Unit 4- Hip Flashcards
The connection between the lower extremity and pelvic girdle
hip joint
What type of joint is the hip?
socket synovial joint
The femoral head is approximately 2/3rd of a ____, expect for the:
sphere
fit of the fovea
The femoral head is covered with what?
articular cartilage
the articular cartilage over the femoral head is thicker where?
over the weight bearing areas
Location of the ligament of the head of femur:
in the fovea
The hollow cup for the femoral head located on the lateral aspect of the hip
Acetabulum
Fibrocartilagenous lip with an inferior defect in the rim segment (acetabular notch)
acetabular rim
What part of the acetabulum is the weight bearing surface covered by articular cartilage?
lunate surface
A lip of fibrocaratilage that increases the depth of the acetabulum-
acetabular labrum
the acetabular labrum allows what?
the acetabulum to “grip” the femoral head beyond the equator
What ligament brisges the acetabular notch?
Transverse acetabular ligament
The acetabular fossa is the ____ part of the acetabulum formed by the ____
non-articular
ischium
When are the articular surface of the acetabulum and femoral head most congruent?
when the hip is flexed at 90 degrees, abducted 5 degrees, and laterally rotated. (this is the quadruped position)
What forms the joint capsule?
A stong and loose external fibrous layer and an internal synovial membrane
The external fibrous layer of the joint capsule attaches proximally on the:
hip bone (all 3 parts) to the rim of the acetabulum and transverse acetabular ligament
The external fibrous layer of the joint capsule attaches distally to the femoral neck only anteriorly at the ____ ____ and the root of the ____ ____
Posteriorly the fibrous layer has an _____ border that crosses the _____ proximal to the ___ ______
intertrochanteric line
greater trochanter
arched
neck
intertrochanteric crest (it is not attached to the neck)
The external fibrous layer of the joint capsule attaches posteriorly:
The synovial membrane extends beyond the free post margin of the joint capsul on the femoral neck.
Posteriorly, The external fibrous layer of the joint capsule forms what?
a bursa for the obturator externus
Fibers of the fibrous layer of the joint capsule take a ____ course from the __ ___ to the _____ ___
spiral
hip bone
intertrochanteric line
Deep fibers present on the posterior capsule wind circularly around the femoral neck
orbicular zone
Thickened parts of the fibrous layer of the joint capsule form ______ which pass:
ligaments
a spiral fashion from the pelvis to the femur
What does extension cause in the joint capsule???
Tightens the spiral ligaments and fibers
Constricts the capsule
And pulls the femoal head into the acetabulum
The joint capsule limits:
extension to approx 10-20 degrees beyond vertical.
flexion unwinds the ligaments and allows increasing hip mobility
Y-shaped ligament attaching from the AIIS and rim anteriorly, and intertrochanteric line distally.
Prevents hyperextention of the hip while standing
Iliofemoral ligament
What is the strongest ligament in the body?
iliofemoral ligament
The iliofemoral ligament reinforces the joint ____ and ____ly
anteriorly and superiorly
Ligament to reinforce the hip joint anteriorly and inferiorly
pubofemoral ligament
the pubofemoral ligament arises from the ___ _____ of the pubic bone and passes ____ and ____ to merge with:
obturator crest
laterally and inferiorly
the fibrous layer of the joint capsule
What does the pubofemoral ligament blend with?
the medial part of the iliofemoral ligament
When does the pubofemoral ligament tighten?
What does it prevent?
during extension and abduction of the hip
hyperabduction of the hip joint
The ischiofemoral ligament is a (WEAK/STRONG) ligament that reinforces the hip joint ____.
Weak
posteriorly
The ischiofemoral ligament arises from the ____ part of the ___ ___ and spirals ______ to the ___ of the femur, medial to the ____ of the ____ ____.
ischial
acetabular rim
superiolaterally
neck
base
greater trochanter
What function to pull the femoral head into the acetabulum?
medial and lateral rotators of the thigh
Medial rotators (located _____) are (STRONGER/WEAKER) and have (POOR/STRONG) mechanical advantage, but associated ligaments are (STRONGER/WEAKER)
anteriorly
weaker
poor
stronger
Lateral rotators (located _____) are (STONGER/WEAKER) with (LESS/MORE) mechanical advantage but associated ligaments are (STRONGER/WEAKER)
posteriorly
stronger
more
weaker
What does the synovial membrane of the hip line?
The fibrous joint capsule and intercapsular bony surfaces not lined by articular cartilage
The synovial membrane of the hip reflects ____ along the ___ ___.
proximally
femoral neck
Synovial folds, AKA
retincaula
Synovial folds of the hip reflect ______ along the femoral neck as ____ ___.
superiorly
longitudinal bands
synovial folds of the hip contain _____ ____ arteries. What do these supply?
subsynovial retinacular arteries (consist of medial and a few lateral circumflex artery branches)
supply the femoral head and neck
The ligament of the head of the femur is a (STRONG/WEAK) ligament.
What forms this?
Weak
Formed by a synovial fold conducting a vessel to the head of the femur (the artery is important developmentally but is unable to adequately supply the mature head)
What does the wide end of the ligament of the head of femur attach to?
What about the narrow end?
Wide end- acetabular margins and transverse acetabular ligament
Narrow end- to the fovea for the ligament of the femoral head
What fills in the acetabular fossa not filled by the ligament of the head?
What does this do?
A fat pad
changes shape to accomodate head movements.
What covers the fat pad and ligament of the head?
synovial membrane
What forms a bursa for the obturator externus muscle?
the synovil membrane protruding beyond the free margin of the joint capsule on the posterior aspect of the femoral neck
Knee flexion releases the _____ muscles, allowing ___ ____ until:
hamstring
thigh flexion
thigh flexion until it reaches the anterior abdominal wall
hip extension is limited by what ligament?
Iliofemoral ligament
Which is freer than the other in the hip? Adduction or abduction?
Abduction
it can reach approc 60 degrees with the thigh extended and increases when the thigh is flexed
which hip rotation is more powerful?
lateral rotation
What muscle is the strongest hip flexor?
iliopsoas muscle
what muscles work hip adduction and flexion?
Adductor magnus (adductor portion), brevis and longus, pectineus and gracilis
what muscle works hip adduction and extension?
hamstring part of the adductor magnus
what muscles work hip abduction and medial rotation?
anterior portion of the gluteus medius and minimus
What is the primary extensor of the hip?
Gluteus maximus- particularly when extending the thigh from a flexed position.
After the leg is straight, the hamstrings become primary extensors
blood supply to femoral neck
medial and lateral circumflx arteries
Where do the medial and lateral circumflex arteries arise?
usually from the profunda femoris
may arise from the femoral artery
which artery is usually the major supply to the femoral neck? what is its pathway?
medial circumflex
passes beneath the unattached post border of the joint capsule to supply the head and neck via retinacular arteries
the artery to teh femoral head is a branch of the _____ artery and travels where?
obturator
to the head in the ligament of the head (this is the one that does not supply the mature head and neck)
Hip flexors are innervated by the ____ nerve and pass:
femoral
anteriorly to the hip joint and supply the anterior aspect of the hip joint
The ____ nerve sends branches to the ____ aspect.
what nerve supplies the post aspect of the hip
obturator
inferior
nerve to the quadratus femoris
what nerve supplies the hip abductors? pathway?
superior gluteal nerve
pass superiorly to the joint
What nerve also provides direct innervation to the femoral neck?
sciatic
Look at slides 22-27 regarding hip injuries if he says he will ask hip injury questions
peace
