The Hip

Question 1

which joint connects the pelvis to the sacrum? [1]

what is the name for the joint between L5 & sacrum? [1]

Answer 1

which joint connects the pelvis to the sacrum? [1]
sacro-iliac joint

what is the name for the joint between L5 & sacrum? [1]​
lumbosacral joint

Question 2

Answer 2

Question 3

explain what is meant by the sacoiliac joint being a compound synovial joint [2]

Answer 3

explain what is meant by the sacoiliac joint being a compound synovial joint [2]

• *- anterior synovial plane joint**
• *- posteiror syndesmosis joint (**A syndesmosis is defined as a fibrous joint in which two adjacent bones are linked by a strong membrane or ligaments). stable joint !!

Question 4

anteriorly, the left and right os coxa join together where? [1]

Answer 4

anteriorly, the left and right os coxa join together where? [1]
pubic symphysis

Question 5

what are the three parts of the pelvic bone?

Answer 5

Question 6

which part of pelvic bone do you sit on? [1]

Answer 6

which part of pelvic bone do you sit on? [1]
ishial tuborisity

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9

A: ASIS (anterior superior iliac spine)
B: pubic tubercle
C: PSIS
D: ischial spine
E: ischial tuborisity
F: inferior pubic ramus

Question 10

the hip joints is an articulation between? [2]

what movements does the hip joint do? [5]

Answer 10

the hip joints is an articulation between? [2]
- femoral head & acetabulum

what movements does the hip joint do? [5]
flexion, extension
abd, add,
lateral and medial rotation
circumduction

Question 11

Hip stability is due to: ? [7]

Answer 11

1. Deep insertion of femoral head into acetabulum
2. Strong tight articular capsule, this is loose in shoulder. Attaches to greater trochanter and neck of the femur, so is a very tight fit. Gives stability yet also restricts movement
3. Ligaments around the joint capsule (especially anteriorly) which will help stabilise the hip joint in extension (the anterior ligaments).
4. Large powerful muscles around joint: single, individual most powerful muscle in the body is the gluteus maximus, and the most powerful group of muscles (quadriceps) all work to stabilise the hip joint
5. Ligament within articular capsule, ligamentum teres. This attaches the head of the femur to the acetabulum and acts as like a tether. Can also be called ‘ligament of the head of the femur’.
6. Fat pad fills central region and adds cushioning for thinnest part of acetabulum. Also helps to keep these two bones together
7. Acetabulur labrum is a fibrocartilaginous ring that helps with suction of the femur into the acetabulum. Doesn’t really add to the surface area, 10%, but acts with the synovial fluid to suction the head of the femur into the acetabulum

Question 12

where in the articular capsule of hip joint is strongest & thickest? [1]
where in the articular capsule of hip joint is thinnest and weakest? [1]

Answer 12

where in the articular capsule of hip joint is strongest & thickest? [1]
upper and anterior parts
where in the articular capsule of hip joint is thinnest and weakest? [1]
lower and posterior parts

Question 13

which is the strongest ligament around the hip joint articular capsule, which strengthens the joint? [1]

Answer 13

which is the strongest ligament around the hip joint articular capsule, which strengthens the joint? [1]
- anterior iliofemoral ligament - makes anterior side more stable than posterior

Question 14

Answer 14

Question 15

when the hip is extended, what happens to the ligament fibres? [1]
what does this do the the femur & acetabulum? [1]

Answer 15

when the hip is extended, what happens to the ligament fibres? [1]
- fibres become twisted and extended (& tighten)

what does this do the the femur & acetabulum? [1]
ligaments pull head of femur & acetabulum closer

Question 16

role of the acetabular labrum? [1]
structure of acetabular labrum? [1] - what makes rest of this? [1]

Answer 16

role of the acetabular labrum? [1]
deepens the socket - stabilises the joint more

structure of acetabular labrum? [1] - what makes rest of this? [1]
C shaped - rest is connect by transverse acetabular ligament

Question 17

ligamentum teres of acetabulum - location? role?

Answer 17

ligamentum teres of acetabulum - location?
runs from acetabulum to the femoral head

ligamentum teres of acetabulum - role?
stabilises the joint

Question 18

* the hip joint is most stable is which position ? *

Answer 18

* the hip joint is most stable is which position ? *
extension !

Question 19

what position are people sitting in for hip dislocation most likelto occur in?

Answer 19

occurs when sitting in flexion and forces pushes head of femur posteriorly, out of acetabulum

Question 20

posterior hip discolation can lead to WHICH nerve injury? [1]

what does this ^ present as? [3]

Answer 20

posterior hip discolation can lead to WHICH nerve injury? [1]
sciatic nerve

what does this ^ present as? [3]​
foot drop
loss of achilles reflex
muscle wasting of hamstring

Question 21

in order to elicit hip flexion, where will the muscles of hip joint be? [1]
in order to elicit hip extension, where will the muscles of hip joint be? [1]

in order to elicit hip adduction, where will the muscles of hip joint be? [1]
in order to elicit hip abduction, where will the muscles of hip joint be? [1]

in order to elicit hip medial rotation , where will the muscles of hip joint be? [1]
in order to elicit hip lateral rotation, where will the muscles of hip joint be? [1]

Answer 21

in order to elicit hip flexion, where will the muscles of hip joint be? [1]
anteriorly
in order to elicit hip extension, where will the muscles of hip joint be? [1]
posterioly

in order to elicit hip adduction, where will the muscles of hip joint be? [1]
medially
in order to elicit hip abduction, where will the muscles of hip joint be? [1]
laterally

in order to elicit hip medial rotation , where will the muscles of hip joint be? [1]
around hip joint
in order to elicit hip lateral rotation, where will the muscles of hip joint be? [1]
around hip joint

Question 22

Answer 22

Question 23

which is the major extensor muscle of the hip? [1]
which are the major abductor muscles of the hip? [2]
which are the lateral rotators muscles of the hip? [2]

Answer 23

which is the major extensor muscle of the hip? [1]
gluteus maximus

which is the major abductor muscles of the hip? [2]
gluteus medius and minimus

which are the lateral rotators muscles of the hip? [2]
piriformis and lateral rotators

Question 24

during locomotion, which muscles stabilise the hip? [2]
how? [1]

Answer 24

during locomotion, which muscles stabilise the hip? [2]

gluteus medius and minimus: contract to keep pelvis aligned during locomotion (otherwise, get contralateral (hip drop)

Question 25

what is iliotibial tract? [1] what movement does tensor fascia lata cause? [1]

Answer 25

_what is iliotibial tract? [1]_ **long band of fascia that runs down lateral aspect of the knee. its a thickened portion of the fascia lata** (fascia that covers the thigh) _what movement does tensor fascia lata cause? [1]_ **abductor of hip**

Question 26

the lateral rotators of the hip are innervated by which nerve supply? [3] which is the most important lateral rotator? [1]

Answer 26

_the lateral rotators of the hip are innervated by which nerve supply? [3]_ **L5, S1 & S2** _which is the most important lateral rotator? [1]_ **piriformis (**important for neurovasc landmark)

Question 27

Answer 27

``` A = gluteus medius B = gluteus maximus C = piriformis D = other lateral rotators ```

Question 28

major flexor of the hip is the WHAT muscle? [1]

Answer 28

major flexor of the hip is the **iliopsoas** muscle? [1]

Question 29

Answer 29

Question 30

anterior compartment of the thigh - cause what movement on the hip? - made by which muscles? - innervated by?

Answer 30

_anterior compartment of the thigh_ - cause what movement on the hip * *flexion** - made by which muscles? * *quadriceps** - innervated by? * *femoral nerve**

Question 31

medial compartment of the thigh - cause what movement on the hip? - made by which muscles? - innervated by?

Answer 31

medial compartment of the thigh - cause what movement on the hip? * *adduction** - made by which muscles? * *adductor longus, brevis and magnus, gracilis, pectineus and obturator externus ​** - innervated by? * *obturator nerve**

Question 32

posterior compartment of the thigh - cause what movement on the hip? - made by which muscles? - innervated by?

Answer 32

posterior compartment of the thigh - cause what movement on the hip? **extension** - made by which muscles? **gluteus maximus hamstrings** - innervated by? **hamstring - sciatic nerve**

Question 33

Answer 33

A: **flexor muscle (anterior comparment)** B: **abductor** C: **adductor**

Question 34

Answer 34

Question 35

what do we use to look at aligment of the hip?

Answer 35

**shentons line:** smooth arch from the superior pubic ramus to the inferomedial border of the neck of the femur

Question 36

where is the hip fracture here?

Answer 36

Question 37

what is blood supply to the head of femur like? which is main blood supply from?

Answer 37

which is main blood supply from: **retinacular artery**

Question 38

where do fractures commonly occur in head of femur? [2] which is more serious regarding blood supply?

Answer 38

where do fractures commonly occur in head of femur? **- head of femur (intracapsular fracture) - disrupts blood flow to the head - necrosis !! - Intertrochanteric Fractures - between trochanters. still allows blood flow**