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Anatomy > ANA 211 Lower Limb Osteology and Gluteal Region > Flashcards

ANA 211 Lower Limb Osteology and Gluteal Region Flashcards

1
Q

What are the types of bones

A

Flat
Long
Irregular
Short
Sesamoid

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2
Q

Function of flat bones and examples

A
  1. They shield and protect organs
  2. They can provide large areas of attachment for muscles

Eg. Scapula, sternum, ribs, cranial bones

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3
Q

Function and examples of long bones

A

1.Supports weight
2. Facilitates movements

Eg. Humerus, femur, tibia, fibula, ulna, radius, metacarpal, metatarsal and phalanges

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4
Q

Function of lower limb bones?

A

Locomotion
Carry the weight of the entire erect body
Support
Points for muscular attachments

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5
Q

Components of the lower limb bones

A

1.Hip (Pectoral girdle)
Ilium
Ischium
Pubis
Acetabulum

2.Thigh
Femur

3.Knee
Patella
Leg
Tibia (medial)
Fibula (lateral)

4.Foot
Tarsals (7)
Metatarsals (5)
Phalanges (14)

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6
Q

What are the bones of the hip?

A

Ilium
Ischium
Pubis
Acetabulum

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7
Q

How many phalanges, metatarsals and tarsals do we have?

A

phalanges, (14)
metatarsals (5)
tarsals (7)

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8
Q

What is the epiphyseal plate?

A

Line of hyaline cartilage between epiphysis and diaphysis where the developing bone lengthens
Responsible for:
The proliferation of the cartilage cells responsible for the length of the developing bone
It disappears when growth in bone length stops

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9
Q

Where is the red bone marrow located in a long bone?

A

The epiphysis

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10
Q

The medullary/marrow cavity is filled with _

A

Yellow bone marrow

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11
Q

Yellow bone marrow makes white blood cells TRUE/FALSE

A

FALSE the yellow bone marrow stores fats and nutrients for the bone

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12
Q

Where are red and white blood cells produced?

A

Both are produced in the red bone marrow

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13
Q

What age does yellow bone marrow develop in humans?

A

7/8 years

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14
Q

Which bone-type functions in strengthening the bone?

A

Compact bone (dense and closely packed cell material)

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15
Q

What are the types of bone structures in a long bone?

A

Spongy bone
Compact bone

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16
Q

What is the function of the spongy bone?

A

To house the red bone marrow
to make the bones light, for ease of movement

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17
Q

Purpose of the arteries in the bone?

A

To deliver nutrients and transport new blood cells throughout the body

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18
Q

Function of the periosteum

A

Consists of a layer of osteoblasts for bone material to grow and heal if broken

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19
Q

What is the metaphysis?

A

Part of the diaphysis adjacent to the epiphyseal plate

The most active site of bone formation in the developing bone

Highly vascularized

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20
Q

List and explain the types of epiphysis

A
  1. Pressure Epiphysis
    Found at the ends of long bones
    Articular in nature
    Takes part in the transmission of weight
  2. Traction Epiphysis
    Produced due to the pull of the muscle and therefore provides attachment to the muscle(s)
    Non-articular in nature
    Does not take part in the transmission of weight
  3. Atavistic Epiphysis
    An independent bone in lower animals, but part of another bone in humans
  4. Aberrant Epiphysis
    Not present in everybody
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21
Q

Examples of the different types of epiphyses

A

Pressure e.g. head of femur, humerus, the lower end of the radius
Traction e.g. greater and lesser tubercles of the humerus, greater and lesser trochanters of the femur, and the mastoid process of the temporal bone.
Atavistic e.g. Coracoid process of scapula, posterior tubercle of talus
Aberrant: e.g. epiphysis at the head of first metacarpal and base of other metacarpals

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22
Q

Flat bones such as the cranial bones and clavicle are developed by which form of ossification?

A

Intramembranous ossification

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23
Q

Long bones such as the humerus and femur are developed by which form of ossification?

A

Endochondral ossification

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24
Q

Types of joint functions

A
  1. Synarthrosis: no movement
  2. Amphiarthrosis: little movement
  3. Diarthrosis: full movement
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25
Q

Examples of synarthrosis joints

A

Skull sutures
Articulations of bony sockets
Teeth in facial skeleton bone

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26
Q

Example of amphiarthrosis joints

A

Distal joint between the tibia and the fibula
Pubic symphysis

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27
Q

Example of diarthrosis joints

A

Elbow, shoulder, ankle

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28
Q

Types of joints according to structure

A

Fibrous joint
Cartilaginous joint
Synovial joint

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29
Q

Why are most fibrous joints immovable

A

They have no joint cavity and are connected via fibrous connective tissues (synarthroses)

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30
Q

Types of fibrous joints

A

1.SUTURESare nonmoving joints that connect bones of the skull. These joints have serrated edges that lock together with fibers of connective tissue.

2.The fibrous articulations between the teeth and the mandible or maxilla are calledGOMPHOSES and are also immovable.

3.ASYNDESMOSISis a joint in which a ligament connects two bones, allowing for a little movement (amphiarthroses). The distal joint between the tibia and fibula is an example of a syndesmosis.

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31
Q

Types of cartilaginous joints

A

(1) ASYNCHRONDOSIS is an immovable cartilaginous joint. One example is the joint between the first pair of ribs and the sternum.

(2) A SYMPHYSIS consists of a compressible fibrocartilaginous pad that connects two bones. This type of joint allows for some movement. The hip bones, connected by the pubic symphysis, and the vertebrae, connected by intervertebral discs, are two examples of symphyses.

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32
Q

Types of synovial joints

A

(1) Gliding joints move against each other on a single plane. E.gs. intervertebral joints and the bones of the wrists and ankles.

(2) Hinge joints move on just one axis. These joints allow for flexion and extension. E.gs. the elbow and finger joints.

(3) A pivot joint provides rotation. At the top of the spine, the atlas and axis form a pivot joint that allows for rotation of the head.

(4) A condyloid joint allows for circular motion, flexion, and extension. The wrist joint between the radius and the carpal bones is an example of a condyloid joint.

(5) A saddle joint allows for flexion, extension, and other movements, but no rotation. In the hand, the thumb’s saddle joint (between the first metacarpal and the trapezium) lets the thumb cross over the palm, making it opposable.

(6) The ball-and-socket joint is a freely moving joint that can rotate on any axis. The hip and shoulder joints are examples of ball and socket joints.

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33
Q

What is an ossification center and what are the types of ossification?

A

A point where ossification starts
1.Primary
2. Secondary

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34
Q

Which joint in the thumb allows for opposition?

A

condyloid joint

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35
Q

Synchrondoses is a _ cartilaginous joint

A

Primary

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36
Q

What is the fibrous joint found in the skull?

A

suture

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37
Q

What is the fibrous joint found between the ulna and radius?

A

syndesmosis

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38
Q

What are the fibrous articulations between the teeth and the mandible or maxilla?

A

gomphosis

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39
Q

What kind of joint can be found between the epiphysis and diaphysis of long bones?

A

a cartilaginous joint

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40
Q

Name the secondary cartilaginous joint

A

Symphysis

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41
Q

What is the joint between the first pair of ribs and the sternum?

A

synchondrosis

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42
Q

What cartilaginous joint is located at the pubis symphyses?

A

Symphysis/ symphyses

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43
Q

Syndesmosis possesses which type of joint mobility?

A

Amphiarthrosis

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44
Q

Gomphosis and Synchondrosis possess which type of joint mobility?

A

Synarthrosis

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45
Q

The gluteal region is between

A

The iliac crest and gluteal fold

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46
Q

What is the line dividing the buttock

A

nata (intergluteal) cleft

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47
Q

What is the clinical relevance of the superficial fascia?

A

intramuscular drug delivery

48
Q

Functions of the Superficial Fascia

A

Gives the characteristic convexity to the buttock
Forms a thick cushion over the ischial tuberosity

49
Q

What are the muscles of the lower limb?

A

Gluteus maximus
Gluteus medius
gluteus minimus
tensor fascia lata
piriformis
superior gemellus
Inferior gemellus
obturator internus
quadratus femoris

50
Q

What is the largest muscle in the body?

A

Gluteus Maximus

51
Q

Where are the points of origin of the Gluteus Maximus?

A

Posterior surface of the sacrum and coccyx
Lumbar fascia
Outer Ilium posterior to the gluteal line
Sacrotuberous ligament

52
Q

What is the point of insertion for the Gluetus Maximus?

A

Most of the muscle (3/4th) inserted into the iliotibial tract
Deeper fibers inserted into the gluteal tuberosity

53
Q

What is the nerve supply of the Gluteus Maximus?

A

Inferior gluteal nerve (L5, S1 & 2)

54
Q

What are the actions of the gluteus Maximus?

A

Extends and laterally rotates hip joint extends the knee joint through iliotibial tract
Gives simultaneous stability to the hip and knee joints through the iliotibial tract

55
Q

What is the chief anti gravity muscle of the hip?

A

Gluteus Maximus

56
Q

What makes up the inferior gluteal nerve?

A

L5, S1 and 2

57
Q

What makes up the superior gluteal nerve?

A

L4, 5 and S1

58
Q

What can be the result of damage to the superior gluteal nerve?

A

Damage to the superior gluteal nerve results in paralysis of the gluteus medius muscle resulting in a characteristic gait on walking and standing known as the Trendelenburg

59
Q

What is the origin of the gluteus medius?

A

Outer surface of the ilium between the anterior and posterior gluteal lines

60
Q

Which gluteal muscle, extends from the pelvis to the gluteal tuberosity of femur?

A

Gluteus maximus

61
Q

What is the blood supply of the gluteus maximus?

A

Inferior gluteal and superior gluteal arteries

62
Q

Which gluteal muscle extends from the ilium to the proximal femur?

A

Gluteus medius

63
Q

What is the insertion of the gluteus medius?

A

Lateral surface of the greater trochanter of the femur

64
Q

Action of gluteus medius?

A

Hip joint: Thigh abduction, thigh medial rotation
Stabilizing the pelvis whilst walking
Connects pelvis to femur by crossing over the acetabulofemoral joint (aka hip joint)

65
Q

What is the blood supply of the gluteus medius?

A

Deep branch of superior gluteal artery, trochanteric anastomosis

66
Q

What is the innervation of the gluteus medius?

A

Superior gluteal nerve L4,L5 and S1

67
Q

Which gluteal muscle spans from the gluteal surface of the ilium to the proximal end of the femur

A

Gluteus minimus

68
Q

What is the origin of the gluteus minimus?

A

Outer surface of ilium between the anterior and interior gluteal lines

69
Q

What is the insertion of the gluteus minimus?

A

Anterior aspect of greater trochanter of femur

70
Q

What is the innervation of the gluteus minimus?

A

Superior gluteal nerve: L4,L5 and S1

71
Q

What is the action of the gluteus minimus?

A

Thigh abduction, thigh medial rotation
Stabilizing the pelvis whilst walking

72
Q

The hip joint is also known as the

A

acetabulofemoral joint

73
Q

What is the origin of the Tensor Fascia Lata?

A

Outer edge of iliac crest between anterior superior iliac spine & iliac tubercle

74
Q

What is the insertion of the Tensor Fascia lata?

A

The iliotibial tract

75
Q

Nerve supply of tensor fascia lata?

A

Superior gluteal nerve (L4,5, S1)

76
Q

Action of tensor fascia lata?

A

Maintains the knee in extended position

77
Q

One of the important landmarks in the gluteal region is _

A

Piriformis

78
Q

Origin of the piriformis

A

Anterior surface of S2,3,4 vertebrae of the sacrum

79
Q

Insertion of piriformis

A

Upper border of greater trochanter

80
Q

Nerve supply of piriformis

A

Anterior rami of S1,2

81
Q

Action of piriformis

A

Lateral rotator of thigh
Assists in stabilizing hip joint especially in abduction

82
Q

What is the landmark between the gluteus maximus and tensor fascia lata?

A

Iliotibial tract

83
Q

Origin of the obturator internus

A

Inner surface of obturator membrane and adjacent bone

84
Q

Insertion of the obturator internus

A

Upper border of greater trochanter along with gemelli

85
Q

Nerve supply to obturator internus

A

Nerve to obturator internus (L4,S1)

86
Q

Action of obturator internus

A

Lateral rotator of thigh

87
Q

Origin of superior and inferior Gemelli

A

Superior from ischial spine
Inferior from ischial tuberosity

88
Q

Insertion of the superior and inferior gemelli

A

Upper border of greater trochanter

89
Q

Nerve supply of the gemelli?

A

Superior from nerve to obturator internus (L4, S1)
Inferior from nerve to quadratus femoris (L4, S1)

90
Q

Action of gemelli

A

Lateral rotators of thigh

91
Q

Origin of the quadratus femoris

A

Lateral border of ischial tuberosity

92
Q

Insertion of the quadratus femoris

A

Quadrate tubercle of femur

93
Q

Insertion of the quadratus femoris

A

Quadrate tubercle, intertrochanteric crest of femur

94
Q

Nerve supply of quadratus femoris

A

Nerve to quadratus femoris (L4,S1)

95
Q

Action of quadratus femoris

A

Lateral rotator of thigh

96
Q

Problems that could lead to a positive trendelenburg test

A

Fracture neck of femur
Dislocation of hip joint
Coxa Vara
Nonfunctioning gluteus medius and minimus due to:
Neurological damage (L4 – 5 disc herniation)
Any disease affecting muscles (myopathy)

97
Q

How does arthritis occurs

A

Inflammation of one or more joints, causing pain and stiffness that can worsen with age.
It occurs when the synovial fluid begins to dry up leading to more friction between bones

98
Q

What are the nerves of the gluteal region?

A

Sciatic
posterior cutaneous nerve of the thigh superior gluteal
inferior gluteal
nerve to quadratus femoris
pudendal nerve
nerve to obturator internus

99
Q

What converts the the sciatic notch of the hip bone into a greater and lesser foramina?

A

Sacrotuberous and sacrospinous ligament

100
Q

Use of the greatest sciatic foramen
And division

A

The greater sciatic foreman forms a passageway through which structures entering and leaving the pelvis passes e.g. sciatic nerve

It can be divided into
Suprapiriform foramen
superior gluteal vessels
superior gluteal nerve

Infrapiriform foramen
inferior gluteal vessels
internal pudendal vessels
nerves of the sacral plexus
inferior gluteal nerve
pudendal nerve
sciatic nerve
posterior femoral cutaneous nerve
nerve to obturator internus
nerve to quadratus femoris

101
Q

Use of the lesser sciatic foramen

A

The lesser sciatic foramen serves as a passageway for structures entering and leaving the perineum eg. pudendal nerve

102
Q

The cluneal nerves innervates…?

A

The skin of the gluteal region
Specifically the e skin over the iliac crest, between the posterior superior iliac spines and I’ve ever iliac tubercle

Consequently these nerves are vulnerable to injury when bone is taken from the ilium for grafting

103
Q

Describe the superior cluneal nerves

A

The superior cluneal nerves are the lateral cutaneous branches of the dorsal rami of L1-L3
They supply the skin of the gluteal region as far as the greater trochanter

104
Q

Describe the medial cluneal nerves

A

The medial cluneal nerves are the lateral cutaneous branches of the dorsal rami of S1-S3
Supplies the skin and subcutaneous tissue over the sacrum and the adjacent area of the buttock

105
Q

Describe the inferior cluneal nerves

A

The inferior cluneal nerves are gluteal branches of the posterior cutaneous nerve of the thigh, a derivative of the sacral plexus (ventral rami S1-S3)

These nerves curl around the inferior border of the gluteus maximus

supplies the inferior half of the buttock

106
Q

Describe the perforating cutaneous nerve

A

The perforating cutaneous nerve (S2 and S3) passes through the sacrotuberous ligaments and the inferior part of the gluteus maximus

107
Q

What are the deep gluteal nerves?

A

Entering the Gluteal region from the pelvis through the greater sciatic foramen:
Superior gluteal nerve
inferior gluteal nerve
sciatic nerve
pudendal nerve
nerve to the quadratus femoris
nerve to the obturator internus
posterior cuntaneous nerve of the thigh

Entering the Gluteal region by passing through the sacrotuberous ligament:

The perforating cutaneous nerve

108
Q

Nerves derived from the sacral plexus

A

superior and infeior gluteal nerves
sciatic nerve
posterior femoral cutaneous
pudendal

109
Q

Arteries of the gluteal region

A

Superior and inferior gluteal arteries enter the gluteal region from the pelvic cavity through the greater sciatic foramen.

They supply structures in the gluteal region and posterior thigh and have important collateral anastomoses with branches of the femoral artery.

110
Q

Discuss the superior gluteal artery

A

Originates from the posterior trunk of the internal iliac artery in the pelvic cavity.
It leaves the pelvic cavity with the superior gluteal nerve through the greater sciatic foramen above the piriformis muscle.

In the gluteal region, it divides into a superficial branch and a deep branch: the superficial branch supplies the gluteus maximus
the deep branch supplies the gluteus medius and minimus muscles.
It also contributes to the supply of the hip joint.

Branches of the artery also anastomose with the lateral and medial femoral circumflex arteries from the deep femoral artery in the thigh, and with the inferior gluteal artery.

111
Q

Discuss the inferior gluteal artery

A

Originates from the anterior trunk of the internal iliac artery in the pelvic cavity.

It leaves the pelvic cavity with the inferior gluteal nerve through the greater sciatic foramen inferior to the piriformis muscle.

The inferior gluteal artery descends through the gluteal region and into the posterior thigh and anastomoses with perforating branches of the femoral artery.

It also supplies a branch to the sciatic nerve.

112
Q

Arterial supply to femoral head

A

Medial & lateral femoral circumflex arteries
Superior and inferior gluteal arteries
Post. obdurator artery via artery of femoral ligament

113
Q

Trendelenberg test

A

To assesses whether the hip abductors (particularly gluteus medius) are functioning normally
Observe patient from behind, ask him/her to stand on one foot and then the other
Negative test: Pelvis ‘tilts up’ on contralateral side
Positive test: Pelvis ‘sags’ on contralateral side

114
Q

Problems that could lead to a positive Trendelenburg test:

A

Fracture neck of femur
Dislocation of hip joint
Coxa Vara
Nonfunctioning gluteus medius and minimus due to:
Neurological damage (L4 – 5 disc herniation)
Any disease affecting muscles (myopathy)

115
Q

Clinical significance of an intramusular injection

A

Intramuscular injection enables a large amount of a drug to be introduced at once but absorbed gradually.
This procedure must be carried out without injuring neurovascular structures.
A typical site for an intramuscular injection is the gluteal region, the upper lateral quadrant of the gluteal region being the safest region

The sciatic nerve passes through this region and needs to be avoided.

A needle placed in this region enters the gluteus medius anterosuperior to the margin of the gluteus maximus.

Anatomy (17 decks)

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