Hip Joint Flashcards

Joint classification, how the joint achieve stability, movements and muscles, innervation and blood supply, what can go wrong and how to tell on examination.

1
Q

Classify the hip joint structurally and functionally.

A

Synovial, ball and socket.

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2
Q

What are the articulating surfaces of the hip joint?

A

Pelvic acetabulum and head of femur.

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3
Q

How does the hip joint achieve stability?

A

Acetabuluar labrum, intracapsular ligamnets, extracapsular ligaments, muscles.

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4
Q

What is the role of the acetabular labrum?

A

Deepens the acetabulum so the hemispherical head of femur fits completely.

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5
Q

Where is the intracapsular ligament?

A

From acetabular fossa to fovea of the femur.

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6
Q

What is enclosed within the intracapsular ligament?

A

Artery to the head of the femur, minor arterial supply to the joint.

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7
Q

What are the extracapsular ligaments?

A

Iliofemoral, pubofemoral, ischiofemoral.

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8
Q

Where does the iliofemoral ligament run?

A

From anterior inferior iliac spine to intertrochanteric line of femur.

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9
Q

What is the role of the iliofemoral ligament?

A

Prevents hyperextension of the hip.

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10
Q

Where does the pubofemoral ligament run?

A

From superior pubic rami to intertrochanteric line of the femur.

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11
Q

What is the role of the pubofemoral ligament?

A

Anterior and inferior support to prevent excessive abduction and extension.

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12
Q

Where does the ischiofemoral ligament run?

A

From the body of the ischium to the greater trochanter of the femur.

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13
Q

What is the role of the ischiofemoral ligament?

A

Supports posteriorly, prevents hyperextension and holds femoral head in place.

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14
Q

What are the movements of the hip?

A

Flexion, extension, abduction, adduction, internal rotation, external rotation.

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15
Q

Which muscles power flexion of the hip?

A

Iliopsoas, rectus femoris, sartorius, pectineus.

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16
Q

Which muscles power extension of the hip?

A

Gluteus maximus, semimembranosus, semitendinosus, biceps femoris.

17
Q

Which muscles power abduction of the hip?

A

Gluteus minimus, gluteus medias, piriformis, tensor fascia lata.

18
Q

Which muscles power adduction of the hip?

A

Adductor longus, adductor brevis, adductor magnus, pectineus, gracilis.

19
Q

Which muscles power internal rotation of the hip?

A

Anterior fibres of gluteus medius and minimus, tensor fascia lata.

20
Q

Which muscles power external rotation of the hip?

A

Biceps femoris, gluteus maximus, piriformis.

21
Q

What are the arteries supplying the hip?

A

Medial and lateral circumflex arteries, artery to the head of the femur, intramedullary arteries, superior and inferior gluteal arteries.

22
Q

Which nerves innervate the hip?

A

Sciatic, femoral, obturator.

23
Q

What is developmental dysplasia of the hip?

A

Congenital hip dislocation due to a shallow acetabulum. .

24
Q

What are the signs of DDH?

A

Limited abduction at hip joint, limb length discrepancy, asymmetrical gluteal or thigh skin folds.

25
Q

What is the management of DDH?

A

Pavlik harness to hold femoral head in place or surgery if no repsonse.

26
Q

What can cause dislocation of the hip?

A

Trauma, complications of THR or hemiarthroplasty.

27
Q

What is the usual direction of hip dislocation?

A

Posterior dislocation, femoral head goes posteriorly and through the inferior and posterior parts of the capsule.

28
Q

What is the clinical appearance of hip dislocations?

A

Shortened and medially rotated, sciatic nerve injury in 10-20% of cases.