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Functional Anatomy > The hip- Palastanga > Flashcards

The hip- Palastanga Flashcards

1
Q

Classification

A

Synovial ball and socket

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2
Q

Direction of articular surfaces

Consequences?

A

Acetabulum- lat ant and inf
Hear of femur- med ant and sup

Loss of coincidence of articular surfaces- anterosuperior aspect of femoral head is not contained within acetabulum but exposed

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3
Q

What is the acetabular notch?

A

A deficiency in the acetabular rim, anteriorly, compensated for by the transverse ligament

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4
Q

How is congruency of the joint increased?

A

Acetabular labrum (wedge shaped fibrocartilage)

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5
Q

Where on the femoral head is the cartilage thickest and why?

A

Superior surface as sustains greatest pressure during loading
(Cartilage is almost spherical in an unloaded femur

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6
Q

Describe the joint capsule

A

Very strong and thickest anteriorly
Attaches to the margins of the acetabulum and the transverse ligament
Attaches to the intertrochanteric line ant and neck of the femur post

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7
Q

What are the capsular ligaments

A

Iliofemoral (strong and triangular, anteriorly)
Pubofemoral (blends with inf band of above, sits anteroinferiorly)
Ischiofemoral (less well defined, spirals laterally and upwards)

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8
Q

Role of the capsular ligaments

A

Limit extension, relax under flexion and are moderately taut during stance

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9
Q

Intracapsular sturctures

A

Transverse ligament
Labrum
Ligamentum teres (thin band of connective tissue attaching to the fovea of the head of the femur)

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10
Q

How does the hip receive its blood supply?

A

Lateral and medial circumflex femoral arteries, obturator artery and gluteal arteries form a peri-articular anastamosis

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11
Q

Stability

A

Articular surfaces fit well together however as transfers weight to lower limb peri-articular muscles (esp those crossing transversely) are essential to maintain stability

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12
Q

What happens to the femoral shaft during embryo and post-natally

A

Becomes adducted and medially rotated angulating the the head and neck against the shaft in both the frontal and lateral plains

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13
Q

What is the angle of inclination in an adult

A

Around 125 degrees

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14
Q

What is the angle of anteversion in an adult

A

About 10 degrees

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15
Q

Difference in mechanical axis to vertical
Difference in anatomical axis to mechanical axis
Difference in anatomical axis to vertical

A

3 degrees
3 degrees
6 degrees

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16
Q

What occurs during hip dislocation

A

Most commonly posterior displacement of femoral head

Limb is shortened, adducted and medially rotated

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17
Q

What is the position of the limb during hip fracture

A

Shortened and laterally rotated

18
Q

Limits to flexion of the hip

A

Is free
Limited by contact with the body wall when knee flexed
Limited by tension in hamstrings when knee extended

19
Q

Range of hip flexion

A

120 degrees without assistance

145 degrees with pulling in

20
Q

Limits to extension

A

Shape of the articular surfaces and associated ligaments

21
Q

Range of extension

A

20 degrees without assistance

30 degrees if leg pulled on

22
Q

Abduction and adduction are?

A

Free
Greatest with the hip flexed
Some 45 degrees each
Limited by tension in opposite muscles

23
Q

Rotation occurs around what axis?

A

The mechanical axis of the femur

not the shaft

24
Q

Range of lateral rotation

A

60 degrees

the freer and more powerful movement

25
Q

Limits to lateral rotation

A

The medial rotators of the thigh

Iliofemoral and pubofemoral ligaments

26
Q

Range of medial rotation

A

30 degrees

27
Q

Limits to medial rotation

A

Thigh lateral rotators

Ischiofemoral ligament

28
Q

Estimation of hip joint forces during one-legged standing

A

1.8 to 3 times body weight

29
Q

Estimation of hip joint forces during stance phase of walking

A

3.3 to 5.5 times body weight

30
Q

What do trabeculae do?

A

Minimise bending and shear stresses

31
Q

What are the trabecular systems of the pelvis

A

2, arising from the inferior and superior auricular articular surface of SI joint, coursing through the pelvis where they cross over and continue into the femoral head via the acetabulum

(So that from sup auricular surface becomes inf femoral and vice versa)

32
Q

Describe the accessory trabecular patterns of the (top of the) femur

A

Trochanteric bundle arising from the cortical layer of the medial aspect of the shaft (so essentially in the middle)
Second bundle entirely with the greater trochanter

33
Q

What happens to the joint contact area under increasing load

A

It increases

34
Q

What happens if load-bearing area of femoral head is decreased? e.g. due to deformity

A

The rest of the load bearing cartilage is under greater stress (non-physiological) and may degenerate at a higher rate

35
Q

Muscles extending the hip joint

A

Gluteus maximus

Hamstrings

36
Q

Muscles abducting the hip joint

A

Gluteus minimus and medius mainly

Gluteus maximus and tensor fascia lata assist

37
Q

Muscles adducting the hip joint

A

Adductors magnus, longus and brevis
Gracilis
Pectineus

38
Q

Muscles flexing the hip joint

A

Iliopsoas
Pectineus
Rectus femoris
Sartorius

39
Q

Muscles medially rotating the hip joint

A

Gluteus medius and minimus (anterior parts)

Tensor fascia lata and iliopsoas assist

40
Q

Muscles laterally rotating the hip joint

A 
Gluteus maximus
Piriformis
Obturators internus and externus
The gemelli (sup and inf)
Quadratus femoris
41
Q

Describe nutation

A

Rotates forwards

  • forwards movement and lowering of the scaral promontory (so cocyx moves back and elevates)
  • separation of the ischia
  • decreases pelvic inlet dimensions
  • increases pelvic outlet dimensions
42
Q

Describe counternutation

A

Vertical integration of the sacrum (rotates backwards)

  • backward movement and elevation of the sacral promontory (so cocyx moves forward and lowers)
  • increases pelvic inlet dimensions

Functional Anatomy (18 decks)

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