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ALT > FT2: w5/6 notes > Flashcards

FT2: w5/6 notes Flashcards

1
Q

parts of hip bone & position relative to the remainder of the bone

A

Pubis
Anteromedially

Ilium
Superolaterally

Ischium
Posteroinferiorly

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2
Q

Pelvis vs pelvic girdle

A

Pelvis
* 2 hip bones (ilium, pubis & ischium)
* Sacrum
* Coccyx

Pelvic girdle
* Hip bone only (ilium, pubis & ischium)

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3
Q

Pelvic inlet
location
boundaries

A

From false pelvis to true pelvis

Boundaries
Posteriorly - sacral promontory
Laterally - arcuate line of ilium
Anteriorly - superior ramus of pubis & pubic symphysis

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4
Q

Male pelvis vs female pelvis
overall shape

A

Overall shape
MALE
Taller in height
Narrower
Narrower pelvic outlet & inlet

FEMALE
Shallower in height
Broader
Wider pelvic outlet & inlet
* To allow for childbirth

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5
Q

Male pelvis vs female pelvis
subpubic angles

A

MALE
Smaller subpubic angle (<90°)

FEMALE
Larger subpubic angle (>90°)

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6
Q

Pelvic outlet
-location
-boundaries

A

from true pelvis to exterior

Boundaries
Posteriorly - tip of the coccyx
Posterolaterally - inferior margin of the sacrotuberous ligament (running b/n coccyx & ischial tuberosity)
Laterally - ischial tuberosities
Anteriorly - ischiopubic ramus & pubic symphysis

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7
Q

True (lesser) pelvis
-location
-boundaries
-contents

A

Location
True (lesser) pelvis - between the pelvic inlet & outlet

Boundaries
Posteriorly - sacrum & coccyx
Laterally - ischium
Anteriorly - superior pubic & ischiopubic rami

Contents
Reproductive, urinary & lower GIT organs + nerves & vessels

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8
Q

False (greater) pelvis
-location
-boundaries
-contents

A

False (greater) pelvis - superior to the pelvic inlet

Boundaries
Posteriorly - lumbar vertebra (anterosuperior aspect of S1 vertebra)
Laterally - ilium
Anteriorly - abdominal muscles

Contents
GIT organs + nerves & vessels

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9
Q

Openings of the pelvis

A

Under inguinal ligament

Obturator foramen & canal
Foramen - canal + membrane
Canal - space above membrane

Greater sciatic foramen

Lesser sciatic foramen

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10
Q

Under inguinal ligament

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening

A

Anterior (opening deep to the inguinal ligament)

Boundaries
Inguinal lig
Superior pubic ramus
Anterior ilium

External - anterior thigh
Internal - false pelvis (because it’s above the pelvic inlet)

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11
Q

Obturator foramen

A

Foramen - canal + membrane

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12
Q

Obturator canal

A

Canal - space above membrane

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13
Q

Obturator foramen & canal

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening
Vessels
Nerves
Muscles

A

Position of opening in relation to pelvis
Medial

Boundaries
Obturator membrane
Obturator foramen

Regions/spaces that communicate via opening
External - medial thigh
Internal - true pelvis (because it’s below the pelvic inlet)

Vessels
Obturator & lymphatics

Nerves
Obturator

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14
Q

greater sciatic foramen

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening
Vessels
Nerves
Muscles

A

Position of opening in relation to pelvis
Posterior

Boundaries
In an anatomical position:
Superior - greater sciatic notch
Anterior - Ischial spine
Posterior - Sacrotuberous lig
Inferior - Sacrospinous lig

Regions/spaces that communicate via opening
External - gluteal region (post thigh)
Internal - true pelvis (because it’s above the pelvic floor)

Vessels
Gluteal & lymphatics

Nerves
Spinal nerves derived from the sacral plexus
* Sciatic nerve
* Sup/inf gluteal
* N. obturator internus
* N. quadratus femoris

Muscles
Piriformis
* Powerful lateral rotator of the hip joint

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15
Q

Lesser sciatic foramen

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening
Vessels
Nerves
Muscles

A

Position of opening in relation to pelvis
Posterior

Boundaries
In an anatomical position:
Anterior - Lesser sciatic notch
Lateral - Ischial spine
Inferoposteiorly - ST lig
Superior - SS lig

Regions/spaces that communicate via opening
External - gluteal region
Internal - perineum (because it’s below the pelvic floor)

Nerves
-

Muscles
Obturator internus
* Powerful lateral rotator of the hip joint

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16
Q

Joints of the pelvis

A

Pubic symphysis
Sacroiliac joint

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17
Q

Pubic symphysis

Definition
Articulating surfaces
Histological classification
Function
Movements possible

A

Definition
Pubic symphysis - joins right & left pubic bones, made of a fibrocartilage disc
* Forms boundary of the true pelvis - contributes to the anterior boundary

Articulating surfaces
* Articulation between superior rami of left & right pubic bones
Attaches to the thin layer of hyaline cartilage that covers the end of both pubic bones

Histological classification
Secondary cartilaginous

Function
Relatively immobile to maintain pelvic stability, especially when standing on one limb

Movements possible
Nil
* Hormones soften the ligaments to allow for very little movement during child birth so pelvis can widen a little bit more

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18
Q

Sacroiliac joint

Definition
Articulating surfaces
Histological classification
Function
Movements possible
Position of the line of gravity in relation to SIJ, describe the effect this has on this joint

A

Definition
Sacroiliac joint - joins appendicular (ilium) to axial (sacrum) skeleton

Articulating surfaces
Oracular surface of ilium & oracular surface of sacrum

Histological classification
Synovial (anterior)
Fibrous (posterior)
* Highly congruent
* Significant ligamentous support (ligaments are dense, fibrous connective tissue)

Function
Very little movement in general

Movements possible
Nutation - anterior tilt movement of the upper sacrum (moves down & forward)
* Caused by bodyweight
* Anterior aspect of the sacrum moves inferiorly (and slightly anteriorly)
* Coccyx moves superiorly and posteriorly

Counter nutation - opposite movement of nutation, sacrum moves up & backward

Position of LOG: anterior
Effect of gravity at joint: pelvic tilt anteriorly (nutation)

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19
Q

Ligaments of the pelvis

A

Sacrotuberous ligament
Sacrospinous ligament

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20
Q

Sacrotuberous ligament

Attachments
Functions
Position in relation to the sacrum

A

Attachments
Ischial tuberosity & sacrum

Functions
Limits nutation of SIJ
Posterior ligament to help stabilise sacroiliac joint
Crosses sacroiliac joint, which limits mutation

Position in relation to the sacrum
Runs anterior & inferior to the sacrum
Openings - GSF & LSF

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21
Q

Sacrospinous ligament

Attachments
Functions
Position in relation to the sacrum

A

Attachments
Ischial spine & sacrum

Functions
Limits nutation of SIJ

Position in relation to the sacrum
Posterior ligament to help stabilise sacroiliac joint
Runs anterior & inferior to the sacrum

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22
Q

Vessels of the pelvis

A

Abdominal aorta

Common iliac artery (R + L)

Internal iliac artery
-Obturator - making their way to the lower limb
-Gluteal (super & inf) - making their way to the lower limb

External iliac artery

Femoral artery

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23
Q

Abdominal aorta

runs alongside
origin
course
termination

A

Runs alongside the inferior vena cava (but is to the left)

Origin
Thoracic aorta

Course
Thoracic aorta, through lower abdomen, to top of false pelvis @L4/5

Termination
Branches into
* R common iliac
L common iliac - further divides

24
Q

Right vs left common iliac artery

A

Right common iliac artery
* Pass more oblique across body of last lumbar vertebra
* Separated from the bodies of L4 & L5 by juncture of 2 common iliac veins & inferior vena cava

Left common iliac artery
* Rests on bodies of L4 & L5
* Partly medial to & partly in front of L common iliac vein

25
Q

Common iliac artery

Origin
Termination

A

Origin
Abdominal aorta @L4 vertebra

Termination
Left common iliac artery branches into
* Internal iliac - goes into the true pelvis
* External iliac - remains in the false pelvis

26
Q

Internal iliac artery

Origin
Termination

A

Origin
Left common iliac artery, goes into true pelvis

Termination
Branches into
* ‘Visceral’
* Obturator - making their way to the lower limb
* Gluteal (super & inf) - making their way to the lower limb

27
Q

External iliac artery

Origin
Termination

A

Origin
Left common iliac artery, goes into false pelvis & runs with external iliac vein

Termination
Femoral artery = name once it passes underneath the inguinal ligament and exits the pelvis, in the thigh where the femur is.

28
Q

Femoral artery

Origin

A

Origin
Continuation of external iliac artery, under inguinal ligament

29
Q

Pelvic vein names

A

Same name as arteries

All tributaries of inferior vena cava
Tributaries - drain into, supply blood to lower abdomen, pelvic region & lower limbs

30
Q

External iliac vein

Origin
Termination
Relationships

A

Origin
Continuation of femoral vein proximal to inguinal ligament

Termination
Tributary of common iliac vein (L & R)

Relationships
Through false pelvis
Accompanies external iliac artery & femoral nerve

31
Q

Inferior vena cava

A

Inferior vena cava - formed by the junction of 2 common iliac veins at L5
* Runs alongside the inferior vena cava (but is to the right)

32
Q

Spinal nerve

A

Spinal nerve - ventral & dorsal root combined, exits the vertebral canal via the intervertebral foramen

Principle NP8 All spinal nerves divide into dorsal & ventral primary rami:

33
Q

Ventral ramus

A

Ventral primary rami - anterior branch of the spinal nerve, leading to the spinal cord

        * Supply all other somatic structures including the limbs
        * forms plexus that makes up the nerves coming down to the lower limb
        * Each ventral ramus divides into anterior & posterior divisions
34
Q

spinal cord vs corda equina

A

Spinal cord - spinal nerves above L2

Corda equina - spinal nerves below L2 & exit down at the lower lumbar & sacral levels

35
Q

Structures attached to the spinal nerve

A

Sympathetic ganglion - enlarged bit of tissue

Sympathetic trunk - length of neural tissue running inferiorly & superiorly down LS plexus, follows vertebral column

36
Q

GSA, GSE & GVE

A

GSAs - travel towards CNS (spinal cord) from body
e.g. Carrying sensory info from skin on the back

GSEs - travel to body from CNS (spinal cord)
e.g. Innervating muscle of the knee joint

GVEs - travel to body from CNS (spinal) cord and in this case, via the sympathetic ganglion
e.g. Pre- and post-ganglionic sympathetic GVE stimulating sweat glands in the armpit

37
Q

Lumbosacral plexus

A

lumbar plexus & sacral plexus together, comes from L2-L4, L4/5 - S1-4

38
Q

Lumbar plexus

Formed by
Major branches

A

Formed by
Lumbar ventral rami (L2, L3 & L4)
* L2-4 ventral rami

Major branches
* Femoral nerve
* Obturator nerve
* Lateral cutaneous nerve of the thigh (LCNT)

39
Q

Sacral plexus

Formed by
Major branches

A

Formed by
Lumbosacral trunk
Lumbar ventral rami (L4, L5)
Sacral ventral rami (S1, S2, S3)
* L4-S3 ventral rami

Major branches
* Sciatic nerve (tibial + common peroneal)
* Gluteal nerves (sup & inf)
* Posterior cutaneous nerve of the thigh (PCNT)

40
Q

Branches of the lumbar plexus

A

Obturator nerve
Femoral nerve
Lateral cutaneous nerve of the thigh (LCNT)

41
Q

Obturator nerve

Origin
Course
Location of innervated muscles
Major action of innervated muscles

A

Branch of the lumbar plexus

Origin
Anterior divisions of the L2-L4 ventral rami

Course
Originates in lower abdomen, travels through false pelvis to the true pelvis
Then, exits the pelvis anteriorly through the obturator canal into medial thigh

Location of innervated muscles
Medial thigh

Major action of innervated muscles
Hip adduction

Flexion, adduction, internal rotation = anterior divisions of anterior primary rami

42
Q

Femoral nerve

Origin
Course
Location of innervated muscles
Major action of innervated muscles

A

Branch of the lumbar plexus

Origin
Posterior divisions of the L2-L4 ventral rami

Course
Originates in lower abdomen, travels through false pelvis & under inguinal ligament w external iliac a&v
Then, exits the pelvis anteriorly through the opening under (deep) inguinal ligament into anterior thigh

Location of innervated muscles
Anterior thigh

Major action of innervated muscles
Knee extension (from quadriceps)

Extension, abduction, external rotation = posterior divisions of anterior primary rami

43
Q

anterior divisions of anterior primary rami actions

A

FAI
Flexion, adduction, internal rotation

44
Q

posterior divisions of anterior primary rami

A

Extension, abduction, external rotation

45
Q

Lateral cutaneous nerve of the thigh (LCNT)

A

origin is branches from L2 & L3 only

46
Q

Branches of the sacral plexus

A

Sciatic (Common peroneal/fibular + Tibial)

Superior gluteal nerve

Inferior gluteal nerve

Posterior cutaneous nerve of the thigh (PCNT)

47
Q

Sciatic nerve

A

common peroneal/fibular + tibial nerves travelling together for a short time, but never innervates a particular muscle

* Emerges in gluteal region, later divide in the lateral thigh separately
48
Q

Common peroneal/fibular

Origin
Course
Location of innervated muscles
Major action of innervated muscles

A

Origin
Posterior divisions of the L4-S3 ventral rami

Course
Originates in lower abdomen as sciatic nerve, exits the pelvis posteriorly through the GSF into the anterior leg

Location of innervated muscles
Anterior leg

Major action of innervated muscles
Dorsiflexion (true extension) ankle

49
Q

Tibial

Origin
Course
Location of innervated muscles
Major action of innervated muscles

A

Origin
Anterior divisions of the L4-S3 ventral rami

Course
Originates in lower abdomen as sciatic nerve, exits the pelvis anteriorly through the GSF into the posterior thigh/leg

Location of innervated muscles
Posterior thigh/leg

Major action of innervated muscles
Knee & ankle flexion

50
Q

Superior gluteal nerve

Origin
Course
Location of innervated muscles
Major action of innervated muscles

A

Origin
Posterior divisions of the L4-S1 ventral rami

Course
Originates in lower abdomen, exits the pelvis posteriorly through the GSF into the gluteal region (posterior)

Location of innervated muscles
Gluteal region

Major action of innervated muscles
Hip abduction - supplies the gluteus medius, gluteus minimus & TFL muscles

51
Q

Inferior gluteal nerve

Origin
Course
Location of innervated muscles
Major action of innervated muscles

A

Origin
Posterior divisions of the L5-S2 ventral rami

Course
Originates in lower abdomen, exits the pelvis posteriorly through the GSF into the gluteal region (posterior)

Location of innervated muscles
Gluteal region

Major action of innervated muscles
Hip extension - travels beneath the piriformis to supply the gluteus maximus

52
Q

Posterior cutaneous nerve of the thigh (PCNT)

A

branches from S2 & S3 only

53
Q

Muscles of the pelvis

A

Muscles of the pelvis - includes psoas & iliacus (iliopsoas) as the major muscles, also includes obturator internus & piriformis (notes in muscles of the gluteal region)

54
Q

Iliacus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

A

Innervation
Femoral nerve
(L2, L3)

Proximal attachment
Iliac fossa

Distal attachment
Lesser trochanter of femur (join to form iliopsoas)

Position & orientation in relation to joint(s) crossed
Anterior & slightly medial to hip jt
Vertical orientation

Function
Hip flexion
Weak hip adduction

55
Q

Psoas major

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

A

Innervation
Anterior rami
L1-L3

Proximal attachment
Lumbar vertebrae TPs
Lateral bodies & intervening IVDs

Distal attachment
Lesser trochanter of femur (join to form iliopsoas)

Position & orientation in relation to joint(s) crossed
Anterior & slightly medial to hip jt
Vertical orientation

Function
Hip flexion
Weak hip adduction

ALT (3 decks)

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