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YR2: Limbs > Hip, buttock and thigh > Flashcards

Hip, buttock and thigh Flashcards

1
Q

What happens to the lower limb during development?

A

It twists, resulting in permanent pronation at mid-thigh level

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2
Q

What specific words are given to the flexion and extension of the foot?

A

Dorsiflexion (pointing toes up)

Plantarflexion (pointing toes down)

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3
Q

What are the 3 parts of the pelvis (hip bone)?

A

Ilium
Ischium
Pubis

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4
Q

What marks the ends of the iliac crest?

A

ASIS + PSIS

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5
Q

What is the name given to the surface of the hipbone that articulates with the sacrum?

A

Auricular Surface

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6
Q

What lies in between the greater and lesser trochanters of the femur?

A

Intertrochanteric line

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7
Q

What short ridge is found just inferior to the lesser trochanter?

A

Gluteal tuberosity

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8
Q

A longer ridge downwards along the shaft of the femur and originates from the short ridge below the lesser trochanter. What is this long ridge called?

A

Linea aspera

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9
Q

Which tubercle is found just superior to the medial epicondyle of the femur?

A

Adductor tubercle

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10
Q

What is the anterior protrusion between the ilium and the pubis called?

A

Iliopubic eminence

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11
Q

What are the two notable parts of the ischium onto which ligaments attach?

A

Tuberosity + spine

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12
Q

Which pelvic bones make up the acetabulum?

A

All 3 (ilium, ischium + pubis)

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13
Q

What notches are present on the posterior aspect of the pelvis?

A

Greater sciatic notch + lesser sciatic notch

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14
Q

What is the angle of inclination?

A

The angle between the long axis of the shaft + long axis of the head + neck

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15
Q

What determines the size of the angle between the long axis of the shaft and the vertical plane?

A

Width of the hips

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16
Q

What structures form the greater and lesser sciatic foramina?

A

Sacrospinous ligament

Sacrotuberous ligament

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17
Q

What are the two fascia found in the thigh?

A

Superficial fascia e.g. subcutaneous tissue

Deep fascia- fascia lata

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18
Q

What is the name given to the lateral thickened area of the fascia lata?

A

Ilio-tibial tract

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19
Q

What are the 4 compartments of the thigh region?

A

Gluteal compartment
Anterior compartment of the thigh
Medial compartment of the thigh
Posterior compartment of the thigh

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20
Q

What movements are the muscles of the gluteal region responsible for?

A

Extension, abduction + external rotation of the hip

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21
Q

What are the gluteal muscles?

A

Gluteus maximus
Gluteus medius
Gluteus minimus
(tensor fasciae latae)

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22
Q

What are the short external rotators of the hip?

A

Piriformis
Obturator internus
Quadratus femoris
Gemelli (superior + inferior)

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23
Q

Describe the attachments of gluteus maximus.

A

Proximal: posterior part of the iliac crest + thick fascia of the sacrum + coccyx
Distal: gluteal tuberosity + ilio-tibial tract

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24
Q

What proportion of the gluteus maximum fibres attach to the gluteal tuberosity?

A

~ 25% attach to the gluteal tuberosity

The rest attach to the ilio-tibial tract

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25
Q

What does the ilio-tibial tract insert into?

A

Anterolateral tubercle of the tibia

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26
Q

Describe the attachments of gluteus medius.

A

Proximal: broad attachment to the external surface of the ilium (between anterior + posterior gluteal lines)
Distal: greater trochanter

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27
Q

Describe the attachments of gluteus minimus.

A

Proximal: broad attachment to the external surface of the ilium (between anterior+ inferior gluteal lines)
Distal: greater trochanter

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28
Q

What movement are gluteus medius and gluteus minimus responsible for?

A

Abduction

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29
Q

What movement are the deep muscles of the gluteal region responsible for? What is their other function?

A

Lateral rotation

Also stabilise hip joint

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30
Q

Describe the attachments of tensor fasciae latae.

A

Proximal: ASIS
Distal: ilio-tibial tract

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31
Q

Which compartment is tensor fasciae latae in?

A

Neurologically: a gluteal compartment muscle because it is innervated by the superior gluteal nerve
Action= flexor of the hip so it functions more like an anterior compartment muscle

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32
Q

Describe the attachments of obturator internus.

A

Rim of the obturator foramen

Greater trochanter of the femur

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33
Q

What movement are the muscles of the anterior compartment of the thigh responsible for?

A

Hip flexion

Knee extension

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34
Q

Which muscles are in the anterior compartment of the thigh?

A 
Pectineus
Ilio-psoas
(Tensor fasciae latae)
Sartorius
Quadriceps (rectus femoris, vastus medialis, vastus intermedius, vastus lateralis)
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35
Q

What is the most powerful flexor of the hip?

A

Ilio-psoas

36
Q

Describe the attachments of Ilio-psoas.

A

Psoas major attaches to the lateral parts of the lumbar vertebrae + T12 + Iliacus attaches to the iliac fossa + crest
The 2 muscles converge to form a common tendon that attaches to the lesser trochanter

37
Q

Describe the attachments of Sartorius. What movement is it responsible for?

A

Sartorius comes off ASIS, descends inferiorly + medially. It crosses the knee + attaches to the upper part of the shaft of the tibia

38
Q

Describe the arrangement of the quadriceps muscles.

A

Rectus femoris is most superficial with vastus medialis + vastus lateralis on either side of rectus femoris
Vastus intermedius is deep to rectus femoris

39
Q

Where do the quadriceps attach distally?

A

Join to form a quadriceps tendon, which attaches to the patella
There is a patellar tendon between the patella + the tibial tuberosity on the anterior of the tibia
The patellar tendon is part of the quadriceps tendon with the patella in between as a sesamoid bone

40
Q

What small muscle is found underneath vastus intermedius?

A

Articularis genu

41
Q

What bursa is found just above the knee joint?

A

Suprapatellar bursa

42
Q

What movement are the muscles in the medial compartment of the thigh responsible for?

A

Adduction of the hip

43
Q

Which muscles make up the medial compartment of the thigh?

A 
Obturator externus 
Gracilis 
Adductor brevis 
Adductor longus 
Adductor magnus
44
Q

Where do most of the muscles of the medial compartment attach proximally?

A

Pubic bone

45
Q

Describe the structure of adductor magnus.

A

Broad attachment to shaft of the femur (medial lip of linea aspera) + a smaller attachment to adductor tubercle (just above medial epicondyle)
Gap inbetween= Hiatus of adductor magnus

46
Q

What movements are the muscles of the posterior compartment of the thigh responsible for?

A

Hip extension

Knee flexion

47
Q

Which muscles make up the posterior compartment of the thigh?

A

Semitendinosus
Semimembranosus
Biceps femoris

48
Q

Where do the muscles of the posterior compartment attach proximally?

A

Ischial tuberosity

49
Q

Describe the attachments of biceps femoris.

A

Long head of biceps femoris comes from the ischial tuberosity + short head comes off the shaft of the femur (lateral lip of linea aspera)
They cross over laterally to attach to the head of the fibula

50
Q

What are the borders of the femoral triangle?

A

Superior: Inguinal Ligament
Lateral: Sartorius
Medial: Adductor Longus

51
Q

What are the contents of the femoral triangle (lateral to medial)? What mnemonic can be used to remember this?

A

Femoral Nerve
Femoral Artery
Femoral Vein
Deep inguinal lymph nodes

NAVY

52
Q

What is the name given to the opening in the fascia lata over the femoral triangle and what is its purpose?

A

Saphenous Opening: allows draining of the long saphenous vein into the femoral vein
Margin of saphenous opening = Falciform Margin

53
Q

What structures form the Adductor Canal?

A

Anterior: Vastus Medialis
Posterior: Adductor Longus + Adductor Magnus
Medial: Sartorius

54
Q

What are some other names for the Adductor Canal?

A

Hunter’s Canal

Subsartorial Canal

55
Q

What are the contents of the Adductor canal?

A

Femoral artery
Femoral vein
Saphenous nerve (major branch of femoral nerve)

56
Q

Where does the sciatic nerve lie within the gluteal region?

A

Inferior medial quadrant

57
Q

What two nerves does the sciatic nerve divide to form?

A

Tibial Nerve

Common Peroneal Nerve

58
Q

Where would you perform an intramuscular injection into the gluteal region?

A

Superior lateral quadrant

59
Q

What does the sciatic nerve supply?

A

All hamstring muscles

All muscles below the knee (supplied by the 2 branches of the sciatic)

60
Q

What test is used to assess the function of the hip abductors?

A

Trendelenberg test
Patient lifts 1 foot off the floor, their hip abductors (gluteus medius + minimus) should contract to keep the pelvis level despite the extra weight of the raised foot on the opposite side

61
Q

Describe the structure of the acetabulum.

A

Acetabulum has a depression in the middle (acetabular fossa) + a lunate surface (surrounding the fossa)
The acetabular notch is filled in by the transverse acetabular ligament

62
Q

What runs within the capsule of the hip joint?

A

Blood supply to femoral head

63
Q

What are the ligaments of the hip joint?

A

Iliofemoral ligament (Y shaped)
Ischiofemoral ligament
Pubofemoral ligament
Transverse acetabular ligament

64
Q

Describe how the arrangement of the hip ligaments changes when the hip is flexed and extended.

A

Flexed: ligaments relaxed
Extended (e.g. when standing): ligaments spiral, which pulls the head of the femur into the acetabulum + helps stabilise the joint when standing

65
Q

Describe the blood supply to the head of the femur.

A

Main blood supply is via the medial + lateral circumflex femoral arteries (from profunda femoris)
Also a small blood supply from artery of the head of the femur (branch of obturator artery- more important in children)

66
Q

What type of hip fracture is most likely to need a hip replacement and why?

A

Intracapsular: more likely to disrupt the blood supply + cause avascular necrosis of the head of the femur

67
Q

When does the external iliac artery become the femoral artery?

A

As it passes under the inguinal ligament

68
Q

What main branch does the femoral artery give off that gives rise to the medial and lateral circumflex femoral arteries?

A

Profunda femoris

69
Q

At what point do the superficial femoral artery and the femoral vein become the popliteal artery and vein?

A

As they pass through the hiatus of adductor magnus from the anterior to posterior compartment

70
Q

Which arteries, that supply the buttock and thigh, are branches of the internal iliac?

A

Superior + Inferior gluteal arteries

Obturator artery

71
Q

What is the main superficial vein of the thigh?

A

Long saphenous vein

72
Q

What other veins drain into the saphenous vein before it enters the sapheno-femoral junction?

A

Superficial circumflex iliac
Superficial epigastric
Superficial external pudendal
Lateral cutaneous vein of thigh

73
Q

What are the deep veins of the thigh?

A 
Popliteal vein 
Femoral vein 
External iliac vein 
Sapheno-femoral junction 
Venae comitantes of the profunda femoris artery
74
Q

What are the main groups of lymph nodes in the thigh?

A

Deep inguinal lymph nodes
Superficial inguinal lymph nodes
External iliac lymph nodes

75
Q

Which nerve supplies the anterior compartment of the thigh and which division of the lumbosacral plexus gives rise to this?

A

Femoral nerve: posterior division of the lumbosacral plexus (L2,3,4)

76
Q

Which nerve supplies the medial compartment of the thigh and which division of the lumbosacral plexus gives rise to this?

A

Obturator nerve: anterior division of lumbosacral plexus (L2,3,4)

77
Q 
State which roots are responsible for:
Hip flexion
Hip extension
Knee extension
Knee flexion
A

Hip flexion: L2,3
Hip extension: L4,5
Knee extension: L3,4
Knee flexion: L5, S1

78
Q

Which nerve supplies the posterior compartment of the thigh, posterior and anterior leg and foot, and which nerve roots give rise to this nerve?

A

Sciatic nerve (L4,5 + S1,2,3)

79
Q

Which nerves supply the gluteal muscles and which nerve roots give rise to these nerves?

A

Superior gluteal nerve (L4,5 + S1)

Inferior gluteal nerve (L5 + S12)

80
Q

Which nerve roots are responsible for the sensory segmental supply to the:
Front of the thigh
Back of the thigh
Buttock

A

Front of the thigh: T12, L1,2,3
Back of the thigh: S1,2,3
Buttock: S2,3,4

81
Q

Which nerve roots give rise to the following sensory peripheral nerves:

A

Subcostal nerve: T12
Ilio-hypogastric nerve: L1
Ilio-inguinal nerve: L1
Genito-femoral nerve: L1,2
Lateral cutaneous nerve of the thigh: L2,3
Sensory branches of the femoral nerve: L2,3,4
Sensory branches of the obturator nerve: L2,3,4
Posterior cutaneous nerve of the thigh: S2,3
Saphenous nerve: L2,3,4
Buttock nerves from the sacral plexus: L1-S3

82
Q

Where are the most common sites of fracture on the femur?

A

Femoral neck

Intertrochanteric fracture

83
Q

How do the semimembranosus and semiteninosus differ in appearance?

A

Tendinosus: forms a more classic tendon (rope like)
Membranosus: forms a flat, membranous, strap like tendon

84
Q

Where odes the sciatic nerve usually enter the gluteal region?

A

Inferior to piriformis, but can be superior or pierce muscle itself

85
Q

Which 2 actions can adductor Magnus perform?

A

Anterior portion: Hip flexion

Posterior portion: Hip extension

86
Q

Where do dermatomes L3 and L4 extend?

A

L3 to the knee

L4 to the floor (foot)

YR2: Limbs (8 decks)

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