The Hip

Question 1

Name the bones which fuse to form the acetabulum

Answer 1

Ilium Ischium Pubis

Question 2

Name the properties of the acetabular labrum

Answer 2

1. Transverse ligament is a continuation of the labrum and bridges acetabular notch 2. Increases acetabular articular surface by 10% 3.Blood vessels pass into joint through the acetabular notch

Question 3

What type of joint is the hip joint? What articulates with what?

Answer 3

Ball and socket synovial joint Round head of femur articulates with cup-shaped acetabulum of the pelvis.

Question 4

What causes the stability of the hip? Name 6 attributes

Answer 4

1. Deep insertion of femoral head into acetabulum 2. Strong tight articular capsule 3. Ligaments around the joint capsule (especially anteriorly) 4. Large powerful muscles around joint 5. Ligament within articular capsule, ligamentum teres 6. Fat pad fills central region and adds cushioning for thinnest part of acetabulum

Question 5

Describe the main features of the articular capsule

Answer 5

1.Strong thick articular capsule 2. Anterior surface and medial half of posterior surface of the femoral neck - intracapsular. 3.Strongest and thickest over upper and anterior parts, thinner over lower and posterior parts. 4. Ligaments around joint blend with articular capsule, strengthening it further. 5.Anterior iliofemoral ligament is the strongest

Question 6

What is the strongest ligament in the hip?

Answer 6

Anterior iliofemoral ligament

Question 7

What happens to the hip joint during knee extension?

Answer 7

Extension twists fibres of Articular capsule pulling acetabulum and femur together

Question 8

Describe the size/strength of muscles and ligaments above and below the hip joint

Answer 8

Above (anterior)- Ligaments stronger (iliofemoral) and muscles smaller (less) Below (posterior)- Ligament weaker (ischiofemoral) and muscles stronger

Question 9

What are the functions of the Anterior iliofemoral ligament

Answer 9

prevents excessive extension of hip relaxed in flexion taut in extension, when standing it holds femoral head in acetabulum.

Question 10

Describe the blood supply to the hip

Answer 10

Main suppy- profunda femoris Branches- lateral and medial circumflex arteries Retinacular arteries penetrate the bone of the femure Obturator artery penetrates the head of the femur

Question 11

Label this image of the hip

Answer 11

Question 12

Name and describe the 3 lines of the hip joint

Answer 12

A- cola line- tangent (straight line) between the lateral boder of pubis and pelvic inlet

Acetabular fossa should be lateral to it

B- shentons line- Imaginary line drawn along the inferior border of the superior ramus of the pubis down to the lesser trochanter

C- iliofemeral line- lateral aspect of the ilium

Question 13

Mucles and nerves responsible for hip flextion?

Answer 13

1. Iliopsoas ( made up of iliacus and psoas major muscles) main hip flexor muscle
2. Quadriceps flex the hip (quite weak)
3. Innervation = femoral nerve

Question 14

Which muscle abducts and laterally rotates the hip? Which nerve is it innervated by

Answer 14

Sartorius (also abducts and laterally rotates hip)

Innervation = femoral nerve

Question 15

Which muscle adducts and medially rotates the hip? Which nerve is it innervated by?

Answer 15

Pectineus (also adducts and medially rotates)

Innervation = femoral nerve

Question 16

Which muscle stabilises the hip joint?

Answer 16

Rectus femoris

Question 17

Mucles responsible for hip extension and which nerve innervates it?

Answer 17

Gluteus maximus- Main hip extensore

Innervation = inferior gluteal nerve

Assisted by Hamstrings- Tibial division of sciatic nerve

Question 18

Mucles responsible for Hip Abduction? Which nerve innervates them?

Answer 18

Gluteus medius and minimus

Tensor fasciae lata

Innervation = superior gluteal nerve

Question 19

Muscle responsible for hip adduction? And innervating nerve? Which part of the thigh are the muscles located?

Answer 19

Adductor group of muscles – medial thigh

Adductor longus, brevis and magnus, gracilis, pectineus and obturator externus

Innervation = obturator nerve

Question 20

Mucles responsible for hip medial and lateral rotation?

Answer 20

Hip lateral rotation

–Gluteus maximus

–Piriformis

–Obturator internus

–Quadratus femoris

Hip medial rotation

–Gluteus medius/minimus

–Tensor fasciae latae

Question 21

What is the iliotibial tract (band)

Answer 21

Acts as a long aponeurosis for tensor fascia lata and superficial and anterior parts of gluteus maximus