hip Flashcards
what percent of the head of the femur will articulate with the acetabulum?
70%
what is located deep in the pocket of the hip to help cushion the hip joint and compress forces?
fat pad
why is the iliofemoral ligament y shaped?
because it attaches to both the lesser and greater trochanter
what does the iliofemoral ligament resist?
extension, internal and external rotation
what does the pubofemoral ligament resist?
abduction and external rotation
what does the ischiofemoral ligament resist?
adduction and internal rotation
true or false: none of the ligaments at the hip joint restrict flexion?
true
name the 4 bursa’s at the hip?
the trochanteric, iliopsoas, ischiogluteal, gluteofemoral
which bursa is commonly injured in sports?
ischiogluteal
what are the 3 muscles of the gluteal region?
gluteus maximus, medius, and minimus
what is the origin of the gluteus maximus?
post, gluteal line, dorsal sacrum and coccyx, and sacrotuberus ligament
what is the insertion of the gluteus maximus?
ITB and gluteal tuberosity
what is the nerve innervation of the gluteus mamimus?
inferior gluteal nerve (L5, S1 and S2)
what is the action of the gluteus maximus?
extends the hip and does some lateral rotation
what is the origin of the gluteus medius?
between the anterior and posterior gluteal line
what is the insertion of the gluteus medius?
lateral greater trochanter
what is the nerve innervation of the gluteus medius?
superior gluteal nerve (L5 and S1)
what is the action of the gluteus medius?
abducts and medial rotates
what is the origin of the gluteus minimus?
between the anterior and inferior gluteal lines
what is the insertion of the gluteus minimus?
anterior greater trochanter
what is the nerve innervation of the gluteus minimus?
superior gluteal (L5,S1)
what is the action of the gluteus minimus?
abducts and medial rotates
what does the gluteus medius and minimus help stabilize and support?
the pelvis
what is the origin of the piriformis?
anterior surface of the sacrum and the sacrotuberous ligament
what is the insertion of the piriformis?
superior greater trochanter
what is the nerve innervation of the piriformis?
anterior rami of S1 and S2
what is the action of the piriformis?
lateral rotation, abduct the flexed thigh, stability of the FA joint
what is the origin of the quadratus femoris?
lateral ischial tuberosity
what is the insertion of the quadratus femoris?
intertrochanteric line
what is the nerve innervation of the quadratus femoris?
nerve to quadratus femoris (L5 and S1)
what is the action of the quadratus femoris?
lateral rotation of the thigh and stability of the FA joint
the trochanteric anastomosis provides blood where?
to the head of the femur
what is included in the trochanteric anastomosis?
the superior gluteal, inferior gluteal, medial femoral circumflex, and lateral femoral circumflex
which part of the lateral femoral circumflex is the most important in the trochanteric anstomosis?
the ascending branch
the cruciate anastomosis is at the level of…?
the lesser trochanter
the cruciate anastomosis includes what?
the inferior gluteal, medial femoral circumflex, lateral femoral circumflex, and the first perforating artery of the profundus
which part of the lateral femoral circumflex is the most important in the cruciate anastomosis?
the transverse branch
where does the descending branch of the lateral femoral circumflex go to form?
it goes down to the lateral knee where it forms a circumflex at the knee
what will the femoral artery split into?
a femoral artery proper and a deep
what is the main artery that supplies blood to the fovea of the head of the femur?
the acetabulum branch of the obturator artery
what other arteries help supply blood to the head of the femur?
the superior, posterior and inferior retinacular arteries and the trochanteric anstomosis
what two major circumflexes come off the deep femoral artery>?
the medial and lateral femoral circumflex
explain the femoral artery proper as it travels down the leg?
it gives rise to the descending genicular branch and goes into the adductor hiatus where it changes name to the popliteal artery
what is descending genicular artery?
comes off the femoral artery proper and forms a circumflex at the medial aspect of the knee
what is the importance of the deep femoral artery?
gives rise to the medial and lateral femoral circumflex and has branches that will help feed blood to the hamstrings
where is the saphenous nerrve cutaneous too?
the anterior medial aspect of the knee
after the saphenous nerve becomes cutaneous what then does it join?
it joins the greater spahenous vein towards the foot
what muscle is the adductor hiatus in?
the adductor magnum
what joint allows for the most ROM in the lower extremity?
the knee
what is the hip so stable?
- ) the concave acetabelum
- ) the convex femoral head
- ) muscular attachments
- ) ligament capsule
- ) labrum
with increase in stability comes what?
decrease in range of motion
the acetabulum is lines with what type of cartilage?
hyaline
what is the purpose of the labrum in the hip joint?
deepens the pocket of the joint and cushions impact forces
what is going to help grip the head of the femur into the acetabulum?
the labrum
what ligament is going to cover the acetabulum notch?
the transverse acetabular ligament
what is going to come out and attach to the fovea of the head of the femur while protecting the acetabulum branch of the obturator artery?
teres femoris
what are the triceps coxa muscles?
the obturator internus, the superior gemellus, and the inferior gemellus
what landmark are you going to use to help find nervous and vascular structures in the posterior hip?
the piriformis
what nervous and vascular strucutres are you going to find superior to the piriformis?
superior gluteal VAN
what nervous and vascular strucutres are you going to find inferior the hip
nerve to obteratur internus, pudendal nerve, internal pudendal artery and vein
what nervous and vascular strucutres are you going to find inferior to the thigh?
sciatic nerve, posterior femoral cutaneous, inferior VAN
which foramen does the sciatic nerve come out of?
the greater sciatic foramen
under which muscle will the sciatic nerve run under?
the piriformis
what are the common anamolies that have to deal with the sciatic nerve and the piriformis?
sometime the sciatic nerve will split superiorly and the common peroneal portion will run through the piriformis or the whole sciatic nerve will run on top of the piriformis
what are the seven muscles that attach to the greater trochanter?
gluteus medius, gluteus minimus, piriformis, superior gemellus, inferior gemellus, obturator internus, obturator externus
what is the origin of the oburator externus?
margins of the obturator foramen and membrane
what is the insertion of the obturator externus?
trochanteric fossa of femur
what is the nerve innervation of the obturator externus?
obturator nerve (L5 and S1)
what is the action of the obturator externus?
lateral rotation and stabliize the FA joint
what is the origin of the obturator internus?
rim of the obturator foramen and the surface of the obturator membrane
what is the insertion of the obturator internus?
medial GT
what is the nerve innervation of the obturator internus?
nerve to obturator internus (L5 and S1)
what is the action of the obturator internus?
lateral rotation
what is the origin of the superior gemellus?
ischial spine
what is the insertion of the superior gemellus?
medial GT
what is the nerve innervation of the superior gemellus?
nerve to the obturator internus (L5 and S1)
what is the action of the superior gemellus?
lateral rotation, abducts the flexed thigh, stablity of the FA joint
what is the origin of the inferior gemellus?
ischial tuberosity
what is the insertion of the inferior gemellus?
medial GT
what is the nerve innervation of the inderior gemellus?
nerve to the quadratus femoris (L5 and S1)
what is the action of the inferior gemellus?
lateral rotation, abducts the flexed thigh and stablity of the FA joint
what is the origin of the pectineus?
superior ramus of the pubis
what is the insertion of the pectineus?
pectineal line
what is the nerve innervation of the pectineus?
femoral nerve L2 and L3
what is the action of the pectineus?
flex the thigh, adduction and medial rotation
what is the origin of the sartorius?
ASIS, inferior notch
what is the insertion of the sartorius?
supero-medial surface of the tibia
what is the nerve innervation of the sartorius?
femoral nerve (L2 and L3)
what is the action of the sartorius?
flex the thigh, abduction, lateral rotation
what is the origin of the vastus lateralis?
GT and the lateral lip of the linea aspera
what is the insertion of the vastus lateralis?
quadricep tendon
what is the nerve innervation of the vastus lateralis?
femoral nerve (L2, L3, and L4)
what is the action of the vastus lateralis?
extend the leg
what is the origin of the vastus intermedius?
anterior and lateral shaft of the femur
what is the insertion of the vastus intermedius?
quadricep tendon
what is the nerve innervation of the vastus intermedius?
femoral nerve (L2, L3, L4)
what is the action of the vastus intermedius?
extend the leg
what is the origin of the vastus medialis?
intertrochanteric line and medial lip of the linea aspera
what is the insertion of the vastus medialis?
quadricep tendon
what is the nerve innervation of the vastus medialis?
femoral nerve (L2, L3 L4)
what is the action of the vastus medialis?
extend the leg
what is the origin of the rectus femoris?
ASIS, illium superior to the acetabulum
what is the insertion of the rectus femoris?
quadricep tendon
what is the nerve innervation of the rectus femoris?
femoral nerve (L2, L3 L4)
what is the action of the rectus femoris?
extends the leg and flexes the hip
the inguinal ligament connects what two bones?
the pelvic bone and the pubic bone
what vertebrae does the sacral plexus go from?
L4-S4
what are the branches of the sacral plexus that goes down the lower limb?
sciatic, superior gluteal, inferior gluteal, nerve to quadratus femoris, nerve to the obturator internus, posterior cutaneous nerve to the thigh, nerve to the piriformis
what portion of the sacral plexus stays more close to the pelvic viscera and the perimeum?
the pudendal nerve and the pelvic splanchnic
what two nerves make up the sciatic nerve?
the tibial (more medial) and the common peroneal ( more lateral)
what two nerve roots make up the lumbosacral trunk?
L4 and L5
what are the two cutaneous veins of the lower extremity?
greater saphenous vein and the lesser saphenous vein
the greater saphenous vein travels with what nerve?
saphenous nerve
how can the greater saphenous vein be used in a coronary bypass surgury?
the vein itself is used as a bypass
the greater spahenous vein leads into what larger strucutre?
the femoral vein
what is the course of the greater saphenous vein?
dorsum of the foot, medial lower leg, medial knee, anteromedial thigh, into saphenous opening and leads into the femoral vein
what is the course of the small saphenous vein?
plantar surface of the foot, between the two heads of the gastrocnemius, into the popliteal fossa and becomes the popliteal vein and then leads into the femoral vein
deep venous structures have what type of valves?
compasete valves
what are compasete valves?
they are valves that prevent backflow, which causes blood to go in only one direction
the lymphatics of the lateral foot and lateral/posterior leg follow what? drain into what?
the small saphenous vein; popliteal lymph nodes
the lymphatics of the deep lymph structures follow what? and drain into what?
femoral vein; deep inguinal nodes
what is the fascia lata?
its a tight piece of fascia that helps draw blood back to the core and helps fight against gravity
what two muscles help keep the IT band taut?
the gluteus maximus and the tensor fascia lata
the femoral triangle is bordered by what?
inguinal ligament, sartorius, and adductor longus
what two lucunae are found in the femoral triangle?
the muscular lucunae and vascular lucunae
what structures are found in the muscular lucunae?
the femoral nerve and the iliopsoas
what structures are found in the vascular lucunae
femoral artery, femoral vein, and femoral ring/canal
what is the femoral ring/canal
it is the opening that leads into the canal that opens in the spahenous opening it contains a bunch of lymph nodes
what are the contents of the femoral triangle?
femoral nerve, artery, and vein, spahenous nerve, and lymph nodes
the femoral sheath is a continuation of what fascia?
transversalis
what are the compartments of the femoral sheath?
medial - lymph nodes
intermediate - femoral vein
lateral -femoral artery
what are the borders of the femoral canal/ring?
anterior - inguinal ligament
posterior - superior ramus of pubis
medial - lucunar ligament
lateral - femroal vein
what is the femoral hernia?
it occurs below and lateral to the pubic tuburcle where the guts enter into the femoral ring
the femoral nerve sits on top of what muscle?
illiacus
the superior gluteal arteries supply what muscles
glute max, med, min and TFL
the inferior gluteal artery supplies what muscles?
glute max, obturator internus, quadratus femoris, superior HS
what muscle is the only muscle that gets blood feed from both the superior and inferior gluteal artery?
gluteus maximus
explain the osteology of the pelvis?
a sacrum, coccyx, and 2 os coxa
what 3 structures make up an os coxa?
ilium, ischium, pubis
the ramus of the ischium and the ramus of the pubis fuse together at what age?
8
what is the origin of psoas major?
sides of T12-L5 and transverse process of lumbar vertebrae
what is the insertion of psoas major?
lesser trochanter of femur
what is the nerve innervation of psoas major?
anterior rami of L1, L2, L3
what is the action of the psoas major?
hip flexion and functional stability
what is the origin of the psoas minor?
sides of t12-L1
what is the insertion of the psoas minor?
pectineal line and iliopectineal arch
what is the nerve innervation of psoas minor?
anterior rami of L1 and L2
what is the action of the psoas minor?
hip flexion and functional stability
what is the origin of the iliacus?
iliac crest, fossa, ala of sacrum, and anterior SI lig
what is the insertion of the iliaucs?
tendon of the psoas major and LT
what is the nerve innervation of the iliacus?
femoral nerve (L2 and L3)
what is the action of the iliacus?
hip flexion and functional stability
what is the origin of teh TFL?
ASIS and anterior iliac crest
what is the insertion of the TFL?
lateral condyle via ITB
what is the nerve innervation of the TFL?
superior gluteal nerve (L5 and S1)
what is the action of the TFL?
medial rotation, abduction and pelvic stability
what is the origin of the adductor brevis?
body of the pubis inferior to crest
what is the insertion of the adductor brevis?
pectineal line and proximal linea aspera
what is the nerve innervation of the adductor brevis?
obturator nerve (L2, L3, L4)
what is the action of the adductor brevis?
adduction and aids in hip flexion
what is the origin of gracilis?
body and inferior ramus of pubis
what is the insertion of gracilis?
superior portion of medial tibia
what is the nerve innervation of gracilis?
obturator nerve (L2 and L3)
what is the action of gracilis?
adduction, medial rotation, flexion of thigh
what is the origin of adductor longus?
inferior body of pubis
what is the insertion of adductor longus?
middle 1/3 of linea aspera
what is the nerve innervation of adductor longus?
obturator nerve (L2,L3,L4)
what is the action of adductor longus?
adduction
what is the origin of semimembranosus?
ischial tuberosity
what is the insertion of semimembranosus?
posterior medial condyle of the tibia
what is the nerve innervation of semimembranosus?
tibial nerve (L5,S1,S2)
what is the action of the semimembranosus?
extend the hip and flex the knee
what is the origin of semitendonosus?
ischial tuberosity
what is the insertion of the semitendonosus?
superomedial tibia
what is the nerve innervation of the semitendonosus?
tibial nerve (L5,S1,S2)
what is the action of the semitendonosus?
extend the hip and flex the knee
what is the origin of the biceps femoris (long head)
ischial tuberosity
what is the insertion of the biceps femoris (Long head)
lateral side of the fibular head
what is the nerve innervation of the biceps femoris (long head)
tibial nerve (L5, S1, S2)
what is the action of the biceps femoris (long head)
extend the hip and flex the knee
what is the origin of the adductor magnus (hamstring)
ischial tuberosity
what is the insertion of the adductor magnus (hamstring)
adductor tuburcle
what is the nerve innervation of the adductor magnus (hamstring)?
tibial nerve (l4)
what is the action of the adductor magnus (hamstring)
extend the thigh
what is the origin of the adductor magnus (add)
inferior ramus of the pubis, ramus of the ishcium
what is the insertion of the adducotr magnus (add)
gluteal tuberosity, linea aspera, supracondylar line
what is the nerve innervation of the adductor magnus(add)
obturator nerve (l2, l3, l4)
what is the action of the adductor magnus (add)
flex the thigh