Hip and Gluteal Region Flashcards
What are the 3 main areas with openings to structures within the lower limb?
Femoral triangle
Popliteal fossa
Tarsal tunnel
Describe the position of the greater sciatic notch
The curve where the sacrum and ala of ilium join
Describe the position of the lesser sciatic notch
The curve behind the pubic tubercle
What is the pectineal line?
The superior ridge on the superior pubic ramus
Where is the ischial spine?
A tubercle on the posterior side of the ischium
What forms the obturator foramen?
The hole formed by the ischium and pubis
Name the cartilage that joins the ilium, pubis and ischium at the acetabulum
Triradiate cartilage
Name the 4 iliac spines involved with the iliac crest
Anterior superior iliac spine
Anterior inferior iliac spine
Posterior superior iliac spine
Posterior inferior iliac spine
What separates the greater and lesser sciatic notch?
Ischial spine
Name the membrane that covers most of the obturator foramen?
Obturator membrane
What is the name of the gap in the obturator foramen?
Obturator canal
What is the name of the joining of the inferior pubic ramus and the ischial ramus?
Ischiopubic ramus
Where is the superior and inferior pubic ramus?
Superior pubic ramus attaches to the top of the pubic tubercle
Inferior pubic ramus attaches to bottom of pubic tubercle
What is Shenton’s line?
Imaginary line between the inferior border of the superior pubic ramus and the inferomedial border of the neck of the femur. Curved shape.
Should Shenton’s line be smooth or jagged?
It should be a smooth curve with nothing disrupting its path
What is the name of the condition where an infant does not have a smooth Shenton’s line?
Congenital dislocation of the hip (CDH)
Name the fibrocartilage surface found on the acetabulum
Acetabular labrum
Name the hyaline cartilage surface found superficial to the acetabular labrum
Lunate surface
Name the ligament that joins both ends of the lunate surface on acetabulum?
Transverse acetabular ligament
Name the branch of the obturator artery found within the hip joint
Acetabular branch of the obturator artery
What kind of cartilage is found on the surface head of femur?
Hyaline cartilage
What kind of cartilage is found on the surface head of femur?
Hyaline cartilage
What ind of membrane encloses the hip joint?
Synovial membrane
Name the intracapsular ligament of hip joint
Ligament of head of femur
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.
How many extra capsular ligaments of the hip joint are there?
3
Name the 3 extra capsular ligaments
Iliofemoral
Pubofemoral
Ischiofemoral
Name the 3 extra capsular ligaments
Iliofemoral
Pubofemoral
Ischiofemoral
Where does the iliofemoral ligament attach?
ASIS to the intertrochantric line of femur. Y shaped, prevents hyperextension
Where does the pubofemoral ligament attach?
Superior pubic rami to the intertrochantric line of femur. Triangular shoed, prevents excessive abduction and extension
Where does the ischiofemoral ligament attach?
Body of ischium to the greater trochanter of femur. Spiral on posterior side, prevents excessive extension
Where is the greater trochanter of the femur?
Projection on the top anterior aspect of the femur, is angled superiorly
Where is the lesser trochanter of the femur?
Smaller projection on the posterior medial side of femur
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
What is the intertrochanteric crest?
Extension of the intertrochanteric line, ridge between the greater and lesser trochanter
Name the grooved line that the pectineal line joins diagonally on the posterior side of the femur
Linea aspera
Name the tuberosity that is a continuation of the intertrochanteric crest?
Gluteal tuberosity
What are the 2 types of femoral fracture that can occur to the neck of the femur?
Intracapsular fractures
Extrscapsular fractures
Which proximal femur fracture can disrupt the blood supply to the femur, causing avascular necrosis?
Intracapsular femur fracture
What is the name of the artery supply that would be cut off in an intracapsular proximal femur fracture?
Medial femoral circumflex artery
Name the ligament that divides the greater sciatic foramen and lesser sciatic foramen
Sacrospinous ligament
How many gateways are there to the lower limb?
6
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
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
Name the structures that pass through the obturator canal
Obturator nerve
Obturator vessels
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
Name the structures that pass through the lesser sciatic foramen
Obturator internus muscle tendon
Pudendal nerve
Internal pudendal vessel from gluteal region to perineum
Name the structures that pass through the greater sciatic foramen above the piriformis muscle
Superior gluteal nerve
Superior gluteal artery
Superior gluteal vein
How many gluteal lines are present on the posterior side of the ala of the ilium?
3
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
How many superficial gluteal muscles are there?
4
Name the 4 superior gluteal muscles
Gluteus maximus
Gluteus minimus
Gluteus medius
Tensor fasciae latae
What is the origin of gluteus maximus?
External ilium posterior to posterior gluteal line, dorsal sacrum, coccyx, sacrotubeous ligament
What is the insertion of gluteus maximus?
Gluteal tuberosity and iliotibial tract
What innervates the gluteus maximus?
Inferior gluteal nerve
What is the action of gluteus maximus?
Powerful hip extensor, abducts and laterally rotates thigh, stabilises hip
What is the origin of tensor fasciae latae?
Lateral iliac crest between ASIS and tubercle
What is the insertion of tensor fasciae latae?
Iliotibial tract
What innervates the tensor fasciae latae?
Superior gluteal nerve
What is the action of the tensor fasciae latae?
Stabilises the knee and hip, helps to tense the IT band and fascia lata
What is the iliotibial tract?
Thickening of the fascia lata laterally, which encloses the tensor fasciae latae, gluteus maximus inserts onto the iliotibial tract
What is the origin of gluteus medius?
External ilium between posterior and anterior gluteal lines
What is the origin of gluteus medius?
External ilium between posterior and anterior gluteal lines
What is the insertion of gluteus medius?
Greater trochanter
What innervates the gluteus medius?
Superior gluteal nerve
What is the action of gluteus medius?
Abducts and medially rotates femur (posterior fibres can laterally rotate)
What is the origin of gluteus minimus?
External ilium between anterior and inferior gluteal lines
What is the insertion of gluteus minimus?
Greater trochanter
What innervates gluteus minimus?
Superior gluteal nerve
What is the action of gluteus minimus?
Abducts and medially rotates femur
Which superficial gluteal muscles help to keep the pelvis steady when standing on one leg?
Gluteus medius and minimus
How many deep muscles of the hip joint are there?
5
Name the 5 deep muscles of the hip joint
Piriformis
Gemellus superior
Obturator internus
Gemellus inferior
Quadratus femoris
What its the origin of piriformis?
Anterior sacrum
What is the insertion of piriformis?
Greater trochanter
What innervates piriformis?
Nerve to piriformis
What is the action of piriformis?
Laterally rotates (when extended) and abducts femur (when flexed)
What is the origin of quadratus femoris?
Lateral aspect of ischium to ischial tuberosity
What is the insertion of quadratus femoris?
Quadrate tubercle and intertrochanteric crest
What innervates the quadratus femoris?
Nerve to quadratus femoris
What is the action of quadratus femoris?
Laterally rotates femur
What is the origin of obturator internus?
Obturator membrane and surrounding bones
What is the insertion of obturator internus?
Greater trochanter
What innervates obturator internus?
Nerve to obturator internus
What is the action of obturator internus?
Laterally rotates (when extended) and abducts femur (when flexed)
What is the origin of the superior gemellus?
Ischial spine
What is the insertion of superior gemellus?
Greater trochanter and tendon of obturator internus
What innervates the superior gemellus?
Nerve to obturator internus
What is the action of the superior gemellus?
Laterally rotates (when extended) and abducts femur (when flexed)
What is the origin of the inferior gemellus?
Ischial tuberosity
What is the insertion of the inferior gemellus?
Greater trochanter and tendon of obturator internus
What innervates the inferior gemellus?
Nerve to quadratus femoris
What is the action of the inferior gemellus?
Laterally rotates (when extended) and abducts femur (when flexed)
Which deep muscle of the hip joint divides the gluteal region into superior and inferior regions?
Piriformis
Which deep muscle of the hip joint divides the gluteal region into superior and inferior regions?
Piriformis
Where does the sciatic nerve enter the gluteal region relative to the piriformis muscle?
Enters directly inferior to piriformis muscle
From which major artery do the lateral and medial circumflex arteries around the hip joint rise from?
Femoral artery
From which major artery do the superior and inferior gluteal artery rise from?
Internal iliac artery
What is the name of the anastomoses at the hip joint?
Cruciate anastomoses
Name the most important source of blood to the femoral head in adults
Medial circumflex artery
Through which foramen does the superior and inferior gluteal artery pass through?
Greater sciatic foramen
Which artery passes through the obturator canal?
Obturator artery
From which major artery does the obturator artery rise from?
Internal iliac artery
Does the obturator artery divide into anterior and posterior branches after passing through the obturator canal?
Yes!
From which branch of the obturator artery does the acetabular branch that supplies the head of the femur rise from?
Posterior branch
How many main lumbar nerves are there?
6
Name the 6 main lumbar nerves
Ilioinguinal
Iliohypogastric
Genitofemoral
Lateral cutaneous nerve of thigh
Femoral
Obturator
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
Which dorsal and ventral nerves do the sciatic nerve divide into?
Common fibular = Dorsal
Tibial = Ventral
Which main nerve from the lumbosacral plexus has dorsal and ventral roots?
Posterior femoral nerve
Name the 3 ventral nerves that come off the sacral plexus
Nerve to obturator internus
Nerve to quadratus femoris
Posterior femoral
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
