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Flashcards in Hip joint Deck (68):
1

What type of synovial joint is the hip

Ball and socket

2

Where is the articular cartilage thickest

Places of weight bearing

3

What makes up the hip bone

Ilium
Ischium
Pubis

4

What structures strengthen the hip joint

Acetabular labrum,
Joint capsule,
Ligaments,
Muscles

5

What is the Acetabular labrum

Fibrocartilaginous collar attached to margin of acetabulum and increases its depth

6

Where does the joint capsule attach

Intertrochanteric line (anteriorly)

7

What part of femur is extra capsular

Posterior lateral neck of femur

8

What is the intracapsular ligament

Ligament of head of femur

9

Attachments of ligament of head of femur

Acetabular fossa to fovea of femur

10

Which artery does the ligament of head of femur enclose

Branch of obturator artery

11

What are the extra capsular ligaments

Iliofemoral (anterior and superior protection, strongest in body)
Pubofemoral (anterior and inferior protection )
Ischiofemoral (posterior protection, weakest)

12

What's the advantage of the orientation of the extra capsular ligaments

Spiral orientation so becomes tighter when joint is extended which increases stability and requires less energy to maintain standing position

13

Origin of iliofemoral ligament

Ilium, inferior to ASIS

14

Attachment of iliofemoral ligament

Intertrochanteric line in 2 places (Y shaped)

15

What does iliofemoral ligament prevent

Hyperextension

16

What does pubofemoral ligament prevent

Excessive abduction

17

Attachment of pubofemoral ligament

Iliopubic eminence and obturator membrane

18

What does ischiofemoral ligament limit

Extension at hip

19

Origin of ischiofemoral

Ischium

20

Attachment of ischiofemoral ligament

Greater trochanter

21

What is the strength of muscles and ligaments anteriorly

Ligaments are strongest
Medial flexors are fewer and weaker

22

What is the strength of muscles and ligaments posteriorly

Ligaments weakest
Medial rotators are greater in number and stronger

23

Muscles performing flexion

Iliopsoas,
Rectus femoris,
Sartorius

24

Muscles performing extension

Gluteus maximus,
Semimembranosus,
Semitendinosus,
Long head of biceps femoris

25

What determines degree of hip flexion

Whether knee is flexed - flexed increases range of hip flexion

26

Muscles performing abduction

Gluteus medius and minimus
Deep gluteals

27

Muscles performing adduction

Adductor longus, brevis and Magnus
Pectineus
Gracilis
Obturator externus

28

Muscles performing lateral rotation

Biceps femoris,
Gluteus maximus,
Deep gluteals

29

Muscles performing medial rotation

Gluteus medius and medialis
Semimembranosus
Semitendinosus

30

Articulation

Head of femur and acetabulum of pelvis

31

Innervation of HJ

Femoral nerve,
Obturator nerve,
Superior gluteal nerve,
Nerve to quadratus femoris

32

Blood supply to HJ

Majority by medial circumflex femoral artery,
Lateral circumflex femoral artery,
Obturator artery via ligament of head of femur (not enough to keep hip alive on own)

33

What separates the hip bones before age 15

Tri-radiate cartilage

34

When is fusion of hip bones complete

20-25

35

Where do the hip bones converge

Acetabulum

36

What are the extra capsular ligaments continuous with

Outer surface of joint capsule

37

Where do the medial and lateral circumflex femoral arteries anastomose

Base of femoral neck

38

What does the lateral circumflex femoral artery have to penetrate to reach the hip joint

Iliofemoral ligament
Therefore medial circumflex femoral artery provides most blood supply to HJ

39

What happens in hip replacement surgery

Plastic socket is cemented to hip bone to replace acetabulum
Stainless steel femoral stem and head to replace femur

40

When do surgical hip replacement take place

After traumatic injury
Degenerative diseases of joint

41

What are the bursae of hip joint

Trochanteric
Iliopsoas
Ischiogluteal

42

When do the bursa of hip joint become inflamed

repetitive strain or direct trauma

43

Where is the trochanteric bursa

Between gluteus maximus and greater trochanter

44

When can the trochanteric bursa be inflamed

In arthritis

45

What percentage of people have iliopsoas bursa communicating with HJ

15%

46

Where is the ischiogluteal bursa

Near ischial tuberosity

47

When can the ischiogluteal bursa become inflamed

Sitting down e.g. Horse riding and cycling

48

What are the types of hip dislocation

Acquired
Congenital

49

What percentage of congenital dislocations are bilateral

50%

50

How common are congenital hip dislocations

1.5 per 1000 births
8x more likely in girls

51

Cause of congenital hip dislocation

During development the femoral head is not placed within the acetabulum

52

Symptoms of congenital hip dislocation

Inability to abduct at hip
Affected limb is shorter
Positive trendelenburg sign

53

Consequence of congenital hip dislocation

Predisposes patient to arthritis of hip later in life

54

How common are acquired hip dislocations
Why

Uncommon
Joint is very strong and stable

55

Common cause of acquired hip dislocation

Traumatic accidents

56

Types of acquired hip dislocation

Anterior
Posterior

57

How are hip dislocations named

Position of femoral head in relation to acetabulum

58

What happens in posterior acquired hip dislocation

Femoral head tears through inferior and posterior part of joint capsule (weakest part)

59

Appearance of affected limb in posterior hip dislocation
Why does this occur

Shortened - extensors and adductors
Medially rotated - gluteus medius and minimus

60

Risk of posterior hip dislocation

Sciatic nerve can be damaged
Paralysis of hamstrings and muscles distal to knee

61

How do anterior hip dislocations occur

Excessive:
extension
abduction
lateral rotation

62

What often occurs in anterior hip dislocations

Femoral head pulls Acetabular labrum with it (anterior and inferior to acetabulum)

63

Where is margin of acetabulum incomplete
What strengthens this portion

Inferiorly (Acetabular notch)
Strengthened by transverse Acetabular ligament

64

What is a slipped upper femoral epiphysis

Fracture through epiphyseal growth plate

65

What age does a slipped upper femoral epiphysis usually occur

10-16

66

Displacement of fragments in slipped upper femoral epiphysis

Distal femur displaced superiorly and anteriorly in relation to growth plate

67

Location of iliopsoas bursa

Deep to iliopsoas

68

How does iliopsoas bursitis present

Swelling under inguinal ligament

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