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