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Questions and Answers
What is the shape of the articular surfaces of the hip joint, and what cartilage covers them?
What is the shape of the articular surfaces of the hip joint, and what cartilage covers them?
The articular surfaces of the hip joint are cup-shaped, and they are covered by hyaline cartilage.
Describe the structure and function of the ligamentum teres in the hip joint.
Describe the structure and function of the ligamentum teres in the hip joint.
The ligamentum teres is a ligament that extends from the fovea of the femur to the acetabulum, playing a role in stabilizing the head of the femur.
How does the fibrocartilaginous acetabular labrum contribute to hip joint stability?
How does the fibrocartilaginous acetabular labrum contribute to hip joint stability?
The acetabular labrum deepens the socket of the acetabulum, enhancing the stability of the hip joint by increasing the surface area of contact.
What are the primary components of the joint capsule in the hip joint?
What are the primary components of the joint capsule in the hip joint?
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What is the significance of the low coefficient of friction in cartilage compared to ice?
What is the significance of the low coefficient of friction in cartilage compared to ice?
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What is the primary action of the iliopsoas muscle group and what nerves supply them?
What is the primary action of the iliopsoas muscle group and what nerves supply them?
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What is the origin and insertion of the adductor magnus muscle, and which nerves innervate it?
What is the origin and insertion of the adductor magnus muscle, and which nerves innervate it?
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Describe the origin and action of the piriformis muscle.
Describe the origin and action of the piriformis muscle.
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Which muscles contribute to the hip flexion, and what is their common insertion point?
Which muscles contribute to the hip flexion, and what is their common insertion point?
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What differentiates the actions of the iliacus from the psoas major?
What differentiates the actions of the iliacus from the psoas major?
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What is the classification of the acetabulofemoral joint?
What is the classification of the acetabulofemoral joint?
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What bony features fuse to form the innominate bone?
What bony features fuse to form the innominate bone?
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Describe the main movements available at the hip joint.
Describe the main movements available at the hip joint.
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What is the significance of the acetabular foramen?
What is the significance of the acetabular foramen?
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How do the capsular and intra-capsular ligaments function in the hip joint?
How do the capsular and intra-capsular ligaments function in the hip joint?
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What is unique about the fovea capitis on the femoral head?
What is unique about the fovea capitis on the femoral head?
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What role do the muscles surrounding the hip joint play?
What role do the muscles surrounding the hip joint play?
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Which surfaces of the femur articulate with the acetabulum?
Which surfaces of the femur articulate with the acetabulum?
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What are the primary blood and nerve supplies to the hip joint?
What are the primary blood and nerve supplies to the hip joint?
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What is the range of flexion available at the hip joint?
What is the range of flexion available at the hip joint?
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What is the shape of the articular surfaces in the hip joint?
What is the shape of the articular surfaces in the hip joint?
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Describe the attachments of the fibrous capsule in the hip joint.
Describe the attachments of the fibrous capsule in the hip joint.
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What is the role of the synovial membrane in the hip joint?
What is the role of the synovial membrane in the hip joint?
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What is the common origin of the hamstrings, and how do they contribute to hip stability?
What is the common origin of the hamstrings, and how do they contribute to hip stability?
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Identify the ligaments that enhance the stability of the hip joint capsule.
Identify the ligaments that enhance the stability of the hip joint capsule.
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What actions do the long head of the biceps femoris perform at the hip and knee joints?
What actions do the long head of the biceps femoris perform at the hip and knee joints?
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How does the iliofemoral ligament contribute to hip joint stability?
How does the iliofemoral ligament contribute to hip joint stability?
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What movements does the ligamentum teres primarily support for the hip joint?
What movements does the ligamentum teres primarily support for the hip joint?
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Describe the nerve supply for the semimembranosus and semitendinosus muscles.
Describe the nerve supply for the semimembranosus and semitendinosus muscles.
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Explain the role of the gluteus maximus in hip movement.
Explain the role of the gluteus maximus in hip movement.
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What function do the deep fibers of the reflected head of rectus femoris serve in the hip joint?
What function do the deep fibers of the reflected head of rectus femoris serve in the hip joint?
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What is the role of the sartorius muscle in hip joint movement?
What is the role of the sartorius muscle in hip joint movement?
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What are the origins and insertions of the gracilis muscle, and its main actions?
What are the origins and insertions of the gracilis muscle, and its main actions?
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Discuss the significance of the acetabular labrum in hip joint stability.
Discuss the significance of the acetabular labrum in hip joint stability.
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Where does the gluteus medius muscle originate, and what are its primary actions?
Where does the gluteus medius muscle originate, and what are its primary actions?
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What impact can a rupture of the joint capsule have on the hip joint?
What impact can a rupture of the joint capsule have on the hip joint?
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Identify the nerve supply for the gluteus maximus and its innervation levels.
Identify the nerve supply for the gluteus maximus and its innervation levels.
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Describe the function of the transverse acetabular ligament in the hip joint.
Describe the function of the transverse acetabular ligament in the hip joint.
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What is the primary role of the ischiofemoral ligament in hip joint movement?
What is the primary role of the ischiofemoral ligament in hip joint movement?
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How does the iliopubic eminence relate to the pubofemoral ligament?
How does the iliopubic eminence relate to the pubofemoral ligament?
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Mention a key feature of the ligament of the head of the femur.
Mention a key feature of the ligament of the head of the femur.
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Study Notes
Hip Anatomy Study Notes
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Learning Outcomes:
- Students should be able to identify key bony features around the hip joint and describe them on X-rays.
- State the shape of the articular surfaces of the hip joint and describe capsule and synovium attachments.
- Describe the capsular and intracapsular ligaments of the hip joint and their role in limiting movement.
- Describe the functions of hip muscles in terms of attachments, actions, nerve supply, and stability.
- Describe the blood and nerve supply to the hip joint and its importance in relation to hip fractures.
Acetabulofemoral Joint
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Classification: Synovial ball and socket joint
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Movements: Flexion, extension, abduction, adduction, medial and lateral rotation
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Planes of Movement: Sagittal, frontal, transverse, and multiaxial (medial-lateral, anterior-posterior, superior-inferior)
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Stability: Deep structure enhances stability but compromises mobility
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Bony Landmarks (Acetabulum):
- Ilium
- Ischium
- Pubis
- Fuse to form the innominate bone
- Acetabulum, iliac crest, ASIS, AIIS, PSIS, PIIS, Greater Sciatic Notch, Ischial Spine, Ischial Tuberosity, Superior Pubic Ramus, Pubic Tubercle, Inferior Pubic Ramus, Obturator Foramen
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Bony Landmarks (Femur):
- Head
- Neck
- Greater Trochanter
- Lesser Trochanter
- Shaft
- Linea aspera
- Intertrochanteric line
- Intertrochanteric Crest
- Greater/Lesser Trochanter
- Fovea Capitis
- Trochanter; Greek for running, muscles attach here
Articular Surfaces
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Shape: Lunate (moon shaped) surface of the acetabulum
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Cartilage: Covered by articular cartilage
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Acetabular Fossa: Nonarticular, contains fat, vessels, nerves
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Acetabular Foramen: Gap allowing nerve and artery to the joint; bridged by transverse acetabular ligament
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Femoral Head: Articulates with the lunate surface -Covered with articular cartilage -Except for the fovea capitis (Ligamentum Teres)
Cartilage Coefficient of Friction
- Around 0.002-0.01 (ice 0.2-0.5)
Acetabular Hyaline Cartilage
- Forms 2/3 of the femoral head in contact with the acetabulum
Acetabular Labrum
- Fibrocartilaginous lip, significantly improves joint stability
Hip Joint Capsule
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Strength: Very strong and fibrous covering the head and neck of the femur
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Attachments:
- proximally, the acetabulum and transverse acetabular ligaments
- distally, the neck of the femur anteriorly
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Synovial Membrane: Lines fibrous capsule, covers acetabular labrum, secretes synovial fluid
Hip Joint Stability
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Anteromedially: Strengthened by deep fibres of reflected head; rectus femoris
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Laterally: Strengthened by deep fibers from gluteus minimus
Capsular Ligaments
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Iliofemoral: Very strong triangular band
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Pubofemoral: Reinforces inferior and anterior aspects of the joint
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Ischiofemoral: Spiral shape; less well defined
Intracapsular Ligaments
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Transverse Acetabular Ligament: Crosses the acetabular notch
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Ligament of Head of Femur (Ligamentum Teres): Attaches to the fovea, minimal role in stability.
Hip Muscles
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Gluteal Muscles:
- Gluteus Maximus:
- Large, powerful extensor
- Extends and laterally rotates thigh
- Gluteus Maximus:
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Gluteus Medius:
- Abducts thigh and medially rotates
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Gluteus Minimus:
- Abducts and medially rotates
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Tensor Fascia Latae (TFL)/Iliotibial Band (ITB):
- Hip flexion, abduction, and medial rotation
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Hip Flexors:
- Rectus Femoris:
- Flexes and extends the knee
- Rectus Femoris:
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Iliacus:
- Flexes thigh
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Psoas Major:
- Flexes thigh
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Adductors: Adductor Brevis, Adductor Longus, Adductor Magnus
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Bursae and Tendons
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Pectineus,Pyramidallis, Tensor Fascia Latae/Iliofemoral Band
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Muscles of posterior & medial thigh (hip flexors) : Semimembranosus, Semitendinosus, and Biceps Femoris
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Rotator Cuffs (hip): Piriformis, Quadratus femoris, Obturator Internus, and Obturator Externus
Limitations of Movement
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Flexion: 90-115 degrees
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Extension : 15-30 degrees (hip flexed)
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Abduction: 50-60 degrees
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Adduction: 15-45 degrees (hip flexed)
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Medial Rotation: 30-45 degrees
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Lateral Rotation: 45-60 degrees
Significance of Blood Supply to Hip Fractures (complications)
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AVascular Necrosis:
- Complication associated with hip fractures
- Occurs when blood supply to the femoral head is disrupted and it dies, typically within 6 hours
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Blood Supply to Femoral Head: Complex system with multiple arteries that deliver supply from distal to proximal
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Profunda Femoris: Major blood vessel supplying the femur
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Key Vessels: Branches to retinacula arteries, Profunda Femoris (Lateral and Medial Circumflex Femoral Arteries); Branches to retinacular arteries.
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Description
This quiz covers key aspects of hip joint anatomy, including the shape of articular surfaces, the role of cartilage, ligaments, and muscles. It also delves into the movements available at the hip joint and the significance of various components that contribute to its stability and function.