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anatomy - physio > The hip joint > Flashcards

The hip joint Flashcards

1
Q

what is a joint?

A

an articulation or a point where 2 bones make contact to allow movement between them

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2
Q

what are the 3 classifications of a joint?

A
  1. fibrous
  2. cartilaginous
  3. synovial
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3
Q

describe fibrous joints & give an example

A
  • fibrous joints have no movements
  • the surfaces are joined by fibrous tissue
  • eg sutures in the skull
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4
Q

do cartilaginous joints have movement?

A
  • they have **slight movement **
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5
Q

what are the **differences **between primary cartilaginous and secondary cartilaginous joints?

A
  • primary cartilaginous joint is where the 2 bones are joined together by hyaline cartilage - only hyaline cartilage present
  • secondary cartilaginous joint is where 2 bones are joined together by fibrocartilage, they may also have hyaline cartilage
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6
Q

what is an example of a primary cartilaginous joint?

A
  • costochondral joints - ribcage
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7
Q

what are examples of a secondary cartilginous joint?

A
  • pubic symphysis
  • intervertebral discs
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8
Q

What is the difference in histology between hyaline cartilage and fibrocartilage

A
  • hyaline - ground substance contains glycoproteins which absorb water- therefore cartilage is more slippery
  • fibrocartilage - dense bundles of collagen fibres with little ground substance
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9
Q

Describe the 6 main features of a synovial joint

A
  • **hyaline articular cartilage **- this cartilage lines the articulating surfaces of the bone
  • capsule - sac like envelope that wraps around joint
  • joint cavity- cavity that contains synovial fluid
  • **synovial membrane ** - membrane that lines on the inside of some of the joints
  • ligaments
  • movement
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10
Q

what are the 3 main bones of the hip?

A
  1. ilium
  2. ischium
  3. pubis
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11
Q

what are the 3 gluteal lines on the ilium?

A
  • posterior gluteal line
  • anterior gluteal line
  • inferior gluteal line
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12
Q

where does the** intertrochanteric crest** lie on the proximal end of the femur - anteriorly or posteriorly?

A

posteriorly

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13
Q

where does the intertrochanteric line lie on the proximal end of the femur- anteriorly or posteriorly?

A

anteriorly

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14
Q

what is the epiphysis?

A
  • ends of the long bone
  • contains the articular surface (of the joint)
  • eg head of femur
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15
Q

what is the metaphysis?

A
  • regions between the epiphysis and diaphysis
  • contains the epiphyseal growth plate
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16
Q

what is the diaphysis?

A
  • the long straight section between the ends of a long bone
  • ie the shaft of the femur
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17
Q

Briefly describe the ossification of the femur

A
  • epiphysis is present at birth and unites around 20 years of age
  • head of femur forms at 1 year
  • greater trochanter at 3/4 years
  • lessor trochanter at 12 years old
  • fusion at 18 years old
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18
Q

what is slipped capital femoral epiphysis?

A
  • a disorder of adolescents in which the **growth plate is damaged **and the femoral head moves or slips with respect to the rest of the femur
  • note that any fractures in children that effect the epiphysis or metaphysis may effect adult limb length and joint movements
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19
Q

what type of joint is the hip joint & what components make up this type of joint?

A
  • synovial ball and socket joint
  • ball = head of femur
  • socket = bony acetabulum, labrum (fibrocartilage) and the transverse ligament
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20
Q

what are the 3 main extra capsular ligaments of the hip joint that act to stabilise the joint?

A
  • iliofemoral ligament
  • pubofemoral ligament
  • ischiofemoral ligament
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21
Q

what is the proximal and distal attachment of the iliofemoral ligament?

A
  • proximal attachment - anterior inferior iliac spine - AIIS
  • distal attachment - upper and lower ends of the intertrochanteric line
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22
Q

what type of shape is the iliofemoral ligament and what is an important fact about it?

A
  • y shape
  • strongest ligament in the body
23
Q

what is the function of the iliofemoral ligament?

A
  • it functions to prevent overextension of the hip
  • it tightens during extension, which restricts extension of the hip joint
24
Q

what is the function of the pubofemoral ligament?

A

it prevents excessive abduction of the hip by tightening during extension and abduction movements

25
Q

what are the proximal and distal attachments of the ischiofemoral ligament?

A

*proximal attachment - posterior margin of the acetabulum
*distal attachment - capsule at zona orbicularis

26
Q

which extracapsular ligament is the weakest out of all 3?

A

the ischiofemoral ligament

27
Q

what is the ligament of head of femur or the ligamentum Teres?

A

an intracapsular ligament that attaches at one end to the fovea of the head of the femur and at the other end to the acetabular fossa

28
Q

what type of surfaces does the synovial membrane line in a joint?

A

it lines all non-articulating surfaces within a joint

29
Q

what are the iliac bursa?

A

sacs containing synovial fluid that are located between the iliopsoas muscle and the anterior capsule of the hip

30
Q

what are the functons of the iliac bursa?

A
  • reduces friction (where tendon rubs over bone)
  • communicates with hip joint
31
Q

what are the movements that the hip can carry out ?

A
  • flexion and extension
  • abduction and adduction
  • medial and lateral rotation
32
Q

what muscles carry out hip flexion and extension?

A
  • iliopsoas - most powerful hip flexor
  • gluteus maximus and hamstring muscles - extension
33
Q

what muscles carry out abduction of the hip?

A
  • gluteus medius and minimus
34
Q

what muscles carry out adduction ?

A
  • adductors and the muscles in the medial compartment of the thigh
35
Q

what is hiltons law?

A
  • nerves that innervate a joint also supply the muscles that move that joint and the skin covering the distal attachments of those muscles
36
Q

what nerves supply the hip?

A
  • sciatic nerve
  • femoral nerve
  • obturator nerve
  • superior & inferior gluteal nerves
37
Q

what is an important point to mention about the nerves that supply the hip and also the knee?

A
  • the same nerves supply the knee as the hip, so therefore pain in the knee joint may be referred pain fromma problem with the hip joint and vice versa
38
Q

what 2 vessels do most branches that supply the hip joint come from?

A
  • profunda femoris artery
  • internal iliac artery
39
Q

what are the retinacular arteries?

A

arteries that provide major blood supply to the femoral head

40
Q

what are clinical signs on a patient that has a hip fracture?

A
  • limb may be shortened and laterally rotated
  • however it may be minimally displaced and hard to see - important to get lots of different views on an x ray
41
Q

for an extra capsular fracture (fracture outside the hip joint capsule), what is the treatment?

A
  • to insert a **dynamic hip screw **- DHS
  • screw in the neck of the femur and it allows a very small amount of movement which can help with recovery
42
Q

for an intracapular fracture - eg head of femur, what is usually the treatment?

A
  • hip replacement - either semi or total as blood supply is disrupted and AVN may occur
43
Q

Describe a hip dislocation

A
  • hip is pushed posteriorly - requires significant force or trauma
  • may have acetabular/labral damage or sciatic nerve injury
44
Q

what is the popliteal fossa?

A

the diamond shaped space behind the knee

45
Q

what are the boundaries of the popliteal fossa?

A
  • superiorly - hamstrings - biceps femoris and semitendinous muscles
  • inferiorly - gastrocnemius
  • roof- fascia lata
  • floor - popliteus muscle, capsule of knee joint and popliteal surface of femur
46
Q

what are the contents of the popliteal fossa?

A
  • sciatic nerve
  • popliteal artery and vein
  • popliteus muscle
  • lymph nodes
  • adipose tissue
47
Q

briefly describe the pathway of the sciatic nerve

A
  • passes deep to long head of biceps femoris
  • visible between the biceps and semis
  • tibial part - hamstrings
  • common peroneal part - short head of biceps femoris
  • divies ar apex of popliteal fossa
48
Q

what are the nerve roots of the sciatic nerve?

A
  • L4-S3
49
Q

describe the pathway of the tibial nerve

A
  • runs vertically along the middle of the popliteal fossa
  • passes between the heads of the gastrocnemius muscle
  • supplies the posterior compartment of leg
50
Q

what artery is the popliteal artery a continuation of?

A

the femoral artery
* once the fa passes through the adductor hiatus, it changes its name to popliteal artery

51
Q

what is the adductor hiatus?

A

an opening in the adductor magnus muscle - which transmits the femoral artery and vein from the adductor canal in the thigh to the popliteal fossa

52
Q

Describe the pathway of the common fibular (peroneal) nerve

A
  • runs laterally, just medial to the biceps tendon
  • enters fibularius longus (muscle of lateral compartment of leg)
  • runs around the neck of the fibula
  • splits into the superifical fibular and deep fibular
53
Q

what does the superficial fibular nerve supply?

A

lateral compartment of leg

54
Q

what does the deep fibular nerve supply?

A
  • anterior compartment of leg

anatomy - physio (17 decks)

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