Hip and gluteal Flashcards
week 10
What are the three apertures of the pelvis?
What forms them?
Greater Sciatic Foramen
lesser Sciatic Foramen
Obturator Canal
Formed by:
Sacrocpinious and sacrotuberous ligaments
Structural and functional type of Hip Joint.
Synovial ball and socket
diathrosis
What is the function of the acetabularlabrum?
fibrocartilaginousrim that further deepens the acetabulum
Name the ligaments that stabilise the Hip Joint
ischiofemoral
pubofemoral
iliofemoral
ligament of head and neck
O/I and function of Iliofemoral Ligament
AIIS –> intertrochanteric line
Function
Holds femoral head into acetabulum (when standing)
Tightening = limited ext, add, abd and lat rotation.
O/I and function of Pubofemoral
Obturator crest and iliopubic eminence –> iliofemoral ligament
Tightening limits ext, abd and lateral rotation
O/I and function of ischiofemoral ligament
Ischial part of acetabular margin –> neck of femur
Tightening limits ext, add and medial rotation
O/I and function of the ligament of the Head of the Femur
Fovea –> acetabulum
Structural support for vessels providing nutrients to head of femur
What is the main muscle of the iliac region and what two muscles make it up?
Iliopsoas
-iliacus
-psoas major
O/I of Illiposaos
Iliac fossa –> blends with psoas major –> lesser trochanter
O/I of Psoas Major
T12-L5 vertebrae –> lesser trochanter
Innervation, movement and other functions of the iliopsoas
Femoral nerve = illacus
Anterior rami L1—3 = psoas major
Hip flexion
Postural muscle
Name the muscles of the gluteal region
Tensor fasciae latae
Gluteus maximus
Gluteus medius
Gluteus minimis
piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris
What are the functions of the gluteus minimis?
Hib abd and medial rotation
Steadies pelvis when opposite foot is raised
Prevents pelvic drop on opposite swing side
Where do all but two (name these two) muscles of the gluteal region insert?
greater trochanter
except for: tensor fasciae latae and Gluteus maximus
What muscles of the gluteal region does the superior gluteal nerve innervate?
gluteus medius, gluteus minimi and tensor faciae latae
What muscles of the gluteal region does the nerve to the Obturator internus innervate?
Superior gemellus and obturator internus
What muscles of the gluteal region does the Nerve to the quadratus femoris innervate?
inferior gemellus and quadratus femoris
What are the two muscles of the Anterior compartment of the thigh?
Quadriceps Femoris group abd sartorius
Name the four muscles that make up the Quadriceps femoris group
Vastus lateralis
Vastus intermedialis
rectus femoris
vastus medialis
What nerve innervates all of the anterior compartment of the thigh?
femoral nerve
What two muscles of the anterior compartment of the thigh are involved in knee extension and stabilising the patellar?
Quadriceps Femoris Group: Vastus medialis and Vastu lateralis
What is the path to insertion for all of the quadricep femoris group muscles?
Tendon of quadriceps –> patellar ligament –> tibial tuberosity
Name the muscles of the medial compartment of the thigh
Obturator externus
Pectineus
Adductor brevis
Adductor longus
Adductor magnus
gracilis
What are all but 1 1/2 (name these) muscles of the medial compartment of the thigh innervated by?
Obturator nerve
exceptions
-hamstring part of adducur magnus and pectineus
What are the two muscles of the posterior compartment of the thigh?
hamstring and short head of biceps femoris
Name the three muscles that make up the hamstring
Semimembranosus
semitendinosus
long head of biceps femoris
What are the common features of the hamstring muscles?
O/I
= all originate from ischial tuberosity
Movements
= all act on BOTH hip and knee joints
Innervation
= all by Tibial nerve
Which parts of the hamstring are involved in medial rotation?
Semitendinosis and semimembranosus
What muscles insert in the Pes Anserinus?
Sargent abbrveited to SGT:
Sartorius, Gracilis and SemiTendinosus
Borders of the femoral triangle
Sup: ingunial ligament
Med: adductor longus
Lat: sartorius
Floor: iliopsoas (laterally), pectineus and add longis (medially)
What are the nerves and their roots of the Lumbosacral plexus?
Sciatic
L4-S3
Superior gluteal
Dorsal division of L4-S1
Inferior gluteal
L5-S2
Signs and affectted muscles of Superior Gliteal Nerve Lesion
Affects:
Gluteus medius and miminis,
Adduction of hip affected
Pelvic tilt
Tredelenburg sign
What is a positive Trendelenburg sign?
=
When a person is standing on one leg and unsupported side decsends
What features of the femoral triangle can be palpated
Inguinal ligament, tendon adductor longus and pubic tubercle.
what is the clinical significance of the superficial position of the femoral artery in the femoral triangle?
palpate the femoral arterial pulse,
compression of this artery will reduce blood flow to the LL and is very vulnerable to trauma
cannulated as a long, thin catheter goes through the artery and passes through iliac artery common ilia artery aorta left ventricle of heart.
what muscle lies most superficial in the buttock?
Gluteus maximus
What nerve lies deep to the buttock and is at risk of damage during a misplaced injection?
sciatic nerve
What muscles does the sciatic nerve innervate (motor)
All posterior compartment of thigh, all leg and foot muscles
where should a needle to the buttock be given and what muscles does it enter?
Upper lateral quadrant
gluteus medius, tensor fascia latae and possibly the gluteus minimus.
What are the two bony parts of the hip joint?
Acetabulum and femoral head
What are the roots of the sciatic nerve?
L4-S3
Roots of the Superior and inferior gluteal nerve.
Superior gluteal
Dorsal division of L4-S1
Inferior gluteal
L5-S2
Why is the gluteus minimus and medius important for walking/
allow for hip abduction and medial rotation
hip abduction= supported leg can swing forwards without hitting ground
when walk, pelvis descends on unsupported side = lower limb becomes too long to clear ground = so individual leans away from unsupported side and raises pelvis
what nerve roots are tested in a knee jerk reflex and what muscle group does it involve
L3 and L4
quadirceips
(femoral nerve)
what is the function of the medial menisci of the knee joint?
deepen joint for better bone congruity and cushion joint for shock absorption
what causes foot drop?
damage to the common fibular nerve
e.g laceration to lateral aspect just below head of fibula
Common Fibula innervates anterior compartment (esp Tibialis anterior) which allows for dorsiflexion. Thus loose ability to dorsiflex
