Introduction to the Lower Limb, Gluteal Region, and Hip Joint Flashcards
Describe developmental rotation of upper and lower limbs
Upper limb: supinates, so anterior muscles are flexors. elbow points posteriorly
Lower limb: pronates, so anterior muscle are extensors (due to joint placement).
What nerve innervates latisimus dorsi?
thoracodorsal nerve
Nerve and function of gluteal region
Nerve: superior and inferior gluteal
Function: Hip abduction, extension, lateral rotation
Nerve and function of anterior thigh
Nerve: femoral (L2-L4)
Function: hip flexion, knee extension
Nerve and function of medial thigh
Nerve: obturator (L4-L4)
Function: adduction
Nerve and function of posterior thigh
Nerve: tibial (L5-S3)
Function: hip extension, knee flexion
Nerve and function of anterior leg
Nerve: deep fibular
Function: ankle dorsiflexion, digit extension
Nerve and function of lateral leg
Nerve: superficial fibular
Function: ankle eversion
Nerve and function of posterior leg
Nerve: tibial (L5-S3)
Function: ankle plantar flexion, digit flexion
What kind of nerves make up lumbosacral plexus? What is the scope of the plexus? At what level do they sync up?
ventral rami, scoping from L2 to S3. they sync at L4/L5
At the hip, what rami levels innervate the motor anterior side? Motor posterior side?
Motor anterior: L2-L3. Causes flexion
Motor posterior: L5, S1. Causes Extension
At the knee, what rami levels innervate the motor anterior side? Motor posterior side?
Motor anterior: L3-L4. Causes extension
Motor posterior: L5, S1. Causes Extension
At the knee, what rami levels innervate the motor anterior side? Motor posterior side?
S1, S2: Plantar flexion
What is the blood supply for the hip?
Femoral and internal iliac
What is the blood supply for the thigh?
deep femoral
What is the blood supply for the knee?
popliteal
What is the blood supply for the leg?
Anterior and posterior tibial
What is the blood supply for the foot?
plantar archers
What are the two major veins of the lower limb?
- Greater saphenous (runs in anterior thigh area)
2. Lesser saphenous (runs in posterior leg area)
What is a deep vein thrombosis, and why is it so lethal? How would you prevent thrombose formaition?
Condition resulting from formation of blood clot thrombus i deep vein. Prevent thrombose formation nby inserting IVC filter
Where are the main lympatic drainages of the lower limb?
- Superficial inguinal
- Popliteal
- Deep inguinal nodes drain to external iliac nodes
Where is center of gravity in the human body?
In front of S2
What is the biggest extensor at the hip?
Glutes
What ligament connect so the anterior superior ileac spine?
inguninum ligament
What level of the vertebral column marks the ileac crest?
L4
What bone connects to the acetabulum?
Head of the femur
List all of the pelvic ligaments
- Sacrospinous
- Sacrotuberous
- Lesser sciatic foramen
- greater sciatic foramen
- Obturator membrane
* Sacroiliac ligament: connect sacrum to anterior inferior iliac spine*
What runs through intertubercular groove?
Long head of the bicep
What are the hip abductors and medial rotators of the thigh? What nerve?
Glutius maximus, medius, and minimus + tensor fascia latae. operating off of superior gluteal nerve
What are the medial rotators of the thigh?
GLuteus maximus, piriformis, gemellus superior, obturator, and gemellus inferior, and quadratus femoris
What is the major hip extensor? What nerve?
Gluteus maximus, innervated by the INFERIOR gluteal nerve. Note that it is the most powerful hip extensor. Gets you out of chairs
What are the different variations to the sciatic nerve?
- United tibial and common fibular nerves stream inferior to piriformis.
- Tibial and common fibular divide. Common Fibular goes THROUGH piriformis (can be compressed. not good) or above the piriformis (danger is that the common fibular nerve could be hit during intergluteal injection)
Describe components of hip joint
Joint capsule and labrum keep socket in place. It’s a synovial joint, but it’s deeper than that of the glenohumeral
What are the 4 hip ligaments? What is their job?
- Iliofemoral
- Ischiofemoral
- Pubofemoral
- Round ligament of femur (ligamentum teres of the femur) (useless ligament)
Their job is to resist hip EXTENSION
Blood supply to the hip joint/head and neck of femor? Movements at the hip? What could go wrong at the hip?
Median circumflex femoral artery.
Movements of the hip = extension and flexion
Problems include: dislocation (normally congenital….2/3 of first born females or 8-90% of first born females…breech in delivery or family history. May evene be due to Ligamentous Laxity
and or Acetabular Dysplasia, …but can be traumatic like a car accident. usually in the left leg.), fracture (mainly in postmenopausal women), and osteoarthritis
How to spot a congenital hip dislocation? A car accident hip location?
Leg will be shorter than the nondislocated one. Also note that you cannot abduct a dislocated leg. In the case of an accident, femor will be dislocated aneriorly in the case of a front end and posteriorly in the case of a rear end accident
What are likely causes of hip fracture? Who is usually effected?
- Trauma resulting from fall
- Fracture results in the fall
Normally effects 65+ yr old women
What is osteoarthritis? How will you know from looking at an x-ray? Options for treatment?
When articular cartilage gets warn down. No nerve endings on the articular cartilage, so you won’t feel the pain from there. However, once cartilage wears down, the free nerve endings are in contact and you will feel this and notice a limited range of motion. Osteoarthritis x-rays will be radio opaque (dumb white) in areas where there should be a gap representing the synovial joint. Treatment = total hip replacement (plastic socket + metal/ceramic ball, 20-40 yr lifespan) or hip resurfacing (never fails.)
