Week 20 - Hip Joint Flashcards
What is the acetabulum?
Y-shaped epiphyseal cartilage that starts to ossify at 12 years and fuses at 16-17 years.
The acetabulum is a crucial part of the hip joint, providing a socket for the femur.
What type of joint is the hip joint?
Multiaxial ball and socket variety of synovial joint.
This classification allows for a wide range of motion.
What are the articular surfaces of the hip joint?
- Head of femur
- Acetabulum
Each articular surface is covered by hyaline cartilage.
What is the function of the synovial membrane in the hip joint?
Lines the fibrous capsule and covers the intracapsular portion of the neck of the femur, acetabular labrum, transverse ligament, fat in the acetabular fossa, and round ligament of the head of the femur.
The synovial membrane plays a critical role in joint lubrication and nutrition.
What are the ligaments of the hip joint?
- Iliofemoral ligament
- Pubofemoral ligament
- Ischiofemoral ligament
- Transverse acetabular ligament
- Ligament of head of femur
These ligaments provide stability and limit movements of the hip joint.
What is the iliofemoral ligament?
Anterior to the hip joint, triangular shaped, prevents overextension during standing.
Its apex is attached to the anterior inferior iliac spine.
What does the pubofemoral ligament limit?
Extension and abduction of the hip joint.
It is anteroinferior to the hip joint.
Where is the ischiofemoral ligament located?
Lies posterior to the fibrous capsule, attached medially to the ischium and laterally to the greater trochanter.
This ligament limits extension of the hip joint.
What is the role of the transverse acetabular ligament?
Bridges the acetabular notch, converting it into a tunnel for blood vessels and nerves.
This ligament is formed by the acetabular labrum.
What does the ligament of the head of the femur transmit?
The artery of the head of the femur, a branch of the obturator artery.
This ligament is crucial for the blood supply to the femoral head.
What is the function of the fibrous capsule of the hip joint?
Attaches proximally to the acetabulum and distally to the neck of the femur, providing stability.
The capsule communicates anteriorly with the psoas bursa.
What structures are anterior to the hip joint?
- Lateral fibers of pectineus
- Tendon of iliopsoas
- Straight head of rectus femoris
- Femoral vessels and nerve
These structures play important roles in hip joint movement and stability.
Which arteries supply the hip joint?
- Medial circumflex femoral artery
- Lateral circumflex femoral artery
- Obturator artery
- Superior gluteal artery
- Inferior gluteal artery
These arteries ensure adequate blood supply to the hip joint.
What nerves supply the hip joint?
- Femoral nerve
- Anterior division of obturator nerve
- Accessory obturator nerve (when present)
- Nerve to quadratus femoris
- Superior gluteal nerve
These nerves are involved in sensation and motor control of the hip joint.
What factors contribute to the stability of the hip joint?
- Articular surfaces are reciprocally curved
- Tension and strength of ligaments
- Strength of surrounding muscles
- Length and obliquity of the neck
- Force of cohesion by synovial fluid
These factors allow for both stability and mobility.
What are the primary movements of the hip joint & the muscles which cause them?
- Flexion - Psoas, Iliacus, Straight head of rectus femoris, & accessory muscles (pectineus)
- Extension - Gluteus maximus & Hamstrings
- Adduction - Adductors
- Abduction - Gluteus medius & minimus, Tensory fascia lata, & sartorius
- Medial rotation - Ant. fibres of Gluteus medius & minimus, tensor fascia lata, & pectineus
- Lateral rotation - Obturators, Gemelli, Quatradus lumborum, piriformis, & Gluteus maximus
These movements occur in three planes, facilitating various activities.
What is congenital dislocation of the hip?
A condition that is 10 times more common in female children than in male children, potentially due to generalized laxity of the joint ligaments or shallow acetabulum.
Ultrasound is used for diagnosis.
What is Perthes disease?
Destruction and flattening of the head of the femur.
This condition primarily affects children.
What are common injuries associated with the hip joint?
- Dislocation of the hip joint
- Fractures of the neck of the femur
- Trochanteric fracture
These injuries can lead to significant complications.
What is avascular necrosis (AVN) of the femoral head?
A condition usually progressing to joint destruction, often requiring total hip replacement.
It typically occurs after fractures of the neck of the femur.
What is coxa vara?
A condition where the neck-shaft angle is reduced.
This can affect hip joint function and stability.
What disease commonly affects the hip joint in the elderly?
Osteoarthritis, characterized by painful limited movements.
It can cause referred pain in the knee due to common nerve supply.
What is the typical position of the lower limb during posterior dislocation of the hip?
Flexed, adducted, and medially rotated.
This position is often associated with automobile accidents.
What is the accuracy of MR arthrogram for diagnosing labral tears?
91% accurate.
This method is particularly useful for young, active patients with groin pain.
What is a common cause of traumatic posterior dislocation of the hip?
Motor vehicle accidents
What position is the hip joint usually in during a posterior dislocation?
Flexed and adducted
In a posterior dislocation of the hip, where does the head of the femur rest?
On the gluteal surface of the ilium
Which nerve is prone to injury in posterior dislocations of the hip?
Sciatic nerve
What shape is the iliofemoral ligament?
Y-shaped
Where is the base of the iliofemoral ligament attached?
Anterior inferior iliac spine
What does the iliofemoral ligament prevent?
Over-extension during standing
Where is the pubofemoral ligament attached?
Superior ramus of the pubis and lower part of intertrochanteric line
What does the pubofemoral ligament limit?
Extension and abduction
What is the function of the ischiofemoral ligament?
Limits extension
What does the transverse acetabular ligament convert?
Acetabular notch into a tunnel for blood vessels
What is the ligament of the head of the femur attached to?
Fovea capitis and transverse ligament
Which ligament is torn in a posterior dislocation of the hip?
Ischiofemoral ligament
Which artery supplies the upper part of the head of the femur in children?
Branch of the obturator artery
What is the main blood supply to the hip joint in adults?
Medial circumflex femoral artery
What indicates possible damage to the tibial portion of the sciatic nerve?
Weakness of extension of the thigh at the hip
What type of fracture is an intertrochanteric fracture?
Break between greater and lesser trochanter
What is a subtrochanteric fracture?
Break between the lesser trochanter and 5 centimeters below it
What are extracapsular fractures often caused by?
Low-energy falls in elderly patients
What are the common symptoms of varicose veins?
Pain and edema in legs
Which veins are most likely to become varicose?
Superficial veins, e.g. greater and lesser saphenous veins
What are perforating veins?
Channels connecting superficial veins to deep veins
What happens when valves in perforating veins fail?
Blood is forced into superficial veins
What is a predisposing factor to varicosity?
Prolonged standing
What surgical options are available for treating varicose veins?
Injecting sclerosing solutions; ligation and stripping
