2. Femur & Pelvis Flashcards
what is the head of femur covered with
hyaline cartilage
what is the fovea capitis
pit in the head of the femur
where does the ligamentum teres insert
into the fovea capitis of the head of femur
what is the intertrochanteric line and is it more on the anterior or posterior surface
the line between the greater and lesser trochanter
anterior surface
what is the trochanteric fossa and is it more on the lateral/medial aspect
depression in the medial aspect of the greater trochanter
medial aspect
neck of the femur is articular true or false
false
the greater trochanter is the bump of bone on the lateral/medial aspect
lateral
which 3 muscles attaches to the greater trochanter
gluteus med/minimus and piriformis
the lesser trochanter is found more distally/proximally and is more on the anterior/posterior aspect of the femur
distally
posterior
what attaches to the lesser trochanter
iliopsoas muscle
what is the intertrochanteric crest and is it located more anteriorly or posteriorly
defined crest of bone that joins the two trochanters posteriorly
where does the short external rotators of the hip insert
at the trochanteric fossa
what is the linea aspera and is it located posteriorly or anteriorly
ridge of bone extending the length of the shaft posteriorly
what attaches to the linea aspera
muscles of the thigh
the head of the femur articulates with what part of the pelvis
the acetabulum of the pelvis
muscles of what region help stabilise the femur and what are their 2 functions
gluteal region
move the hip joint and stabilise the pelvis during locomotion
do you have more lateral rotation medially or laterally
roughly similar
30* lateral and 40* medial
flexion is created by muscles that pass anterior/posterior to the hip joint
anterior
what happens to your range of motion of rotation medially and laterally when you flex your knee
medial rotation decreases but lateral rotation increases significantly
extension is created by muscles that pass anterior/posterior to the hip joint
posterior
do you have more lateral rotation or medial when you rotate with a extended femur
lateral rotation decreased compared to flexed hip
is there a greater range of abduction and adduction on a flexed or extended hip
greater abduction and less adduction for flexed hip
what is circumduction of the femur
composite movement created by putting all movements together
circling thigh and leg
each hemipelvis is composed of 3 major components what are these
and what portion of the pelvis are they located at (eg superior/posterior/inferior/anterior)
ilium - superiorly
ischium - inferior and posteriorly
pubis - inferiorly and anteriorly
what are the 5 bony landmarks found on the ilium
iliac crest iliac fossa ASIS PSIS GSN
what is the ASIS and PSIS
Anterior and posterior superior iliac spine
what is the GSN
greater sciatic notch
what are the 2 bony landmarks found on the ischium
ischial tuberosity
ischial spine
what are the 2 bony landmarks found on the pubis
pubic tubercle
pubic symphisis
on the pelvis where is the iliac crest
top most border of the pelvis
which 2 bony landmarks is the GSN found between
PSIS and ischial spine
which is located lower down the ischial spine or the tuberosity
ischial tuberosity
the 2 iliac crests articulate anteriorly/posteriorly with the alae of the sacrum and anteriorly/posteriorly with each other at the pubic symphysis creating a ring
posteriorly with the alae of the sacrum and anteriorly with each other at the pubic symphysis
what is contained in the pelvis of the body
abdominal viscera - small/large bowels
pelvic viscera - bladder, rectum, vagina, uterus, internal genitalia of males and females
the ilium, pubis and ischium are all joined where
at the acetabulum
what type of cartilage lines the acetabulum and is it a continuous ring
hyaline cartilage
crescent shape non-continuous ring
what is the name of the surface of the cartilage in the acetabulum
lunate surface
what is the portion in the middle of the lunate surface called and what is significant about its structure
acetabular fossa
devoid of cartilage
what is the acetabular notch
space between 2 free ends of the lunate surface/acetabular cartilage
what is ligament forms the acetabular foramen with the acetabular notch
transverse acetabular ligament
what passes through the acetabular foramen
ligamentum teres
what passes through the obturator foramen
obturator nerve and obturator artery
what forms the obturator foramen
pubic and ischial bones
what effect does trauma have on the ring structure of the pelvic bones and sacrum
if it breaks in one place it usually breaks/dislocates in another place as well
what is the difference between female and male pevlises
females have a rounder pelvic inlet and a subpubic angle larger than 90*
males have a pelvic inlet that is heart shaped and narrower and a subpubic angle smaller than 90*
The hip joint is a ___ joint
synovial joint
what is the hip joint composed of in terms of the inner and outer layers
synovial inner layer
fibrous capsular outer layer
what are the 3 ligaments of the hip joint capsule
pubofemoral
iliofemoral
ischiofemoral
describe the attachments of the hip joint
from the acetabulum rim medially to the intertrochanteric line (anterolaterally) the greater trochanter and the neck of the femur (posterolaterally)
what movements does the ischiofemoral ligament limit
limits adduction and medial rotation
what movements does the iliofemoral ligament limit
limits adduction and abduction (superior and inferior bands respectively)
what movements does the pubofemoral ligament limit
limits abduction and lateral rotation
what are the two other ligaments that stabilise the hip joint and pelvis
sacrospinous
sacrotuberous
which ligaments form the greater and lesser sciatic foramina with the G/LSNs
sacrospinous & sacrotuberous ligaments
what ligament prevents the femoral head from dislocating
transverse acetabular ligament
what is the function of the ligamentum teres normally and what is its function during development
maintains femoral head in the acetabulum
during development it helps supply arteries to the developing femoral head
what is the artery that accompanies the ligamentum teres and delivers blood to the femoral head and when is this artery functional
obturator artery
during childhood
what is the major artery in the pelvis
common iliac artery
what are the 2 arteries that the common iliac artery split into
internal and external iliac artery
what does the internal iliac artery supply
pelvic contents and gluteal region
what does the external iliac artery supply
entire lower limb
what artery does the external iliac artery become
femoral artery
the hip joint is supplied by a anastamotic network of arteries derived from what artery
deep branch of the femoral artery
what does anastamose mean
join together
what 2 arteries does the deep branch of the femoral artery give off
medial and lateral circumflex arteries
the medial and lateral circumflex arteries anastamose with eachother and some branches of which 2 arteries
superior and inferior gluteal arteries
what artery does the superior and inferior gluteal arteries come from
internal iliac artery
which bony landmark on the pelvis do the sup/inf gluteal arteries emerge from
Greater sciatic foramen
why is there a collateral network of arteries in the pelvis
Collateral network for redundancy so if one path is blocked, there are different paths, occlusion could be naturally from flexing elbow/knee etc
what is the purpose of an anastamotic network
provides collateral flow if occlusion occurs (pathological or non-pathological)
what is the path of arteries that blood flows through to get from the pelvis to the lower leg
common iliac into
1/ external iliac -> femoral (and splits into profunda femoris)
2/ internal ilac -> superior and inferior gluteal -> circumflex branches
what does the blood supply for the femoral head come from
retinacular arteries
how do the retinacular arteries supply the femoral head
pierce the capsule and runs along the femoral neck
what might critically compromise the retinacular arteries
femoral neck fracture leads to avascular necrosis to the femoral head
what is the path of the blood flow through the arteries to the femoral head
profunda femoris artery
lateral and medial circumflex artery
retinacular arteries
what 3 structures run in the femoral triangle (from lateral to medial)
femoral nerve (most lateral) femoral artery femoral vein (most medial)
the femoral nerve is made up of which nerve roots of which plexus
L2-4 nerve roots
lumbar plexus
what muscles do the femoral nerve supply
muscles of the anterior compartment of the thigh
what function do the muscles of the anterior compartment of the thigh have at the hip and knee
hip = flexion knee = extension
the base of the femoral triangle is formed by which ligament
inguinal ligament
proximal to the inguinal ligament are which femoral artery and vein
external iliac artery and vein
what are the 2 nerves in the pelvis
sciatic nerve and femoral nerve
what does the sciatic nerve supply
entire posterior compartment of the thigh (ham strings) and everything below the knee (except for some of the medial shin that is supplied by the femoral nerve)
which nerve roots do the sciatic nerve come from and which 2 plexus do they come from
L4-S4 nerve roots of the lumbar and sacral plexus
what is the sciatic nerves relationship to the hip joint
posterior to the hip joint
how does the sciatic nerve exit the pelvis to enter the gluteal region
what position is its exit relative to the muscle (which muscle)
passes laterally through the greater sciatic foramen
anterior to the piriformis
the GNS leads in/out of the pelvis and the LSN leads in/out of the pelvis
GSN = out LSN = in