Hip Flashcards

2
Q

Classify the hip joint according to type and complexity

A

Synovial

Simple

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3
Q

Classify the hip joint according to shape and degrees of motion

A

Unmodified ovoid

3 degrees

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4
Q

Hip osteokinematics (mechanical axis)

A

Transverse axis through femoral neck

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5
Q

Hip osteokinematics (available movements and axis of movement)

A

Flex/extn - sagittal plane, transverse axis

Abd/add - coronal plane, sagittal axis

Int rot/Ext rot - transverse plane, vertical axis

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6
Q

Hip arthrokinematics (for each movement)

A

SPIN

Flex/extn

GLIDES

Abd - inferior

Add - superior

Int rot - posterior

Ext rot - anterior

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7
Q

What deepens the acetabulum and what is it made of?

A

The acetabular labrum (triangular fibrocartilaginous rim)

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8
Q

Where is the acetabulum deficient and why?

A

Labrum is deficient inferiorly for the acetabular notch (transverse acetabular ligament bridges it)

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9
Q

Where does the hip capsule attach to the labrum and what does it create?

A

Attaches at its peripheral base (creates a circular recess)

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10
Q

Describe the shape of the femoral head

A

Ellipsoid, convex 2/3 sphere with hyaline cartilage

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11
Q

Why is there a fovea in the femoral head?

A

Fovea for ligamentum teres

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12
Q

Describe the direction of the femoral head and the neck angle

A

Directed superior, anterior, medial

Femoral neck angle 120-125deg

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13
Q

Where is the articular cartilage thickest in the hip joint?

A

Thickest at anterosuperior acetabulum and anterolateral femoral head

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14
Q

Does articular cartilage cover of the neck of the femur?

A

Covers small area of intraarticular part of the neck of femur

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15
Q

Where is the hip capsule thickest and thinnest?

A
  1. Strong and dense
  2. Thickest anterosuperiorly and lax/thin posteroinferiorly
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16
Q

Where does the hip capsule attach proximally?

A

To bone (5mm beyond acetabular labrum) and the transverse acetabular ligament

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17
Q

Where does the capsule attach distally?

A

Anteriorly to trochanteric line and posteriorly to femoral neck above trochanteric crest

18
Q

Describe the orientation of the layers of hip joint capsule (external and internal)

A

External = longitudinally oriented

Internal = circularly oriented

19
Q

Describe the Zona orbicularis of the hip

A

Encircles proximal femoral neck, indents the synovium, no bony attachment

20
Q

What does the zona orbicularis of the hip do?

A

Divides synovial cavity into medial and lateral recess

21
Q

Describe the shape and direction of the acetabulum

A

Roughly concave and hemispheric

Projects anterolaterally and inferiorly

22
Q

Describe the central fossa of the acetabulum (3)

A

Central fossa

  • non-articular
  • filled with loose areolar tissue
  • covered with synovium (fat pad) for proprioception
23
Q

Where is the acetabulum broadest?

A

Broadest superiorly (resist WB)

24
Q

Hip nerves (segmental, peripheral, other)

A

L2-S1

Peripheral (obturator nerve and branches) - to capsule and intraarticular structures

Other - Accessory articular branches of femoral, superior gluteal and sciatic nerves supply each muscle crossing the hip

25
Q

What arteries supply the hip joint?

A

Femoral arteries

  • medial circumflex
  • lateral circumflex

Foveal artery

26
What contribution does the foveal artery make?
Small contribution Avoid avascular necrosis of femoral head with disruption of circumflex arteries
27
What are the two important anastomoses of the hip?
Anastamoses - Cruciate - Trochanteric
28
What are the bursae of the hip? (and where are they located)
BURSAE - Greater trochanteric - Gluteofemoral (between gluteus maximus and linea aspera) - Ischial/ischiogluteal (between gluteus medius and ischial tuberosity) - Iliopectineal (separates external hip joint capsule and iliopsoas) - Psoas (psoas and lesser trochanter) - Iliac (insertion of iliopsoas into lesser trochanter)
29
What muscles internally rotate the hip?
Gluteus minimus and medius with hip extended TFL Semitendinosis Semimembranosus
30
What muscles ABduct the hip?
TFL Gluteus medius Gluteus minimus
31
What muscles ADduct the hip?
Adductors - magnus - longus - brevis Gracilis Pectineus
32
What muscles flex the hip?
Iliopsoas Sartorius Rectus femoris TFL Pectineus
33
What muscles extend the hip?
Gluteus maximus Semitendinosus Semimembranosis Biceps femoris
34
What are the 6 deep muscles that externally rotate the hip?
Deep - Piriformis - Gamellus superior and inferior - Obturator internus and externus - Quadratus femoris
35
What other 4 muscles externally rotate the hip?
Other - Gluteus maximus (lower fibres) - Gluteus medius and minimus when hip is flexed - Psoas maj/min - Sartorius
36
What is this hip ligament (#1)?
Pubofemoral ligament
37
What is this hip ligament (#2)?
Iliofemoral ligament (Y-shaped - iliotrochanteric and inferior band)
38
What is this ligament (#3)? (Posterior view)
Ischiofemoral ligament
39
What intraarticular ligaments are in the hip?
Ligamentum teres Transverse acetabular ligament