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Y2 CONTROL & MOVEMENT > Gluteal Region & Hip > Flashcards

Gluteal Region & Hip Flashcards

1
Q

What is the pelvic girdle?

A

a bony ring formed by the left and right innominate bones and the sacrum

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2
Q

What are the articulations of the innominate bones?

A

each innominate bone articulates with the sacrum posteriorly at the sacroiliac joint

the innominate bones articulate with each other anteriorly at the pubic symphysis

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3
Q

What does the innominate bone develop as in the embryo?

What happens after development?

A
  1. ilium
  2. ischium
  3. pubic bone

The area which the innominate bones fuse together is the acetabulum

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4
Q

What are the 2 major functions of the pelvis?

A
  1. locomotion
  2. supporting the body weight
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5
Q

Label the features of the pelvis

A
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6
Q

Label the features of pelvis from a lateral view

A
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7
Q

Label the features of the medial aspect of the pelvis

A
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8
Q

what is the pubic symphysis?

what is the articular surface covered by?

A

a secondary cartilagenous joint between the 2 pubic bones

the articular surfaces of the pubic bones are covered by a layer of hyaline cartilage

they are connected by a fibrocartilagenous disc

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9
Q

What happens to the pelvis during the later stages of pregnancy and why?

A

the hormone relaxin helps to soften and relax the ligaments to make the pelvis more elastic

this allows the pelvic bones to stretch and open more easily for birth

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10
Q

What types of pelvic fractures are common in elderly people?

How are they managed?

A

fractures of the pubic rami are common after falls

they are managed conservatively

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11
Q

What causes major pelvic fractures?

Why can they be fatal?

A

considerable traumatic force e.g. falling from a height or road traffic accidents

the pelvic bones are in close proximity to major blood vessels so fracture can cause extensive bleeding

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12
Q
A
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13
Q

What are the ligaments between the sacrum and innominate bone?

Why are they important?

A

sacrotuberous and sacrospinous ligaments

they provide stability

they transform the greater and lesser sciatic notches of the ischium into the greater and lesser sciatic foramen

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14
Q

Label the ligaments and features of the pelvis

A

sacrotuberous attaches to the ischial tuberosity

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15
Q

What are the 2 articulations of the femur?

A

it articulates proximally with the acetabulum to form the hip joint

it artculates distally with the tibia to form the knee joint

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16
Q

label the features of the proximal femur

A
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17
Q

label the features of the femur

A
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18
Q

What type of joint is the hip joint?

What is it formed by?

A

it is a “ball and socket” synovial joint

it is formed by the articulation between the acetabulum of the innominate bone and the head of the femur

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19
Q

What are the movements possible at the hip joint?

A
  1. flexion
  2. extension
  3. adduction
  4. abduction
  5. lateral rotation
  6. medial rotation
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20
Q

label the components of the hip joint

A
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21
Q

What is the pain like in osteoarthritis of the hip?

A

there is pain in the hip that is exacerbated with activity and eased with rest

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22
Q

What are the three ligaments of the hip joint?

What is their function?

A

they surround the joint capsule and stabilise the hip joint

  1. iliofemoral
  2. pubofemoral
  3. ischiofemoral
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23
Q

label the ligaments of the hip joint

A
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24
Q

What is the fascia lata and the iliotibial tract?

A

the fascia lata is the deep fascia of the thigh

it is thickened laterally into a longitudinal band - the iliotibial tract

25
Q

How does the superior aspect of the fascia lata split?

A

the superior aspect of the fascia lata in the gluteal region splits anteriorly to enclose the tensor fasciae latae muscle and posteriorly to enclose the gluteus maximus muscle

26
Q

How do the tensor fasciae latae and gluteus maximus muscles work together?

A

they work through their attachments to the iliotibial tract to hold the leg in extension once other muscles have extended the leg at the knee joint

27
Q

How do the iliotibial tract and its associated muscles stabilise the hip joint?

A

they prevent lateral displacement of the proximal end of the femur away from the acetabulum

28
Q
A
29
Q

What are the 3 superficial muscles of the hip?

What is their main function?

A
  1. gluteus maximus
  2. gluteus medius
  3. gluteus minimus

they mainly abduct and extend the hip

30
Q

label the superficial muscles of the hip

A
31
Q

What is the origin and insertion of gluteus maximus?

A

origin:
ilium - posterior to the posterior gluteal line

insertion:

greater trochanter of femur

innervation:

inferior gluteal nerve (L5, S1, S2)

32
Q

What are the actions of gluteus maximus?

A
  1. extends flexed femur at hip joint
  2. lateral stabiliser of hip joint and knee joint
  3. laterally rotates and abducts the thigh
33
Q

What is the origin and insertion of gluteus medius?

What is its innervation?

A

origin:

external surface of ilium between anterior and posterior glutea; lines

insertion:

greater trochanter of femur

innervation:

superior gluteal nerve (L4, L5 and S1)

34
Q

What is the insertion and origin of gluteus minimus?

What is its innervation?

A

origin:

external surface of ilium between inferior and anterior gluteal lines

insertion:

greater trochanter of femur

innervation:

superior gluteal nerve (L4, L4, S1)

35
Q

What are the functions of gluteus minimus and gluteus maximus?

A
  1. abduction of the femur at the hip joint
  2. medial rotation of the thigh
36
Q

What is the role of the gluteus minimus and gluteus medius during walking?

A

they hold the pelvis secure over stance leg to prevent pelvic drop on the opposite swing side when walking

when standing on one leg, the muscles on that side coontract

this prevents the pelvis from tilting over to the other side

37
Q

What are the 2 arteries that enter the gluteal region from the pelvic cavity via the greater sciatic foramen?

A
  1. superior gluteal artery
  2. inferior gluteal artery
38
Q

Where do the gluteal arteries originate from?

A

inferior gluteal artery:

  • originates from anterior trunk of internal iliac artery

superior gluteal artery:

  • originates from posterior trunk of internal iliac artery
  • divides into superficial and deep branches in the gluteal region
39
Q

What 4 structures does the superior gluteal artery supply blood to?

A
  1. all 3 gluteal muscles
  2. tensor fasciae latae
  3. piriformis
  4. the hip joint
40
Q

label the vessels

A
41
Q

Which structures does the inferior gluteal artery supply blood to?

A
  1. gluteus maximus
  2. piriformis
  3. internal obturatorius
  4. gemellus superior and inferior
  5. quadratus femoris
42
Q

What is the passage of the superior and inferior gluteal veins like?

A

they follow the superior and inferior gluteal arteries into the pelvis

they join the pelvic plexus of veins

peripherally the veins anastomose with superficial gluteal veins, which drain anteriorly into the femoral vein

43
Q

What are the 5 deep muscles of the gluteal region?

What is their main function?

A
  1. piriformis
  2. obturator internus
  3. quadratus femoris
  4. superior gemellus
  5. inferior gemellus

they are mainly involved in lateral rotation of the femur at the hip joint

44
Q

label the gluteal muscles

A
45
Q

What is the origin and insertion of piriformis?

What is its innervation?

A

origin:

anterior surface of sacrum between anterior sacral foramina

insertion:

greater trochanter of femur

innervation:

nerve to the piriformis

this originates as branches from S2 and S1 of the sacral plexus

46
Q

What are the actions of piriformis?

A
  1. laterally rotates extended femur at the hip joint
  2. abducts flexed femur at the hip joint
47
Q

Where does the sciatic nerve emerge from?

What are its nerve roots?

A

it emerges from the greater sciatic foramen inferior to the lower border of piriformis

it is formed from spinal nerves L4 - S3

48
Q

Which 3 structures arise superior to piriformis?

A
  1. superior gluteal nerve
  2. superior gluteal artery
  3. superior gluteal vein
49
Q

Which 4 structures emerge inferior to the piriformis?

A
  1. inferior gluteal nerve
  2. inferior gluteal artery
  3. inferior gluteal vein
  4. sciatic nerve
50
Q

label the deep gluteal muscles

A
51
Q

What is the origin and insertion of quadratus femoris?

A

origin:

lateral aspect of ischium just anterior to ischial tuberosity

insertion:

quadrate tubercle on proximal femur

52
Q

What is the origin and insertion of obturator internus?

A

origin:

deep surface of obturator membrane and surrounding bone on the anterolateral wall of pelvis

insertion:

greater trochanter of femur

53
Q

What are the origins and insertions of the gemelli?

A

origin:

  • superior - ischial spine
  • inferior - ischial tuberosity

insertion:

greater trochanter of femur

54
Q

What are the common actions of quadratus femoris, obturator internus and the gemelli?

A
  1. lateral rotation of the extended femur at the hip joint
  2. abduction of the flexed femur at the hip joint
55
Q

Label the blood supply to the hip

A
56
Q

What actually is a ‘hip fracture’?

A

it is actually a fracture of the femoral neck

57
Q

How does the leg appear in a hip fracture?

A

the leg appears in external rotation and abduction, with shortening

58
Q

How do hip fractures differ in young and old people?

A

they can occur with very low energy trauma in elderly people with osteoporosis

they are uncommon in young people and are associated with high energy trauma

Y2 CONTROL & MOVEMENT (69 decks)

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