanical grinding
63
Q

What is rheumatoid arthritis?

A
  • Autoimmune condition where the joint cartilage is destroyed
  • Inflammatory pain then mechanical pain
64
Q

What are the bursa of the hip?

A
  • Iliopsoas
  • Trochanteric
  • Gluteus medius
  • Ischiogluteal
65
Q

What is the largest bursa of the hip and where is it?

A

-Trochanteric bursa between the greater trochanter and gluteus maximus

66
Q

Why is bursitis of the iliopsoas bursa significant?

A

-It may present as a swelling below the iguinal ligament and thus is a differential diagnosis of a femoral hernia

67
Q

What is a common cause of inflammation of the ischiogluteal bursa?

A

-Prolonged sitting eg biking

68
Q

When does bursitis cause pain?

A

-On movement and application of direct pressure

Musculoskeletal System (34 decks)

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