The Hip Joint, Anterior Thigh and Neurovascular Structures Flashcards
What type of joint is the hip joint?
Synovial ball and socket
Why is the hip joint more stable than the shoulder?
Deeper socket
What is the acetabular labrum and what does it cover?
Fibrocartilaginous membrane
Covers lunate surface of acetabulum
What are the three main ligaments of the hip joint?
Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament
What is the function of the iliofemoral ligament?
To prevent hyperextension of the hip joint
What is the function of the pubofemoral ligament?
To prevent hyperabduction of the hip joint
Identify the structures labelled 1-3
1- Iliofemoral ligament
2- Pubofemoral ligament
3- Ischiofemoral ligament
What movements are permitted at the hip joint?
Flexion/extension Abduction/adduction External (lateral)/internal (medial) rotation Circumdiction
What are the flexors of the hip?
Iliopsoas
Rectus femoris
Sartorius
Pectineus
Identify the structures labelled 1-3 FLEXORS OF HIP
1- Iliacus 2- Psoas major 3- Pectinus
What are the attachments of iliacus and psoas major?
Iliacus arises from the inner pelvic wall Psoas major arises from the posterior abdominal wall Two muscles join to form iliopsoas muscle and share a common tendinous attachment on the femur
What muscle is the chief flexor of the thigh?
Sartorius
Which muscle is the main extensor of the hip?
Gluteus maximus
When is gluteus maximus most active in hip extension?
When standing from sitting and climbing stairs Relatively inactive during normal walking
What are the extensors of the hip?
Gluteus maximus
Hamstrings- semimembranous, semitendinous, biceps femoris
What are the adductor muscles of the hip?
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Obturator externus
Identify the structures labelled 1-4 ADDUCTORS OF THIGH 1
1- Obturator externus
2- Adductor brevis
3- Adductor longus
4- Adductor magnus
Identify the structures labelled 1-6
1- Femoral nerve 2- Femoral artery 3- Adductor longus 4- Adductor brevis 5- Obturator nerve 6- Gracilis
Which nerve supplies the adductor compartment of the thigh?
The obturator nerve
Where does the obturator nerve exit the pelvis?
Via the obturator canal
Which muscles carry out the abductor function of the hip and how?
Gluteus medius, gluteus minimus, piriformis and tensor fascia latae
Role carried out via attachment to greater trochanter of femur
Identify the structures labelled 1-5 ABDUCTORS OF HIP
1- Gluteus medius 2- Piriformis 3- Obturator internus 4- Quadratus femoris 5- Gluteus minimus
How do the abductors of the hip act in a normal gait?
When one limb is raised, that side of the pelvis becomes unsupported and will drop Abductors on the opposite side of the pelvis contract to prevent this
What is the result of injury to the nerve supply of the adbuctors?
Trendelenberg gait
What are the lateral rotators of the hip?
Biceps femoris
Gluteus maximus
Piriformis
Obturators
Gemilli
Quadratus femoris
Where do the lateral rotators of the hip lie?
They cross the joint on the posterior side
Where do the medial rotators of the hip lie?
They cross the joint on the anterior surface
Which muscles are the medial rotators of the hip?
Gluteus medius
Gluteus minimus
Tensor fascia latae
What compartments are the muscles of the thigh organised into?
Anterior/quadriceps/extensors of knee Medial/adductors of hip Posterior/hamstrings/flexors of knee
Identify the structures labelled 1-7 ANTERIOR THIGH MUSCLES
1- Psoas major 2- Iliacus 3- Rectus femoris 4- Vastus medialis 5- Vastus lateralis 6- Sartorius 7- Pectineus
What are the four heads of quadriceps femoris?
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis
Which nerve innervates the anterior thigh muscles?
The femoral nerve
What is the action of rectus femoris on the hip joint?
Stabilises hip and helps iliopsoas flex hip
Where do the four heads of the quadriceps unite?
The four heads of the quadriceps unite to form the quadriceps tendon proximal to the patella, continuing as the patellar ligament distal to the patella to its attachment on the tibia
To which part of the tibia does the patellar ligament attach?
The tuberosity
What is the most superficial muscle in the anterior thigh?
Sartorius
What are the actions of the sartorius muscle?
Flex, abduct and laterally rotate the hip Flex the leg at the knee
How can the sartorius muscle flex both the hip and knee?
This is possible as it spirals around the thigh from lateral to medial, crossing the hip joint anteriorly and the knee joint posteriorly
What are the medial thigh muscles?
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Obturator externus
Which nerve innervates the medial thigh muscles?
The obturator nerve
How does the obturator nerve enter the thigh?
Through the obturator foramen
Which structures pass through the adductor hiatus?
The femoral artery and vein
Of which artery is the femoral artery a continuation?
The external iliac artery
Where does the femoral artery originate?
Changes from the external iliac artery as it passes under the inguinal ligament and enters the femoral canal
Where does the femoral artery enter the thigh?
Midway between the anterior superior iliac spine and the pubic tubercle
Where does the popliteal branch?
Branches off the femoral artery and passes posteriorly towards the hamstrings
Of which vein is the femoral vein a continuation?
The popliteal vein
What does the femoral vein continue as?
Passes under the inguinal ligament to continue as the external iliac vein
Which veins drain into the external iliac vein and where?
Profunda femoris and femoral veins in the femoral triangle
What procedure involves cannulation of the femoral vein?
Right cardiac angiography
What is the course of the femoral nerve in the thigh?
Largest branch of lumbar plexus
Passes deep to inguinal ligament and enters the femoral triangle lateral to the femoral vessels
Which muscles are supplied by the femoral nerve?
Sartorius
Pectineus
Iliacus
Quadriceps femoris
