Hip and Gluteal Region Flashcards

1
Q

What is the acetabulum?

A

An incomplete ring of bone formed by the intersection of the ilium, ishium, and pubis at the triradiate cartilage

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2
Q

What completes the circle created by the acetabulum?

A

The transverse acetabular ligament

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3
Q

What is the acetabular foramen?

A

An opening formed between the ligament and the central acetabular fossa

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4
Q

The acetabular fossa houses a

A

Fat pad

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5
Q

The weight of the body is borne by articular cartilage on the ___ surface of the acetabulum

A

Lunate

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6
Q

What is the acetabular labrum and what does it do?

A

It is a ring of fibrocartilage that projects beyond the bony rim of the acetabulum

It helps improve the fit of the femoral head into the acetabulum

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7
Q

What is the structure of the synovial membrane?

A

It attaches around the head of the femur and extends down the neck of the femur and then reflects back to the rim of the acetabulum

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8
Q

What is the function of the synovial membrane?

A

It can bunch up and stretch out to accomodate the large range of movement of the femur

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9
Q

What is the structure and function of the zona orbicularis?

A

It is located in the fibrous joint capsule of the femur and wraps around the neck of the femur

It is smaller in diameter than the head of the femur, so it promotes joint stability

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10
Q

What accomodates the movement of the femoral head within the acetabulum?

A

Synovial folds

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11
Q

What is the purpose of the ligament of the head of the femur?

A

It limits the range of motion of the hip joint, but NOT through tension

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12
Q

What is the consequence of the ligament of the head of the feur being too thick to fit between the femoral head and acetabulum?

A

The range of motion of the hip joint is limited to the area defined by the central fat pad

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13
Q

What elements of the pelvis is the femur bound to?

A

Ilium

Ishium

Pubis

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14
Q

What ligaments attach the femur to the bones of the pelvis?

A

Iliofemoral

Pubofemoral

Ishiofemoral

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15
Q

The iliofemoral ligament attaches on the

A

anterior surface of the femur, along the intertrochanteric line

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16
Q

The pubofemoral ligament attaches on the

A

inferior aspect of the femoral neck

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17
Q

The ischiofemoral ligament attaches on the

A

Superior aspect of the femoral neck, continuing to the upper part of the intertrochanteric line

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18
Q

What happens to the femur-pelvis ligaments when a person is standing?

A

The ligaments are twisted, which exerts a force that pulls the head of the femur firmly into the socket formed by the acetabulum

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19
Q

What happens to the head of the femur when standing?

How is this corrected?

A

Part of the articular cartilage on the head of the femur is exposed on the anterior and superior aspect of the articular ball

To bring the articular surface into contact with the acetabulum requires flexing and abducting the femur

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20
Q

What is the true physiological position of the hip?

A

When the femur is flexed and abducted

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21
Q

The ligaments around the head of the femur are laxed when the hip is

A

Flexed

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22
Q

What happens to the ligaments of the hip when someone is in the seated position?

A

The ligaments are lax, which makes the hip joint particularly susceptible to posterior dislocations

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23
Q

Dislocations of the femur are prevalent ANTERIORLY between the

A

Iliofemoral and pubofemoral ligaments

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24
Q

Dislocations of the femur are prevalent POSTERIOLY between the

A

Iliofemoral and ishiofemoral ligaments

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25
Q

Parts of the femur/hip joint from deep to superficial

A

Acetabular membrane (located inside the synovial membrane)

Synovial membrane is inside the fibrous capsule of the joint (contains the zona orbicularis)

Fibrous capsule of joint is inside the tube of ligaments that bind the femur to the hip (iliofemoral, ischiofemoral, and pubofemoral ligaments)

These ligaments are surrounded by the muscles of the hip

The muscles of the hip are covered by fascia lata

Fascia lata is covered by subcutaenous fat and skin

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26
Q

What supplies the acetabulum?

A

Obturator atery- anterior and posterior branches

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27
Q

Blood is supplied to the femoral head by

A

Lateral femoral circumflex artery

Medial femoral circumflex artery

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28
Q

Both the lateral and medial femoral circumflex arteries branch from or near the

A

Profunda femoris artery

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29
Q

What are the two anastomoses of the lateral and femoral circumflex arteries

A

Circulate anastomosis that occur around the femur, below the greater troachanter

Both also give off ascending branches that anastomose around the femoral neck

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30
Q

What supplies the acetabulum?

A

Acetabular branches of the posterior obturator artery

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31
Q

What is fascia lata?

A

Outer layer of the deep fascia over the thigh

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32
Q

Fascia lata is anchored superiority in a ring that includes

A

Inguinal ligament

Iliac crest

Sacrum

Coccyx

Sacrotuberous ligament

Pubis

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33
Q

Fascia lata is inferiorly continuous with

A

Deep fascia of the leg (fascia cruris)

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34
Q

What is the iliotibial tract/band?

A

It is the thickened, lateral aspect of the fascia lata

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35
Q

The iliotibial tract/band is attached superiorly to

A

The tubercle of the crest of the ilium

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36
Q

The iliotibial tract/band is attached inferiorly to

A

The proximal part of the tibia

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37
Q

What is the function of the iliotibial tract?

A

To reduce bending load on the femur

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38
Q

Function of tensor fasciae lata

A

Stabilizes knee in extension

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39
Q

The obturator externus is innervated by

A

Obturator nerve, posterior division

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40
Q

Tensor fascia lata is innervated by

A

Superior gluteal nerve

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41
Q

Gluteus maximus is innervated by

A

Inferior gluteal nerve

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42
Q

Gleuteus medius and gluteus minimus are innervated by

A

Superior gluteal nerve

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43
Q

Piriformis muscle is innervated by

A

Nerve to piriformis

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44
Q

Obturator internuis is innervated by

A

Nerve to obturator internus

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45
Q

Superior gemellus is innervated by

A

Nerve to obturator internus

46
Q

Inferior gemellus is innervated by

A

Nerve to quadratus femoris

47
Q

Quadratus femoris is innervated by

A

Nerve to quadratus femoris

48
Q

Femoral nerve and its sidekicks innervated

A

Iliacus and psoas

49
Q

Common fibular sidekicks are

A

Gluteal nerves

50
Q

Tibial nerve and its sidekicks innervate

A

Lateral rotators

51
Q

Posterior division of obutrator nerve comes from

A

L3-L4

52
Q

Superior gluteal nerve that innervates tensor fascia lata comes off

A

L4-S1

53
Q

Inferior gluteal nerve that innervates gluteus maximus comes off

A

L5-S2

54
Q

Superior gluteal nerve that innervates gluteus medius and minimus comes off

A

L5-S1

55
Q

Nerve to piriformis comess off

A

S1-S2

56
Q

Nerve to obturator internus comes off

A

L5-S2

57
Q

Nerve to quadraus femoris comes off

A

L4-S1

58
Q

Sidekicks to common fibular nerve include

A

Superior gluteal nerve

Inferior gluteal nerve

Nerve to piriformis

59
Q

Sidekicks of tibial nerve include

A

Nerve to obturator internus

Nerve to quadratus femoris

60
Q

Dorsiflexion (extension) of upper foot is done by

A

L4-S1 (common fibular)

61
Q

Extension of upper leg is done by

A

L2-L4 (Femoral nerve)

62
Q

Flexion of upper thigh done by

A

L1-L2 (Femoral nerve)

63
Q

Flantarflexion (flexion) of bottom foot is done by

A

L4-S5, S1-S2 (Tibial nerve)

64
Q

Flexion of bottom of leg done by

A

L5-S2 (Tibial nerve)

65
Q

Extension of bottom thigh done by

A

L5-S2 (Common fibular)

66
Q

What defines the inferior border of the buttock

A

Gluteal/natal fold

67
Q

The most superficial muscle in the superior-lateral region of the buttock is the

A

Gluteus medius

68
Q

Where does the gluteus maximus insert?

A

Deep distal 1/4 inserts on the femus

Remainder inserts on IT tract

69
Q

Function of the gluteus maximus

A

Powerful extensor of flexed thigh

Laterally stabilizes hip and knee via IT tract

Laterally rotates and abducts thigh

70
Q

Overall function of small glutes

A

Abduct femur

Pervents pelvic tilt

71
Q

What do the anterior part of small glutes do?

A

Flex and internally rotate thigh

72
Q

What do the posterior parts of the small glutes do?

A

Extend and laterally rotate thigh

73
Q

What runs above the piriformis?

A

Superior gluteal artery, vein, and nerve

74
Q

What runs below the piriformis?

A

Inferior gluteal artery, vein, and nerve

Sciatic nerve

Posterior femoral cutaneous nerve

75
Q

Arterial supply to the pirifromis may include

A

Superior and inferior gluteal arteries

Lateral sacral artery

76
Q

Circulate anastomosis involves ___ superiorly

A

Inferior gluteal artery

77
Q

Circulate anastomosis invovles __ mediolaterally

A

Lateral and medial femoral circumflex arteries

78
Q

Circulate anastomosis invovles ____ inferiorly

A

First perforating branch of the profunda femoris artery

79
Q

What are the bursae of the hip?

A

Ischial bursae

Trochanteric burase

Gluteofemoral bursa

80
Q

Ischial bursae separates

A

gluteus maximus from ischial tuberosity

81
Q

Trochanteric burase separates

A

gluteus maximus from greater trochanter

82
Q

Gluteofemoral bursa separates

A

IT tract from proximal attachment of hamstrings

83
Q

What are the lateral rotators of the hip?

A

Piriformis

Obturator internus

Gemellus superior

Gemellus inferior

Quadratus femoris

84
Q

Origin of piriformis

A

Anterior surface of sacrum

85
Q

Origin of obturator internus

A

Deep surface of obutrator membrane and surrounding bone

86
Q

Gemellus inferior origin

A

upper aspect of ischial tuberosity

87
Q

Gemellus superior origin

A

External surface of ischial spine

88
Q

Where do the piriformis, obutrator internus, gemellus supeior, and gemellus inferior insert

A

On greater trochanter of femur

89
Q

What is the overall function of the piriformis, obturator internus, gemellus supeior, and gemellus inferior?

A

Laterally rotate extended femur

Abduct flexed femur

90
Q

Origin of quadratus femoris

A

Lateral aspect of ischium

91
Q

Insertion of quadratus femoris

A

Quadrate tubercle on intertrochanteric crest

92
Q

Action of quadratus femoris

A

Strong lateral rotator of femur

93
Q

Fibers of the obturator internus exit the pelvis through

A

Lesser sciatic foramen

94
Q

What forms the lesser sciatic foramen?

A

Lesser sciatic notch

Sacrospinous ligament

Sacrotuberus ligament

95
Q

Obutrator externus originates from

A

External surface of obturator membrane

96
Q

Obturator externus inserts into

A

Trochanteric fossa

97
Q

What is the function of obturator internus?

A

Laterally rotates thigh

98
Q

What innervates the obturator externus

A

Obturator nerve

99
Q

Sensory innervation of the buttock is done by

A

Cluneal nerves

Lateral branch of iliohypogastic nerve

100
Q

What is the source of the superior and middle cluneal nerves?

A

Dorsal rami of the lumbar and sacral vertebrae

101
Q

What is the source of the inferior cluneal nerve

A

Posterior femoral cutaneous nerve

102
Q

Perforating cutaneous nerve overlaps with the

A

Posterior cutaneous nerve of the thigh

103
Q

Perforating cutaneous nerve innervates

A

Skin over the medial aspect of the gluteal fold

104
Q

Perforating cutaneous nerve is derived from

A

S2-S3

105
Q

Perforating cutaneous nerve leaves the pelvic cavity by

A

Penetrating directly through the sacrotuberous ligament, after which it passes inferiorly around the lower border of the gluteus maximus

106
Q

What is sciatica?

A

Symptoms of pain in the lower back, gluteal region, thigh, or leg

It caused by compression/irritation of sciatic nerve

107
Q

What is piriformis syndrome?

A

Irritation of sciatic nerve by piriformis muscle

108
Q

What are the extensors of the hip?

A

Gluteus maximus

109
Q

What are the abductors of the hip?

A

Small glutes

110
Q

What are the lateral rotators of the hip

A

Piriformis

Obturator internus

Gemelli

Quadratus femoris