LEA: Hip Joint
What is a complication of hip fractures?
*Aseptic vascular necrosis* of the femoral head.
The hip joint is located between the lower limb and the ________ ________.
Pelvic girdle
The acetabular branch of the obturator artery (and middle circumflex artery) supplies blood to?
Head and neck of the femur
What ligament resists excessive extension, lateral rotation and adduction?
Iliofemoral ligament (*the upper band*)
What is the significance of retinacula?
It *covers and protects blood vessels* which travel into the vascular foramina.
What does the hip joint articulate with?
It articulates between the acetabulum of the os coxae and the head of the femur.
Where is hyaline cartilage the thickest in the hip joint? Why?
It is thickest *anterosuperiorly* where weight transfer is the greatest.
Where does the iliofemoral ligament begin and end?
It starts from: the iliac part of the acetabular rim and AIIS to: the greater trochanter and upper band of the iliofemoral ligament (iliotrochanteric band)
Where does the pubofemoral ligament begin and end?
It starts from: the pubic portion of the acetabular rim, obturator crest, iliopubic eminence, and obturator membrane to: the femur anterior to the lesser trochanter, neck and iliofemoral ligament
The anterior weak area of the hip joint will be strengthened by the tendon of what muscle?
Psoas major (Dr. Washburn) Iliopsoas (in the book)
The deeper fibers of the hip joint capsule that are reflected onto the femoral neck (and reflection of synovium) and transmit blood vessels to the head and neck are called?
Retinacula
What are the proximal attachments of the joint capsule (so at the hip bone)?
Rim of the acetabulum External surface of labrum Transverse acetabular ligament.
In posterior hip dislocation the head of the femur is driven posteriorly (obviously) out of the acetabulum. What movements cause this?
The it is because the hip is *flexed, adducted, and medially rotated.*
What are the bony components of the hip joint?
The lunate surface and the head of the femur.
The iliofemoral ligament is also known as the...
Y ligament of Bigalow
The ischiofemoral ligament (flexed hip) resists:
excessive extension, medial rotation, and adduction.
The acetabular fossa is filled with ____ ____.
fat pad. (softness permits it to occupy the ever-changing space of the joint)
Of the three capsular ligaments of the hip joint, which is the strongest?
iliofemoral
The hip joint capsule encloses the joint completely and most of the femoral neck except the...
posterior 1/3.
iliofemoral is to anterior as ischiofemoral is to __________ and pubofemoral is to __________.
posterior;medial
All the three capsular ligaments of hip joint are ______ in ___________ and ________ in extension.
slack;flexion;tense
The femur articulates with....
the *lunate surface of the acetabulum* of the os coxae.
Hyaline cartilage covers most of the femoral head except for...
the fovea.
When the knee is extended, active flexion of the hip is at about ____°, while with the knee flexed it is at about ____°. Passive flexion of the knee allows the hip to move at about ____°
70°;130°,150°
Abduction-Adduction happens in what axis and plane?
Anterior-posterior axis and Coronal (frontal) plane.
Hip fractures are usually ______ ____ fractures.
Femoral neck
By what nerve(s) are the hip joint capsule and ligaments innervated by?
Femoral, obturator, nerve to quadratus femoris and superior gluteal nerves
What kind of motion can occur in the medial-lateral axis of the hip joint? What plane is it?
Flexion and extension occur in this axis, this is done in the sagittal plane.
What are the *anterior distal attachments* of the joint capsule (at the femur)?
Greater trochanter Intertrochanteric line Tubercle of the femur Femoral neck
The pubofemoral ligament resists excessive extension and ________.
Abduction.
What are the three intracapsular structures of the hip joint?
1. transverse acetabular ligament (part of the labrum) 2. ligament of the head of the femur 3. acetabular labrum or rim
When the knee is extended the hip can be actively extended to ____°. When but what happens when the knee is flexed?
10°; mobility disappears when knee is flexed.
One can passively extend the hip to about ____°-____°. What muscle limits active hip extension?
20°-30°. The quadriceps limit the active hip extension.
The femur can move in about __ cardinal axes and __ cardinal planes. This makes motion about the hip joint _________.
3;3;multiaxial/triaxial
Why does flexion and extension of the hip depend on the position of the knee?
Because the hamstrings and rectus femoris cross both joints.
Where is the hip joint the weakest?
Between the pubofemoral and iliofemoral ligament (anteriorly) and posteriorly where the zona orbicularis is exposed.
Hip fractures will usually tear what vasculature?
Branches of the *medial circumflex femoral artery* frequently are torn.
The hip joint has more than three surfaces. This makes it a __________ joint.
Compound (3 bones of acetabulum and femoral head)
What are the *posterior distal attachments* of the joint capsule (at the femur)?
Covers the *femoral neck 1cm medial to the intertrochanteric crest* (no real bony attachement).
In what movement is the hip joint most stable?
Extension
What is the (most important) blood supply to the hip joint?
Medial circumflex femoral artery.
What motion can occur in the tranverse plane? What axis is that?
Medial-lateral rotation (internal-external). This occurs in the longitudinal axis (vertical/superoinferior)
What type of joint can the hip joint be classified as?
Synovial, ball and socket joint ("spheroid joint")
What ligament begins at the ichial part of the acetabular rim to the superomedial aspect of the greater trochanter and upper band of the iliofemoral ligament?
The ichiofemoral ligament
