Week 1 - Pelvic girdle + hip joint

Question 1

Does the pelvic girdle move?

Answer 1

No

Question 2

What are the three parts of the hip bone?

Answer 2

Ilium (superior)
Pubis (anterior)
Ischium (inferior)

Question 3

Which ligaments prevent undue movement at the sacro-iliac joint?

Answer 3

Sacrotuberous & sacrospinous

Question 4

Describe the six key landmarks of the top of the femur

Answer 4

Head
Greater trochanter
Lesser trochanter
Neck
Intertrochanteric line
Crest (posterior side)

Question 5

Where do the flexors of the hip joint attach to the thigh?

Answer 5

They attach on the anterior side of the gemer, high up ear the lesser trochanter

Question 6

Are knee flexors anterior or posterior?

Answer 6

Posterior i.e. Hamstrings

Question 7

What is the linea aspera?

Answer 7

A rough line down the centre of the posterior side of the femur

Question 8

Why is the hip joint more stable than the shoulder joint?

Answer 8

It has an actual ball and socket joint, with a better fitting head and a deeper socket

Question 9

Where is the labrum of the hip joint?

Answer 9

In the acetabulum

Question 10

Where is the capsule of the hip joint?

Answer 10

Around the ring of the acetabulum

Question 11

What are the boundaries of the acetabulum?

Answer 11

The body of the ischium, body of the ilium and body of the pubis

Question 12

Describe the location of the acetabular notch

Answer 12

Found above the border of the inferior rami of the ischium and the pubis, present as the boundaries of the acetabulum don’t form a complete circle
It’s continuous with the acetabular fossa (non-articular region) at the base of the cavity

Question 13

What is the acetabular notch?

Answer 13

A deep notch in the acetabulum of the hipbone. It is converted into a foramen by the transverse acetabular ligament. Nutrient vessels and nerves enter the joint through this foraman

Question 14

How does the Ligamentum teres capitis femoris/ligament of the head of the femur attach the hip to the femur?

Answer 14

It links the fovea capitis femoris (pit in the head of the femur) to the margins of the acetabular notch

Question 15

What are the three ligaments attached to the hip capsule?

Answer 15

Iliofemoral, Ischiofemoral and Pubofemoral ligaments

Question 16

Describe the hip joint capsule in relation to the femur

-Lateral and medial

Answer 16

On the lateral side, the capsule moves from the articular surface of the hip joint, down the femur neck, then reflects back along the surface of the neck
On the medial side, the capsule attaches away from the articular surface of the hip joint, moving down the neck of the femur and again reflecting back along the neck surface
–> neck of the femur is intracapsular

Question 17

What is a major source of blood supply to the head of the femur?

Answer 17

The reflected parts of the hip joint capsule

Question 18

What is a very common hip fracture in the elderly and how can this be complicated?

Answer 18

Very common fracture is through the neck of the femur
If this tears the reflected part of the hip joint capsule, blood supply to the head of the femur is compromised and can cause avascular necrosis.

Question 19

Describe how the three main ligaments of the hip bone/capsule strengthen it?

Answer 19

They take a spiral course around the capsule to reach the femur from their specific hip bone origins, blending with the capsule.
When hip joint is fully extended, these ligaments are at maximum stretch

Question 20

Where do the hip flexors originate from?

Answer 20

The lumbar vertebrae and the iliac fossa

Question 21

What are the two main hip flexors and where do they attach to the femur?

Answer 21

Psoas major and iliacus. Share a common tendon and often referred to a iliopsoas.
Cross hip joint anteriorly, attach just below the lesser trochanter

Question 22

What are three minor hip flexors?

Answer 22

Rectus femoris, sartorius, pectineus

Question 23

Where must hip abductors pass relative to the joint?

Answer 23

Lateral side

Question 24

What are the two main hip abductors and what are their origin/insertion points?

Answer 24

Gluteus medius and gluteus minimus
Origin - outer surface of ilium
Insertion - greater trochanter

Question 25

What is the main hip extensor, and what are it’s origin and insertion points?

Answer 25

Gluteus maximus
Origin - hipbone and sacrotuberous ligament
Insertion - gluteal crest of the femur

Question 26

Describe the hamstring muscles - pattern, placement, action and origin

Answer 26

Posterior
Cross the knee to reach the tibia/fibula
Extensors of hip, flexors of knee
Common origin is the ischial tuberosity

Question 27

What are the three adductors, and what are their common origin and insertion points?

Answer 27

Three main ones: Adductor longus, adductor brevis and adductor magnus
Origin - pubis/ischiopubic ramus
Insertion - line aspera

Question 28

What are the muscles of the quadricep?

Answer 28

Rectus femoris

Three ‘vast’ femoral heads - Vastus lateralis, V.intermedius, V.medialis

Question 29

Where does the rectus femoris originate from and what does it look like on the quad?

Answer 29

Originates from the Ilium at the anterior inferior iliac spine, and crosses the hip anteriorly.
Appears as a straight, flat band

Question 30

What part of the femur do the Vastus muscles cover?

Answer 30

Almost all of the femoral shaft, except the linea aspera

Question 31

Which muscles of the quad form the common tendon attaching to the patella?

Answer 31

Rectus femoris, vastus lateralis and vastus intermedius.

Vastus medialis has muscular fibres going right down to the knee joint

Question 32

What type of bone is the patella?

Answer 32

A sesamoid bone - aka it develops within the tendon

Question 33

Describe the sartorius muscle

Answer 33

A thin muscle that originates on the lateral side of the hip and crosses the anterior thigh to insert to the tibia, crossing the knee joint.
Flexes the hip, rotates the hip and flexes knee joint

Question 34

Where do you find the Pectineus?

Answer 34

Between the iliopsoas and the adductors

Question 35

What is the TFL?

Answer 35

The tensor fasciae latae.
Tensor of the deep fascia of the thigh
Belongs to the gluteal group, is attached to the iliotibial tract

Question 36

What is the gracilis, and where do you find it?

Answer 36

A slender adductor, originating at the pubis and inserting at the upper medial tibia surface

Question 37

How many short lateral rotators of the hip joint are there and where are they?

Answer 37

There are six, found in the gluteal region. They stabilise the hip joint

Question 38

What is special about the iliofemoral ligament?

Answer 38

Supposedly one of the strongest ligaments of the body. Stops us falling over backwards when upright

Question 39

Where are the lumbar and sacral plexuses?

Which rami make these up?

Answer 39

In the abdomen and pelvis

Ventral rami of L2-S3

Question 40

Which ventral rami form the lumbar plexus?

Answer 40

L2, L3 and part of L4

Question 41

Which ventral rami form the sacral plexus?

Answer 41

Part of L4, L5, S1-S3

Question 42

What forms the lumbosacral trunk and where does this go?

Answer 42

Part of L4 and L5 ventral rami. This moves into the sacral plexus

Question 43

Where are the three nerve entry portals in the hip bone?

Answer 43

Under the inguinal ligament - Anterior to the femur
Through the obturator foramen, medial to the hip joint
Through the greater sciatic foramen. Posterior to the hip joint, looks after the gluteal nerves and sciatic nerve