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Anatomy II Fall 2023 > Hip region > Flashcards

Hip region Flashcards

1
Q

What are similarities in the upper extremities and lower extremities?

A
  • pelvic and pectoral girdles
  • proximal segments have unpaired long bone
  • second segment has 2 parallel bones
  • 8 carpals and 7 tarsals
  • 5 metacarpals and 5 metatarsals
  • 2 bones in thumb and great toe
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2
Q

What are some differences in the upper and lower extremities?

A

LE
- more stability
- pelvic girdle complete ring
- tibia only connects to the femur
- leg cannot pronate or supinate

UE
- more mobility
- pectoral girdle incomplete ring
- both bones in forearm connect to humerus
- forearm can pronate/supinate

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3
Q

What muscles/ ligaments, fascia attach to the iliac crest?

A
  • thoracolumbar fascia
  • Tensor Fascia Lata
  • Iliacus
  • Latissimus dorsi
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4
Q

What muscles/ ligaments, fascia attach to the ASIS?

A
  • Sartorius
  • TFL
  • inguinal ligament
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5
Q

What muscles/ ligaments, fascia attach to the AIIS?

A
  • Iliofemoral ligament
  • rectus femoris
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6
Q

What muscles/ ligaments, fascia attach to the PSIS?

A
  • Posterior sacroiliac ligament
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7
Q

What muscles/ ligaments, fascia attach to the Ischial spine?

A
  • sacrospinous ligament
  • superior gemellus
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8
Q

What muscles/ ligaments, fascia attach to the ischial tuberosity?

A

-fascia lata
- quadratus femoris
- inferior gemellus
- Hamstrings (adductor magnus, semimembranosus, semitendinosus, long head of bicep femoris)

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9
Q

What ligament separates the greater and lesser sciatic foramen?

A
  • sacrospinous ligament
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10
Q

What muscles/ ligaments, fascia attach to the pubic crest?

A
  • abdominal muscles
  • adductor longus (just inferior)
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11
Q

What muscles/ ligaments, fascia attach to the Pubic tubercles?

A
  • inguinal ligament
  • Fascia Lata
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12
Q

What muscles/ ligaments, fascia attach to the greater trochanter?

A
  • obturator internus
  • gluteus medius
  • gluteus minimus
  • piriformis
  • vastus lateralis
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13
Q

What muscles/ ligaments, fascia attach to the lesser trochanter?

A
  • iliopsoas
  • psoas major
  • iliacus
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14
Q

What muscles/ ligaments, fascia attach to the trochanteric fossa?

A
  • superior and inferior gemellus
  • obturator internus
  • obturator externus
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15
Q

What muscles/ ligaments, fascia attach to the Linea aspera?

A
  • Vastus lateralis
  • vastus medialis
  • adductor brevis
  • adductor longus
  • adductor magnus
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16
Q

What muscles/ ligaments, fascia attach to the Gluteal tuberosity?

A
  • Gluteus maximus
  • adductor magnus
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17
Q

What muscles/ ligaments, fascia attach to the adductor tubercle?

A
  • adductor magnus (hamstring portion)
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18
Q

Where does the iliofemoral ligament live?

A
  • attaches to the AIIS then to the intertrochanteric line of the femur
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19
Q

Where does the pubofemoral ligament live?

A
  • attaches to obturator crest of pubic bone to merge w/ fibrous layer of joint capsule
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20
Q

Where does the ischiofemoral ligament live?

A
  • from acetabular rim to femoral neck
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21
Q

Where does the ligamentum teres ligament live?

A
  • runs through fovea of the femur from the transverse acetabular ligament
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22
Q

What does the Iliofemoral ligament do?

A
  • strongest ligament in the body
  • prevents hyperextension
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23
Q

What does the pubofemoral ligament do?

A
  • prevents hyperabduction
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24
Q

What does the ischiofemoral ligament do?

A
  • weakest of the 3 ligaments
  • taut during hip flexion
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25
What does the ligamentum teres ligament do?
- early life it is a passageway for blood flow to femoral head - does NOT aid in stability - obturator artery runs through
26
What is the coxafemoral joint comprised of?
- femoral head - acetabulum
27
Why is the coxafemoral joint so stable?
- most stable joint - depth of the ball-in-socket joint (more than half of the femoral head inside the labrum - compared to 1/3rd of humeral head in labrum w/ glenohumeral joint) - many muscles/ligaments runs around this joint
28
What are the boundaries of the femoral triangle?
Superior - Inguinal ligament Medial - adductor longus Lateral - sartorius Floor - Iliopsoas & pectineus
29
What are the contents of the femoral triangle from lateral to medial?
- femoral nerve - femoral artery - femoral vein - deep inguinal lymph nodes
30
What do the vessels of the femoral triangle run through?
- vessels run through adductor canal all the way to the adductor hiatus made by the adductor magnus tendons
31
Describe the pathway of the femoral nerve
- passes under the inguinal ligament through femoral triangle to the anterior thigh muscles
32
Describe the pathway of the saphenous nerve
- branches off of femoral nerve and extends beyond the knee - passes medial malleolus to the dorsum of the foot
33
Describe the pathway of the superior gluteal nerve
- leaves through greater sciatic foramen & passes superior to piriformis muscle
34
Describe the pathway of the inferior gluteal, sciatic, nerve to quatratus femoris, nerve to obturator internus, posterior femoral cutaneous, and pudendal nerves
- leaves through greater sciatic foramen & passes inferior to piriformis muscle
35
What muscle do the anterior and posterior divisions of the obturator nerve descend around?
- adductor brevis
36
Describe what the femoral nerve innervates
- anterior thigh muscles - hip & knee joints - cutaneous branches to anteromedial thigh
37
What muscles does the femoral nerve innervate?
- iliopsoas - sartorius - pectineus - rectus femoris - Vastus intermedius - vastus lateralis - vastus medialis
38
What muscles does the obturator nerve innervate?
- obturator externus - pectineus - adductor brevis - adductor longus - adductor magnus (anterior head) - Gracilis
39
What muscles does the sciatic nerve innervate?
Tibial portion: - adductor magnus - bicep femoris (long head) - semimembranosus - semitendinosus Fibular portion: - biceps femoris (short head)
40
Describe what the saphenous nerve innervates
- supplies skin and fascia of anteromedial aspect of the leg - supplies articular branches of the ankle joint - supplies skin of the medial side of the foot to the head of the first metatarsal - last cutaneous branch of the femoral nerve
41
Describe what the clunial nerves innervate
- supply the skin over the iliac crest, b/w PSIS's, and over iliac tubercles - skin of buttock
42
Describe what the superior gluteal nerve innervates
- gluteus medius - gluteus minimus - tensor fasciae latae
43
Describe what the inferior gluteal nerve innervates
gluteus maximus
44
Describe what the sciatic nerve innervates
- all muscles to posterior thigh, leg, & foot - tibial division for all except short head of biceps femoris which is supplies by common fibular division
45
Describe what the nerve to quadratus femoris innervates
- Quadratus femoris - inferior gemellus - hip joint
46
Describe what the nerve to obturator internus innervates
- obturator internus - superior gemellus
47
Describe what the posterior femoral cutaneous nerve innervates
- supplies skin of inferior half of buttocks - skin over posterior thigh and popliteal fossa - skin of lateral perineum & upper thigh
48
Describe what the pudendal nerve innervates
- principle nerve to perineum
49
What are some key landmarks for dermatomes in the lower extremities?
L1: inguinal region L3: anteromedial thigh to medial aspect of the knee L4: top of knee down medial aspect of leg/foot L5: lateral aspect of knee to lateral aspect of lower leg to b/w great toe and pinky toe (dorsal & plantar) S1: posterolateral thigh to pinky toe S2: posteromedial thigh to medial sole of foot
50
What are some key myotomes for the hip?
Flexion: L2-L3 Extension: L4-L5 Abduction: L5-S1 Adduction: L2-L4 ER: L5-S1 IR: L4-L5
51
What are some key myotomes for the knee?
Flexion: L5-S1 Extension: L3-L4
52
What are some key myotomes for the ankle?
Dorsiflexion: L4-L5 Plantarflexion: S1-S2 Inversion: L4-L5 Eversion: L5-S1
53
Which myotomal actions would be weak if a disc were compressing the L5 nerve root?
Hip Ext Hip ER/IR Hip abduction Knee Flex Dorsiflexion Ankle eversion/inversion
54
Describe the arterial branching that occurs in the hip and thigh region
External iliac -> Femoral -> 1) obturator artery & 2) Profunda Femoris 1) obturator artery 2) profunda femoris -> medial/lateral circumflex & perforating arteries Internal Iliac -> superior & inferior gluteal, & internal pudendal
55
What is a potential consequence of injury to the femoral artery?
- death
56
Which artery is most responsible for blood flow to the femoral head?
- medial circumflex artery
57
What is a potential consequence of injury to the medial circumflex artery?
- avascular necrosis of the femoral head
58
How are the great and small saphenous veins similar to the cephalic and basilic veins of the upper extremity?
- both are superficial and come from venous plexuses from the distal appendages
59
Describe the deep venous drainage of the lower extremities
1) anterior & 2) posterior -> popliteal vein -> femoral vein -> external iliac vein 1) anterior: dorsal venous arch -> anterior tibial vein 2) medial/lateral plantar veins -> posterior tibial/fibular veins *Femoral vein receives blood from the great saphenous vein and profunda femoris vein
60
Explain the gluteal region and muscles associated with the region
- unique to humans for upright standing - angle of inclination allows for abductors to sit high in gluteal region Muscles: - Gluteus max, med, & min - Tensor Fascia Latae - piriformis - superior gemellus - Obturator internus - inferior gemellus - quadratus femoris - obturator externus
61
Explain the anterior group of muscles for the hip and the muscles associated
- extensor group (knee) & hip flexion - innervated by the femoral nerve Muscles: - Iliopsoas (major, minor, iliacus) - sartorius - pectineus - rectus femoris - vastus lateralis, medialis, & intermedius
62
Explain the medial group of muscles for the hip and the muscles associated
- adductor group - innervated by obturator nerve Muscles: - gracilis - adductor longus (most anterior) - adductor brevis (shortest) - adductor magnus (largest) - (technically obturator externus but that performs ER)
63
Explain the posterior group of muscles for the hip and the muscles associated
- flexor group (knee) - innervated by tibial portion of sciatic nerve Muscles: - semitendinosus - semimembranosus - biceps femoris (long head)
64
Which muscles are considered to be part of the "Rotator Cuff of the hip?"
6 ER muscles - piriformis - superior gemellus - obturator internus - inferior gemellus - quadratus femoris - obturator externus Abductors - gluteus medius - gluteus minimus - tensor fascia latae
65
What is the triceps coxae?
- "triceps of the hip: - 3 muscles of 2 gemelli & obturator internus -act together to ER the hip
66
List the muscles that perform hip flexion
- iliopsoas - sartorius - pectineus - rectus femoris - tensor fascia latae - some of adductor magnus (adductor part)
67
List the muscles that perform hip extension
- gluteus maximus - semitendinosus - semimembranosus - biceps femoris (long head) - some of adductor magnus (hamstring part)
68
List the muscles that perform hip abduction
- gluteus medius - gluteus minimus - tensor fascia latae *When hip is flexed* - piriformis - obturator internus - superior/inferior gemelli
69
List the muscles that perform hip adduction
- pectineus - gracilis - adductor longus - adductor brevis - adductor magnus
70
List the muscles that perform hip ER
- piriformis - superior gemellus - obturator internus - inferior gemellus - quadratus femoris - obturator externus - gluteus maximus
71
List the muscles that perform hip IR
- gracilis (when flexed) - gluteus medius - gluteus minimus - tensor fasciae latae
72
What can be a complication of an intrascapular fracture of the femur?
- occurs inside capsule of hip joint - degeneration or avascular necrosis can occur due to a loss of blood supply
73
What anatomical structures are replaced during a total hip arthroplasty?
- acetabulum & femoral head - PT is important with this surgery
74
What is a congenital hip dislocation?
- in neonates - more in females than males - femoral head sits higher in acetabulum and the limb appears to be shorter
75
What is an acquired hip dislocation?
Posterior dislocation (usually a car accident) - uncommon b/c hip joint is so stable - sitting in the car puts hip into flexion, adduction, & IR then an A -> P force tears the posterior capsule of the hip joint dislocating the hip posteriorly Anterior dislocation - position: extension, abduction, & ER - acetabulum usually fractures
76
How does a proximal hamstring strain differ from an ischial tuberosity avulsion fracture?
Hamstring strain: - caused from muscle tearing Ischial tuberosity avulsion fracture: - caused from one being pulled away by the muscle
77
Explain how bursitis occurs in trochanteric bursitis
- pain radiates or is local - repetitive friction from TFL & glute max over greater trochanter - common in running - greater trochanter will be TTP - pain w/ resisted abduction or ER
78
Explain how bursitis occurs in ischial bursitis
- repetitive hip extension while seated (rowing) - ischial tuberosity TTP - pain while sitting is local
79
What is the Trendelenburg Sign and why does it happen?
- opposite side of pelvis drops w/ contralateral leg left Causes: - superior gluteal nerve injury - spinal cord injury at L4-S1 levels - gluteus Medius injury & weakness/atrophy - trochanteric bursitis
80
What is piriformis syndrome?
- compression of sciatic nerve by piriformis Causes: - excessive use of gluteal muscles - Trauma = piriformis spasm - 12% of population the fibular division runs through the piriformis instead of under
81
How does a Psoas Abscess form?
Causes: - TB -> retroperitoneal pyogenic infection - Crohn's disease -> regional enteritis of ileum - usually from an infected area that the psoas runs through/around Pus usually appears on anterior superior part of thigh - often mistaken as a femoral hernia
82
What is the relationship of iliopsoas to pathology of the posterior abdominal region?
- adenocarcinoma of pancreas invades surrounding muscles (iliopsoas) causing excruciating pain - disease of intervertebral joints or SI joints causes iliopsoas spasm & a protective reflex if iliopsoas runs through these regions it is vulnerable to infection/disease

Anatomy II Fall 2023 (11 decks)

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