Lower Limb Anatomy: Hip Region and Thigh

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Questions and Answers

What is the primary reason for the lateral positioning of the femur proximally?

To support body weight and address the forces of gravity

To align the hip and knee joints

To facilitate the opposing thigh muscles to work together

To increase the range of movement of the hip joint (correct)

What is the average angle of inclination for males?

130 degrees

126 degrees (correct)

120 degrees

124 degrees

What is the term for an angle of inclination above 130 degrees?

Angle of anteversion

Cova vara

Coxa valga (correct)

Angle of inclination

What is the significance of a right angle (90 degrees) in the angle of inclination?

It is less able to withstand the load of forces and more likely to break Signup and view all the answers

What is the purpose of the mechanical axis of the femur?

To align the hip and knee joints Signup and view all the answers

What is the approximate angle of inclination in a 3-year-old?

140 degrees Signup and view all the answers

What is the term for an angle of inclination below 120 degrees?

Cova vara Signup and view all the answers

Why do females have a slightly smaller angle of inclination compared to males?

Due to their wider pelvis Signup and view all the answers

What is the primary function of the capsular ligaments of the hip joint?

To limit joint movement Signup and view all the answers

Which of the following is NOT a principal feature of the hip bone?

Cranium Signup and view all the answers

What is the main importance of the blood supply to the hip joint in hip fractures?

It aids in the healing process of the fracture Signup and view all the answers

What is the consequence of a hip dislocation on the patient?

Pain and limited mobility in the affected limb Signup and view all the answers

What is the alignment of the bones in the hip joint related to?

The movement of the hip joint Signup and view all the answers

What is the primary function of the muscles surrounding the hip joint?

To facilitate movement of the hip joint Signup and view all the answers

What is a characteristic of a child with excessive anteversion?

They prefer to medially rotate their limb Signup and view all the answers

What is the primary function of the capsular and intra-capsular ligaments?

To limit joint movement Signup and view all the answers

What is the characteristic of the hip joint capsule?

It is strong, yet sufficiently lax to permit a wide range of movement Signup and view all the answers

What will be discussed in the next section of the lecture?

The remaining learning outcomes from this section Signup and view all the answers

What is a learning outcome of this part of the lecture?

To state the shape of the articular surfaces and describe the attachments of the capsule and synovium Signup and view all the answers

What is the shape of the articular surfaces of the hip joint?

This information is not provided in the content Signup and view all the answers

What is the function of the muscles surrounding the hip joint?

This information is not provided in the content Signup and view all the answers

What is medially rotated?

A limb that is rotated inwards Signup and view all the answers

What is the effect of shortening of the limb on the medial rotators?

They are made ineffective Signup and view all the answers

What type of fracture has a better healing outcome?

Intertrochanteric fracture Signup and view all the answers

Why are elderly females more prone to hip fractures?

All of the above Signup and view all the answers

What is the consequence of interruption of the blood supply to the head of the femur?

The head of the femur will die within 6 hours Signup and view all the answers

Why is a hip dislocation a clinical emergency?

Because it can lead to avascular necrosis Signup and view all the answers

What is the term for thinning of the bones?

Osteoporosis Signup and view all the answers

Why do post-menopausal women have a higher incidence of osteoporosis?

Because of hormonal changes Signup and view all the answers

What is the significance of the blood supply to the head of the femur?

It is essential for the health of the femur Signup and view all the answers

What is the main reason for the capsule's strength?

The presence of thickenings of the capsule - capsular ligaments Signup and view all the answers

How many ligaments are there in total, and from which bones do they arise?

3 ligaments, one from each of the bones making up the acetabulum Signup and view all the answers

What is the approximate tensile strength of the iliofemoral ligament compared to reinforced concrete?

20 times that of reinforced concrete Signup and view all the answers

What is the shape of the iliofemoral ligament?

Upside-down Y-shape Signup and view all the answers

What is the distal attachment of the iliofemoral ligament?

The greater and lesser trochanters, and the intertrochanteric line Signup and view all the answers

What is the function of the zona orbicularis?

To pinch the capsule around the neck of the femur Signup and view all the answers

From which ligament does the zona orbicularis arise?

Ischiofemoral ligament Signup and view all the answers

What is the proximal attachment of the pubofemoral ligament?

The pubic margin of the acetabulum and the superior ramus of the pubis Signup and view all the answers

Study Notes

Hip Region and Thigh I

The hip region and thigh consist of the hip bone and femur, which are essential for a wide range of movements.
The shaft of the femur is pushed laterally away from the joint, and its long neck keeps the shaft well away from the joint, allowing for a wide range of movement.
The distal end of the femur needs to be more medially placed to support body weight.

Osteology

The angle of inclination of the femur is 120-130 degrees relative to the shaft, which varies between sexes and ages.
Females have a wider pelvis, resulting in a slightly smaller angle of inclination (124 degrees) compared to males (126 degrees).
The angle of inclination changes with age, with newborns having an angle of approximately 160 degrees, and adults retaining a high angulation throughout life.
An angle above 130 degrees is termed a coxa valga (outward bending), while an angle below 120 degrees is termed a coxa vara (inward bending).
The closer the angle is to 90 degrees, the less stable the bones are, making them more prone to break.

Angle of Anteversion

The mechanical axis of the femur aligns the hip and knee joints, requiring lateral rotation of the limb.
In children, excessive anteversion can result in medial rotation of the limb, leading to splayed limbs.

Supporting Structures

The hip joint capsule is strong and lax, allowing for a wide range of movement.
The capsule has three ligaments: iliofemoral, pubofemoral, and ischiofemoral, which attach to the intertrochanteric line.
The iliofemoral ligament is the strongest ligament in the human body, with a tensile strength 20 times that of reinforced concrete.
The pubofemoral ligament arises from the pubic margin of the acetabulum and inserts onto the lesser trochanter.
The ischiofemoral ligament arises from the ischial margin of the acetabulum and inserts into the iliofemoral ligament and the greater trochanter.

Zona Orbicularis

The zona orbicularis is a circular ligament that arises from the ischiofemoral ligament and serves to pinch the capsule around the neck of the femur, aiding in holding the femoral head into the acetabular socket.
The zona orbicularis acts like a purse-string, preventing the femoral head from being displaced laterally.

Hip Fractures

The location of the hip fracture has a bearing on its chances of a successful outcome.
Intertrochanteric and subtrochanteric fractures are extracapsular and have a better healing outcome.
Transcervical and subcapital fractures are likely to cause interruption of the joint and have a poorer prognosis.

Blood Supply of the Hip Joint

Displacement of the femoral head through fracture or dislocation can lead to avascular necrosis, where the blood supply to the head of the femur is interrupted.
Avascular necrosis can result in the death of the femoral head within 6 hours, making hip dislocation a clinical emergency.

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Description

Explore the anatomy of the lower limb, focusing on the hip region and thigh, including bony features, arteries, nerves, and bone alignment.