MSK Session 8 Flashcards
(31 cards)
What does the hip joint do?
Supports body weight in standing
Involved in locomotion
Ball and socket : large range of motion
Strong joint: takes a lot to disrupt, most stable joint in the body
What does the ligament of head of femur have?
Contains small arterial blood supply to the head of femur
What are the three hip bones? When do the begin to fuse and when is fusion complete?
i) Ilium, Ischium and Pubis
ii) Begins to fuse at 15-17 years, fusion complete by 20-25 years
Where is the margin of the acetabulum incomplete? What is this called? What is this strengthened by?
Inferiorly
Acetabular notch - strengthened bu transverse acetabular ligament
What is the acetabular labrum made of? What does it do?
Fibrocartilaginous rim attached to margin of acetabulum
Increases the articular contact area by 10% (more than 50% of head of femur fits in)
Where does the joint capsule of the hip attach anteriorly and posteriorly?
Ant - intertrochanteric line
Post - lateral part of neck is extra-capsular
What are the three ligaments that strengthen the joint capsule? Which is the weakest?
Iliofemoral
Pubofemoral
Ischiofemoral - weakest, positioned posteriorly
What are the accessory ligaments of the hip joint?
Ligament of head of femur
Transverse acetabular ligament
What protection does the iliofemoral and pubofemoral ligaments give? What does the pubofemoral prevent?
Iliofemoral - protects anteriorly and superiorly
Pubofemoral - protects ant + inf, prevents over abduction
What are the main flexors of the hip joint?
Iliopsoas - iliacus + psoas major
Rectus femorus
Sartorius
What are the main hip adductors ?
Adductor : magnus, brevis, longus
Pectineus
Gracilis
Obturator externus
What are the main hip extensors?
Gluteus maximus
Long head of biceps femoris
Semimembranosus
Semitendinosus
What are the main hip abductors?
Gluteus medius
Gluteus minimus
Tensor fasciae latae
What are the main hip lateral rotators?
Piriformis Superior gemellus Obturator internus Inferior gemellus Quadratus femoris
What is hilton’s law?
Nerve supplying a joint also supplies both the muscles that move the joint and the skin covering the articular insertion of those muscles
What are the five major nerves that supply the anterior and posterior compartments of the thigh?
1) Femoral
2) Obturator
3) Nerve to quadratus femoris
4) Superior gluteal
5) Inferior gluteal
What is the main blood supply to the hip joint?
Major source (deep femoral artery)
- medial circumflex femoral artery
- lateral circumflex femoral artery
Minor source (adult) -obturator artery (via ligament of head of femur)
What can be the problem of a fracture of the neck of femur?
Tear retinacula arteries causing avascular necrosis
What is hip dysplasia? Where and what is the problem?
Abnormal growth of the hip
Bilateral in approx half of cases
Can be dislocated at birth or sometime later
Problem with bony structures:
-Acetabulum
- Head of femur
or supporting capsule
Promblems range from:
- subluxation to dislocation
- instability
What is a slipped upper femoral epiphysis?
Fracture through epiphysis
Ages 10-16 years most affected
Rest of femur rides up and forward up relation to epiphysis
Describe features of acquired hip dislocations?
Uncommon because stable articulation Posterior dislocation in RT Capsule and acetabulum disrupted Limb shortened/medially rotated Possible sciatic nerve damage
What are the features of a femoral neck fracture?
Mainly elferly affected
Intra-capsular
Blood supply may be disrupted (circumflex arteries)
Px : shortened/externally rotated
Tx: depends on age and health»_space;> replacement if old
Describe trochanteric fractures ?
Extra-capsular
Less risk of osteonecrosis
Usually treated with a dynamic hip screw
What are the three main bursae around the hip joint?
Trochanteric bursa
Iliopsoas bursa
Ischiogluteal bursa
