The hip joint Flashcards
1
Q
what is a joint?
A
an articulation or a point where 2 bones make contact to allow movement between them
2
Q
what are the 3 classifications of a joint?
A
- fibrous
- cartilaginous
- synovial
3
Q
describe fibrous joints & give an example
A
- fibrous joints have no movements
- the surfaces are joined by fibrous tissue
- eg sutures in the skull
4
Q
do cartilaginous joints have movement?
A
- they have **slight movement **
5
Q
what are the **differences **between primary cartilaginous and secondary cartilaginous joints?
A
- primary cartilaginous joint is where the 2 bones are joined together by hyaline cartilage - only hyaline cartilage present
- secondary cartilaginous joint is where 2 bones are joined together by fibrocartilage, they may also have hyaline cartilage
6
Q
what is an example of a primary cartilaginous joint?
A
- costochondral joints - ribcage
7
Q
what are examples of a secondary cartilginous joint?
A
- pubic symphysis
- intervertebral discs
8
Q
What is the difference in histology between hyaline cartilage and fibrocartilage
A
- hyaline - ground substance contains glycoproteins which absorb water- therefore cartilage is more slippery
- fibrocartilage - dense bundles of collagen fibres with little ground substance
9
Q
Describe the 6 main features of a synovial joint
A
- **hyaline articular cartilage **- this cartilage lines the articulating surfaces of the bone
- capsule - sac like envelope that wraps around joint
- joint cavity- cavity that contains synovial fluid
- **synovial membrane ** - membrane that lines on the inside of some of the joints
- ligaments
- movement
10
Q
what are the 3 main bones of the hip?
A
- ilium
- ischium
- pubis
11
Q
what are the 3 gluteal lines on the ilium?
A
- posterior gluteal line
- anterior gluteal line
- inferior gluteal line
12
Q
where does the** intertrochanteric crest** lie on the proximal end of the femur - anteriorly or posteriorly?
A
posteriorly
13
Q
where does the intertrochanteric line lie on the proximal end of the femur- anteriorly or posteriorly?
A
anteriorly
14
Q
what is the epiphysis?
A
- ends of the long bone
- contains the articular surface (of the joint)
- eg head of femur
15
Q
what is the metaphysis?
A
- regions between the epiphysis and diaphysis
- contains the epiphyseal growth plate
16
Q
what is the diaphysis?
A
- the long straight section between the ends of a long bone
- ie the shaft of the femur
17
Q
Briefly describe the ossification of the femur
A
- epiphysis is present at birth and unites around 20 years of age
- head of femur forms at 1 year
- greater trochanter at 3/4 years
- lessor trochanter at 12 years old
- fusion at 18 years old
18
Q
what is slipped capital femoral epiphysis?
A
- a disorder of adolescents in which the **growth plate is damaged **and the femoral head moves or slips with respect to the rest of the femur
- note that any fractures in children that effect the epiphysis or metaphysis may effect adult limb length and joint movements
19
Q
what type of joint is the hip joint & what components make up this type of joint?
A
- synovial ball and socket joint
- ball = head of femur
- socket = bony acetabulum, labrum (fibrocartilage) and the transverse ligament
20
Q
what are the 3 main extra capsular ligaments of the hip joint that act to stabilise the joint?
A
- iliofemoral ligament
- pubofemoral ligament
- ischiofemoral ligament
21
Q
what is the proximal and distal attachment of the iliofemoral ligament?
A
- proximal attachment - anterior inferior iliac spine - AIIS
- distal attachment - upper and lower ends of the intertrochanteric line
22
Q
what type of shape is the iliofemoral ligament and what is an important fact about it?
A
- y shape
- strongest ligament in the body
23
Q
what is the function of the iliofemoral ligament?
A
- it functions to prevent overextension of the hip
- it tightens during extension, which restricts extension of the hip joint
24
Q
what is the function of the pubofemoral ligament?
A
it prevents excessive abduction of the hip by tightening during extension and abduction movements
25
what are the proximal and distal attachments of the ischiofemoral ligament?
*proximal attachment - posterior margin of the acetabulum
*distal attachment - capsule at zona orbicularis
26
which extracapsular ligament is the weakest out of all 3?
the ischiofemoral ligament
27
what is the ligament of head of femur or the ligamentum Teres?
an intracapsular ligament that attaches at one end to the fovea of the head of the femur and at the other end to the acetabular fossa
28
what type of surfaces does the synovial membrane line in a joint?
it **lines all non-articulating surfaces within a joint**
29
what are the iliac bursa?
sacs containing synovial fluid that are located between the iliopsoas muscle and the anterior capsule of the hip
30
what are the functons of the iliac bursa?
* **reduces friction** (where tendon rubs over bone)
* communicates with hip joint
31
what are the movements that the hip can carry out ?
* flexion and extension
* abduction and adduction
* medial and lateral rotation
32
what muscles carry out hip flexion and extension?
* iliopsoas - most powerful hip flexor
* gluteus maximus and hamstring muscles - extension
33
what muscles carry out abduction of the hip?
* gluteus medius and minimus
34
what muscles carry out adduction ?
* adductors and the muscles in the medial compartment of the thigh
35
what is hiltons law?
* nerves that innervate a joint also supply the muscles that move that joint and the skin covering the distal attachments of those muscles
36
what nerves supply the hip?
* sciatic nerve
* femoral nerve
* obturator nerve
* superior & inferior gluteal nerves
37
what is an important point to mention about the nerves that supply the hip and also the knee?
* the same nerves supply the knee as the hip, so therefore pain in the knee joint may be referred pain fromma problem with the hip joint and vice versa
38
what 2 vessels do most branches that supply the hip joint come from?
* profunda femoris artery
* internal iliac artery
39
what are the retinacular arteries?
arteries that provide major blood supply to the femoral head
40
what are clinical signs on a patient that has a hip fracture?
* limb may be shortened and laterally rotated
* however it may be minimally displaced and hard to see - important to get lots of different views on an x ray
41
for an extra capsular fracture (fracture outside the hip joint capsule), what is the treatment?
* to insert a **dynamic hip screw **- DHS
* screw in the neck of the femur and it **allows a very small amount of movement** which can help with recovery
42
for an intracapular fracture - eg head of femur, what is usually the treatment?
* hip replacement - either semi or total as blood supply is disrupted and AVN may occur
43
Describe a hip dislocation
* hip is pushed posteriorly - requires significant force or trauma
* may have acetabular/labral damage or sciatic nerve injury
44
what is the popliteal fossa?
the diamond shaped space behind the knee
45
what are the boundaries of the popliteal fossa?
* superiorly - hamstrings - biceps femoris and semitendinous muscles
* inferiorly - gastrocnemius
* roof- fascia lata
* floor - popliteus muscle, capsule of knee joint and popliteal surface of femur
46
what are the contents of the popliteal fossa?
* sciatic nerve
* popliteal artery and vein
* popliteus muscle
* lymph nodes
* adipose tissue
47
briefly describe the pathway of the sciatic nerve
* passes deep to long head of biceps femoris
* visible between the biceps and semis
* tibial part - hamstrings
* common peroneal part - short head of biceps femoris
* divies ar apex of popliteal fossa
48
what are the nerve roots of the sciatic nerve?
* L4-S3
49
describe the pathway of the tibial nerve
* runs vertically along the middle of the popliteal fossa
* passes between the heads of the gastrocnemius muscle
* supplies the posterior compartment of leg
50
what artery is the popliteal artery a continuation of?
the femoral artery
* once the fa passes through the adductor hiatus, it changes its name to popliteal artery
51
what is the adductor hiatus?
an opening in the adductor magnus muscle - which transmits the femoral artery and vein from the adductor canal in the thigh to the popliteal fossa
52
Describe the pathway of the **common fibular (peroneal) nerve**
* runs laterally, just medial to the biceps tendon
* enters fibularius longus (muscle of lateral compartment of leg)
* runs around the neck of the fibula
* splits into the superifical fibular and deep fibular
53
what does the superficial fibular nerve supply?
lateral compartment of leg
54
what does the deep fibular nerve supply?
* anterior compartment of leg
