Hip and gluteal joint Flashcards
What bone does NOT contribute to the knee joint?
Fibula
What arteries does the internal iliac artery feed?
Superior gluteal artery
Inferior gluteal artery
Obturator artery
What arteries does the external iliac artery?
Femoral artery
When does the external iliac artery become the femoral artery?
When it passes deep to the inguinal ligament
Where are the lymphatics concentrated in the lower limb?
Popliteal nodules
Superficial inguinal nodules
Deep inguinal nodules
What are the spinal nerves of the lumbar plexus?
L1-L4
What are the spinal nerves of the sacral plexus?
L4-S4
What important nerves come from the lumbar plexus?
Femoral nerve
Obturator nerve
What important nerves comes from the sacral plexus?
Superior gluteal nerve
Inferior gluteal nerve
Sciatic nerve
What stabilizes the pubic symphysis?
Pubic ligaments
What kind of joint is the sacroiliac joint?
Synovial
What things stabilize the the sacroiliac joint?
Articular surfaces with interlocking elevations/depressions
Sacrospinous ligament
Sacrotuberous ligament
What does the sacrospinous ligament create?
The greater sciatic notch becomes the greater sciatic foramen.
(ligament goes from ischial spine to sacrum)
What does the sacrotuberous ligament create?
Lesser sciatic foramen
ligament goes from ischial tuberosity to sacrum
Most of the obturator foramen is covered with a membrane except _____.
the obturator canal
What bones make the acetabulum (hip socket)?
Ilium, ischium, pubis
What are the parts of the acetabulum?
Acetabular fossa (filled with fat) surrounded by lunate surface (covered with hyaline cartilage) with an acetabular notch (closed with transverse acetabular ligament) on the inferior point
What is the divot on the head of the femur? What attaches there?
Fovea, the ligamentum teres attaches there and goes into the transverse acetabular ligament
What are the 3 ligaments of the hip joint stability?
Iliofemoral ligament (Y ligament on anterior side, most strong)
Pubofemoral ligament
Ischiofemoral ligament
What does the iliofemoral ligament do?
Prevents hyperextension of the hip
What does the pubofemoral ligament do?
Limits hip abduction
What does the ischiofemoral ligament do?
Limits hip hyperextension
What is a trendelenburg gait? What causes it?
Unilateral pelvic drop
Weakness in gluteus medius/minimus
What are the muscles of the gluteal region?
Gluteus maximus
Gluteus medius
Gluteus minimus
Piriformis Superior gemellus Obturator internus Inferior gemellus Quadratus femoris
What is the innervation of the gluteus maximus?
Inferior gluteal nerve
What muscles does the superior gluteal nerve innervate?
Gluteus medius
Gluteus minimus
Tensor fascia lata
What is the action of the gluteus maximus?
Hip extension AND External rotation (it is oblique!)
Where do gluteus medius and minimus attach?
More laterally on the pelvis to the greater trochanter
What is the action of gluteus medius and minimus?
Abduction and internal rotation
What space does the piriformis go through?
Greater sciatic foramen
What are the muscles of external rotation? What about their innervation?
Piriformis Superior gemellus Obturator internus Inferior gemellus Quadratus femoris
All except the gemelli have their own nerves (e.g. nerve to piriformis)
What is at risk in a lateral approach to a THR?
Superior gluteal nerve (medius and minimus)
What nerve innervates the superior gemellus?
Nerve to obturator internus
What nerve innervates the inferior gemellus?
Nerve to quadratus femoris
Does the sciatic nerve innervate muscles in the gluteal region?
no!! Just passes below (inferior) piriformis but does not innervate muscles here
What provides sensory info from the skin of the gluteal region?
Posterior cutaneous nerve which branches into clunial nerves
What provides blood supply to gluteal region?
Superior and inferior gluteal arteries from internal clinical artery (barrier is piriformis)
Where should gluteal injections go?
Upper lateral quadrant
Using left hand, between 2nd and 3rd digit
