Gluteal Region, Hip Joint and Posterior Thigh

Question 1

What are the main differences between male and female pelvises?

Answer 1

Pelvic inlet: women = circular, men = <3 shaped
Infrapubic angle: larger in women, more acute in men
Ischial spines: project further in men
Sciatic notches: wider in female

Question 2

Which movements are possible at the hip joint?

Answer 2

Flexion, extension, adduction, abduction, medial/lateral rotation

Question 3

Which structures help to stabilise the hip joint?

Answer 3

Acetabular notch + labrum
Fibrous capsule
Iliofemoral, Ischiofemoral, Pubofemoral ligaments

Question 4

What is the function of the iliotibial tract?

Answer 4

Connects hip muscles to tibia, contributes to lateral knee stability. Extends / abducts / laterally rotates hip.

Question 5

What is the vascular supply of the gluteal muscles? Where do these arteries arise?

Answer 5

Inferior gluteal: anterior trunk of internal iliac
Superior gluteal: posterior trunk of internal iliac. - superficial branch = gluteus max, deep branch passes between min and med

Question 6

Which foramen does piriformis pass through?

Answer 6

Greater sciatic foramen

Question 7

Which nerve roots form the sciatic nerve?

Answer 7

L4-S3

Question 8

Piriformis is a landmark for structures entering the gluteal region through the greater sciatic foramen. Which structures pass

a) above piriformis
b) below piriformis

Answer 8

a) superior gluteal nerve, artery and vein

b) inferior gluteal nerve, artery and vein, sciatic nerve, nerve to obturator interns, nerve to quadratus femoris

Question 9

What is compartment syndrome?

Answer 9

Bleeding + swelling within muscle compartment, occurs when pressure in compartment increases e.g. broken bone, crush. Treatment = emergency fasciotomy

Question 10

What is the common origin of the hamstring muscles?

Answer 10

Ischial tuberosity

Question 11

What is the common nerve supply of the hamstring muscles?

Answer 11

Tibial part of sciatic nerve

Question 12

What is the function of the hamstrings at

a) hip
b) knee

Answer 12

a) extension, medial/lateral rotation

b) flexion, medial/lateral rotation

Question 13

What is the vascular supply to the posterior thigh?

Answer 13

Profunda femoris (perforating branches)

Question 14

What does sciatic nerve bifurcate into in the posterior thigh?

Answer 14

tibial and common fibular (peroneal) nerves

Question 15

What is a Baker’s cyst?

Answer 15

fluid filled swelling at back of knee caused by trauma / arthritis / gout

Question 16

What is the acetabular labrum?

Answer 16

Rim of cartilage that deepens the articular surface between femur and acetabulum

Question 17

Which hip ligament is the strongest?

Answer 17

Ileofemoral - Y-shaped.

Question 18

Which hip joint is the weakest?

Answer 18

Ischiofemoral

Question 19

What is the function of the pubofemoral ligament?

Answer 19

Prevents excessive abduction

Question 20

What is the function of the ileofemoral ligament?

Answer 20

Prevents hyperextension during standing by screwing in femoral head

Question 21

When does posterior hip dislocation occur and how does the limb appear?

Answer 21

Impact when seated. Limb appears shortened and internally rotated.

Question 22

What is the function of the synovial fluid and synovial membrane?

Answer 22

membrane: lines inner joint surface and mediates nutrient exchange
fluid: lubricates articular cartilage + provides nourishment