Week 3- iRA/tRA: Hip Anatomy and Biomechanics Flashcards
What are the structures of the hip? (5)
- Femur
- Innominate
- Labrum
- Ligaments
- Musculature
Femur:
- ________ and ________ bone in the body.
- Shaft is nearly cylindrical.
- Inclined ______ and ________ from tibia.
- longest and strongest
- upward and outward
Femoral Head:
- Faces ________, _______, and ______.
- Spheroidal
- The ______ is the attachment for the ligamentum teres.
- anterior, superior, and medial
- fovea
Femoral Neck:
- Allows limb movement without impact from ________.
- Anterior neck intracapsular, though posterior capsule extends ~ mid ______.
- pelvis
- mid neck
- Greater trochanter projects ____________.
- Lesser trochanter projects ___________.
- Intertrochanteric line ________ at neck/shaft junction.
- Intertrochanteric crest ridge on posterior femur between _________.
- superiomedially
- posteriomedially
- anterior
- trochanters
Femoral Shaft:
- Angle from vertical ~__ degrees (__-__ degrees from tibia).
- Sustains ________ loads, ridges at muscular attachment sites.
- Dense compact bone with medullary cavity.
- __________ bone at proximal and distal ends.
- 10 degrees (5-7 degrees)
- compressive
- Trabecular bone
Femur Distal End:
-What are the 4 parts of the distal end of the femur?
- Patellar surface (anterior extensions w/ groove for patella)
- Medial condyle (medial convexity)
- Lateral condyle
- Intercondylar fossa
Angle of Inclination:
- Angle of femoral ____ to femoral ____.
- Normal = ______
- Coxa Vara = _______
- Coxa Valga = _______
- Angle of femoral neck to femoral shaft.
- Normal = 135 (125-140)
- Coxa Vara = <120
- Coxa Valga = >140
Angle of Anteversion:
- _____ and posterior borders of femoral _________.
- Normal = ______
- Excessive anteversion = ______
- Retroversion
- Excessive anteversion exposes more femoral head and puts patient at ________ dislocation risk.
- Neck and posterior borders of femoral condyles.
- Normal = 10-15
- Excessive anteversion = 40 degrees
- anterior
Hip Vascularity:
- The arterial supply to the hip joint is largely via the ________ and _________ _________ arteries.
- It also gets minor contributions from inferior and superior gluteal arteries.
- In early childhood, reaches the head along the ________ ______.
- medial and lateral circumflex arteries
- ligamentum teres
What are the (3) parts of the innominate?
- Pubis
- Ilium
- Ischium
What are the parts of the pubis? (4)
- Body
- Superior Pubic Ramus
- Inferior Pubic Ramus
- Pubic Tubercle
What are the parts of the ilium? (5)
- Iliac crest
- Ant/Post/Med borders
- Gluteal surface
- Iliac fossa
- Sacropelvic surface
What are the parts of the ischium? (3)
- Ischial Ramus
- Ischial Tuberosity
- Ischial Spine
- Inclination of the Acetabulum = ___ degrees
- Acetabular angle of Anteversion (Men=___ deg, Women = ___ deg)
- 45 degrees
- Men = 14 degrees, Women = 19 degrees
What are 4 important spaces, canals, and foramens?
- Gap between inguinal ligament and pelvis
- Greater sciatic foramen (above/below piriformis)
- Lesser sciatic foramen
- Obturator canal
What is a good way to remember the structures that pass through the inguinal ligament and pelvis?
-NAVL (nerve, artery, vein, lymphatic)
Hip Stability:
- Contact area of articulating surfaces > ___ sphere.
- Labrum
- _______ effect
- ______ capsule
- Strong ligamentous structures
- _________ ligament of acetabulum
- Joint angles
- _________ stability
- 1/2 sphere
- vacuum effect
- thick capsule
- transverse ligament
- muscular stability
Arthrology-HIP:
- Femoral Head:
- Spheroidal (or slightly ovoid)
- Covered by ___ (except ligamentum teres)
- Contacts on ____________ surface
- Acetabular Surface:
- ________ surface.
- Incomplete ring (transverse acetabular ligament).
- Contacts on ____________ margin.
- Deficient __________ (opposite acetabular notch).
- Acetabular fossa contains acetabular fat.
- AC
- anteriolateral
- Lunate
- anteriosuperior margin
- inferiorly
Labrum:
- ____________ rim attached to the acetabular margin.
- Stressed with ___________ loading.
- What is the purpose of the labrum?
- Fibrocartilaginous rim
- compressive
- Deepens the acetabulum. Bridges acetabular notch for static restraint, proprioceptive info, and has free nerve endings.
Labrum:
- What portion of the labrum is vascularized?
- It is innervated and branches from nerve to quads and obturator nerve for ______/______ception.
- Outer 1/3 vascularized, Inner 2/3 avascular
- nociception/proprioception
Hip Joint Capsule:
- Thickest ____________.
- Vascularized (carry vessels to femoral head, neck, labrum)
- Strengthened by ___________ of the hip.
- anteriosuperiorly
- ligaments
What are the (3) main ligaments of the hip?
- Iliofemoral Ligament
- Pubofemoral Ligament
- shiofemoral Ligament
Which ligament is triangular in shape, has its base at the iliopubic eminence/superior pubic ramus/obturator crest/obturator membrane, and distal at deep fibers of medial iliofemoral ligament?
-Pubofemoral Ligament
Which ligament is a strong, inverted “Y” that is located at the anterior hip between the AIIS and acetabular rim to intertrochanteric line?
-Iliofemoral Ligament
Which ligament is located posteriorly and hass 3 parts (central, lateral and medial) that wind around femoral neck?
-Ischiofemoral Ligament
During flexion of the hip the ischio/pubo/iliofemoral ligaments are all _________, creating instability of the hip in this position.
-slackened
During extension of the hip, the ischio/pubo/iliofemoral ligaments are all _______, which helps to check __________ tilt of the pelvis.
-taut, posterior tilt
During adduction of the hip, the ischiofemoral and iliofemoral ligaments become ________ while the pubofemoral ligament is _________.
- taut
- slackened
During abduction of the hip, the ischiofemoral and iliofemoral ligaments become ______ while the pubofemoral ligament is _______.
- slackened
- taut
- During ER, the _____ ligaments are tautened.
- During IR, the _______ ligaments are tautened.
- anterior
- posterior
What are (2) other ligaments of the hip?
- Transverse Acetabular Ligament
- Ligamentum Teres
The ____________ ligament is continuous with the labrum and forms foramen for entry of vasculature/nerves.
-Transverse Acetabular
The _____________ is attached at the fovea on femoral head and acetabular notch and provides tensile loading with partial flexion and adduction and is slackened in abduction.
-Ligamentum Teres
Ligaments are in a slackened position in hip _______ vs neutral positioning.
-flexion
Hip Musculature:
- Psoas Major = ___-___
- Psoas Minor = ____
- Iliacus = ___-___
- Sartorius = ___-___
- Quadriceps Femoris = ___-____
- TFL = ____-___
- Gracilis = ___-___
- Psoas Major L1-3
- Psoas Minor L1
- Iliacus L1-4
- Sartoruius L2,3
- Quadruceps Femoris L2,3,4
- TFL L4,5
- Gracillis L2,3
Psoas Major:
- :Location: anterior to quadratus, running oblique course __________ following the pelvic rim.
- Origin: ______ of lumbar vertebrae, T12-L5 bodies and IV disc
- Insertion: Tip of _____________
- Innervated by ventral rami ___-___
- anteriolaterally
- TP
- lesser trochanter
- L1-L2
Hip Musculature:
Pectineus = ___-___
Glut Max = ___-___
Semitendinosus (tibial division ___-___)
Semimembranosus (tibial division ___-___)
Biceps Femoris (long head tibial portion L5-S2; short head common fibular portion L5-S2)
- Pectineus L2,3,4
- Glut Max L5-S2
- Semitendinosus (tibial division L5-S2)
- Semimembranosus (tibial division L5-S2)
- Biceps Femoris (long head tibial portion L5-S2; short head common fibular portion L5-S2)
Hip Musculature:
- Adductor Longus __-__
- Adductor Brevis __-__
- Adductor Magnus __-__
- Adductor Longus L2,3,4
- Adductor Brevis L2,3,4
- Adductor Magnus L2,3,4
Hip Musculature:
- Gluteus Medius __-__
- Gluteus Minimus __-__
- Obturator Internus
- Gemellus Superior
- Gemellus Inferior
- Piriformis
- Quadratus Femoris
- Obturator Externus __-__
- Gluteus Medius L5/S1
- Gluteus Minimus L5/S1
- Obturator Internus
- Gemellus Superior
- Gemellus Inferior
- Piriformis
- Quadratus Femoris
- Obturator Externus L3,4
Biokinematics (AROM):
- Flexion =
- Extension =
- IR =
- ER =
- Abd =
- Add =
- Flexion = 120
- Extension = 20
- IR = 30-40
- ER = 45-60
- Abd = 45
- Add = 30
Biokinematics (PROM):
- Flexion =
- Extension =
- IR =
- ER =
- Abd =
- Add =
- Flexion = <145
- Extension = <30
- IR = 30-40
- ER = 45-60
- Abd = 45
- Add = 30
What is the resting position of the hip?
- 30 degrees flexion
- 30 degrees abduction
- slight ER
What is the closed pack position of the hip?
-full extension with abduction and IR
