11. Lower Limb I: Hip to Knee (HARC) Flashcards
FUNCTIONS of the HIP BONE
- BEAR WEIGHT / TRANSFER WEIGHT from the back, through the hip, to the FEMUR
- PROTECTION
3 BONES of the HIP BONE
ILIUM
PELVIS
ISCHIUM
name for the SOCKET in the HIP BONE for the FEMUR
- where the 3 bones come together and fuse
ACETABULUM
name of the JOINT between the SACRUM and the ILIUM of the HIP
SACROILIAC JOINT
the ISCHIAL SPINE splits the posterior part of the ISCHIUM into 2 PARTS:
- GREATER SCIATIC NOTCH
- LESSER SCIATIC NOTCH
name of the FORAMEN in the HIP BONE
OBTURATOR FORAMEN
(mostly filled with muscle)
name for the bump on the HIP that you can feel
ANTERIOR SUPERIOR ILIAC SPINE (ASIS)
part of the HIP BONE that is the boney part of the bottom
ISCHIAL TUBEROSITY
name of the DEPRESSION found in the HEAD of the FEMUR and what goes in it
FOVEA
ARTERY goes in to supply the head of the femur
(artery of the ligament of the head of the femur)
2 parts that stick out on the FEMUR
GREATER TROCHANTER
LESSER TROCHANTER
name for the CREST that runs between the 2 TROCHANTERS of the FEMUR
INTERTROCHANTERIC CREST
2 things that provide STABILITY to the HIP JOINT
- LARGE ACETABULUM
with ACETABULAR LABRUM to make the joint even deeper, head of femur fits snugly - LIGAMENTS
particularly the TWISTING of ligaments in hip EXTENSION
what type of joint is the HIP JOINT
SYNOVIAL
LIGAMENT found in HIP JOINT
LIGAMENT OF THE HEAD OF THE FEMUR
(brings an artery with it)
relationship between the LIGAMENT OF THE HEAD OF THE FEMUR and the SYNOVIAL HIP JOINT
does the ligament go inside the synovium?
LIGAMENT goes inside the capsule but DOES NOT GO INSIDE THE SYNOVIUM (NOT INTRASYNOVIAL)
the SYNOVIAL MEMBRANE COATS the LIGAMET=NT
relationship between the LIGAMENT OF THE HEAD OF THE FEMUR and the SYNOVIAL HIP JOINT
does the ligament go inside the synovium?
LIGAMENT goes inside the capsule but DOES NOT GO INSIDE THE SYNOVIUM (NOT INTRASYNOVIAL)
the SYNOVIAL MEMBRANE COATS the LIGAMENT
3 LIGAMENTS of the PELVIS AND HIP JOINT
anterior:
- ILIOFEMORAL LIGAMENT
(between ilium and femur) - PUBOFEMORAL LIGAMENT
(between pubis and femur)
posterior:
- ISCHIOFEMORAL LIGAMENT
(between ischium and femur)
how does the ACTION of the HIP JOINT LIGAMENTS (iliofemoral, pubofemoral, ischiofemoral) PROVIDE STABILITY
during EXTENSION:
the LIGAMENTS naturally SCREW the HEAD OF THE FEMUR INTO the ACETABULUM
- ligaments become TWISTED
- Screw femur CLOSER up
during FLEXION:
ligaments are STRAIGHT
when do LIGAMENTS need to provide the most STABILITY for the HIP JOINT
during EXTENSION
- need most stability when standing
- weight-bearing
FLEXION: fixed femur, not weight-bearing
is it only the FEMUR that MOVES during motion of the HIP
eg walking, rotation
NO
PELVIS can MOVE
femur may not move at all, may be just pelvis moving
CLASSIFICATION of HIP MUSCLES into 5 GROUPS:
- EXTRINSIC hip muscles
- INTRINSIC hip muscles (superficial & deep)
- HIP ADDUCTORS
- HIP FLEXORS, KNEE EXTENSORS
- HIP EXTENSORS, KNEE FLEXORS
EXTRINSIC HIP MUSCLES:
ILIOPSOAS MUSCLE
- PSOAS MAJOR (originates from lumbar spine)
- ILIACUS (originates in iliac fossa)
FUNCTION of the ILIOPSOAS MUSCLE - PSOAS MAJOR & ILIACUS
(extrinsic hip muscles)
FLEXION of the HIP
the ILIOPSOAS MUSCLE - PSOAS MAJOR & ILIACUS 2 parts come together and ATTACH where
LESSER TROCHANTER of the FEMUR
INTRINSIC HIP MUSCLES
SUPERFICIAL:
(POSTERIOR)
- GLUTEUS MAXIMUS
(biggest & most powerful muscle) - TENSOR FASCIA LATAE
- contracts and pulls on the ILIOTIBIAL TRACT (band of FASCIA)
FUNCTIONS of the GLUTEUS MAXIMUS
- most powerful HIP EXTENSOR
- ADDUCTION & ABDUCTION
- some LATERAL ROTATION
how can the GLUTEUS MAXIMUS do both ADDUCTION and ABDUCTION
it passes over the AXIS OF ROTATION
ADDUCTION: muscles BELOW/inferior to AXIS of rotation CONTRACT
ABDUCTION: muscles ABOVE/superior to AXIS of rotation CONTRACT
FUNCTION of the TENSOR FASCIA LATAE
- using the ILIOTIBIAL TRACT
- STABILISES the KNEE in EXTENSION
(contracts and pulls on the iliotibial tract to do so)
can also help FLEXION slightly depending on the current state of knee joint
- if already flexed (iliotibial tract lying below axis of rotation)
what is the ANGLE between the MECHANICAL AXIS (straight down due to gravity) and the ANATOMICAL AXIS
174 DEGREES
INTRINSIC HIP MUSCLES
DEEP:
- GLUTEUS MEDIUS
- GLUTEUS MINIMUS
- PIRIFORMIS
- GEMELLUS SUPERIOR
- GEMELLUS INFERIOR
- OBTURATOR INTERNUS
- QUADRATUS FEMORIS
name of a MUSCLE that COVERS the OBTURATOR FORAMEN
and where is it
what is its function
OBTURATOR INTERNIS
INTRINSIC Hip Muscle in the DEEP LAYER
- LATERAL ROTATION
- ABDUCTION
FUNCTION of the GLUTEUS MEDIUS and GLUTEUS MINIMUS
(intrinsic hip muscles, deep)
ABDUCTION of femur
also PREVENT PELVIC DROP
how do the GLUTEUS MEDIUS and GLUTEUS MINIMUS PREVENT PELVIC/HIP DROP
when WALKING and opposite leg is LIFTED,
they CONTRACT and so PULL the PELVIS UP
(if no muscles, pelvis would drop due to gravity and weight)
what do you DEVELOP from PARALYSIS of the GLUTEUS MEDIUS
TRENDELENBURG GAIT
- HIP DROP
(lean to the other side)
FUNCTION of the PIRIFORMIS, GEMELLUS SUPERIOR, GEMELLUS INFERIOR & OBTURATOR FORAMEN
(Intrinsic, Deep)
LATERALLY ROTATES
ABDUCTS
FUNCTION of the QUADRATOR FEMORIS
(Intrinsic, Deep)
LATERAL ROTATION
3 COMPARTMENTS of the THIGH
ANTERIOR
POSTERIOR
MEDIAL
HIP ADDUCTORS in THIGH:
(most posterior)
- ADDUCTOR MAGNUS (fans over whole femur)
(more anteriorly)
- PECTINEUS
- ADDUCTOR LONGUS
- ADDUCTOR BREVIS
(most medially)
- GRACILIS (goes over the knee joint)
what can you find in the ADDUCTOR MAGNUS
ADDUCTOR HIATUS
- small ARTERY (FEMORAL ARTERY) PASSES THROUGH
where are the HIP ADDUCTOR MUSCLES
in the THIGH
FUNCTION of PECTINEUS
- ADDUCTION
- FLEXION
FUNCTION of ADDUCTOR LONGUS
- ADDUCTION
- MEDIAL ROTATION
FUNCTION of GRACILIS
- ADDUCTION
- FLEXION at KNEE
HIP FLEXORS KNEE EXTENSORS:
QUADRACEP MUSCLES:
- RECTUS FEMORIS (straight)
- VASTUS LATERALIS
- Vastus intermedialis
- VASTUS MEDIALIS
- SARTORIUS (crosses over the thigh, lateral to medial and inserts onto tibia)
HIP FLEXOR & KNEE EXTENSOR MUSCLES are on which SIDE of the THIGH
ANTERIOR
FUNCTIONS of the RECTUS FEMORIS and SARTORIS
HIP FLEXION
KNEE EXTENSION
FUNCTION of the VASTUS MEDIALIS & VASTUS LATERALIS
KNEE EXTENSION
HIP EXTENSORS & KNEE FLEXORS aka the..
HAMSTRINGS
where are the HAMSTRINGS / HIP EXTENSOR & KNEE FLEXOR MUSCLES
POSTERIOR side of the THIGH
The HAMSTRINGS / HIP EXTENSOR & KNEE FLEXOR MUSCLES:
(laterally)
- BICEPS FEMORIS (LONG HEAD)
- BICEPS FEMORIS (SHORT HEAD)
(more medially)
- SEMI-TENDINOSIS
- SEMI-MEMBRANOSIS
FUNCTIONS of the BICEPS FEMORIS in posterior thigh
HIP EXTENSION
KNEE FLEXION
LATERAL ROTATION
FUNCTIONS of the SEMI-TENDINOSIS & SEMI-MEMBRANOSIS in posterior thigh
HIP EXTENSION
KNEE FLEXION
MEDIAL ROTATION
BLOOD SUPPLY of the LOWER LIMB starts from the…
ABDOMINAL AORTA
in the pelvis what does the ABDOMINAL AORTA DIVIDE into
and what does this DIVIDE into
- COMMON ILIAC
-> INTERNAL ILIAC & EXTERNAL ILIAC
the EXTERNAL ILIAC passes into the LOWER LIMB and becomes the
FEMORAL ARTERY
What is the 1st BRANCH coming from the FEMORAL ARTERY
PROFUNDA FEMORIS
aka DEEP ARTERY OF THE THIGH
2 BRANCHES of the PROFUNDA FEMORIS
(DEEP ARTERY OF THE THIGH)
MEDIAL CIRCUMFLEX
LATERAL CIRCUMFLEX
(circle the NECK of the FEMUR)
What does the INTERNAL ILIAC DIVIDE into and what do these SUPPLY
- SUPERIOR GLUTEAL
- INFERIOR GLUTEAL
SUPPLY GLUTEAL MUSCLES
which ARTERY SUPPLIES the PROXIMAL HEAD of the FEMUR
ARTERY OF THE LIGAMENT OF THE HEAD OF THE FEMUR
which ARTERY SUPPLIES the DISTAL HEAD of the FEMUR
MEDIAL CIRCUMFLEX
What is the FEMORAL TRIANGLE in the thigh BOUND by (BORDERS)
LATERALLY:
MEDIALLY:
SUPERIORLY:
LATERALLY:
- medial border of the SARTORIUS
MEDIALLY:
- medial border of the ADDUCTOR LONGUS
SUPERIORLY:
- the INGUINIAL LIGAMENT
(which runs from the ASIS - anterior superior iliac spine- to the pubic tubercle)
what does the FEMORAL TRIANGLE CONTAIN
NEUROVASCULAR BUNDLE:
-FEMORAL ARTERY
- FEMORAL VEIN
- FEMORAL NERVE
which ARTERY is in the FEMORAL TRIANGLE
FEMORAL ARTERY
what is the PURPOSE of the ADDUCTOR HIATUS in the ADDUCTOR MAGNUS
Hole that ALLOWS PASSAGE of the FEMORAL ARTERY to the BACK of the knee
ANTERIOR TO POSTERIOR
where it will be called the POPLITIEAL ARTERY
name for the CONTINUATION of the FEMORAL ARTERY found at the back of the knee
POPLITIEAL ARTERY
main BLOOD SUPPLY of the FEMORAL HEAD in an adult
LATERAL EPIPHYSEAL ARTERY