ANATOMY PHYSIOLOGY OF HIP JOINT

The hip is a ball-and-socket joint, but is much more stable. The stability

in the hip begins with a deep socket—the acetabulum. Additional stability is

provided by the strong joint capsule and its surrounding muscles and ligaments.

It’s the need for such a high degree of stabilization of the joint that limits

movement. If you think of the hip joint in layers, the deepest layer is bone, then

ligaments of the joint capsule and the tendons and muscles are on top. Nerves

and vessels supply the muscles and bones of the hip.

Bony Structures of the Hip :

The hip is formed where the thigh bone (femur) meets the three bones that

make up the pelvis: the ilium, the pubis (pubic bone) and the ischium. You can

feel the arching bones of the ilium by placing your hands on your waist. The

pubis attaches to the lower part of the ilium and curves forward. The ischium is

slightly behind the pubis. The three bones converge to form the acetabulum, a

deep socket on the outer edge of the pelvis.

The shape of the acetabulum is a half of a sphere; the femoral head is about

two-thirds of a sphere. Without weight bearing, the ball-and-socket are not

completely congruent. As the joint bears more weight, the contact of the surface

areas increases as does joint stability. The articular cartilage is thicker on the

back part of the socket where most of the force is placed on the joint with

walking, running and jumping. When standing, the body’s center of gravity

passes through the center of the acetabula. Obviously, injury to the acetabulum .

The femur is the longest bone in the body. The neck of the femur

connects the femoral head with the shaft of the femur. The capsular ligament of

the hip joint attaches to the posterior part of the femoral neck. The neck ends at

the greater and lesser trochanter prominences. The greater trochanter serves as

the site of attachment for the abductor muscles. The lesser trochanter is the site

of the iliopsosas tendon.

The greater trochanter is a very prominent bump on the femur and easy

to feel on the outside of your thigh. It is the widest part of the lower legs and is

where the tendons of several muscles attach including the gluteus, obturator,

gemelli and piriformis muscles. The lesser trochanter serves as the attachment

for the iliopsoas and iliacus muscle tendons.

Hip Ligaments

The stability of the hip is increased by the strong ligaments that encircle

the hip (the iliofemoral, pubofemoral, and ischiofemoral ligaments). These

ligaments completely encompass the hip joint and form the joint capsule.

The iliofemoral ligament is the strongest ligament in the body. Damage to the

ligamentum teres can result in avascular necrosis because of injury to the small

artery within the ligament that supplies most of the blood to the head of the

femur. Death of the bone in the femoral head is one cause for hip replacement.

Muscles of hip :

The muscles of the thigh and lower back work together to keep the hip

stable, aligned and moving. It is the muscles of the hip that allow the 4 basic

movements of the hip:

flexion – bend

extension – straighten

abduction – take the leg away from the body

adduction – bring the leg back toward the body

The hip muscles are divided up into three basic groups based on their

location: anterior muscles (front), posterior (back), and medial (outside). The

muscles of the anterior thigh make up the quadriceps group (vastus medialis,

intermedius, lateralis and rectus femoris muscles). The quads make up about

70% of the thigh’s muscle mass. The purpose of the quads is flexion (bending)

of the hip and extension (straightening) of the knee.

The hip also has the ability to rotate internally (medially)—turning the

foot in (pigeon-toed) and externally (laterally)—turning the foot out. Medial

rotation is needed for squatting. The piriformis muscle assist in lateral rotation

of the hip. Lateral rotation is needed for crossing the legs.

The hip muscles do not attach right at the hip joint, thereby giving the hip

more stability. The gluteus medius muscle connects to the greater trochanter, a

bony prominence on the neck of the femur. The gluteus medius helps keep the

pelvis.

CASE PRESENTATION

ON

SEPTIC ARTHRITIS IN CHILDREN

SUBMITTED TO

Mrs.saraswathi

HOD of Pediatric nursing

SMVNC

SUBMITTED BY

E.sundara bharathi

M.Sc Nursing Ist Year

SMVNC

CASE PRESENTATION ON SEPTIC ARTHRITIS IN CHILDREN

PATHOPHYSIOLOGY OF SEPTIC ARTHRITIS

Bacteria deposits in synovium producing inflamation

↓

Spreads to synovial fluid and multiplies

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Products of inflamation destroys joint components

(Swollen, painful joint)

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SEPTIC ARTHRITIS