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Hip Ch17

Hip joint structure, motions, bones, landmarks, muscles & other structures

QuestionAnswer
What parts of the body make up the lower extremity? Pelvis, thigh, leg & foot.
What parts of the body make up the pelvis? Hip bone, (OS coxae), ilium, ischium, pubis, sacrum, coccyx.
What parts of the body make up the thigh? Femur & patella.
What parts of the body make up the leg? Fibula & tibia.
What are the important functions of the hip? Weight bearing & walking.
Unlike the shoulder, the hip joint is what type of joint? Very stable ball -n-socket joint with decreased motion.
What is the shape of the head of the femur? Convex.
What is the shape of the acetabulum? Concave.
The hip is a uniaxial, biaxial, or triaxial joint? Triaxial joint.
What are the actions of the hip? Flexion, (hyper) extension, abduction/adduction, and IR/ER.
Explain: "45 degrees of rotation each in anatominical position". Explaination to come...
What parts of the body make up the os coxae? Ilium, ischium, and pubis.
What parts of the body make up the pelvis? OS coxae (ilium, ischium, pubis), sacrum, and coccyx.
What parts of the body make up the foot? 7 tarsals, (calcaneus, talus, cuboid, navicular, cuneform-lateral, intermediate & medial (3). 5 metatarsals (first through fifth). 14 phalanges (5 proximal, 4 middle & 5 distal).
Does the pelvis include the femur? NO! 2 hip bones, sacrum, and coccyx.
Ilium Superior part of the hip bone.
Iliac crest Superior ridge of the ilium, the bony area felt when you place your hands on your hips.
Posterior superior iliac spine (PSIS) Posterior projection of the iliac crest & serves as an attachment for the posterior sacroiliac ligament.
Posterior inferior iliac spine (PIIS) Lies inferior to the PSIS and serves as an attachment for the sacrotuberous ligament.
Iliac fossa Large, smooth, concave area on the internal surface to which the iliac portion of the iliopsoas muscle attaches.
Anterior superior iliac spine (ASIS) The projection on the nterior end of the iliac crest. The tensor fascia lata, sartorius, and inguinal ligament attach here.
Where do the tensor fascia lata, sartorius, and inguinal ligament attach? ASIS
Anterior inferior iliac spine (AIIS) The projection is just inferior to the ASIS to which the rectus femoris muscle attaches.
Where does the rectus femoris muscle attach? AIIS
Ischium The posterior inferior portion of the hip bone.
Ischium body Makes up 2/3 of the acetabulum.
Ischium ramus Extends medially from the body to connect with the inferior ramus of the pubis. The adductor magnus, obturator externus, and obturator internus muscles attach here.
Where do the adductor magnus, obturator externus, and obturator internus muscles attach? Ischium ramus
Ischial tuberosity Rough, blunt projection of the inferior part of the body, which is weight bearing when you are sitting. It provides attachment for the hamstring and adductor magnus muscles.
What provides attachment for the hamstring and adductor magnus muscles? Ischial tuberosity
Ischium spine Located on the postier portion of the body between the greater and lesser sciatic notch. It provides attachment for the sacrospinous ligament.
What provides attachment for the sacrospinous ligament? Ischium spine
Pubis Forms the anterior inferior portion of the hip. It can be divided into 3 parts, the body, and it's 2 rami.
What can be divided into 3 parts, the body, and it's 2 rami? Pubis
Pubis body Externally forms about 1/5 of the acetabulum & internally provides attachment for the obturator internus muscle.
What internally provides attachment for the obturator internus muscle? Pubis body
Superior ramus of the pubis Lies superior between the acetabulum and the body and provides attachment for the pectineus muscle.
What provides attachment for the pectineus muscle? Superior ramus of the pubis
Inferior ramus of the pubis Lies posterior, inferior and lateral to the body. Provides attachment for the adductor magnus and brevis and gracilis muscles.
What provides attachment for the adductor magnus and brevis and gracilis muscles? Inferior ramus of the pubis
Pubis Symphysis A cartilaginous joint connecting the bodies of the two pubic bones at the anterior midline.
Pubic tubercle Projects anteriorly on the superior ramus near the symphysis pubis & provides attachment for the inguinal ligament.
What provides attachment for the inguinal ligament? Pubic tubercle
Acetabulum A deep, cup shaped cavity that articulates with the femur. It is made up of nearly equal portions of the ilium, ischium & pubis.
What is made up of nearly equal portions of the ilium, ischium & pubis? Acetabulum
Obturator foramen A large opening made up of the bodies & rami of the ischium & pubis and through which pass blood vessels & nerves.
Greater sciatic notch Large notch just below the PIIS that is actually made into a foramen by the sacrospinous ligament. The sciatic nerve, piriformis muscle, and other structures pass through this opening.
What is the opening called where the sciatic nerve, piriformis muscle, and other structures pass through? Greater sciatic notch.
Femur Longest, strongest, and heaviest bone of the body.
What bone articulates woth the hip bones to form the hip joint? Femur
Head of the femur The rounded portion covered with articular cartilage articulating with the acetabulum.
Neck of the femur The narrower portion located between the head and the trochanters.
Greater trochanter of the femur Large projection located laterally between the neck and the body of the femur, providing attachment for the gluteus medius & minimus, and most deep rotator muscles.
What provides attachment for the gluteus medius & minimus, and most deep rotator muscles? Greater trochanter of the femur
Lesser trochanter of the femur A smaller projection located medially and posteriorly just distal to the greater trochanter, providing attachment for the iliopsoas muscle.
What provides attachment for the iliopsoas muscle? Lesser trochanter of the femur
Femur body The long cylindrical portion between the bone ends; also called the shaft. It is bowed slightly anteriorly.
Medial condyle of the femur Distal medial end.
Lateral condyle of the femur Distal lateral end.
Lateral epicondyle of the femur Projection proximal to the lateral condyle.
Medial epicondyle of the femur Projection proximal to the medial condyle.
Adductor tubercle of the femur Small projection proximal to the medial epicondyle to which a portion of the adductor magnus muscle attaches.
Linea aspera of the femur Prominent longitudial ridge or crest running most of the posterior length.
Pectineal line of the femur Runs from below the lesser trochanter diagonally toward the linea aspera. It provides attachment for the adductor brevis.
What provides attachment for the adductor brevis? Pectineal line of the femur.
Patellar surface Between the medial and lateral condyle anteriorly. It articulates with the posterior surface of the patella.
Tibial tuberosity Large projection at the proximal end in the midline. It provides attachemnt for the patellar tendon.
Where is the attachemnt for the patellar tendon? Tibial tuberosity
Hip joint capsule Strong, thick & fibrous; 3 ligaments reinforce the capsule.
What are the 3 ligaments that reinforce the hip joint capsule? Iliofemoral, ischiofemoral, and pubofemoral ligaments.
Iliofemoral ligament Most important ligament of the hip, reinforces the capsule anteriorly. Resembles and inverted Y and is called the Y ligament. Limits hyperextension.
Pubofemoral ligament Located anteriorly on the hip. Limits hyperextension and abduction.
Ischiofemoral ligament Covers the capsule posteriorly. Limits huperextension and medial rotation.
Ligamentum teres Small intracapsular ligament. Attaches proximally in the acetabulum & distally in the fovea of the femoral head. Contains a blood vessel that supplies the head of the femur.
Fovea of the femur Indentation on the head of the femur.
Acetabular labrum Located around acetabular rim.
What do you call the anatomical separation between the pelvis & the thigh? Inguinal ligament
Iliotibial band or tract The very long, tendinous portion of the tensor fascia latae muscle. Anterior - Tensor fascia lata (TFL) Posterior - Gluteus maximus
Congential hip dislocation or dysplasia Shallow acetabulum causing head to slide upward. Joint capsule is stretched but intact.
What is Dysplasia? Deformity reducing contact of head in acetabulum.
Legg-Calve-Perthes disease (coxa plana) Femoral head undergoes necrosis. Usually seen in children 5-10yrs. Can take 2-4 years for the head to die, revascularize & remodel. Children are casted w/long leg casts in extreme abduction.
Slipped capital femoral epiphysis Seen in children in the growth spurt years. Proximal epiphysis slips off femoral head.
Angle of inclination Angle between the shaft & neck of the femur. (frontal plane) Normal is 125 degrees.
Coxa valga Neck-shaft angle greater than 125 degrees.
Coxa vara Deformity where the neck-shaft angle is less than 125 degrees.
Valgus Distal end moves lateral.
Varus Distal end moves medial.
Angle of torsion The angle between the neck and shaft of the femur in the transverse plane. (looking down)
Normal angle for femur and neck Head & neck rotated anteriorly/laterally 15-20 degrees compared to line of condyles.
Anteversion Increase in angle. MR of hip = "toe in"
Retroversion Decreased in angle. LR of hip = "toe out"
Osteoarthritis Degeneration of the articular cartilage of the joint.
What can cause osteoarthritis? Trama, wear & tear, and typically seen later in life.
Osteoarthritis can lead to possible joint replacement. True
THA Total Hip Arthroplasty
TKA Total Knee Arthroplasty
TSA Total Shoulder Arthroplasty
Name the 2 types of Hip Fractures (Fx) Intertrochanteric & femoral neck (surgical)
Common causes for hip fractures? Falls of the elderly and motor vehicle accidents of young.
Iliotibial band syndrome Overuse, lateral knee pain. Seen in runners and bicyclists. Friction of IT band over lateral condyle of the femur.
Trochanteric bursitis Acute trama or overuse. Seen in runners, bicyclists, perons with leg length discrepancies or repeated stress of tissue over bursa.
Hamstring strain (pulled hamstring) Most common muscle problem in the body for sports injury where speed is required. Occur @ attachments & along length. Overload on muscle or moving muscle to fast (elongating too fast). Often recurrent.
Hip Pointer Occurs @ pelvis. Severe bruise caused by direct contact to the iliac crest. Common in football, spearing w/helmet.
Anterior muscles of the hip One Joint - Iliopsoas Two Joint - Rectus femoris & sartorius
Medial muscles of the hip One Joint - Pectineus, Adductor magnus, Adductor longus, Adductor brevis Two Joint - Gracilis
Posterior muscles of the hip One Joint - Gluteus maximus, Deep rotators (6) Two Joint - Semimembranosus, Semitendinosus, Biceps femoris
Lateral muscles of the hip One Joint - Gluteus medius, Gluteus minimus Two Joint - Tensor fascia latae
Created by: Sue Stanisz Russel Sue Stanisz Russel on 2010-10-25



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