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MSK 2 > Gluteal Region > Flashcards

Gluteal Region Flashcards

1
Q

3 bones of the hip bone and their site of fusion

A

ilium
ischium
pubis

acetabulum is where they fuse, fusion of former triradiate cartilage

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2
Q

lunar surface of hip bone

A

articular surface for femur head

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3
Q

dx of congenital hip dysplasia, which lines on xray

A

tri radiate cartilage is helpful

more common in girls

hilgenriener horizontal line, perkins vertical line creat quadrants- ossification center for femoral head should be found in lower inner quadrant

shentons line denoted by continuous, symmetrical line b/w obturator foramen and medial femur, broken in CHD

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4
Q

hip joint contents

A

head of femur in acetabulum of hip bone

articular capsule surrounding, one of the strongest, lined by synovial membrane internally and bursa anteriorly

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5
Q

hip joint ligaments

A

iliofemoral ligament- strongest, anterior aspect of jioin and prevents hyperextension

pubofemoral ligament- anterior/inferior, prevents hyperabduction

ischiofemoral- strong triangular ligament posteriorly

fibers are spiralled, become tight in extension to help stabilize while standing

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6
Q

acetabular labrum

A

deepens hip joint, protects rim of acetabulum

stretches across inferior aspect of lunate surface, forms transverse acetabular ligament

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7
Q

transverse acetabular ligament attachment to femur

A

ligament of the head- attaches to femoral head at the fovea

contains artery of the head to vascularize the femoral head

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8
Q

4 arteries vascularizing head of the femur

A

medial and latter circumflex arteries (from profundal femoral artery)

retinacular arteries (femoral neck vessels, branches from circumflex arteries)

artery of the head- from obturator artery that courses w/i ligament of the head

medial circumflex is main contributor

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9
Q

“hip fracture”

A

truly a femoral neck fractur or inter trochanteric fractures

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10
Q

femoral neck fracture complication

A

often assoc w/ osteoporosis- high incidence of AVN of femoral head after damage to vessels

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11
Q

intertrochanteric fracture

A

usually in elderly, usually from a fall

dont need replacement as much, lower AVN risk

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12
Q

joints of the pelvic girdle

A

sacroiliac joints- synovial b/w sacrum and hip bones, stabilized by sacroiliac ligaments

pubic symphysis- cartilagenous joint in midline for joining pubic portion of hip bones, has a disc

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13
Q

2 strong posterior ligaments of the sacrum/hip

A

sacrotuberous

sacrospinous

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14
Q

4 openings in pelvis

A

greater sciatic foramen- above sacrospinous ligament

lesser sciatic- under sacrospinous

obturator
beneath inguinal ligament

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15
Q

5 things exiting greater sciatic foramen

A

piriformis muscle

sciatic nerve

superior/inferior gluteal nerves/vessels

posterior femoral cutaneous nerve

pudendal nerve and internal pudendal artery

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16
Q

lesser sciatic foramen contents

A

pudendal nerve and internal pudendal artery go back in the LSF

obturator internus tendon

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17
Q

gluteus maximus

A

arises from sacrum and sacrotuberous ligament, inserts into gluteal tuberosity and IT band after coursing inferolaterally

extend and laterally rotate thigh at hip joint

innervated by inferior gluteal nerve(L5, S1,2)

18
Q

gluteus medius and minimus

A

abductors of hip (in addition to tensor fascia lata), play essential rol in stabilizing pelvis during ambulation (contralateral leg)

superior gluteal nerve (L4,5 S1)

19
Q

trendelenburg gait

A

secondary to weakness of gluteal minimus/medius or damage to superior gluteal nerve

compensatory gait, bring body weight over pathological side to have room to bring leg thru

20
Q

trendelenburg test

A

patient stands on each leg, checking strenght of hip abductors

21
Q

5 lateral rotators of hip joint

A 
obturator internus
superior gemellus
inferior gemellus
quadratus femoris
piriformis
22
Q

piriformis

A

pear shaped muscle, exits GSF attaches greater trochanter

sacral plexus on anterior surface

23
Q

nerves to lateral rotators of hip

A

nerve to piriformis- piriformis alone

nerve to obturator internus- both that muscle and superior gemellus

nerve to quadratus femoris- both that muscle and gemellus inferior

24
Q

3 hamstrings and innervation

A

semimembranosis
semitendinosis (these two are medial)
biceps femoris (lateral, most commonly injured)

sciatic nerve (L5, S1,2)

25
Q

origin insertion and blood supply of hamstrings

A

arise from ischial tuberosity, insert distal to knee joint

vascularized by perforating arteries from deep femoral artery(anterior artery)

26
Q

hamstring fn, risk of injury

A

flexors of knee and extensors of hip

two joints! risk of tearing

27
Q

popliteus muscle

A

unlocks the knee when in full extension, initiates flexion of the knee

28
Q

pulled hamstring

A

sudden acceleration of muscles, can tear proximal tendinous attachment or avulse small fragment of ischial tuberosity

often have hematomas as big arteries ruptured

29
Q

sciatic nerves is actually 2 nerves:

A

tibial nerve

common fibular or peroneal nerve

30
Q

sciatic exits…

A

GSF below piriformis

exceptions w/ fibular portion going through or over piriformis

31
Q

track of sciatic nerve

A

along posterior thigh innervating hamstrings

divides into tibial and common fibular in the popliteal region

32
Q

safe zone for gluteal injections (antibiotics)

A

upper outer placement

want to avoid sciatic nerve and superior gluteal nerve

33
Q

posterior hip dislocation cause, complicaitons

A

usually from car accidents w/ high degree of force posteriorly

can damage sciatic nerve, fracture the posterior aspect of acetabulum

medical emergency- high risk of AVN from damaged femoral neck vessels

34
Q

leg presentation of hip fracture vs hip dislocation

A

both shortened

fractures- externally rotated
dislocation- internally rotated

35
Q

cutaneous innervation to posterior thigh

A

posterior femoral cutanous nerve (S1,2,3)

36
Q

obturator internus muscle

A

covers lateral wall of pelvis (obturatur foramen)

exits pelvis via LSF, tendon inserts into greater trochanter

37
Q

gemelli muscles

A

assist obturator internus

small tendons are parallel, fust w/ obturator tendon

superior muscle from ischial spine, inferior from posterior ischium, both insert onto greater trochanter

38
Q

quadratus femoris

A

short flat quadrangular msucle, inferior to gemelli and obturator internus

attaches posterior ischium and inserts trochanteric crest of femur

39
Q

contents of GSF above piriformis

A

superior gluteal nerve, artery, vein

40
Q

LSF contents

A

obturator internus muscle/tendon

pudendal nerve and internal pudendal artery (coming from GSF, towards perineum)

41
Q

GSF contents below piriformis

A

sciatic nerve
inferior gluteal nerve, artery, vein

pudendal nerve and internal pudendal vessels (exiting only to reenter via LSF)

posterior femoral cutaneous nerve

MSK 2 (6 decks)

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