The Hip

Question 1

What is the hip equivalent to the sternoclavicular joint?

Answer 1

Sacroiliac joint

Question 2

What movements can occur at the hip

Answer 2

extension flexion abduction addiction lateral and medial rotation

Question 3

When is the hip joint more relaxed?

Answer 3

When sat down, extended when standing

Question 4

What is the most powerful muscle in the body?

Answer 4

Gluteus maximus

Question 5

What is the most powerful group of muscles in the body

Answer 5

quadriceps

Question 6

what does the ligament of the head of the femur do?

Answer 6

attaches the head of the femur to acetabulum inside the joint keeping the two structures together

Question 7

What is another name for the ligament of the head of the femur

Answer 7

ligamentum teres

Question 8

What is the purpose of the fat in the joint?

Answer 8

provides cushioning for thinnest part of acetabulum filling central region

Question 9

What is the acetabular labrum?

Answer 9

fibrocartilage ring goes round joint and adds suction with synovial fluid

Question 10

Why is there so much stability in the hip?

Answer 10

deep insertion of femoral head in acetabulum, strong articulate capsule, ligament of head of femur, large powerful muscles, fat pad

Question 11

What is the role of the rotators?

Answer 11

medial and lateral rotators, medial pull on anterior side and lateral on posterior side of femur into the cup, helps stability

Question 12

what happens to the rotator fibres when sitting down and standing up

Answer 12

sitting - fibres are horizontal

standing - vertical and twist winding head of femur into cup

Question 13

What is the purpose of the greater trochanter and where is it

Answer 13

proximal femur, muscle attachment point

Question 14

What is the acetabulum made up of?

Answer 14

ischium
pubis
ilium

Question 15

What is the the rim of fibrocartilage?

Answer 15

acetabular labrum
increases acetabular articular surface by 10%
blood vessels pass into joint through notch and in ligamentum teres

Question 16

What does the pubic symphysis join!

Answer 16

2 hemi pelvises

Question 17

Where is the articular capsule strongest?

Answer 17

over anterior parts as less muscle here to strengthen it

Question 18

What is the weakest part of the articular capsule!

Answer 18

posterior as more muscle here like your gluteus maximus

Question 19

what is the strongest ligament in the articular capsule? what does it do?

Answer 19

anterior iliofemoral joint preventing excessive hip extension

Question 20

how does the anterior iliofemoral ligament change when sitting and standing?

Answer 20

sitting relaxed

standing taut

Question 21

What is seen in a dislocated hip

Answer 21

leg is shortened
medially rotated
addicted
hip joint goes posteriorly onto weakest part of capsule (thin articular iliofemoral ligament)

Question 22

What can happen to the nerves in a hip dislocation

Answer 22

sciatic nerve compressed or stretched by femur head as taken out of acetabulum and end up with nerve palsy

Question 23

why is the blood supply not really affected by hip dislocation

Answer 23

blood supply is posterior through femoral sheath under Inguinal ligament

Question 24

What nerve is responsible for hip flexion

Answer 24

femoral nerve

Question 25

which muscles allow hip flexion

Answer 25

iliopsoas (iliacus and psoas major) sartorius pectineus

Question 26

What does the sartorius do?

Answer 26

hip flexion hip abduction lateral rotation of hip

Question 27

what does pectineus do

Answer 27

addiction and medial rotation of the hip

Question 28

what is the iliopsoas made up of

Answer 28

iliacus and psoas major

Question 29

What does the psoas minor do

Answer 29

helps stabilise psoas major in hip flexion

Question 30

what are the main hip abductors

Answer 30

gluteus medius | gluteus minimus

Question 31

what is the muscle for lateral rotation

Answer 31

piriformis

Question 32

Which muscles allow hip flexion

Answer 32

quadriceps | mainly rectus femoris

Question 33

Which muscles allow hip extension

Answer 33

gluteus maximus | hamstrings assist

Question 34

what is the gluteus maximus innervated by

Answer 34

inferior gluteal nerve

Question 35

what are the hamstrings innervated by

Answer 35

tibial division of the sciatic

Question 36

which muscles allow hip abduction | what innervation

Answer 36

gluteus medius and minumus superior gluteal nerve tensor fascia lata - superior gluteal nerve

Question 37

which muscles allow hip addiction innervation

Answer 37

``` medial thigh adductor longus, adductor, adductor Magnus gracious pectineus obturator externus ``` obturator nerve

Question 38

which muscles allow hip lateral rotation

Answer 38

gluteus maximus | adductor group

Question 39

which muscles allow hip medial rotation

Answer 39

gluteus medius/minumus | tensor fascia lata

Question 40

What is an aponeurosis?

Answer 40

layers of broad flat tendons which have multiple muscles entering it

Question 41

What is the iliotibial tract

Answer 41

long aponeurosis for tensor fascia lata and superficial and anterior parts of gluteus maximus

Question 42

What is the role of the iliotibial tract

Answer 42

thickening of deep fascia from ilium to tibia stabilising lateral side of hip and knee, muscles around tightened

Question 43

how can you get IT band syndrome

Answer 43

iliotibial tract runs over laterofemoral epicondyle and gets irritated from repetitive use

Question 44

Which sites are femur fractures usually at

Answer 44

high in femoral neck - sub capital across the neck - cervical trochanteric region pretrochanteric

Question 45

where do older patients normally get fractures in the femur and why

Answer 45

across the neck cervical | osteoporosis so weaker and more brittle

Question 46

which femur fracture can affect blood supply

Answer 46

trochanteric

Question 47

what is seen in femur fractures

Answer 47

external rotation and shortened | shentons line disrupted by fracture

Question 48

what orthopaedic hardware is used for femur fractures

Answer 48

screws hip replacement compression plate

Question 49

What is the main problem as a result of a fracture to the neck of the femu

Answer 49

disruption to blood supply to femoral head and Avascular necrosis acetabular branch of obturator artery will close in most adults and becomes fibrotic so doesn't do anything but profunda femoris sends off lateral and medial circumflex around femur neck and branches to head and neck of femur, retrograde blood supply