Podcast
Questions and Answers
What type of joint is the hip joint?
What type of joint is the hip joint?
- Gliding
- Pivot
- Hinge
- Ball and socket (correct)
Which of the following is a main function of the hip joint?
Which of the following is a main function of the hip joint?
- Facilitating neck extension
- Enabling wrist rotation
- Supporting body weight during standing (correct)
- Assisting in elbow flexion
Which bone does the head of the femur articulate with to form the hip joint?
Which bone does the head of the femur articulate with to form the hip joint?
- Fibula
- Scapula
- Tibia
- Acetabulum (correct)
What covers the head of the femur, except for the fovea capitis?
What covers the head of the femur, except for the fovea capitis?
Which of the following is a feature of the acetabulum?
Which of the following is a feature of the acetabulum?
Which structure increases the depth of the acetabulum?
Which structure increases the depth of the acetabulum?
Which of the following ligaments is considered the strongest ligament of the hip joint?
Which of the following ligaments is considered the strongest ligament of the hip joint?
To which anatomical feature on the femur is the capsular ligament attached anteriorly?
To which anatomical feature on the femur is the capsular ligament attached anteriorly?
Where is the hip joint capsule thickest?
Where is the hip joint capsule thickest?
What are the two types of fibers that make up the hip joint capsule?
What are the two types of fibers that make up the hip joint capsule?
What is another name for the iliofemoral ligament?
What is another name for the iliofemoral ligament?
Where does the apex of the iliofemoral ligament attach?
Where does the apex of the iliofemoral ligament attach?
What is the strongest ligament in the body?
What is the strongest ligament in the body?
What is the shape of the pubofemoral ligament?
What is the shape of the pubofemoral ligament?
Where does the base of the pubofemoral ligament attach?
Where does the base of the pubofemoral ligament attach?
Which ligament supports the hip joint capsule posteriorly and is considered relatively weak?
Which ligament supports the hip joint capsule posteriorly and is considered relatively weak?
What is another name for the round ligament of the head of the femur?
What is another name for the round ligament of the head of the femur?
Which of the following describes the shape of the acetabular labrum in cross section?
Which of the following describes the shape of the acetabular labrum in cross section?
Which structure does the transverse acetabular ligament bridge?
Which structure does the transverse acetabular ligament bridge?
Which factor contributes to the stability of the hip joint?
Which factor contributes to the stability of the hip joint?
Which nerve is located anterior to the hip joint?
Which nerve is located anterior to the hip joint?
Which ligament does NOT significantly contribute to the stability of the hip joint?
Which ligament does NOT significantly contribute to the stability of the hip joint?
Superiorly, the hip joint is related to which structure?
Superiorly, the hip joint is related to which structure?
Which muscle is NOT located laterally to the hip joint?
Which muscle is NOT located laterally to the hip joint?
Which of the following muscles is located inferiorly to the hip joint?
Which of the following muscles is located inferiorly to the hip joint?
How many bursae are located around the hip joint?
How many bursae are located around the hip joint?
The subpsoas bursa is located between the iliopubic eminence and which tendon?
The subpsoas bursa is located between the iliopubic eminence and which tendon?
What is the common name for the inflammation and enlargement of the subgluteal bursa between the gluteus maximus and ischial tuberosity?
What is the common name for the inflammation and enlargement of the subgluteal bursa between the gluteus maximus and ischial tuberosity?
Which artery is NOT a source of arterial supply to the hip joint?
Which artery is NOT a source of arterial supply to the hip joint?
From which artery do the retinacular vessels, the chief source of blood supply to the head of the femur, arise?
From which artery do the retinacular vessels, the chief source of blood supply to the head of the femur, arise?
Which of the following is the name of a nerve that supplies the hip joint?
Which of the following is the name of a nerve that supplies the hip joint?
Which nerve provides a branch to the hip joint via the nerve to the rectus femoris?
Which nerve provides a branch to the hip joint via the nerve to the rectus femoris?
Which of the following movements is NOT permitted by the hip joint?
Which of the following movements is NOT permitted by the hip joint?
Movement around the transverse axis of the hip joint primarily allows which actions?
Movement around the transverse axis of the hip joint primarily allows which actions?
What is the typical range of extension movement at the hip joint?
What is the typical range of extension movement at the hip joint?
Which muscle is the chief extensor of the hip joint?
Which muscle is the chief extensor of the hip joint?
Which of the following muscles is a chief flexor of the hip?
Which of the following muscles is a chief flexor of the hip?
Which of the following muscles is a chief adductor of the hip joint?
Which of the following muscles is a chief adductor of the hip joint?
The anterior fibers of which muscles are the chief medial rotators of the hip?
The anterior fibers of which muscles are the chief medial rotators of the hip?
What is a typical characteristic presentation of congenital hip dislocation in newborns?
What is a typical characteristic presentation of congenital hip dislocation in newborns?
What is a common cause of acquired hip dislocation?
What is a common cause of acquired hip dislocation?
In an acquired hip dislocation due to a head-on collision, what is the typical position of the hip joint at the time of injury?
In an acquired hip dislocation due to a head-on collision, what is the typical position of the hip joint at the time of injury?
What is the most common type of hip dislocation?
What is the most common type of hip dislocation?
Which nerve is most likely to be injured in a posterior hip dislocation?
Which nerve is most likely to be injured in a posterior hip dislocation?
What is a key characteristic of Perthes' disease?
What is a key characteristic of Perthes' disease?
What term describes a decreased neck-shaft angle of the femur?
What term describes a decreased neck-shaft angle of the femur?
Why is pain from hip joint disease often referred to the knee?
Why is pain from hip joint disease often referred to the knee?
Flashcards
Hip Joint
Hip Joint
A ball and socket synovial joint between the head of the femur and the acetabulum of the hip bone.
Hip Joint Functions
Hip Joint Functions
Support body weight during standing and transmit forces during movement.
Articular Surfaces of Hip
Articular Surfaces of Hip
Head of the femur and horseshoe-shaped acetabulum.
Articular Cartilage (Femoral Head)
Articular Cartilage (Femoral Head)
Covers most of the femoral head, except at the fovea capitis.
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Acetabulum Features
Acetabulum Features
Lunate surface (articular), acetabular notch, and acetabular fossa.
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Acetabular Labrum Function
Acetabular Labrum Function
Increases the depth of the acetabulum.
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Main Ligaments of Hip
Main Ligaments of Hip
Iliofemoral, pubofemoral, ischiofemoral.
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Capsular Ligament
Capsular Ligament
Connects acetabulum to femur, enclosing the joint.
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Hip Capsule Thickness
Hip Capsule Thickness
Thicker anterosuperiorly where stress is maximal, especially when standing; thinner and loosely attached posteroinferiorly.
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Capsule Fibers Types
Capsule Fibers Types
Inner circular fibers (zona orbicularis) and outer longitudinal fibers (retinacula).
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Zona Orbicularis
Zona Orbicularis
Collar of circular fibers around the femoral neck, not directly attached to bone.
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Synovial Membrane
Synovial Membrane
Lines the inner fibrous capsule, femoral neck, glenoid labrum, transverse acetabular ligament, ligamentum teres, and acetabular fossa fat.
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Iliofemoral Ligament
Iliofemoral Ligament
Inverted Y-shaped ligament, anterior and blended with the capsule; prevents trunk from falling backward when standing.
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Iliofemoral Attachements
Iliofemoral Attachements
Attached to the lower half of the anterior inferior iliac spine, the area above the acetabular margin and attaches to the intertrochanteric line.
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Pubofemoral Ligament
Pubofemoral Ligament
Triangular ligament, inferomedial, supporting the joint; attached to the iliopubic eminence, superior pubic ramus, and obturator crest.
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Ischiofemoral Ligament
Ischiofemoral Ligament
Relatively weak, supports the capsule posteriorly; attached to the ischium posteroinferior to the acetabulum and greater trochanter.
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Lateral hip muscles
Lateral hip muscles
Gluteus minimus, gluteus medius, and gluteus maximus.
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Inferior hip muscles
Inferior hip muscles
Pectineus and Obturator externus.
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Bursae function
Bursae function
Located between muscles or tendons and bony prominences to reduce friction.
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Ischial bursa
Ischial bursa
This bursa lies between the gluteus maximus and ischial tuberosity.
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Weaver's bottom
Weaver's bottom
Inflammation of the subgluteal bursa due to prolonged sitting.
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Arterial supply to hip
Arterial supply to hip
Medial and lateral circumflex femoral, obturator, superior and inferior gluteal.
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Femoral head blood supply
Femoral head blood supply
Acetabular branches, retinacular vessels, and nutrient artery of femur.
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Arteries in the round ligament
Arteries in the round ligament
Acetabular branches of the obturator artery and medial circumflex femoral arteries
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Iliopsoas
Iliopsoas
Primary hip flexors, combining to form a powerful flexor.
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Gluteus Maximus
Gluteus Maximus
Main muscle responsible for hip extension.
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Gluteus Medius & Minimus
Gluteus Medius & Minimus
The key muscles responsible for abduction of the hip.
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Adductors
Adductors
Muscles that bring the leg towards the midline.
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Medial Rotators
Medial Rotators
Muscles that rotate the hip inward.
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Lateral Rotators
Lateral Rotators
Piriformis, Obturator internus/externus, Gemelli, Quadratus Femoris
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Circumduction
Circumduction
Movement that combines flexion, extension, abduction, and adduction in a circular motion.
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Femoral Nerve
Femoral Nerve
Nerve to rectus femoris
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Round Ligament of Femur
Round Ligament of Femur
Also known as ligamentum teres. It is a flat, triangular ligament attached to the fovea of the femoral head and the transverse acetabular ligament. It transmits arteries to the femoral head.
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Acetabular Labrum
Acetabular Labrum
A fibrocartilaginous rim attached to the acetabular margin that deepens the socket and lightly grasps the femoral head.
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Transverse Acetabular Ligament
Transverse Acetabular Ligament
A part of the acetabular labrum that bridges the acetabular notch, converting it into a foramen for the passage of vessels and nerves.
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Hip Joint Stability Factors
Hip Joint Stability Factors
Depth of acetabulum, strong ligaments (iliofemoral, pubofemoral, ischiofemoral), surrounding muscles, and the length/obliquity of the femoral neck work together.
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Anterior Relations of Hip Joint
Anterior Relations of Hip Joint
Iliopsoas tendon (separated by bursa), pectineus, straight head of rectus femoris, femoral nerve, femoral artery, and femoral vein.
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Posterior Relations of Hip Joint
Posterior Relations of Hip Joint
Piriformis, obturator internus/externus, gemelli, quadratus femoris, gluteus maximus, superior/inferior gluteal nerves/vessels, sciatic nerve, posterior cutaneous nerve of thigh, nerve to quadratus femoris.
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Superior Relations of Hip Joint
Superior Relations of Hip Joint
Primarily the reflected head of rectus femoris and gluteus minimus.
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Inferior Relations of Hip Joint
Inferior Relations of Hip Joint
Obturator externus muscle, adductor brevis, adductor longus, gracilis, and adductor magnus.
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Hypoplasia of the acetabulum and femoral head
Hypoplasia of the acetabulum and femoral head
A condition where the head of the femur slips upwards, often due to a deficient acetabulum.
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Clinical Signs of Hip Dysplasia
Clinical Signs of Hip Dysplasia
Inability to abduct the thigh, limb shortening, external rotation, asymmetric skin folds, and lurching gait.
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Acquired Hip Dislocation
Acquired Hip Dislocation
Occurs when the hip is flexed, adducted, and medially rotated, often from car accidents where the knee hits the dashboard.
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Symptoms of Dislocated Hip
Symptoms of Dislocated Hip
Shortening and medial rotation of the affected limb.
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Types of Hip Dislocation
Types of Hip Dislocation
Posterior (most common), anterior, or central.
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Perthes' Disease
Perthes' Disease
A condition causing destruction and flattening of the femoral head.
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Coxa Vara
Coxa Vara
Decreased neck-shaft angle of the femur (less than 120° in adults).
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Coxa Valga
Coxa Valga
Increased neck-shaft angle of the femur (greater than 120° in adults).
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Hip Joint Overview
- The hip joint connects the head of the femur to the acetabulum and is the largest ball and socket synovial joint.
- It supports body weight while standing and transmits forces during movements like walking.
- The hip joint enables similar movements as the shoulder joint but with a restricted range due to its weight-bearing function.
Articular Surfaces
- The head of the femur articulates with the acetabulum and forms the hip joint.
- The femoral head is more than half a sphere, covered in hyaline cartilage except at the fovea capitis.
- The acetabulum has a horseshoe-shaped lunate surface and acetabular notch and fossa.
- Only the lunate surface is covered by cartilage with depth enhanced by the acetabular labrum.
Ligaments of the Hip Joint
- Key ligaments include the capsular, iliofemoral, pubofemoral, ischiofemoral, transverse acetabular ligament, acetabular labrum, and ligamentum teres femoris.
Capsular Ligament
- It is a strong fibrous sac attached 5-6 mm beyond the acetabular margin on the hip bone and to the intertrochanteric line on the anterior femur.
- The capsule is thicker anterosuperiorly and thinner posteroinferiorly.
- It has inner circular fibers forming the zona orbicularis and outer longitudinal fibers forming retinacula.
- The synovial membrane lines the capsule's inner aspect, femoral neck, glenoid labrum, transverse acetabular ligament, ligamentum teres, and acetabular fossa.
Iliofemoral Ligament
- The iliofemoral ligament is Y-shaped and anteriorly located, with its apex connecting to the anterior inferior iliac spine.
- Its base attaches to the intertrochanteric line and has three parts: a lateral thick band, a medial thick band, and a central thin portion.
- As the strongest ligament in the body, it prevents trunk from falling backward.
Pubofemoral Ligament
- The pubofemoral ligament lies inferomedially and supports the joint.
- It connects the iliopubic eminence, superior pubic ramus, and obturator crest to the capsule and iliofemoral ligament.
Ischiofemoral Ligament
- The ischiofemoral ligament located posteriorly supports the capsule.
- It attaches from the ischium near the acetabulum to the greater trochanter.
Transverse Acetabular Ligament
- It bridges the acetabular notch which becomes foramen, and transmits vessels and nerves.
Round Ligament of Head of Femur
- This ligament attaches from the fovea of the femoral head to the transverse acetabular ligament.
- The arteries transmit blood to the head of the femur.
Acetabular Labrum
- It is triangular in cross-section and attaches to the acetabular margin, improving hip joint stability.
Hip Joint Stability
- The depth of the acetabulum and acetabular labrum, along with strong ligaments and surrounding muscles provide stability.
- The length and obliquity of the femoral neck contribute to hip joint stability.
Relations of the Hip Joint
- Anterior relations include the iliopsoas tendon, femoral nerve, artery, vein, and pectineus.
- Posterior relations include the piriformis, obturator muscles, gemelli, quadratus femoris, gluteus maximus, and relevant nerves and vessels.
- Superior relations: reflected head of rectus femoris, gluteus minimus, medius, and maximus.
- Inferior relations include the pectineus and obturator externus.
Bursae Around the Hip Joint
- Bursae location: four under the gluteus maximus, one each under the gluteus medius, the gluteus minimus, and the psoas tendon.
Arterial Supply to the Hip Joint
- Arteries supplying the joint: Medial and lateral circumflex femoral, obturator, and superior and inferior gluteal arteries.
- Clinically important arterial supply to the femoral head from acetabular branches, retinacular vessels, and nutrient artery of the femur.
Nerve Supply to the Hip Joint
- The hip joint is innervated by the femoral and obturator nerves, as well as branches from the sacral plexus (L2-L5).
Movements of the Hip Joint
- The multiaxial hip joint allows flexion & extension, abduction & adduction, medial & lateral rotation, and circumduction.
Range of Motion
- Flexion typically spans 110°-120°, while extension is around 15°.
- The angle of abduction is about 50°.
- Medial rotation is about 25°.
- Lateral rotation is about 60°.
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