Lecture 12: Hip and Knee Joints Flashcards Preview

04. MSK Exam 2 Final > Lecture 12: Hip and Knee Joints > Flashcards

Flashcards in Lecture 12: Hip and Knee Joints Deck (32)
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1

What makes up the hip joint?

Femoral Head and Acetabulum of Pelvis

Ball and Socket 

2

What three bones fuse to make up the acetabulum?

Ilium

Ischium 

Pubis

3

What is the femur mostly covered with?

Articular Cartilage 

4

Calcar Femorale

Where is this found?

What does it do?

  • Location: Vertical plane of bone on posterior aspect of femur and is deep to lesser trochanter
  • Function: Helps determine if fractures are stable of not

5

Iliofemoral Ligament

What are its attachments?

What does it do?

  • Attachments: ASIS to the middle of greater and lesser trochanter of femur (B/t femur and ilium) 
  • Function: Prevents hyperextension of thigh

 

Strongest Hip Ligament 

6

Pubofemoral Ligament

What are its attachments?

What does it do?

  • Attachments: Superior pubic ramus to lesser trochanter of femur (B/t femur and pubis) 
  • Function: Prevents hyperabduction of thigh

 

Blends with Iliofemoral Ligament

7

Ischiofemoral Ligament

What are its attachments?

What does it do?

  • Attachments: Lower part of Ischium to femoral neck
  • Function: Limits internal rotation of hip

Weakest of all hip ligaments: why posterior hip injuries are most common

8

Ligamentum Teres (Ligament of Head of Femur)

What is its attachments?

What is its function?

  • Attachments: Goes from the fovea of the head of the femur to the acetabulum
  • Function: Holds head of the femur into the joint and provides blood supply

9

Acetabular Labrum

Where is it found?

What does it do?

  • Location: Ring of cartilage that surrounds acetabulum on the rim
  • Functoin: Deep pocket for the head of the femur

Anterior portion is most vulnerable when the labrum tears

10

Transverse Acetabular Ligament

What are its attachments?

What does it do?

  • Location: Bridges Acetabular notch
  • Function: Covers acetabular notch and prevents dislocation inferiorly 

11

What artery supplies the acetabulum?

Anterior and Posterior Branch of Obturator Artery

 

12

What arteries supplies the head of the femur?

  • Acetabular Branch of Obturator Artery 
    • Runs with Ligamentum Teres
  • Lateral Femoral Circumflex Artery (mostly anterior side)
    • Ascending, Transverse, and Descending Branches
  • Medial Femoral Circumflex Artery (mostly posterior side)
  • Retinacular Arteries 

13

What does Hilton's Law state?

Nerves supplying muscles that diretly overly a joint also innervate that joint 

14

What would you palpate on the hip?

Anterior

  • Iliac Crest
  • Greater Trochanter of Femur
  • Pubic Tubercle

Posterior

  • Iliac Crest
  • PSIS
  • Greater Trochanter
  • Ischial Tuberosity 

15

FADIR Test

How do you perform this test?

What does a positive test indicate?

  • Flex hip to 90o
  • Adduct
  • Internally Rotate

Positive test (groin pain) indicates labral pathology/Femoroacetabular Impingement (FAI)

16

What is a Cam Impingement?

(Type of FAI Impingement)

  • Femoral head is not perfectly round and cannot rotate smoothly inside the acetabulum.
    • Results from a bump formed from excess bone growth at the end of the femur.
  • During movement, the bump grinds the cartilage inside the acetabulum.

17

What is a Pincer Impingement?

(Type of FAI Impingement)

  • Acetabulum is excessively deep or covers too much of the femoral head.

    • Often results from excess bone growth that extends out over the normal rim.

  • Overhang can impinge the neck of the femur and tear labrum

18

Patrick's FABER Test

How do you perform this test?

What does a positive test indicate?

  • Flex
  • Abduct
  • Externally rotate 

Positive test (pain) indicates iliopsoas issues or SI pain

19

Log Roll Test

How do you perform this test?

What does a positive test indicate?

  • Patient supine
  • Internally and Externally rotate 

Positive test (pain) helps indicates possible hip fracture

20

Thomas Test

How do you perform this test?

What does a positive test indicate?

  • Patient supine
  • Drops contralateral leg off table and pulls tested leg to chest

Positive test (contralateral thigh raises off thigh) indicates flexion contracture of hip.

21

Ober's Test

How do you perform this test?

What does a positive test indicate?

  • Patient lateral recumbent with affected side up
  • Extend hip/flex knee and allow to drop

Positive test (affected leg not passing neutral adduction) indicates IT Band tightness.

22

Stinchfield Test

How do you perform this test?

What does a positive test indicate?

  • Patient supine
  • Resist hip flesion with straight leg

Positive test (pain) helps indicates intraarticular pathology.

23

Hip dislocations 

What direction and position is it most likely?
 

Posterior (90% cases)

Flexed hip more susceptile to dislocation because of capsular laxity 

24

Why do hip fractures need to be treated immediately?

The blood supply to femoral head will be compromised

25

Lateral Collateral Ligament (LCL)

What are its attachments?

What does it do?

  • Location: Lateral epicondyle of femur to head of fibular
  • Function: Prevents femur gliding laterally over tibia and fibula; Resists Varus Stress

 

Ropey Like

26

Anterolateral Ligament (ALL)

What are its attachments?

What does it do?

  • Location: Lateral Femoral Epicondyle to Gerdy's tubercle on tibia
  • Function: Rotational stability to knee

Much bigger than LCL

27

What is a Segond Fracture?

Avulsion of ALL from tibial insertion 

28

Medial Collateral Ligament (mCL)

What are its attachments?

What does it do?

  • Location: Medial epicondyle of femur to proximal tibia
  • Function: Prevents femur gliding medially over tibia and fibula; Resists Valgus Stress

Weaker than LCL

29

Meniscus

What does it do?

What ligament connects the lateral and medial meniscus?

 

  • Optimizes force transmission across knee
    • Shock absorption
  • Can help with knee stabilization
    • Especially if ACL is deficient
  • Lateral and medial meniscus are connected by Inter meniscal ligament

30

Anterior Cruciate Ligament

What are its attachments?

What does it do?

  • Location: Anterior Intracondylar Eminence to Medial aspect of lateral femoral condyle
  • Function:
    • Prevent Hyperextension of the knee
    • Prevents posterior movement of femur on tibial plateu when flexing

Moves posteriorally, superiorally, laterally