Hip and Gluteal Region Flashcards
1
Q
What are the 3 main areas with openings to structures within the lower limb?
A
Femoral triangle
Popliteal fossa
Tarsal tunnel
2
Q
Describe the position of the greater sciatic notch
A
The curve where the sacrum and ala of ilium join
3
Q
Describe the position of the lesser sciatic notch
A
The curve behind the pubic tubercle
4
Q
What is the pectineal line?
A
The superior ridge on the superior pubic ramus
5
Q
Where is the ischial spine?
A
A tubercle on the posterior side of the ischium
6
Q
What forms the obturator foramen?
A
The hole formed by the ischium and pubis
7
Q
Name the cartilage that joins the ilium, pubis and ischium at the acetabulum
A
Triradiate cartilage
8
Q
Name the 4 iliac spines involved with the iliac crest
A
Anterior superior iliac spine
Anterior inferior iliac spine
Posterior superior iliac spine
Posterior inferior iliac spine
9
Q
What separates the greater and lesser sciatic notch?
A
Ischial spine
10
Q
Name the membrane that covers most of the obturator foramen?
A
Obturator membrane
11
Q
What is the name of the gap in the obturator foramen?
A
Obturator canal
12
Q
What is the name of the joining of the inferior pubic ramus and the ischial ramus?
A
Ischiopubic ramus
13
Q
Where is the superior and inferior pubic ramus?
A
Superior pubic ramus attaches to the top of the pubic tubercle
Inferior pubic ramus attaches to bottom of pubic tubercle
14
Q
What is Shenton’s line?
A
Imaginary line between the inferior border of the superior pubic ramus and the inferomedial border of the neck of the femur. Curved shape.
15
Q
Should Shenton’s line be smooth or jagged?
A
It should be a smooth curve with nothing disrupting its path
16
Q
What is the name of the condition where an infant does not have a smooth Shenton’s line?
A
Congenital dislocation of the hip (CDH)
17
Q
Name the fibrocartilage surface found on the acetabulum
A
Acetabular labrum
18
Q
Name the hyaline cartilage surface found superficial to the acetabular labrum
A
Lunate surface
19
Q
Name the ligament that joins both ends of the lunate surface on acetabulum?
A
Transverse acetabular ligament
20
Q
Name the branch of the obturator artery found within the hip joint
A
Acetabular branch of the obturator artery
21
Q
What kind of cartilage is found on the surface head of femur?
A
Hyaline cartilage
21
Q
What kind of cartilage is found on the surface head of femur?
A
Hyaline cartilage
22
Q
What ind of membrane encloses the hip joint?
A
Synovial membrane
23
Q
Name the intracapsular ligament of hip joint
A
Ligament of head of femur
24
Where does the ligament of head of femur attach?
Attaches to the acetabular fossa to the fovea of the femur. Encloses the acetabular branch of the obturator artery.
25
How many extra capsular ligaments of the hip joint are there?
3
26
Name the 3 extra capsular ligaments
Iliofemoral
Pubofemoral
Ischiofemoral
27
Name the 3 extra capsular ligaments
Iliofemoral
Pubofemoral
Ischiofemoral
28
Where does the iliofemoral ligament attach?
ASIS to the intertrochantric line of femur. Y shaped, prevents hyperextension
29
Where does the pubofemoral ligament attach?
Superior pubic rami to the intertrochantric line of femur. Triangular shoed, prevents excessive abduction and extension
30
Where does the ischiofemoral ligament attach?
Body of ischium to the greater trochanter of femur. Spiral on posterior side, prevents excessive extension
31
Where is the greater trochanter of the femur?
Projection on the top anterior aspect of the femur, is angled superiorly
32
Where is the lesser trochanter of the femur?
Smaller projection on the posterior medial side of femur
33
What is the intertrochanteric line?
Ridge of bone that runs on anterior of femur between the greater and lesser trochanter. Quadrate tubercle is on this. After it passes lesser trochanter it becomes the pectineal line
34
What is the intertrochanteric crest?
Extension of the intertrochanteric line, ridge between the greater and lesser trochanter
35
Name the grooved line that the pectineal line joins diagonally on the posterior side of the femur
Linea aspera
36
Name the tuberosity that is a continuation of the intertrochanteric crest?
Gluteal tuberosity
37
What are the 2 types of femoral fracture that can occur to the neck of the femur?
Intracapsular fractures
Extrscapsular fractures
38
Which proximal femur fracture can disrupt the blood supply to the femur, causing avascular necrosis?
Intracapsular femur fracture
39
What is the name of the artery supply that would be cut off in an intracapsular proximal femur fracture?
Medial femoral circumflex artery
40
Name the ligament that divides the greater sciatic foramen and lesser sciatic foramen
Sacrospinous ligament
41
How many gateways are there to the lower limb?
6
42
List the 6 gateways to the lower limb
Abdominal cavity
Subinguinal space
Obturator canal
Greater sciatic foramen below piriformis muscle
Greater sciatic foramen above the piriformis muscle
Lesser sciatic foramen
43
Name the structures that pass through the subinguinal space
Femoral nerve
Psoas major
Iliacus
Pectineus muscles
Femoral artery
Femoral vein
Lymphatics
Femoral branch of genitofemoral nerve
Lateral cutaneous nerve of thigh
44
Name the structures that pass through the obturator canal
Obturator nerve
Obturator vessels
45
Name the structures that pass through the greater sciatic foramen below the piriformis muscle
Sciatic nerve
Inferior gluteal nerve
Inferior gluteal artery
Inferior gluteal vein
Pudendal nerve
Inferior pudendal artery
Inferior pudendal vein
Posterior femoral cutaneous nerve
Nerve to obturator internus and superior gemellus muscles
Nerve to quadratus fermoris and inferior gemellus muscles
46
Name the structures that pass through the lesser sciatic foramen
Obturator internus muscle tendon
Pudendal nerve
Internal pudendal vessel from gluteal region to perineum
47
Name the structures that pass through the greater sciatic foramen above the piriformis muscle
Superior gluteal nerve
Superior gluteal artery
Superior gluteal vein
48
How many gluteal lines are present on the posterior side of the ala of the ilium?
3
49
Name the 3 gluteal lines present on the posterior side of the ala of the ilium
Inferior gluteal line
Anterior gluteal line
Posterior gluteal line
50
How many superficial gluteal muscles are there?
4
51
Name the 4 superior gluteal muscles
Gluteus maximus
Gluteus minimus
Gluteus medius
Tensor fasciae latae
52
What is the origin of gluteus maximus?
External ilium posterior to posterior gluteal line, dorsal sacrum, coccyx, sacrotubeous ligament
53
What is the insertion of gluteus maximus?
Gluteal tuberosity and iliotibial tract
54
What innervates the gluteus maximus?
Inferior gluteal nerve
55
What is the action of gluteus maximus?
Powerful hip extensor, abducts and laterally rotates thigh, stabilises hip
56
What is the origin of tensor fasciae latae?
Lateral iliac crest between ASIS and tubercle
57
What is the insertion of tensor fasciae latae?
Iliotibial tract
58
What innervates the tensor fasciae latae?
Superior gluteal nerve
59
What is the action of the tensor fasciae latae?
Stabilises the knee and hip, helps to tense the IT band and fascia lata
60
What is the iliotibial tract?
Thickening of the fascia lata laterally, which encloses the tensor fasciae latae, gluteus maximus inserts onto the iliotibial tract
61
What is the origin of gluteus medius?
External ilium between posterior and anterior gluteal lines
61
What is the origin of gluteus medius?
External ilium between posterior and anterior gluteal lines
62
What is the insertion of gluteus medius?
Greater trochanter
63
What innervates the gluteus medius?
Superior gluteal nerve
64
What is the action of gluteus medius?
Abducts and medially rotates femur (posterior fibres can laterally rotate)
65
What is the origin of gluteus minimus?
External ilium between anterior and inferior gluteal lines
66
What is the insertion of gluteus minimus?
Greater trochanter
67
What innervates gluteus minimus?
Superior gluteal nerve
68
What is the action of gluteus minimus?
Abducts and medially rotates femur
69
Which superficial gluteal muscles help to keep the pelvis steady when standing on one leg?
Gluteus medius and minimus
70
How many deep muscles of the hip joint are there?
5
71
Name the 5 deep muscles of the hip joint
Piriformis
Gemellus superior
Obturator internus
Gemellus inferior
Quadratus femoris
72
What its the origin of piriformis?
Anterior sacrum
73
What is the insertion of piriformis?
Greater trochanter
74
What innervates piriformis?
Nerve to piriformis
75
What is the action of piriformis?
Laterally rotates (when extended) and abducts femur (when flexed)
76
What is the origin of quadratus femoris?
Lateral aspect of ischium to ischial tuberosity
77
What is the insertion of quadratus femoris?
Quadrate tubercle and intertrochanteric crest
78
What innervates the quadratus femoris?
Nerve to quadratus femoris
79
What is the action of quadratus femoris?
Laterally rotates femur
80
What is the origin of obturator internus?
Obturator membrane and surrounding bones
81
What is the insertion of obturator internus?
Greater trochanter
82
What innervates obturator internus?
Nerve to obturator internus
83
What is the action of obturator internus?
Laterally rotates (when extended) and abducts femur (when flexed)
84
What is the origin of the superior gemellus?
Ischial spine
85
What is the insertion of superior gemellus?
Greater trochanter and tendon of obturator internus
86
What innervates the superior gemellus?
Nerve to obturator internus
87
What is the action of the superior gemellus?
Laterally rotates (when extended) and abducts femur (when flexed)
88
What is the origin of the inferior gemellus?
Ischial tuberosity
89
What is the insertion of the inferior gemellus?
Greater trochanter and tendon of obturator internus
90
What innervates the inferior gemellus?
Nerve to quadratus femoris
91
What is the action of the inferior gemellus?
Laterally rotates (when extended) and abducts femur (when flexed)
92
Which deep muscle of the hip joint divides the gluteal region into superior and inferior regions?
Piriformis
92
Which deep muscle of the hip joint divides the gluteal region into superior and inferior regions?
Piriformis
93
Where does the sciatic nerve enter the gluteal region relative to the piriformis muscle?
Enters directly inferior to piriformis muscle
94
From which major artery do the lateral and medial circumflex arteries around the hip joint rise from?
Femoral artery
95
From which major artery do the superior and inferior gluteal artery rise from?
Internal iliac artery
96
What is the name of the anastomoses at the hip joint?
Cruciate anastomoses
97
Name the most important source of blood to the femoral head in adults
Medial circumflex artery
98
Through which foramen does the superior and inferior gluteal artery pass through?
Greater sciatic foramen
99
Which artery passes through the obturator canal?
Obturator artery
100
From which major artery does the obturator artery rise from?
Internal iliac artery
101
Does the obturator artery divide into anterior and posterior branches after passing through the obturator canal?
Yes!
102
From which branch of the obturator artery does the acetabular branch that supplies the head of the femur rise from?
Posterior branch
103
How many main lumbar nerves are there?
6
104
Name the 6 main lumbar nerves
Ilioinguinal
Iliohypogastric
Genitofemoral
Lateral cutaneous nerve of thigh
Femoral
Obturator
105
Name the 7 main sacral nerves
Superior gluteal nerve
Inferior gluteal nerve
Nerve to piriformis
Sciatic nerve
Posterior femoral
Nerve to obturator internus
Nerve to quadratus femoris
106
Which dorsal and ventral nerves do the sciatic nerve divide into?
Common fibular = Dorsal
Tibial = Ventral
107
Which main nerve from the lumbosacral plexus has dorsal and ventral roots?
Posterior femoral nerve
108
Name the 3 ventral nerves that come off the sacral plexus
Nerve to obturator internus
Nerve to quadratus femoris
Posterior femoral
109
Name the 7 dorsal nerves that come off the lumbar and sacral plexus
Lateral cutaneous nerve
Femoral
Obturator
Superior gluteal nerve
Inferior gluteal nerve
Nerve to piriformis
Sciatic nerve
