Gluteal region, hip and thigh

Question 1

What are the 4 phases of walking?

Answer 1

Heel strike, support, toe-off, swing/carry through

Question 2

What part of the pelvic girdle is part of the axial skeleton?

Answer 2

Sacrum

Question 3

If a limb is shortened, flexed, adducted and can be internally rotated, what type of dislocation is it?

Answer 3

Posterior dislocation

Question 4

If a limb is abducted, externally rotated, what type of dislocation is it?

Answer 4

Anterior dislocation

Question 5

What is the function of the sacroiliac joints?

Answer 5

They are synovial joints which transmit weight of body to the hip bones.

Question 6

How are the Sciatic foramen formed?

Answer 6

Sciatic foramen formed by the borders of the sacrospinous and sacrotuberous ligaments

Question 7

Which muscles attach to the greater trochanter?

Answer 7

Attachment for very strong muscles

(gluteus medius and minimus) that stabilise the pelvis on the lower limb during walking

Question 8

Which muscle attaches to the lesser trochanter?

Answer 8

Attachment point for iliopsoas – powerful hip flexor

Question 9

What is Wolff’s law?

Answer 9

Bone is deposited and reabsorbed in accordance with the stresses placed upon it (it is able to remodel)

Question 10

What surrounds the acetabulum?

Answer 10

The acetabular labrum is a horseshoe shaped fibrocartilage rim of tissue that surrounds the acetabulum
Can get impinged within joint causing pain on movement

Question 11

What does the synovial membrane of the hip joint do?

Answer 11

Synovial membrane of the hip joint attaches to the margins of the articular surfaces of the femur and acetabulum
Membrane forms a tubular covering which lines the inside of the fibrous membrane of the joint

Question 12

What 3 ligaments reinforce the external surface of the fibrous membrane and stabilize the hip joint? and when are they the tightest?

Answer 12

Iliofemoral, Pubofemoral and Ischiofemoral ligaments. When standing

Question 13

What is the consequence of an intracapsular femoral neck fracture?

Answer 13

Intra-capsular femoral neck fractures can disrupt blood supply to femoral head
Avascular necrosis of femoral head can result from intra-capsular fracture

Question 14

What is the blood supply to the femoral head?

Answer 14

Circumflex femoral arteries surround the femoral neck and pass through retinacular fibres of the joint capsule to the femoral head. These are vulnerable to interruption from injury

Question 15

What does the Artery of ligament of head of femur supply?

Answer 15

this artery only supplies small region of the joint articular surface
It is NOT big enough to provide blood supply to femoral head, if circumflex branches are lost

Question 16

Name the nerves, blood supply and main function of the anterior thigh compartment.

Answer 16

Femoral nerve (L2 – L4)
Femoral artery
Hip Flexor / Knee Extension

Question 17

Name the nerves, blood supply and main function of the posterior thigh compartment.

Answer 17

Sciatic nerve (L4 – S3)  Tibial nerve (L5, S1)
Branches of Deep Femoral (Profunda Femoris)
Hip Extension / Knee Flexion

Question 18

Name the nerves, blood supply and main function of the medial thigh compartment.

Answer 18

Obturator nerve (L2 – L4)
Obturator artery
Hip adductors

Question 19

What fascia covers the thigh?

Answer 19

Fascia lata

Question 20

What is the iliotibial tract (ITT)? and what is its function? Which muscle attaches to it? What vein runs close to it?

Answer 20

Iliotibial tract (ITT) is a lateral thickening of fascia lata

ITT acts as a muscle attachment point

ITT assists in knee extension & stability

Much of your Gluteus Maximus inserts into the ITT

Saphenous veins run superficial to the fascia

Question 21

Which nerve innervates gluteus maximus?

Answer 21

Inferior gluteal nerve (L5 - S2)

Question 22

Which nerve innervates gluteus medius and minimus?

Answer 22

Superior gluteal nerve (L4 – S1)

Question 23

What do the gluteal muscles allow you to carry out?

Answer 23

Stair climbing and arising from chairs

Question 24

Damage to the gluteus medius and minimus results in what?

Answer 24

Damage/paralysis can lead to Trendelenburg sign and lurch when walking

Question 25

What will happen if the gluteus maximus is damaged?

Answer 25

Gluteus maximus keeps trunk from tipping forward when walking Damage to it makes getting out of chairs very difficult Damage/paralysis can lead to patient lurching backward when the weaker limb is on the floor

Question 26

What are the lateral rotator muscles?

Answer 26

Piriformis, Gemelli (superior and inferior), Quadratus femoris and obturator internus

Question 27

The piriformis divides the greater sciatic foramen into ____?

Answer 27

Divides the greater sciatic foramen into supra and infra piriform parts

Question 28

What nerve runs emerges from underneath the piriformis?

Answer 28

Sciatic nerve

Question 29

What does the iliopsoas do?

Answer 29

Composite muscle formed from the psoas major muscle, and the iliacus muscle. Powerful flexor of the hip

Question 30

What can a psoas abscess do?

Answer 30

can track down the fibrous sheath covering psoas producing a femoral triangle swelling that can mimic a femoral hernia

Question 31

What are the 4 adductor muscles? and which compartment are they in?

Answer 31

``` Pectineus (Fem n.) Adductor Longus Adductor Magnus Adductor Brevis Medial compartment ```

Question 32

What happens to the femoral artery when it passes through the adductor hiatus to go behind the knee?

Answer 32

Becomes the popliteal artery

Question 33

Name the quadriceps muscles and what compartment are they in?

Answer 33

``` Rectus femoris Vastus intermedius Vastus Lateralis Vastus Medialis Anterior compartment ```

Question 34

Name the hamstring muscles and what compartment are they in?

Answer 34

Semitendinosus Semimembranosus Biceps femoris (long and short head)

Question 35

What does the ischial tuberosity attach to?

Answer 35

Hamstring muscles