A: Gluteal region & back of thigh

Question 1

Ligaments in posterior hip bone

Answer 1

Sacrospinous
Sacrotuberous

Question 2

Deep muscles of gluteal region:

Answer 2

• Piriformis
• Gemellus superior
• Obturator internus
• Gemellus inferior
• Quadratus femoris

Question 3

Superficial muscles of gluteal region

Answer 3

• Gluteus maximus
• Gluteus medius
• Gluteus minimus
• Tensor fasciae latae

Question 4

3 Hamstring muscles:

Answer 4

• Lateral side = biceps femoris (two heads)
• Semitendinosus
• Semimembranosus

Question 5

Sciatic nerve passage

Answer 5

Enters gluteal region through greater sciatic foramen, inferior to piriformis.
Runs downwards on posterior surface of short muscles of hip joint, deep to gluteus maximus.
Enters posterior compartment deep to hamstrings on posterior surface of adductor magnus.

Question 6

Popliteal fossa boundaries

Answer 6

Top medial: semitendinous + semimembraneous
Top lateral: tendon of bicep femoris
Bottom medial: Medial head of gastrocnemius
Bottom lateral: lateral head of gastrocnemius

Question 7

Contents of popliteal fossa

Answer 7

Popliteal artery, popliteal vein, tibial + common fibular branches of sciatic nerve, popliteal lymph nodes.

Question 8

Bicep femoris

Answer 8

• Long head: ischial tuberosity. Short head: linea aspera of femur
• Head of fibula
• Flexion at knee, extension at hip, lateral rotation at hip + knee joints, extend trunk on fixed femur.
• Sciatic nerve

Question 9

Semitendinosus

Answer 9

• Ischial tuberosity
• Upper part of shaft of tibia
• Extend hip, flex knee, medial rotation at hip + knee, extend trunk on fixed femur
• Sciatic nerve

Question 10

Semimembranosus

Answer 10

• Ischial tuberosity
• Medial condyle of tibia
• Flexion at knee, extension at hip, medial rotation at hip + knee, extend trunk on fixed femur.

Question 11

Gluteus maximus

Answer 11

• External surface ilium, sacrum, sacrotuberous ligament
• Iliotibial tract of fascia lata, gluteal tuberosity of femur
• Extension + lateral rotation of thigh at hip, extends trunk on LL, stabilizes hip + knee joint
• inferior gluteal nerve

Question 12

Gluteus medius

Answer 12

• External surface of ilium
• Greater trochanter of femur
• Abducts + medial rotates hip joint, tilts pelvis when walking + prevents pelvis from dropping on side of swinging limb
• superior gluteal nerve

Question 13

Gluteus minimus

Answer 13

• External surface of ilium
• Greater trochanter of femur
• Abducts + medial rotates hip joint, tilts pelvis when walking + prevents pelvis dropping on side of swinging limb
• superior gluteal nerve

Question 14

Tensor fascia latae

Answer 14

• Iliac crest
• Iliotibial tract
• Abduction, stabilizes knee joint
• Superior gluteal nerve

Question 15

Which blood vessels are the main blood supply to the hip joint

Answer 15

Medial + lateral circumflex femoral arteries

Question 16

What is the saphenous opening and where is it located

Answer 16

An opening in the fascia lata through which the great saphenous vein passes to drain into the femoral vein.
Located inferior to the medial end of the inguinal ligament.

Question 17

describe course taken by obturator nerve

Answer 17

Medial border of psoas major muscle–> obturator canal–> medial compartment of thigh.

Question 18

What type of joint is found between the two pubic bones?

Answer 18

secondary cartilaginous joint

Question 19

Where can you palpate the femoral artery pulse?

Answer 19

At mid-inguinal point: midway between anterior superior iliac spine + pubic symphysis.

Question 20

List the muscles that cause flexion at the knee joint

Answer 20

Iliopsoas, Sartorius, Rectus femoris, Pectineus, Adductor longus, Adductor brevis, Adductor magnus.

Question 21

List the muscles that cause adduction at hip

Answer 21

Adductor longus, Adductor brevis, Adductor magnus, Pectineus, Gracilis, Obturator externus.

Question 22

Piriformis

Answer 22

• Anterior surface of sacrum
• Greater trochanter of femur
• Lateral rotation at hip, stabilizes hip
• Sacral plexus

Question 23

Superior gemellus

Answer 23

• Spine of ischium
• Greater trochanter of femur
• Lateral rotation at hip joint, stabilizes hip joint
• Sacral plexus

Question 24

Obturator internus

Answer 24

• Internal surface of obturator membrane + adjacent bone
• Runs posteriorly to exit pelvis through lesser sciatic foramen. Passes laterally behind hip joint, to insert in greater trochanter of femur.
• Lateral rotation of hip joint, stabilizes hip joint
• Sacral plexus

Question 25

Inferior gemellus

Answer 25

- Ischial tuberosity - Greater trochanter of femur - Lateral rotation at hip joint - Sacral plexus

Question 26

Quadratus femoris

Answer 26

- Ischial tuberosity - Intertrochanteric crest of femur - Lateral rotation at hip joint, stabilizes hip joint - Sacral plexus

Question 27

Identify this and its function

Answer 27

Iliofemoral ligament - prevents over-extension

Question 28

What is the acetabular fossa?

Answer 28

Non-articulating part of acetabulum

Question 29

What are the attachments of the ligament of head of femur? What does it contain?

Answer 29

Head of the femur --> acetabular notch, transverse acetabular ligament & acetabular fossa. Contains acetabular branch of obturator artery which contributes to the blood supply of head of femur.

Question 30

A woman with osteoporosis falls and fractures the head of her right femur. Why is there a risk of avascular necrosis of the femoral head?

Answer 30

Branches of medial and lateral circumflex femoral arteries run along femoral neck to reach femoral head. These may be damaged by the fracture. Avascular necrosis of femoral head will occur if there is an inadequate blood supply through the acetabular branch of obturator artery (which passes from the acetabulum to the femoral head, through the ligament of head of femur).

Question 31

List the articulating surfaces of the knee

Answer 31

Condyles of femur (Medial & lateral), Condyles of tibia (Medial & lateral), Patella.

Question 32

What are the attachments of the cruciate ligaments

Answer 32

Intercondylar area of tibia and femoral condyles.

Question 33

Identify this + what structures run through it

Answer 33

Knee capsule, Tendon of popliteus muscle, which exits the joint cavity posteriorly.

Question 34

Why is the medial collateral ligament prone to injury?

Answer 34

Is attached to medial meniscus, so is less mobile.

Question 35

List the bursae in the knee with their locations. Mention which communicate with the knee joint.

Answer 35

- Suprapatellar (between quadriceps femoris muscle / tendon + femur). Communicates with knee joint. - Prepatellar (between skin and patella) - Infrapatellar (between skin and tibia)

Question 36

Superior tibiofibular joint:

Answer 36

Surfaces: Head of fibula & lateral condyle of tibia. Synovial plane joint. Slight gliding movement occurs during dorsiflexion / plantarflexion

Question 37

Inferior tibiofibular joint

Answer 37

Fibrous joint. Very little movement

Question 38

What does the posterior cutaneous nerve of the thigh innervate

Answer 38

Posterior aspect of thigh Popliteal fossa Upper part of back of leg Skin of gluteal fold, upper medial thigh + perineum.

Question 39

Medial plantar nerves

Answer 39

Gives rise to common plantar digital nerves which give rise to proper plantar digital nerves. Supplies abductor hallucis, flexor hallucis brevis, flexor digitorum brevis + 1st lumbrical. Supplies skin of anterior 2/3 of sole and medial 3/5 digits.

Question 40

Where does the popliteal artery begin?

Answer 40

In adductor hiatus as continuation of femoral artery

Question 41

At what position should intramuscular injections be given in the gluteal region? Explain why.

Answer 41

Upper lateral quadrant - avoid injuring sciatic and gluteal nerves.

Question 42

What does posterior cutaneous nerve of thigh innervate

Answer 42

Skin over posterior aspect of thigh, popliteal fossa and upper part of the back of leg. Skin of gluteal fold, upper medial thigh and perineum

Question 43

Muscles that cause medial rotation at hip?

Answer 43

Gluteus medius, Gluteus minimus, Adductor longus, Adductor brevis, Adductor magnus, Semitendinosus, Semimembranosus.

Question 44

Lateral rotation at hip?

Answer 44

Gluteus maximus, Piriformis, Superior gemellus, Inferior gemellus, Obturator internus, Obturator externus, Biceps femoris.

Question 45

After it passes through space behind knee, what is the course of the popliteal vein

Answer 45

exits fossa by passing through the adductor hiatus (in adductor magnus) to enter the adductor canal and becomes the femoral vein

Question 46

Where can you palpate the pulse of popliteal artery? Why is it difficult to palpate?

Answer 46

Deeply in centre of Popliteal fossa. Difficult to palpate: deepest of neurovascular structures in fossa