Hip and Pelvis

Question 1

What are the primary functions of the hip and pelvis?

Answer 1

Anchor the axial and appendicular skeleton.

Support body weight.

Facilitate locomotion.

Question 2

Name the bones that make up the pelvis.

Answer 2

Ilium

Ischium

Pubis

Sacrum

Coccyx

Question 3

What are the key bony landmarks of the pelvis (anterior view)?

Answer 3

Iliac crest

Anterior Superior Iliac Spine (ASIS)

Anterior Inferior Iliac Spine (AIIS)

Pubic tubercle

Pubic symphysis

Question 4

What are the bony landmarks of the femur?

Answer 4

Femoral head

Femoral neck

Greater trochanter

Lesser trochanter

Intertrochanteric line (anterior)

Linea aspera (posterior)

Question 5

Describe the hip joint and its movement.

Answer 5

Type: Synovial, polyaxial, ball-and-socket.

Movements:

Flexion/Extension (Sagittal plane)
Abduction/Adduction (Frontal plane)
Medial/Lateral rotation (Transverse plane).

Question 6

What are the features of the acetabulum?

Answer 6

Lunate surface of hyaline cartilage (horseshoe-shaped).

Non-articular region of acetabular fossa filled with fat.

Acetabular labrum (fibrocartilaginous rim).

Question 7

List the ligaments of the hip joint.

Answer 7

Iliofemoral ligament (anterior)

Pubofemoral ligament (anterior)

Ischiofemoral ligament (posterior)

Ligamentum Teres (internal)

Question 8

What is the function of the iliofemoral ligament?

Answer 8

Superior band: Limits extension and adduction.

Inferior band: Limits extension and abduction.

Question 9

Describe the pubofemoral ligament.

Answer 9

Base: From the pubic eminence.

Apex: To the capsule, medial iliofemoral ligament, and intertrochanteric line.

Limits extension and abduction.

Question 10

What are the stability factors of the hip joint?

Answer 10

Strong surrounding ligaments.

Cup-shaped acetabulum, deepened by the labrum.

Strong capsule.

Vacuum effect of the ball-and-socket structure.

Arrangement of surrounding muscles.

Question 11

What are the ligaments of the sacroiliac joint?

Answer 11

Anterior sacroiliac ligament

Interosseous sacroiliac ligament

Posterior sacroiliac ligament

Question 12

What is the function of the sacrotuberous ligament?

Answer 12

Limits nutation of the sacrum.

Prevents posterior rotation of the ilium.

Question 13

What is the function of the symphysis pubis?

Answer 13

Classification: Secondary cartilaginous joint.

Contains an interpubic disc.

Supported by the superior and inferior pubic ligaments.

Allows minimal movement.

Question 14

Define femoral neck inclination and its clinical relevance.

Answer 14

Angle between the femoral shaft and neck.

Variations (e.g., coxa vara or coxa valga) can affect biomechanics and stability.

Question 15

What is acetabular anteversion and retroversion?

Answer 15

Anteversion: Acetabulum faces forward, increasing mobility but decreasing stability.

Retroversion: Acetabulum faces backward, enhancing stability but reducing mobility.

Question 16

What is nutation and counter-nutation at the sacroiliac joint?

Answer 16

Nutation: Anterior tilting of the sacrum.

Counter-nutation: Posterior tilting of the sacrum.

Question 17

What is the clinical relevance of the neck of the femur (NOF)?

Answer 17

Common site for fractures, especially in elderly individuals due to falls.

Question 18

What are the active movements of the hip joint and their range of motion?

Answer 18

Flexion: 120-130°

Extension: 10-15°

Abduction: 45°

Adduction: 20-30°

External Rotation: 40-50°

Internal Rotation: 30-40°

Question 19

What are the factors limiting the range of motion in the hip joint?

Answer 19

Tension of antagonists.

Soft tissue apposition.

Tension of ligaments.

Relative congruency of articular surfaces.

Question 20

Define the close-packed and open-packed positions of the hip joint.

Answer 20

Close-packed position: Maximum extension, internal rotation, and abduction.

Open-packed position: Slight flexion, abduction, and external rotation.

Question 21

What muscles act as hip flexors, and what are their primary innervations?

Answer 21

Iliopsoas: Anterior rami (L1-L3).

Pectineus: Femoral nerve (L2-L3).

Rectus Femoris: Femoral nerve (L2-L4).

Sartorius: Femoral nerve (L2-L3).

Question 22

Which muscles are responsible for hip extension, and what limits this movement?

Answer 22

Muscles:

Gluteus Maximus

Adductor Magnus (hamstring part)

Biceps Femoris

Semimembranosus

Semitendinosus

Limits: All ligaments and close-pack position.

Question 23

What are the primary hip abductors, and what is their clinical relevance?

Answer 23

Muscles:

Gluteus Medius
Gluteus Minimus
Tensor Fascia Lata (TFL)

Clinical Relevance: Weak abductors may result in a Trendelenburg sign or gait.

Question 24

Name the hip adductors and their nerve supply.

Answer 24

Adductor Longus: Obturator nerve (L2-L4).

Adductor Magnus:
Adductor part: Obturator nerve (L2-L4).
Hamstring part: Sciatic nerve (L4).

Adductor Brevis: Obturator nerve (L2-L3).

Pectineus: Femoral nerve (L2-L3).

Gracilis: Obturator nerve (L2-L3).

Question 25

What are the deep lateral rotators of the hip?

Answer 25

Piriformis Obturator Internus Obturator Externus Gemellus Superior Gemellus Inferior Quadratus Femoris

Question 26

Describe the boundaries of the femoral triangle.

Answer 26

Base: Inguinal ligament. Medial border: Adductor longus. Lateral border: Sartorius. Floor: Pectineus, adductor longus, and iliopsoas. Apex: Points inferiorly and continues with the adductor canal.

Question 27

What are the contents of the femoral triangle (lateral to medial)?

Answer 27

Femoral nerve Femoral artery Femoral vein Lymphatic vessels

Question 28

Which muscles perform internal rotation of the hip?

Answer 28

Gluteus Medius (anterior fibres). Gluteus Minimus (anterior fibres). Tensor Fascia Lata (TFL). Adductor Magnus. Limit: Ischiofemoral ligament and posterior capsule.

Question 29

Which muscles perform external rotation of the hip?

Answer 29

Gluteus Maximus Piriformis Obturator Internus/Externus Gemellus Superior/Inferior Quadratus Femoris Sartorius Limit: Iliofemoral ligament (lateral band).

Question 30

What are the clinical implications of weak hip flexors?

Answer 30

Weak hip flexors may result in a circumducting gait.

Question 31

What is the function of the Tensor Fascia Lata (TFL)?

Answer 31

Stabilizes the knee joint. Weak abductor and internal rotator of the hip.

Question 32

What is the clinical relevance of the Trendelenburg sign?

Answer 32

A positive Trendelenburg sign indicates weak hip abductors, leading to a pelvic drop on the opposite side during walking.