Answer Guide - Tell us all about the hip joint. 25 pts.

The Question Verbatim

TJP13 was a passenger in an 1800 lb Honda Insight when a gnat collided with the windshield. The force of the impact drove TJP13's right knee into the glove box. A posterior dislocation of the right hip occured. TJP13 was rushed, by ambulance, to the Emergency Department at HMC where he was attended to by the noteable pediatric orthopaedic surgeon. You, a first year medical student visiting the ER, are asked to demonstrate your capacity for "higher cognitive thinking" by reviewing the hip joint at the next Grand Rounds. Note: We do our best to encourage "higher cognitive thinking." Yes, I know, the phrase "higher cognitive thinking" is a triple redundancy. A succinct statement of the "question" follows. Organize an essay that demonstrates your knowledge of the hip joint. Include the following subheadings: Introduction; Bony articulations; Intracapsular specializations; Capsular specializations; Ligaments; Muscles crossing the joint; Movement and limitations to movement; Stability and joint position; Lines of gravity; Vascularization (AVL) and anastomoses; Innervation (motor/sensory, somatic/autonomic). Finally, discuss the mechanical consequences and gate disturbances that result from superior gluteal nerve injury. (25 pts)

Introductory Comments

• A synovial ball and socket joint
• Extremely stable on extension

Bony Articulations

• Acetabulum
• Receives contributions from each of three fused bones
• Thin walled
• Rim for the acetabular labrum
• Head of the femur

Cartilage, synovium, and intracapsular specializations

• Hyaline cartilage
• Synovial membrane and reflections
• Acetabular labrum and notch

Capsular specializations

Ligaments

Muscles crossing the joint

Movement and limitations to movement

Stability and joint position

Lines of gravity

Vascularization (VAL) and anastomosis

Innervation (motor/sensory, somatic/autonomic)

Nerve Injury

• SuperiorGlutealNerveInjury?

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