exam 3-2 Flashcards
(Fractures) Pelvis
Fractures can result from direct trauma to the bone (e.g. automobile accident) or can be caused by forces transmitted to the bone during a fall on the feet or knees. Areas most prone to fractures: pubic rami, acetabulum, region of the sacroiliac joint, and most lateral aspect of the ilium.
(Mortality with Fractures) Pelvis
Fractures {here} may cause injury to soft tissue, blood vessels, nerves, and organs. There is a high morbidity and mortality rate associated with these types of fractures because of hemorrhagic shock and organ damage. Internal damage assumed until proven otherwise.
(Trauma to) Pelvis
Since {this} is a solid bony ring it often responds to trauma by suffering fractures in two places - one where the force is directly applied and the second 180° opposite that.
Acetabular Fossa
The rough non-articular center portion of the acetabulum.
Acetabular Notch
The deficient at the inferior end of the acetabular rim which is bridged by the transverse acetabular ligament.
Acetabulum
Area where ilium, ischium, and pubis come together located near the middle of the lateral surface of the innominate bone. It receives the head of the femur to form the hip joint.
Adductor Brevis (General)
A small muscle found deep to the pectineus and the adductor longus.
Anterior, Posterior, and Inferior Gluteal Lines
The bony origins of the gluteal muscles found on the lateral surface of the ilium.
Anthropoid Pelvis
Exaggerated male pelvis.
Arcuate Line
The curved line inferior to the iliac fossa that marks the boundary between the major (or false) pelvis from the minor (or true) pelvis.
Arterial Embolism (Popliteal Artery)
The result of a bifurcation of the popliteal artery may become {this} which would result in loss of blood flow to the leg and foot.
Articularis Genu
The distinct bundle of fibers that occasionally separates from the deepest layers of the vastus intermedius and becomes attached to the synovial membrane of the knee joint.
Auricular Surface
Area posterior to the iliac fossa and inferior to the iliac tuberosity on the medial surface of the ilium where each innominate articulates with the sacrum.
Avulsion of the Ischial Tuberosity
{This} may result from forcible flexion of the hip when the knee is extended.
Biceps Femoris (General)
These are the most laterally situated of the hamstring muscles. The long head has common origin with the other hamstring muscles on the ischial tuberosity, but its short head originates on the linea aspera of the femur.
Bipartite (or Tripartite) Patella
Condition of the patella in which the superior lateral angle ossifies independently. It occurs in about 3% of the population and is usually bilateral. The clinical significance of this type of patella is to be able to recognize it and not confuse it with a fracture of the patella.
Body (Ischium)
The portion of ischium which enters into the formation of the acetabulum.
Body (Pubis)
The portion of the pubis where the symphyseal surface, which articulates with the pubis from the opposite innominate, is found.
Charley Horse
A term that is used to refer to a cramping of the quadriceps muscles. It usually is due to a blow to the muscles which causes a tearing and contusions of the muscle fibers leading to ruptured blood vessels and the formation of a hematoma.
Common Fibular (Nerve)
Part of sciatic nerve formed from the posterior division which wraps around the neck of the fibular and has two branches (deep and superficial) that supply the muscles and skin of the anterior leg, lateral leg, and dorsum of the foot.
Coxa Valga
An increase in the angle of inclination that can occur with developmental dysplasia of the hip (formerly congenital dislocation).
Coxa Vara
A decrease in the angle of inclination that occurs in fractures of the proximal part of the femur and the condition known as Rickets. It causes a mild shortening of the affected limb(s).
Descending Genicular (Artery)
Artery which arises from the medial side of the femoral artery and supplies the knee and medial aspect of the leg.
Distal End (Femur)
Portion of the femur consisting of three articular surfaces: the lateral condyle, the medial condyle, and the patellar facet. Found just above each condyle are the epicondyles.
Fascia Lata
The deep fascia of the thigh, which encloses it like a pant leg. It provides a dense envelope for the thigh and prevents bulging outward of thigh muscles during contraction. It functions to enhance the effectiveness of the contraction of these muscles. It attaches proximally to the pelvic bone and distally to the tibia.
Female (Acetabulum)
Acetabulum: faces more anteriorly
Female (Anterior Superior Iliac Spines)
Anterior Superior Iliac Spines: further apart
Female (Greater Sciatic Notch)
Greater Sciatic Notch: wider
Female (Obturator Foramen)
Obturator Foramen: triangle shaped
Female (Pelvic Arch)
Pelvic Arch: obtuse angle (>90°)
Female (Pelvic Bone General Structure)
Pelvic Bone General Structure: thinner, less prominent processes, shorter
Female (Pelvic Inlet)
Pelvic Inlet: round or oval shaped
Female (Pelvic Outlet)
Pelvic Outlet: wider
Female (Symphysis Pubis)
Symphysis Pubis: shorter
Femoral (Vein)
{This} vein enters the thigh by passing through the opening in the adductor magnus as a continuation of the popliteal vein. As it leaves the femoral triangle and enters the pelvis it becomes the external iliac vein. In the inferior part of the femoral triangle, the vein lies deep to the femoral artery and receives tributaries from the femoral profundus vein and the great saphenous vein.
Femoral Artery
The main arterial supply of the lower extremity. It is the continuation of the external iliac artery and runs from the midpoint of the inguinal ligament, through the femoral triangle, and then goes deep to the sartorius muscle within the adductor canal. It passes through the adductor hiatus to become the popliteal artery.
Femoral Canal
The most medial and smallest of the three compartments of the femoral sheath. The space allows the femoral vein to expand when there is increased venous return from the lower extremity. The canal also contains some adipose tissue, lymphatic vessels and a lymphatic lymph node. The canal is wider in females than in males. There is an opening in the roof of the canal, the femoral ring.
Femoral Hernias
The femoral ring is a weak area in the abdominal wall and is the usual originating site for {this}. This type is a protrusion of abdominal viscera (often a loop of the small intestines) through the femoral ring into the femoral canal. It will compress the contents of the femoral canal and distend its walls. Initially small, because it is contained within the femoral canal, but it can enlarge by passing inferiorly through the saphenous opening into the subcutaneous tissue of the anterior thigh. Often appears as a tender mass in the proximal anterior thigh region and may become strangulated.
Femoral Nerve (General)
The largest branch of the lumbar plexus. It passes from the pelvic cavity to the thigh by going deep to the inguinal ligament. Before the nerve leaves the pelvic cavity it gives off some muscular branches. It than terminates in the thigh into numerous cutaneous and muscular branches.
Femoral Profundus
Deep artery of the thigh which is the first major branch off the femoral artery, arising about two inches below the inguinal ligament. Branches: Lateral and Medial Circumflexes, and Perforating Arteries.
Femoral Sheath
Connective tissue which encloses the femoral blood vessels. It is a downward protrusion of the fascia covering of the floor of the abdomen. The function of the sheath is to allow the femoral artery and vein to glide deep to the inguinal ligament during movements of the hip joint. The sheath is subdivided into three compartments by vertical septa: lateral (femoral artery), intermediate (femoral vein), and medial compartment known at the femoral canal.
Femur
The longest, heaviest, and strongest bone in the body. Its length is about a quarter of the body. When a person is standing it transmits weight from the pelvic bone to the tibia. It is well covered with muscles so only its proximal and distal ends are palpable. It consists of three parts: shaft, proximal and distal ends.
Femur (Ossification)
One 1° center of ossification (shaft), and four 2° centers (head, distal end, greater trochanter, and lesser trochanter). Bone completes its development by 15-17.5 years (female-male).
Fovea Capitis (Femur)
Pit or small depression on the head of the femur where the capitis femoris ligament attaches.
Gemellus Inferior (General)
A muscle situated between the obturator internus and the quadratus femoris.
Gluteal (Trendelenburg) Gait
A type of abnormal locomotion when there is displacement of body weight to the unaffected side when one walks with a deficient gluteus medius and minimus.
Gluteal Bursae
Group of bursae which separate the gluteus maximus from underlying bony features.
Gluteal Line
A roughened area that is found inferior to the greater trochanter of the femur.
Gluteus Maximus (General)
This is the largest and most superficial muscle of the posterior hip region. This muscle is conspicuous in humans for its great bulk which, together with a variable amount of adipose tissue forms the buttocks. This muscle is the largest muscle by mass in the human body. The buttock, a characteristic feature of humans is associated with the assumption of the erect posture and bipedal locomotion.
Gluteus Maximus (Nerve Supply)
Nerve Supply: inferior gluteal nerve (L₅, S₁, and S₂)
Gluteus Maximus (Weakness)
Weakness of this muscle will cause patients difficulty in getting from a sitting to a standing position (patients may have to actively push themselves to the standing position), straightening from a bending position, walking uphill and up stairs. Paralysis of the muscle does not seriously affect walking on level ground or when standing still.
Gluteus Medius (General)
A muscle which is partly deep to the gluteus maximus but its superior portion remains superficial.
Gluteus Medius and Minimus, and Tensor Fascia Lata (Nerve Supply)
Nerve Supply: superior gluteal nerve (L₄, L₅, and S₁)
Gluteus Minimus (General)
The smallest of the gluteal muscles and deep to the gluteus medius.
Great Saphenous Vein (Other)
{This} vein is commonly used for coronary artery bypass surgery because it (1) is readily accessible, (2) has enough length so sufficient amounts can be harvested and (3) contains a higher percentage of muscular and elastic fibers than do other superficial veins of the body. When part of the vein is removed by a bypass, the vein is reversed so that the valves do not obstruct blood flow in the graft. Removal rarely produces a significant problem in the lower extremity.
Greater Sciatic Notch
The deep notch just inferior to the posterior inferior iliac spine.
Greater Trochanter
Large bony prominence at the proximal end of the femur shaft.
Gynecoid Pelvis
Typical female pelvis.
Hamstring Muscles
Posterior thigh muscles: semitendinosus, semimembranosus, and biceps femoris. These muscles have a common origin (except the short head of the biceps femoris) from the ischial tuberosity and they are all supplied by the sciatic nerve (L₄, L₅, S₁, S₂, and S₃).
Hamstrings (Length)
The length of {these} muscles will vary considerably in individuals. In some they are not long enough to allow them to touch their toes when they flex their vertebral column and keep their knees from flexing. In others, they are long and these individuals can easily touch their toes or possibly even the floor.
Hamstrings (Weakness)
If you have weak or tight {these}, your body may compensate by tilting your pelvic bone forward placing stress on your lower back that can lead to postural abnormalities.
Head (Femur)
The portion of the femur that articulates with the acetabulum of the pelvic bone to form the hip joint.
Hiatus Tendinous
The slit like opening in the tendon of insertion of the adductor magnus which leads into the popliteal fossa. This opening is where the femoral vessels become the popliteal vessels.
Hip Pointer
A common painful contusion injury of the soft tissue associated with the iliac crest. They are common in contact sports (e.g. football, hockey, and volleyball). A painful hematoma (bruise) usually occurs in the area of the injury.
Iliac Crest
The superior border of the ilium.
Iliac Fossa
The internal or medial surface of the ilium.
Iliac Spines
Four distinct features of the ilium. The anterior and posterior terminations of the iliac crest, and the two areas just inferior to them.
Iliac Tubercle
A distinct bump found on the lateral most aspect of the iliac crest.
Iliac Tuberosity
Area posterior to the iliac fossa and superior to the auricular surface on the medial surface of the ilium where ligaments attach.
Iliacus and Psoas Major (Weakness)
Weakness of {these} muscles will result in marked disability in carrying out such activities as stair climbing, walking up an incline, getting up from a reclining position, bringing the trunk of the body forward in the sitting position before rising from a chair.
Iliohypogastric (Nerve)
Nerve found lateral to the psoas major muscle.
Iliopsoas
Formed by the fusion of iliacus and psoas major tendons of insertion as they leave the abdominal cavity.
Iliotibial Band Syndrome (IBS)
An overuse syndrome which occurs when the distal end of the iliotibial band repetitively snaps over the lateral condyle of the femur. Patients describe a stinging pain at the lateral aspect of the knee. This pain appears to get worse when running up and down hills or climbing stairs.
Iliotibila Tract
The thickened lateral aspect of the fascia lata that receives insertion from the tensor fascia lata and the gluteus maximus muscles.
Ilium
The largest and uppermost portion of the innominate bone.
Inferior Gluteal (Artery)
Branch of the internal iliac artery supplying: gluteus maximus, obturator internus, quadratus femoris, and the proximal part of the hamstrings.
Inferior Ramus (Pubis)
Portion of the pubis that extends posterior and inferior from the body to join the ramus of the ischium.
Inguinal Lymph Nodes
There are numerous lymphatic vessels and nodes found in the femoral triangle. The vessels and nodes are found along and accompanying the great saphenous vein and its tributaries. These lymphatic vessels and the superficial nodes then pass directly to the external iliac lymph nodes, associated with the external iliac vein. Some however may pass to the deep inguinal lymph nodes. Lymphatic vessels which accompany the lesser saphenous vein enter the popliteal lymph nodes which surround the popliteal vein in the popliteal fossa.
Innominate Bone
Part of the pelvic bone consisting of three parts: ilium, ischium, and pubis.
Intercondylar Fossa
The depression between the condyles of the femur.
Intercondylar Line
The most superior part of the intercondylar fossa of the femur.
Intertrochanteric Crest
The femur’s trochanters are joined posteriorly by {this}.
Intertrochanteric Line
The femur’s trochanters are joined anteriorly by {this}.
Ischial (Bursae)
Bursae which separates the inferior part of the gluteus maximus muscle from the ischial tuberosity.
Ischial Spine
A small projection off the body of the ischium.
Ischial Tuberosity
The large roughened area inferior to the lesser sciatic notch where the hamstring muscles originate.
Ischium
An “L” shaped bone consisting of a body and ramus. One of the three bones comprising the innominate bone.
Jumper’s Knee (Patellar Tendonitis)
A painful overuse injury of the common tendon of insertion of the quadriceps or the patellar ligament. It is common in individuals who participate in activities where there is continuous jumping or running (e.g. aerobics, jogging, cycling, basketball, volleyball, etc.).
Lateral and Medial Circumflexes
Deep branches of the femoral profundus artery which wind around the neck of the femur and supply many of the muscles on the lateral and medial aspect of the thigh. They also are the main supply to the neck and head of the femur.
Lesser Sciatic Notch
A small notch just below the ischial spine.
Lesser Trochanter
A blunt projection at the junction of the inferior border of the neck with shaft of the femur.
Ligamentum Patella
The tendon which runs from the patella to the tibia and is continuous with the common tendon of insertion of the quadriceps femoris.
Linea Aspera
The longitudinal ridge on the posterior aspect of the shaft of the femur formed by the spiral, pectineal, and gluteal lines coming together. It consists of two lips, the lateral and the medial.
Lumbar Plexus
{This} is found in the pelvic cavity embedded for the most part in the psoas major muscle. It originates from the ventral rami of L₁-L₄.
Lumbosacral Trunk
A group of nerve axons from L₄ and L₅ that allow communication between the lumbar plexus and the sacral plexus.
Lunar Surface
The horseshoe shaped articular surface of the acetabulum.
Major (or False) Pelvis
Bounded posteriorly by the sacrum and coccyx, laterally and anteriorly by the ilium, ischium, and pubis. This portion of the pelvis surrounds the birth canal in females.
Male (Acetabulum)
Acetabulum: faces laterally
Male (Anterior Superior Iliac Spines)
Anterior Superior Iliac Spines: closer together
Male (Greater Sciatic Notch)
Greater Sciatic Notch: narrower
Male (Obturator Foramen)
Obturator Foramen: round or oval shaped
Male (Pelvic Arch)
Pelvic Arch: acute angle (<90°)
Male (Pelvic Bone General Structure)
Pelvic Bone General Structure: thicker, prominent processes, longer
Male (Pelvic Inlet)
Pelvic Inlet: heart shaped
Male (Pelvic Outlet)
Pelvic Outlet: narrower
Male (Symphysis Pubis)
Symphysis Pubis: longer
Patella (Function)
The function of {this} bone is to give additional leverage to the quadriceps during the last part of extension of the leg helping increase the power of the extension movement.
Patella (Ossification)
This bone forms from a single center of ossification that appears early in the third year of life and completes between 10-13 years old (female-male).
Patella Emarginata
Condition of the patella in which the superior lateral portion of the bone remains unossified.
Patellar Reflex
Test that is carried out by tapping the patellar ligament to test the segmental innervation of L₂, L₃, and L₄. If when carrying out the test the leg is able to be extended this indicates that the spinal nerves are functioning properly.
Pectineal Line
A faint line or ridge found just inferior to the lesser trochanter of the femur.
Obturator Foramen
The opening in the innominate that is bounded by the ischium and pubis.
Obturator Groove
The indentation found at the superior border of the obturator foramen.
Obturator Internus (General)
A small muscle which takes its origin within the pelvic cavity and whose tendon emerges through the lesser sciatic notch. It is situated between the two gemellus muscles. It derives its name from its origin on the internal aspect of the membrane which covers the obturator foramen.
Neck (Femur)
Area that is found just lateral to the head of femur which forms the angle of inclination with the shaft and contains a large number of prominent pits for blood vessels.
Obturator (Nerve Damage)
The nerve may be damaged during a difficult birth or by an anterior dislocation of the hip joint. If one suspects that the nerve has been damaged, adduction of the femur is tested against resistance.
Pelvic Bone (Ossification)
Three 1° ossification centers (ilium, ischium, and pubis), and five 2° centers (iliac crest, anterior inferior iliac spine, ischial tuberosity, pubis symphysis, and the center of the acetabulum). It completes ossification between 20-22 years (female-male).
Pelvic Brim
Formed by the arcuate lines of each innominate which separate the minor (or true) pelvis from the major (or false) pelvis.
Perforating (Arteries)
Deep branch of the femoral profundus artery that perforate the adductor muscles. Usually 3-5 in number. They supply muscles and skin on the posterior aspect of the thigh.
Piriformis (General)
A muscle which originates within the pelvic cavity and emerges through the greater sciatic notch. It is deep to the gluteus maximus and parallel to the gluteus medius.
Psoas Minor (Action)
Action: flexion of the pelvic bone (upward movement)
Psoas Minor (General)
This muscle is missing in about half the population. When present it is a small insignificant muscle, which lies superficial to the psoas major. It is often mistaken for a nerve coming off the lumbar plexus. This muscle is well developed in mammals which are able to carry out a good deal of flexion of the lumbar vertebrae (arching of the back) as in cats.
Pubic Crest
A line from the pubic tubercle to the symphyseal surface.
Pubic Pecten
A prominent ridge on the superior border of the superior ramus of the pubis that is continuous with the arcuate line of the ilium.
Pubic Tubercle
The superior lateral aspect of the body of the pubis.
Pubis
One of the three bones comprising the innominate bone consisting of a body and two rami.
Quadriceps (Test)
{This} muscle group is tested with the patient lying on their back with knees partly flexed. The patient is asked to extend the knee against resistance. If the muscles are functioning normally, they can be easily seen and palpated. With paralysis of the muscles, the patient is not able to extend the leg. An individual with paralysis will often press the distal end of their thigh during walking to prevent flexion occurring at the knee joint.
Quadriceps Femoris (General)
This group of muscles occupy the anterior aspect of the femur and are divided into separate parts. The four muscles have a common tendon of insertion on the base of the patella. The portion of the tendon which runs from the patella to the tibia is known as the ligamentum patella.
Ramus (Ischium)
The most inferior portion of the ischium.
Rectus Femoris (General)
The most superficial muscle of the quadriceps and is situated in the middle of the thigh between the vastus lateralis and the vastus medialis, and superficial to the vastus intermedius.
Sacral Plexus
Nerve plexus formed from L₄ and L₅ (the lumbosacral trunk) and S₁, S₂, S₃, and S₄. The plexus lies largely on the piriformis muscles and the sacral nerves enter the pelvis via the anterior sacral foramina. Much of the plexus innervates the lower extremity, but a number of branches supply structures within the pelvis or perineum.
Saphenous (Nerve Compression)
In athletes this may occur within the adductor canal or where the nerve exits the fascia. Entrapment neuropathy causes knee pain and paresthesia along the distribution of the nerve.
Saphenous Opening
An opening found in the proximal anterior aspect of the fascia lata. It allows the great saphenous vein to reach its termination at the femoral vein.
Superficial (Cutaneous) Veins
Certain prominent veins, unaccompanied by arteries are found in the subcutaneous tissue of the lower limbs. The most important of these are the great and lesser saphenous veins. Both veins communicate with deep veins via what are known as perforating veins. The vein of the lower extremity possess numerous “one way” valves that maintain blood flow in an upward direction and are clinically relevant.
Superficial Branches
{These} branches of the femoral artery arise with the femoral triangle, about one inch below the inguinal ligament and usually emerge through the saphenous opening. Branches: Superficial Circumflex Iliac, Superficial Epigastric, and Superficial Pudendal.
Superficial Circumflex Iliac (Artery)
Superficial branch of femoral artery which passes superiorly and laterally to supply the skin of the groin.
Superficial Epigastric (Artery)
Superficial branch of femoral artery which passes superiorly to supply the skin over the lower abdominal wall.
Superficial Pudendal
Superficial branch of femoral artery which passes medially to supply the groin and perineal region.
Superior Gluteal (Artery)
Branch of the internal iliac artery supplying: gluteus maximus, medius, and minimus and the tensor fascia lata.
Tibial (Nerve)
Part of sciatic nerve formed from the anterior division which supplies the muscles and most of the skin of the posterior leg and plantar surface of the foot.
Trendelenburg Sign
The supportive effect of the pelvis when the foot is raised off the ground is dependent partly on the gluteus medius and minimus. When the muscles or the superior gluteal nerve are not functioning normally, the pelvis will drop on the unaffected side when the foot is raised off the ground. If the fold of the buttocks falls on the side that foot is raised off the ground {this} is positive. This indicates that the muscles on the side opposite from where the foot is raised are not functioning properly.
Trochanteric (Bursae)
Bursae which separates the superior part of the gluteus maximus muscle from the greater trochanter.
Trochanteric Fossa
Deep pit on the medial aspect of the greater trochanter of the femur.
