14. Lower Limb I Flashcards
What are the 3 Bones that make up the Hip?
- Ilium
- Ischium
- Pubis
Where do the 3 Bones of the Hip meet?
Acetabulum
Which cartilage separates the Hip bones at Puberty?
Tri - Radiate Cartilage
What type of Joint is the Hip joint?
Synovial Ball and Socket Joint
What are the main bony features of the Acetabulum?
- Acetabular Notch
- Acetabular Fossa
- Lunate Surface
What is the function of the Lunate Surface?
The Lunate Surface articulates with the Head of the Femur to form the Hip Joint.
What is the function of the Acetabular Fossa?
The Acetabular Fossa deepens the Ball and Socket Joint,
And contains the Ligament of the Head of the Femur,
This is the Round Ligament of the Femur.
What does the Round Ligament of the Femur contain?
The Acetabular Branch of the Obturator Artery.
What are the main bony features of the Ilium?
- Iliac Crest:
- Wing (Ala) Of Ilium
- Gluteal Lines:
- Anterior Superior Iliac Spine
- Anterior Inferior Iliac Spine
- Posterior Superior Iliac Spine
- Posterior Inferior Iliac Spine
- Greater Sciatic Notch
- Wing (Ala) Of Ilium
- Iliac Fossa
- Iliac Tuberosity
- Auricular Surface (For Sacrum)
- Body Of Ilium
- Arcuate Line
What are the components of the Iliac Crest?
- Tuberculum
- Outer Lip
- Inner Lip
What are the 3 Gluteal Lines?
- Anterior Gluteal Line
- Posterior Gluteal Line
- Inferior Gluteal Line
Which muscle attaches to the ASIS?
Sartorius
What is the Vertebral level of
the highest point of the Iliac Crest?
L4
What is the Vertebral Level of the PSIS?
Between S1/S2
Which Muscle passes through the Greater Sciatic Notch?
Piriformis
Which Vessels pass through the Greater Sciatic Notch?
Internal Pudendal Vessels
Superior Gluteal Vessels
Inferior Gluteal Vessels
Which Nerves pass through the Greater Sciatic Notch?
Sciatic Nerve Superior Gluteal Nerve Inferior Gluteal Nerve Posterior Femoral Cutaneous Nerves Nerve to Obturator Internus Nerve to Quadratus Femoris
Which Bony landmark is important for locating the Appendix (McBurney's Point)?
Anterior Superior Iliac Spine
What are the main bony features of the Pubis?
- Iliopubic Eminence
- Superior Pubic Ramus
- Inferior Pubic Ramus
- Pecten Pubis (Pectineal Line)
- Pubic Tubercle
- Symphyseal Surface
- Obturator Crest
- Obturator Groove
- Pubic Tubercle
Which Ligament attaches to the Pubic Tubercle?
Inguinal Ligament
What are the main bony features of the Ischium?
- Ischial Spine
- Lesser Sciatic Notch
- Body Of Ischium
- Ischial Tuberosity
- Ischial Spine
- Lesser Sciatic Notch
- Ramus Of Ischium
What is the Ischial Tuberosity?
The Bony Portion of the Hip that we sit on.
Which structures attach to the Lower Part of the
Ischial Tuberosity?
Adductor Magnus
Sacrotuberous Ligament
Which structures attach to the Upper Part of the
Ischial Tuberosity?
Semimembranosus Muscle
Long Head of Biceps Femoris
Semitendinosus Muscle
Which Vessels pass through the Lesser Sciatic Notch?
Internal Pudendal Vessels
Which Nerve passes through the Lesser Sciatic Notch?
Nerve to Obturator Internus
What are the main bony features of the Femur?
- Head
- Neck
- Fovea For Ligament Of Femur Head
- Greater Trochanter
- Lesser Trochanter
- Intertrochanteric Crest
- Intertrochanteric Line (Quadrate Tubercle)
- Pectineal Line
- Gluteal Tuberosity
- Linea Aspera
- Nutrient Foramen
- Shaft (Body)
- Popliteal Surface
- Patellar Surface
- Medial Condyle
- Lateral Condyle
- Medial Epicondyle
- Lateral Epicondyle
- Lateral Supracondylar Line
- Medial Supracondylar Line
- Intercondylar Fossa
- Adductor Tubercle
What are the 2 Lips of the Linea Aspera?
- Medial Lip
- Lateral Lip
Which Muscles attach to the Greater Trochanter?
Gluteus Medius Obturator Externus Obturator Internus Superior Gemellus Inferior Gemellus
Which Muscles attach to the Lesser Trochanter?
Psoas Major
Iliopsoas
Which Ligament attaches Superior
to the Intertrochanteric Line?
Iliofemoral Ligament
One of strongest Ligaments in the body
Which 2 Quadriceps Femoris Muscles attach
to the Linea Aspera?
- Vastus Medialis: Attaches to the Medial Lip
2. Vastus Lateralis: Attaches to the Lateral Lip
List the Major Ligaments in the Hip Joint:
- Fibrous Joint Capsule
- Iliofemoral Ligament
- Pubofemoral Ligament
- Ischiofemoral Ligament
- Transverse Acetabular Ligament
- Ligamentum Teres Femoris
What are the attachments of the Fibrous Capsule at the Hip?
Hip:
- Acetabular Margin
- Labrum
- Transverse Acetabular Ligament
- Obturator Foramen
What are the attachments of the Fibrous Capsule at the Femur?
Femur:
- Intertrochanteric Line
- Intertrochanteric Crest.
What is the Shape of the Iliofemoral Ligament?
It is Y - Shaped
What is the role of the Iliofemoral Ligament in Posture?
Maintains posture without need for Muscular Activity.
When standing the Ligament is Twisted and Tense,
Preventing trunk from falling backwards.
How does the Iliofemoral Ligament facilitate Hip Flexion?
Hip Flexion:
Ligament Tension reduced
Hip Mobility increased.
Which movements does the Transverse Part of the
Iliofemoral Ligament control?
Lateral Rotation
Adduction
What movement is limited by the Descending Part of the
Iliofemoral Ligament?
Medial Rotation is limited
by the Descending Part.
How is the Femoral Head attached to the Transverse Acetabular
Ligmament?
Femoral Head is attached to the Transverse Acetabular Ligament.
By the Ligamentum Teres Femoris (Ligment of the Head of the Femur).
What Deepens the Acetabulum?
Acetabulum is Deepened by the Acetabular Labrum.
What structure runs within the Ligamentum Teres?
Acetabular Branch of the Obturator Artery.
Which Arteries supply the Head and Neck of the Femur?
Inferior Gluteal Artery
Deep Femoral (Profunda Femoris) Artery
Medial Circumflex Femoral Artery
Lateral Circumflex Femoral Artery
How do Arteries supply the Head and Neck of the Femur?
Via the Cruciate Anastomosis.
What is the main contributor to the Head and Neck of the Femur?
Medial Circumflex Femoral Artery.
What condition is the Hip Joint susceptible to?
Osteoarthritis
How can Pelvic Fractures occur?
Direct Trauma (automobile accident/crush injuries) Forces transmitted by Lower Limbs during falls on the feet.
What is the nature of Fractures of the Bony Pelvis?
Fractures of the Bony Pelvic Ring are almost always Multiple Fractures
Or a Fracture combined with a Joint Dislocation.
What are the weak areas of the Pelvis that often Fracture?
Pubic Rami
Acetabula
Sacroiliac Joints
Alae of the ilia
What are Broken Hips in the Elderly often referring to?
Femoral Neck Fracture
Which group is more susceptible to Femoral Neck Fracture?
Women over 60 years more than Men,
Because Bones in Females are more frequently weakened by Osteoporosis.
What are the 2 types of Femoral Neck Fracture
Give Examples of each?
- Intracapsular Fractures:
- Femoral Head Fracture
- Femoral Neck Fracture
- Extracapsular Fractures:
- Intertrochanteric Fracture
- Subtrochanteric Fracture
- Femoral Shaft Fracture
Which other structure is vulnerable to injury from
Femoral Neck Fractures?
Retinacular Arteries run parallel to the Femoral Neck,
Making them vulnerable to injury when the neck of the Femur Fractures.
Why do Femoral Neck Fractures need to be assessed quickly?
As increased risk of Avascular Necrosis of the Femoral Head.
What are the Boundaries of the Gluteal Region?
- Superior: Iliac Crest
- Inferior: Gluteal Fold (Bottom Of Bum)
- Lateral: Greater Trochanter
- Medial: Intergluteal Cleft (Bum Crack)
What are the Muscles of the Gluteal Region?
- Gluteus Maximus
- Gluteus Medius
- Piriformis
- Superior Gemelli
- Inferior Gemelli
- Obturator Internus Tendon
- Quadratus Femoris
- Obturator Externus
What is the Origin of the Gluteus Maximus Muscle?
Hip:
Posterior Gluteal Line of Ilium Sacrum and Coccyx
And Sacrotuberous Ligament.
What is the Insertion of the Gluteus Maximus Muscle?
Femur:
Gluteal Tuberosity
And Iliotibial Tract
What is the Action of the Gluteus Maximus Muscle?
Hip Extension
External Rotation
(Helps in Rising from Sitting)
What are the Nerve Roots of the Gluteus Maximus Muscle?
L5, S1 & S2 Nerve Roots
What is the Action of the Gluteus Medius Muscle?
Abducts Femur at the Hip
Internal Hip Rotation
Aids in Early Hip Flexion
What is the Innervation of the Gluteus Medius Muscle?
Superior Gluteal
Nerve Roots: L4 - S1
What is the Action of the Gluteus Minimus Muscle?
Abducts Femur at the Hip
Internal Hip Rotation
Early Hip Flexion
What is the Innervation of the Gluteus Minimus Muscle?
Superior Gluteal
Nerve Roots: L4 - S1
What are the Ligaments of the Gluteal Region?
- Sacrotuberous Ligament
2. Sacrospinous Ligament
What Foramen is formed by the Sacrotuberous and Sacrospinous?
Greater Sciatic Foramen
What is the function of the Sacrotuberous Ligament?
Important in preventing Body Weight from Rotating the Pelvic Girdle Forwards.
Which Surgical Procedure is associated with the Sacrospinous?
Correcting Vaginal Prolapse
Which important Neurovascular structures emerge from
The Greater Sciatic Foramen?
Superior Gluteal Nerves and Vessels Superior to Piriformis
Inferior Gluteal Nerves and Vessels Inferior to Piriformis.
How is the Sciatic Nerve related to the Piriformis?
Sciatic Nerve lays Inferior to Piriformis,
Though in 12% of people, the Common Fibular Portion may exit through the Muscle.
What are the Short Rotator Muscles of the Hip?
- Piriformis
- Superior Gemellus
- Obturator Internus
- Inferior Gemellus
- Quadratus Femoris
What are the Actions of the Short Rotator Muscles of the Hip?
Laterally Rotate
Extend Thigh
Help Abduction
What is the Action of the Quadratus Femoris?
This Muscle helps laterally Rotate Thigh.