Gluteal region and hip Flashcards

1
Q

what structure divides the greater and lesser sciatic notch

A

ischial spine

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2
Q

what part of the hip bone will bear the weight of the hip bone when seated

A

ischial tuberosity

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3
Q

what is the bony projection of the ischium inferiorly

A

ischial tuberosity

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4
Q

the sacrospinous ligament goes between

A

the sacrum and the ischial spine

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5
Q

the sacrotuberous ligament goes between the

A

sacrum and ischial tuberosity

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6
Q

what is the name of the angle found between the long axis of the head and neck of the femur and the long axis of the shaft

A

angle of inclination

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7
Q

what does the angle of inclination mean in terms of the orientation of the proximal and distal ends of the femur

A

the distal end of the femur is more medial than the proximal end

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8
Q

the angle of inclination of the femur is greater/less than 90 degrees

A

greater than

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9
Q

what is the angle of anteversion/torsion

A

angle found between the axis of the femoral head and neck and the transverse axis of the femoral condyles

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10
Q

what is the angle of anteversion of the femur

A

12 degrees

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11
Q

what connects the greater and lesser trochanters anteriorly

A

intertrochanteric line

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12
Q

what connects the greater and lesser trochanters posteriorly

A

intertrochanteric crest

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13
Q

what are the 3 groups of muscles of the gluteal region

A
  • lateral rotators of the hip
  • medial rotators and abductors of the hip
  • support
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14
Q

what are the lateral rotators of the hip in the gluteal region

A

gluteus maximus
piriformis
obturator internus
gemelli
quadratus femoris

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15
Q

gluteus maximus is a lateral rotator of the hip and also

A

an extensor

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16
Q

what are the medial rotators and abductors of the hip in the gluteal region

A

gluteus medius and minimus

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17
Q

what muscle in the gluteal region is there for support

A

tensor fascia latae

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18
Q

what are the attachments of gluteus maximus

A

sacrum, sacrotuberous ligament and ilium behind posterior gluteal line –> 3/4 to the the iliotibial tract and 1/4 to the gluteal tuberosity of femur

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19
Q

what is the function of gluteus maximus

A

extends hip
assists with lateral rotation

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20
Q

what is the innervation of gluteus maximus

A

L5 S1 S2

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21
Q

what are the attachments of tensor fascia latae

A

anterior iliac crest and ASIS –> to the iliotibial tract

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22
Q

what is the function of tensor fascia latae

A

tenses fascia latae and iliotibial tract; supports femur on tibia during standing

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23
Q

what is the innervation of tensor fascia latae

A

superior gluteal nerve (L4, L5, S1)

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24
Q

what are the attachments of gluteus medius

A

ilium between posterior and anterior gluteal lines –> to the greater trochanter of the femur (lateral surface)

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25
Q

what is the function of gluteus medius

A

abducts and medially rotates hip

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26
Q

what is the innervation of gluteus medius

A

superior gluteal nerve (L4, L5, S1)

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27
Q

what are the attachments of gluteus minimus

A

ilium between anterior and inferior gluteal lines –> to the greater trochanter of the femur (anterior surface)

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28
Q

what is the function of gluteus minimus

A

abducts and medially rotates the hip

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29
Q

what is the innervation of gluteus minimus

A

superior gluteal nerve (L4, L5, S1)

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30
Q

what muscle is found deep to gluteus medius

A

gluteus minimus

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31
Q

how can gluteus medius and minimus produce medial rotation of the hip

A

because of the angle of torsion; greater trochanter is actually positioned slightly posterior to the position of the head of the femur and so attachments of these muscles will actually be slightly anterior to the axis of movement

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32
Q

what are the attachments of piriformis

A

anterior sacrum and sacrotuberous ligament –> to the greater trochanter of the femur (superior border)

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33
Q

what foramen does piriformis pass through

A

greater sciatic foramen

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34
Q

what is the function of piriformis

A

lateral rotation of the hip

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35
Q

what is the innervation of piriformis

A

anterior rami of S1 S2 (direct)

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36
Q

what are the attachments of obturator internus

A

pelvis surface of obturator membrane and surrounding bones –> to the medial side of the greater trochanter (trochanteric fossa)

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37
Q

obturator internus passes through what foramen

A

lesser sciatic foramen

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38
Q

what muscle passes through the greater sciatic foramen

A

piriformis

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39
Q

what muscle passes through the lesser sciatic foramen

A

obturator internus

40
Q

what is the function of obturator internus

A

laterally rotates the hip

41
Q

what is the innervation of obturator internus

A

nerve to obturator internus (L5, S1)

42
Q

what are the attachments of the superior gemelli

A

ischial spine to blend with the tendon of obturator internus on medial side of the greater trochanter

43
Q

what are the attachments of the inferior gemelli

A

ischial tuberosity to blend with the tendon of obturator internus on the medial side of the greater trochanter

44
Q

what is the function of the gemelli

A

laterally rotate hip

45
Q

what is the innervation of the superior gemelli

A

nerve to obturator internus

46
Q

what is the innervation of the inferior gemelli

A

nerve to quadratus femoris

47
Q

the gemelli are found either side of what

A

obturator internus / tendon

48
Q

what is the most inferior muscle of the gluteal region

A

quadratus femoris

49
Q

what are the attachments of quadratus femoris

A

ischial tuberosity to the quadrate tubercle on the intertrochanteric crest of femur

50
Q

what is the function of quadratus femoris

A

laterally rotates hip

51
Q

what is the innervation of quadratus femoris

A

nerve to quadratus femoris

52
Q

what compartment is obturator externus in

A

muscle is in medial compartment, tendon is in gluteal region

53
Q

what are the attachments of obturator externus

A

outer surface of obturator membrane to the trochanteric fossa

54
Q

what is the function of obturator externus

A

laterally rotates hip

55
Q

what is the innervation of obturator externus

A

obturator nerve (L3,4)

56
Q

what are the roots of the sciatic nerve

A

L4 L5 S1 S2 S3

57
Q

what are the 2 branches of the sciatic nerve

A

tibial and common peroneal

58
Q

the sciatic nerve exits the pelvis via ____ and passes through the ___

A

greater sciatic foramen
gluteal region

59
Q

where does the tibial branch of the sciatic nerve leave

A

below piriformis

60
Q

where does the common peroneal branch of the sciatic nerve leave

A

below, through or above piriformis

61
Q

the superior and inferior gluteal vessels and nerves are named in relation to what

A

relative to the piriformis

62
Q

superior gluteal nerves and vessels divide into

A

superficial and deep

63
Q

deep branches of the superior gluteal nerves and vessels course ____ in the plane between what

A

anteriorly
between gluteus medius and gluteus minimus

64
Q

how will the deep branch of the superior gluteal nerve terminate

A

by supplying the tensor fascia lata muscle anteriorly

65
Q

what nerves lies on the posterior aspect of the sciatic nerve

A

posterior cutaneous nerve of the thigh (anterior rami S1,2,3)

66
Q

what branch does the posterior cutaneous nerve of the thigh give off to supply the skin of the inferior half of the buttock

A

inferior clunial nerve

67
Q

what are the roots of the posterior cutaneous nerve of the thigh

A

S1 2 3

68
Q

what are the roots of the middle clunial nerve

A

posterior rami S1 2 3

69
Q

what are the roots of the superior clunial nerve

A

posterior rami L1 2 3

70
Q

what holds head of femur in the acetabulum

A

ligament of head of femur attaching to fovea of head and floor of acetabulum

71
Q

describe the surface of the acetabulum

A

articular cartilage plus a fat pad in acetabular fossa
articular cartilage is in a horse shoe shape with ligament joining two ends (acetabular notch)

72
Q

what ligament joins the two ends of the horse shoe shaped articular cartilage in the acetabulum

A

transverse acetabular ligament

73
Q

what travels in the ligament of head of femur

A

artery to head of femur

74
Q

describe the capsular attachments of the hip at the acetabulum

A

capsule attaches around border of articular surface - closely follows margins of articular surfaces and spans acetabular notch

75
Q

what is the acetabular notch

A

gap in the articular cartilage

76
Q

describe the capsular attachments of the hip at the femur

A

capsule not attached to articular margins but attaches closely along margin of junction of neck of femur to shaft

77
Q

what is the advantage of the capsular attachment at the femur

A

creates a looseness that allows the capsule to have a large ROM

78
Q

what are the attachments of the iliofemoral ligament

A

AIIS –> intertrochanteric line

79
Q

describe the structure of the iliofemoral ligament

A

upper and lower bands

80
Q

describe the attachments of the iliofemoral ligament

A

small attachment on hip bone with broad attachment on intertrochanteric line on femur

81
Q

what is the function of the iliofemoral ligament

A

limits extension and lateral rotation of the hip
upper part limits adduction
lower part limits abduction

82
Q

what part of the iliofemoral ligament limits adduction

A

upper part

83
Q

what part of the iliofemoral ligament limits abduction

A

lower part

84
Q

what are the attachments of the pubofemoral ligament

A

iliopubic eminence to the lower part of the intertrochanteric line

85
Q

what is the function of the pubofemoral ligament

A

limits extension, lateral rotation and abduction

86
Q

what are the attachments of the ischiofemoral ligament

A

posterior aspect of the acetabulum to the greater trochanter

87
Q

what is the function of the ischiofemoral ligament

A

limits extension, medial rotation and adduction

88
Q

compare the function of the pubofemoral and ischiofemoral ligaments

A

pubofemoral ligament limits extension, lateral rotation and abduction

ischiofemoral limits extension, medial rotation and adduction

89
Q

are there any ligaments that limit flexion

A

no trunk does this

90
Q

the artery of the head of the femur is a branch of what artery

A

obturator

91
Q

the lateral and medial circumflex arteries that supply the hip joint are branches of what

A

profunda femoris

92
Q

what movements are important at the hip to allow walking

A

medial and lateral rotation and abduction

93
Q

as you walk forward and the pelvis rotates, in what direction does the advancing limb move

A

As we are advancing, the limb itself is going to rotate in the opposite direction as the movement of the pelvis

94
Q

As we are advancing, the limb itself is going to rotate in the opposite direction as the movement of the pelvis - why?

A

so the toes remain pointing forward so the feet stay parallel while we walk

95
Q

As you plant one limb and advance the other you will get medial rotation at ___ and lateral rotation at ___

A

medial rotation at the planted side
lateral rotation at the advancing side

96
Q

in walking gluteus medius and minimius are also important as they cause medial rotation and abduction in what limb

A

hip of the planted leg

97
Q

abduction of the hip of the planted leg allows what

A

because the hip is planted it causes the hip on the other side to raise up which allows toes to not drag along ground when advancing