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Anatomy - MSK (UL) > 9: Hip & Femur Bones > Flashcards

9: Hip & Femur Bones Flashcards

1
Q

Hip bone is formed by the union of what bones?

A

Hip bone is formed by the union of three bones-ilium, ischium and pubis.

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2
Q

At birth, bones making hip are separated -not fused yet-.
What joins those bones?

A

hyaline cartilage ((triradiate cartilage- found at acetabulum fossa- ))

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3
Q

When do the hip bones fuse (what age?)

A

Btw 20-25 yrs

“Initially, they are three separate bones joined by a hyaline cartilage, which completely fuse between 20 and 25 years of age”

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4
Q

Which surface of hip bone is related to the lower limb to which muscles attach?

A

Lateral surface

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5
Q

Cup shaped depression at a point where all bones are attached to each other

A

Acetabulum

“The three bones join to form the acetabulum (ileum, ischium, pubis)”

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6
Q

Where are the three gluteal lines found?

A

The lateral surface of ilium has three gluteal lines

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7
Q

What separates the greater sciatic notch from the lesser sciatic notch?

A

Ischial spine

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8
Q

What part of the hip bone touches the chair while sitting?

A

Ischial tuberosity

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9
Q

What landmarks of the hip bone can be felt?

A

iliac spines and iliac crest

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10
Q

What parts of the hip is felt when you put your hands on your waist?

A

iliac crest

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11
Q

What type of joint is pubic symphysis?

A

Secondary cartilaginous joint

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12
Q

Which landmark of the hip gives attachment to inguinal ligament?

A

Pubic Tubercle

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13
Q

What is formed by the ischium and pubis, and it’s covered by a membrane?

A

Obturator foramen

“Obturator foramen is formed by the ischium and pubis, which is covered by the obturator membrane”

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14
Q

What is the acetabulum or what are parts of the acetabulum?

A

Acetabular margin, lunate surface, acetabular notch

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15
Q

Where is fovea found?

A

In femur head

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16
Q

Longest bone, heaviest, not straight (tilted)

A

Femur

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17
Q

What forms lines of attachment of capsule of knee joint?

A

Femural condyles & tibia

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18
Q

On which surface is linea aspera found (anterior or posterior)?

A

Posterior surface

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19
Q

Linea aspera divides into two ….. & ……

A

Spiral line (medial) & gluteal tuberosity (lateral)

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20
Q

Triangular area enclosed by supracondylar lines found on posterior surface of femur

A

Popliteal surface

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21
Q

What angle is formed by shaft of femur ?

A

The proximal femur is bent, so that the long axis of head and neck projects superomedially forming an angle with the long axis of the shaft, which is the angle of inclination of 126°.
(The angle of inclination varies with age, sex, and development of the femur)

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22
Q

Angle of inclination in females (more or less obtuse)? Why?

A

Angle of inclination is less obtuse in female because of wider pelvis.

(Also note: The angle of inclination is very obtuse at birth, which gradually reduces to adulthood and to
old age )

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23
Q

Importance of angle of inclination?

A
  • The angle of inclination allows greater mobility of femur at the acetabulum, and the abductors and rotators attach to the greater trochanter (apex of the angle) to bring about better movement
  • The angle of inclination also brings the knee below the trunk, thus helping in walking
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24
Q

What is angle of torsion? What degree in M/F?

A

The inferior end of femur (two condyles) is rotated backwards compared to the superior end of the femur, thus forming an angle between the side-to-side axes of the superior and inferior ends called angle of torsion

(12° in females and 7° in males)

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25
Q

Why is femur prone to fracture?

A

Bcz it’s lateral to weight-bearing line, so the neck of femur bears pressure & prone to fractures

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26
Q

Pelvic fracture refer to?

A

Fractures of the hip bone are referred to as pelvic fractures (fracture of bony pelvis)

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27
Q

Hip fracture refer to?

A

The term hip fracture refers to fractures of femoral head, neck and trochanters

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28
Q

What fracture happens in sports due to sudden acceleration and deceleration? What part of bone affected?

A
  • Avulsion fractures of the hip bone
    (avulsion = pulled by tendon or ligament)
  • Happens at bony projections
    (Eg: ischial tuberosity, iliac spines, etc )
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29
Q

Decreased angle of inclination is referred to as

A

Coxa vara

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30
Q

Increased angle of inclination =

A

Coxa valga

31
Q

What is the commonest area of fracture in femur?

A

Neck

(Neck of the femur is most fractured as it is the weakest in middle-aged people, and because it forms an angle with the weight bearing line )

32
Q

Because of…………, these fractures are unstable, and impaction occurs, thus shortening the limb

A

angle of inclination

33
Q

The fracture at the proximal end of the femur such as…….. occur because of trauma

A

intertrochanteric fracture

34
Q

………… are complicated because of avascular necrosis of femoral head and ……… of neck need to be surgically fixed.

A

Intracapsular fractures

35
Q

Neck fractures lead to ……. rotation of lower limb. What complication happens?

A

Lateral (bcz lateral muscles are stronger than right)

  • disrupt blood supply to the head as the retinacular arteries from the medial circumflex artery are torn (MCA: main supplier to head)
36
Q

In the case of neck fracture, this artery is unable to provide enough blood, so the fragment undergoes avascular necrosis.

A

Artery of ligament of femoral head (supplying the proximal fragment of the head)

37
Q

What complicates inferior end of femus fractures?

A

Fractures of inferior end of the femur are complicated by separation of condyles resulting in malalignment of articular surfaces of knee joint

38
Q

Artery of ligament of femoral head originates from …… artery

A

Obturator

39
Q

What artery chiefly supply femoral head and if torn lead to osteonecrosis?

A

Medial circumflex femoral artery

40
Q

What type of joint is hip joint?

A

Multiaxial ball and socket joint stable and mobile

41
Q

What are the articular surfaces in hip joint?

A
42
Q

What is attached to fovea?

A

Ligament of head of femur

43
Q

Joint capsule of hip joint attachments:
- proximally ?
- distally ?

A
  • Proximally: it is attached to the periphery of acetabulum just outside the rim and transverse acetabular ligament
  • distally anteriorly: it is attached to the intertrochanteric line
  • distally posteriorly: (free, stops before the intertrochanteric crest on the neck, but not attached to it)
44
Q

Some deep fibers of the capsule are arranged in circular manner around the neck called…..

A

orbicular zone

45
Q

How fibers arrangement restricts extension, but not flexion? (Direction)

A

Superficial fibers anteriorly spiral downwards and laterally from the hip bone to the femur

46
Q

What are orbital zone ligaments (name them)

A

1- Iliofemoral ligament:
Located anteriorly-strongest- and prevents hyperextension
(doesn’t allow the body to fall back)

2- Pubofemoral ligament:
Antero-inferior- extends from the pubis to the iliofemoral ligament- prevents over-abduction and extension of the joint

3- Ischiofemoral ligament
Posterior-from ischium to femoral neck-weakest-spirals superolaterally , limits internal rotation

47
Q

……. and ……. pull the femoral head medially to tightly fit into the acetabular fossa

A

Ligaments and muscles

48
Q

What ligament closes the acetabular notch?

A

Transverse acetabular ligament

49
Q

Extension is limited by …… ligament

A

iliofemoral

50
Q

Abduction is limited by ….

A

pubofemoral ligament

51
Q

What are movements of hip joint

A
52
Q

the medial and lateral circumflex femoral arteries
(usually branches of the …A… but may arise from the …B…)

A

A- profunda femoris artery
B- femoral artery

53
Q

The artery to the head of the femur that traverses the ligament of the head is a branch of…?

A

Obturator A

54
Q

The main blood supply of the hip joint is from ..?

A

The main blood supply of the hip joint is from the retinacular arteries arising from the two circumflex femoral arteries, mainly from the medial circumflex, but few from the lateral circumflex.

55
Q

………. arising from the medial circumflex artery pass beneath the unattached posterior border of the joint capsule>

A

Retinacular arteries

56
Q

Decreases in the degree in this angle may indicate joint instability.

A

angle of Wiberg

-Decreases in the degree to which the ilium overlies the femoral head (the angle of Wiberg)may indicate joint instability-

57
Q

The antero-lateral direction of the axis of the acetabulum makes an angle with posterolateral direction of the axis of the femoral head and neck forming an angle of 30–40°- (what does it indicate)

A

indicates the articular surfaces of the head and acetabulum are not fully congruent in the erect (bipedal) posture

58
Q

Congenital dislocation is more common in F or M by what #?

A

It is a common abnormality (1.5/1000) in neonates, usually bilateral, and at least 8 times more in females than in males

59
Q

In congenital dislocation of hip, how dislocation happen? What movement is lost?

A

Dislocations happen when the femoral head is not there in the
acetabulum and the patient is unable to abduct the thigh

60
Q

What is Trendelenburg sign

A

In congenital dislocation of hip joint, The affected limb appears shorter, as the head moves up compared to the normal side resulting in positive Trendelenburg sign

61
Q

Why acquired dislocation of hip is uncommon?

A

It is uncommon because the joint is stable

62
Q

How can acquired hip dislocation happen?

A

It is uncommon because the joint is stable, however, in a head-on-collision when the knee hits the dashboard, or when the foot is firmly on the floor while knee extended, the femoral head is forced out of the acetabulum (eg at road car accidents)

63
Q

What type of dislocation is most common in hip?

A

Posterior dislocation is the most common, the capsule ruptures
posteriorly and inferiorly and the head goes and stays on the lateral surface of the ilium

64
Q

Complications of posterior hip dislocation?

A

This posterior dislocation can injure the sciatic nerve, thus affecting the muscles such as hamstrings, and affecting the sensory innervation in the lower limb

65
Q

Anterior hip dislocations are rare however they happen due to …?

A

Anterior dislocation occurs due to trauma to the joint when the
joint is extended, abducted and laterally rotated

66
Q

Fractures of greater trochanter and femoral shaft occur due to ….?

A

trauma such as direct hit, fall, or motor vehicle accidents

67
Q

Mcq: Which artery ruptures in a femoral neck fracture and forms the basis of avascular necrosis of the proximal end of the femur?

a. Artery of the ligaments of the femur
b. Branches of obturator
c. Branches of the superior gluteal
d. Lateral circumflex artery
e. Retinacular

A

E

68
Q

Mcq: What structure is affected in a “broken hip”? 2017

A. Pelvis
B. Fibrous capsule of hip joint
C. Acetabulum
D. Femoral neck

A

D

69
Q

Mcq: What’s the commonest fracture site in elderly?

A

Femoral neck

70
Q

Mcq: What prevents hyperextension of the hip joint while standing?

A

Iliofemoral ligament

71
Q

Mcq: What is the main blood supply to the head and neck of the femur bone?

A

Medial circumflex femoral

72
Q

Mcq: Which one is a branch of the internal iliac artery?
a. Obturator
b. superficial iliac circumflex

A

a. Obturator

73
Q

Jumping very high or if you hyperextended your hip joint will cause injury to what?

A

Hamstring’s injury

Anatomy - MSK (UL) (17 decks)

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