Anatomy - Pelvic

Question 1

Where does the
a) inferior gluteal line
b) anterior gluteal line
c) posterior gluteal line
start and end?

Answer 1

a) just superior to AIIS, end at the posterior margin of the acetabulum
b) starts between ASIS and tuberculum of iliac crest, ends at the greater sciatic notch
c) from iliac crest to PIIS

Question 2

which muscle originates at the AIIS and between the acetabulum and inferior gluteal line?

Answer 2

Rectus Femoris

Question 3

which muscle originates between the inferior and anterior gluteal lines?

Answer 3

gluteus minimus

Question 4

where is the ischial tuberosity in relation to the acetabulum?

Answer 4

postero-inferior to acetabulum

Question 5

how is the ischial tuberosity divided? by what?

Answer 5

upper and lower areas by transverse line

upper part further divided by an oblique line which descends from medial to lateral across the surface
- medial part is origin for semiT and biceps femoris
- lateral part is origin of semiM

lower part is divided into medial and lateral regions by a ridge of bone
- medial part covered by connective tissue and bursa
- lateral part origin of adductor magnus

Question 6

the ischiopubic ramus are attachments for ?

Answer 6

adductor longus, adductor brevis, adductor magnus, pectineus, gracilis (medial compartment of thigh)

Question 7

describe the acetabulum.

Answer 7

inferiorly is the acetabular notch
rough non articular part called the acetabular fossa
articular part is the lunate surface (deficient inferiorly at acetabular notch)

Question 8

acetabular fossa provides attachment for ?

Answer 8

ligament of head of femur

Question 9

acetbaular notch allows what to pass thru

Answer 9

blood vessels and nerves

Question 10

what is the non-articular pit of the head of femur called. what does it do

Answer 10

fovea. attachment of ligament of head of femur

Question 11

what is the angle of the neck of femur to the shaft

Answer 11

125

Question 12

describe the relations of the greater trochanter?

Answer 12

extends superiorly from the shaft of the femur just lateral to the region where the shaft joins the neck of the femur

continues posteriorly where its medial surface is deeply grooved to form the trochanteric fossa - lateral wall of this fossa bears a distinct oval depression for attachment of the obturator externus muscle

elongate ridge on anterolateral surface for attachment of gluteus minimus; similar ridge more posterolateral surface for attachment of gluteus medius

on the medial side of the superior aspect of the GT and just above the trochanteric fossa is an impression for the attachment of the obturator internus and assocuated gemelli muscles; immediately above and behind this feature is an impression for the piriformis

Question 13

describe the relations of the lesser trochanter?

Answer 13

attachment site for the combined tendons of psoas major and iliacus

Question 14

intertrochanteric line extends from ___ to ____ on the ____ side of the femur.

it is continous with the ____, before ________ to merge with the ____ on the ____ side of the femur

Answer 14

GT to LT.

Pectineal line. curves medially under the LT and around the shaft. linea aspera. posterior

Question 15

describe course of intertrochanteric crest. there is a muscle that attaches along here name the muscle and what particular point does it attach to

Answer 15

descends medially from greater to lesser trochanter but on the posterior side.

Has a quadeate tubercle on upper half for attachment of quadratus femoris

Question 16

what is the line connecting the GT to the linea aspera called. what muscle is attached to it

Answer 16

gluteal tuberosity. Gluteus maximus

Question 17

describe the 4 types of pelvic fractures and state complications

Answer 17

Type 1: No disruption of bony pelvic ring
Type 2: Single break in bony pelvic ring
Type 3: Double breaks in bony pelvic ring
Type 4: Around acetabulum

Pelvic hematoma, compress nerves, press on organs, inhibit pelvic visceral function

Question 18

what is the blood supply of the femoral head and neck? risk?

Answer 18

1. Medial Circumflex Femoral
2. Lateral Circumflex Femoral
3. Artery of ligamentum teres (branch of obturator artery)

avascular necrosis of the femoral head in neck of femur fractures

Question 19

types of femoral neck fracture and their demographics.

which is most predisposed to necrosis?

Answer 19

subcapital most risk of necrosis; basicervical least

Question 20

do intertrochanteric fractures preserve femoral neck blood supply?

common demographic?

Answer 20

yes. elderly, from low energy impct

Question 21

fractures to GT and LT in isolation?

Answer 21

pathological, due to underlying malignant deposit commonly

Question 22

Describe in detail, the hip joint.

Answer 22

The acetabular fossa contains loose connective tissue, surrounding it the lunate surface which consists of hyaline cartilage.
Around the rim of the acetabulum is a fibro-cartilaginous collar – acetabular labrum. This labrum bridges across the acetabular notch as the transverse acetabular ligament, converting the acetabular notch into a foramen.
Except for the fovea, the head of the femur is also covered by hyaline cartilage.

The ligament of the head of femur attaches from the fovea to the acetabular fossa, transverse acetabular ligament and margins of the acetabular notch. It carries a small branch of the obturator artery (contributes to blood supply of head of femur).

The synovial membrane attaches to the margins of the articular surfaces of the femur and acetabulum, forming a tubular covering around the ligament of the head of femur, margin of head of femur, and neck of femur, before reflecting onto the fibrous membrane.

This joint thus far is then reinforced by three ligaments
* Iliofemoral Ligament – Anterior to the hip joint, from between the AIIS and (STRONGEST)
margin of acetabulum, to the intertrochanteric line
* Pubofemoral Ligament – antero-inferior to the hip joint, from the iliopubic eminence to blending with the iliofemoral ligament.
* Ischiofemoral Ligament – posterior to the hip joint, from ischium to greater trochanter

Question 23

which 6 arteries supply the hip joint

Answer 23

1. Obturator
2. Medial Circumflex Femoral
3. Lateral Circumflex Femoral
4. Superior Gluteal
5. Inferior Gluteal
   6, 1st perforating branch of deep artery of the thigh

ANASTOMOSES

Question 24

what nerve roots are covered by the lumbro-sacral plexus?

Answer 24

L1- S4