Hip

Question 1

psoas Major

Answer 1

Origin - bodies of adjacent vertebrae and discs T12-L5

Insertion - Into lesser trochanter of femur

Nerve Supply - Anterior Rami of L1,2,3

Flexion

Question 2

Iliacus

Answer 2

Origin - upper and posterior 2/3 iliac fossa and anterior sacroiliac ligament

Insertion - Lesser trochanter

Nerve - Femoral nerve

Flexion

Question 3

Pectineus

Answer 3

Origin - superior ramus of pubis, iliopubic eminence and pubic tubercle

Insertion - Pectineal line on posterior femur

Nerve - femoral nerve

Flexion and adducts

Question 4

Gluteus Maximus

Answer 4

Gluteal surface

Origin - ilium, iliac crest and posterior aspect of sacrum and coccyx

Insertion - deep part of tuberosity of femur and illiotubercel tract

Nerve - Inferior Gluteal nerve

Extension and lateral rotation

Question 5

Adductor magnus

Answer 5

Origin - Femoral surface of ischiopubic ramus and inferior ischial tuberosity

Insertion - Linea aspera and supracondylar ridge

Nerve - Obturator nerve

Adducts and extends

Question 6

Adductor longus

Answer 6

Origin - Anterior of body of Pubis

Insertion - Middle half linea aspect of femur

Nerve obturator nerve

Adduction

Question 7

Adductor brevis

Answer 7

Origin - body and inferior ramus of pubis

Insertion - upper half linea aspect of femur

Nerve - Obturator nerve

Adduction

Question 8

Gracillis

Answer 8

Origin - body and inferior ramus of pelvis

Insertion - Medial surface of tibia between sartorius and semitendinosus

Nerve - Obturator nerve

Adducts hip and flexes knee

Question 9

Gluteus medius

Answer 9

Origin - Gluteal surface of ilium and covering fascia

Insertion - lateral side of greater trochanter

Nerve - Superior gluteal nerve

Abducts and medial rotation

Question 10

Gluteus minimus

Answer 10

Origin - Gluteal surface of ilium deep to medius

Insertion - anterosuperior aspect of greater trochanter

Nerve - Superior gluteal nerve

Abductor

Question 11

Piriformis

Answer 11

Origin - front of 2nd,3rd,4th sacral segments and lateral to gluteal surface of ilium

Insertion - Upper border and medial side greater trochanter

Nerve - Anterior rami sacral plexus

Lateral rotator and abductor

Question 12

Function of Glute medius, glute minimus
(Tensor Fascia Lata)

Answer 12

Work with reversed origin insertion to maintain a level pelvis.
If left foot is raised, the muscles prevent right side dropping

Question 13

Function of the Hip

Answer 13

Maintain stability
Reverse origin insertion
adductors for gait

Question 14

Talk about the articular surfaces

Answer 14

Acetabulum :
Site of fusion of ilium, pubis and ishium
Covered with hyaline cartilage
Central part, articular fossa which is non articular to stop head of femur dislocating

Head of femur :
Covered by hyaline cartilage
Surface contact increases as load increases to distribute load and prevent excessive stress on cartilage

Only when hip is weight bearing and flexed does the inferior part of the femoral head articulate with the acetabulum

Question 15

Capsule

Answer 15

Thicker anteriorly and superiorly

Attaches to the acetabulum an distally to intertrochanteric line

Longitudinal and oblique fibres pass from acetabulum to femur

Arcuate fibres - arch from one side of acetabulum to the other

Zona Orbicularis - Deep part of the capsule there to strengthen it

Question 16

Inarticular features

Answer 16

Acetabular Labrum:
Attaches to outer surface of acetabulum to cup head of femur in the socket preventing dislocation

Ligamentum Teres:
attaches to fovea capitis and acetabular notch
Provides resistance and has a blood supply role

Acetabular fat pad :
Occupies non articular floor of acetabulum. Has nerve ending

Transverse acetabular ligament:
Bridges the notch inferiorly to complete the socket

Question 17

Movements at the hip

Answer 17

Flexion and extension
Abduction and adduction
medial and lateral rotation

Pubofemoral, iliofemoral and ischiofemoral ligaments all limit extensionby tensing.

Flexion is free

Adduction and abduction and rotations are greatest when the hip is flexed

Medial rotation the femur moves anteriorly
Lateral rotation it moves posteriorly