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MED221A/B Lectures > MSK 22 - Hip joint > Flashcards

MSK 22 - Hip joint Flashcards

1
Q

what bones form the acetabulum - what parts do they make up

A

ilium (superior part)
ischium (posterior part)
pubis (anterior part)

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2
Q

what is the lunate surface of the hip joint

A

the rim of cartilage that covers most of the articular surface

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3
Q

what is the surface that gets worn out in OA

A

lunate surface

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4
Q

what is the acetabular fossa and what is different about its structure

A

central area

doesnt have cartilage over bone

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5
Q

what fills the acetabular fossa

A

fat

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6
Q

the acetabular fossa has a blood vessel that is inside a ligament

what is the name of the ligament and blood vessel

A

ligamentum teres

branch of obturator artery

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7
Q

what does the ligamentum teres do

A

connect acetabular fossa to fovea of femoral head

prevents hip dislocation

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8
Q

what does the obturator artery do

A

in infancy supplies blood to femoral head but overtime as an adult it atrophies and supplies very little blood

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9
Q

where is the transverse acetabular ligament located

A

between the 2 ends of the lunate surface

covers acetabular notch inferiorly where there is no cartilage

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10
Q

what does the transverse acetabular ligament do

A

suspends femoral head in acetabulum

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11
Q

what does the acetabular labrum do for the hip joint

A

increases articular area

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12
Q

how is the femoral neck directed

A

superomedially and slightly anteriorly in its articulation with the acetabulum

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13
Q

what is the bony ridge that runs between the 2 trochanters of the femur

A

intertrochanteric line

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14
Q

what does the angle of the femur allow

A

greater mobility at the hip joint and puts force through the femoral neck

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15
Q

where is most of the force on the femoral neck and what is the structural difference here to address this

A

on lower half of neck

the inferior part of the neck is thicker to support the weight transmitted through the head

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16
Q

what is the role of the joint capsule at the hip

A

hold things together tightly to prevent dislocations

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17
Q

where does the joint capsule of the hip joint attach to on the pelvis and femur

A

proximally attach to acetabulum and transverse acetabular ligament

distally into intertrochanteric line of femur

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18
Q

how many parts/ligaments does the joint capsule of the hip have

A

3

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19
Q

what is the orbicular zone of the hip joint capsule created by

A

created by fibres that circle around the femoral head

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20
Q

the fibres of the hip joint take a spiral course what does this mean when you move the thigh in flexion and extension

A

the fibres are tightened as you extend the thigh and unwind when you flex the thigh

this allows more flexion than extension

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21
Q

the thicker parts of the joint capsule of the hip also have what role when regarding the femoral head

A

pulls femoral head medially into the acetabulum

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22
Q

what 3 muscles are responsible for hip flexion

A

iliopsoas

rectus femoris

sartorius

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23
Q

what myotome levels and nerves are involved in hip flexion

A

L2 and L3

femoral nerve

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24
Q

what 2 muscles are responsible for hip extension

A

gluteus maximus

hamstrings

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25
Q

what myotome levels and nerves are involved in hip extension

A

L4, L5 and S1

tibial nerve L4-S1 and inferior gluteal nerve L5-S2

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26
Q

what 5 muscles are responsible for hip adduction

A

adductor magnus

adductor longus

adductor brevis

pectineus

gracilis

27
Q

what myotome levels and nerves are involved in hip adduction

A

L2-4

obturator nerve

28
Q

what 5 muscles are responsible for hip adduction

A

gluteaus medius

gluteus minimus

tensor fascia lata

piriformis

sartorius

29
Q

what myotome levels and nerves are involved in hip abduction

A

L5 and S1

superior gluteal nerve L4-S1

30
Q

what are the 2 arteries that supply the hip joint

where do they branch off from

A

medial and lateral circumflex arteries

branch off from profunda femoris artery

31
Q

the two circumflex arteries form anastomoses with which arteries

A

with the superior and inferior gluteal arteries and minor anastomoses with the obturator artery

32
Q

where do the medial and lateral circumflex arteries run relative to the femoral neck

A

medial artery runs posteriorly around the femoral neck

lateral artery runs anteriorly around the femoral neck

33
Q

femoral artery gives off profundal femoris branch at what level

A

at level of neck of femur

34
Q

the femoral artery extends down which side of the leg and how does it travel down from the thigh to the leg

A

extends down the medial side of the leg

until it joins the adductor hiatus where it then goes posteriorly into the popliteal region

35
Q

what do the perforating arteries of profunda femoris artery supply

A

muscles of anterior thigh

branches of the perforating arteries also supply the posterior part of leg

36
Q

what arteries come off the internal iliac artery

A

gluteal arteries

37
Q

what vessels come off the circumflex arteries

A

retinacular arteries

38
Q

how do the retinacular arteries travel

A

off the circumflex arteries to pierce the capsule and run in the retinacular folds of synovial membrane and up into the femoral head

39
Q

what does the retinacular arteries supply

A

femoral head and neck

40
Q

what is hiltons law

A

nerves supplying a joint come from any that cross it or any that supplies muscles that cross the joint

41
Q

which 5 nerves supply the hip joint

A

femoral nerve

obturator nerve

superior gluteal nerve

nerve to QF

sciatic nerve

42
Q

what muscle is supplied by the femoral nerve

A

iliacus

43
Q

what group of muscles is supplied by the obturator nerve

A

medial compartment adductors

44
Q

what muscle is supplied by the superior gluteal nerve

A

gluteus medius

45
Q

what part of the hip joint is supplied by the nerve to QF

A

the posterior portion

46
Q

is bone more sensitive to ischemia or is cartilage

why is this

A

bone is more sensitive to ischaemia as cartilage does not rely on blood supply and can still get nutrients from the synovial fluid

47
Q

ischaemic bone develops what condition

A

avascular necrosis

48
Q

what are the 5 types of femur fractures and which are intra/extracapsular

A

capital (intracapsular)

subcapital (intracapsular)

transcervical (intracapsular)

intertrochanteric (extracapsular)

subtrochanteric (extracapsular)

49
Q

which of the 5 femur fractures are most dangerous

A

the intracapsular fractures capital, subcapital and transcervical

50
Q

why are intracapsular fractures dangerous

A

they involve the blood supply to femoral head and prevent retinacular artery from getting to the head

51
Q

what is a capital femur fracture

A

through the femoral head

52
Q

what is a subcapital femur fracture

A

base of femoral head

53
Q

what is a transcervical femur fracture

A

across neck of femur

54
Q

what are the risks of a DHS

A

might put nails and screws too far in the femur and hit the profunda artery

55
Q

most hip dislocations are in which direction

A

posterior

56
Q

where does the femoral head land in posterior dislocation

A

superiorly

57
Q

what is the mechanism of a posterior hip dislocation - what position does this normally happen in

A

flexed hip that is adducted and internally rotated

58
Q

how is the leg oriented after sustaining a posterior hip dislocation

A

internally rotated

59
Q

what are the associated structures that could be damaged by a hip dislocation

A

soft tissue an joint capsule

risk of avascular necrosis from arterial damage

60
Q

why are hip joint dislocations common after hip joint replacement

A

youve cut through the fascia lata to get to hip joint so less stable post op

61
Q

what is the mechanism of an anterior hip dislocations

A

forceful abduction with external rotation of leg

62
Q

where does the femoral head end up in a anterior hip dislocation?

A

inferior to pelvis

63
Q
A

MED221A/B Lectures (23 decks)

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