Introduction to the Lower Limb, Gluteal Region, and Hip Joint

Question 1

Describe developmental rotation of upper and lower limbs

Answer 1

Upper limb: supinates, so anterior muscles are flexors. elbow points posteriorly
Lower limb: pronates, so anterior muscle are extensors (due to joint placement).

Question 2

What nerve innervates latisimus dorsi?

Answer 2

thoracodorsal nerve

Question 3

Nerve and function of gluteal region

Answer 3

Nerve: superior and inferior gluteal
Function: Hip abduction, extension, lateral rotation

Question 4

Nerve and function of anterior thigh

Answer 4

Nerve: femoral (L2-L4)
Function: hip flexion, knee extension

Question 5

Nerve and function of medial thigh

Answer 5

Nerve: obturator (L4-L4)
Function: adduction

Question 6

Nerve and function of posterior thigh

Answer 6

Nerve: tibial (L5-S3)
Function: hip extension, knee flexion

Question 7

Nerve and function of anterior leg

Answer 7

Nerve: deep fibular
Function: ankle dorsiflexion, digit extension

Question 8

Nerve and function of lateral leg

Answer 8

Nerve: superficial fibular
Function: ankle eversion

Question 9

Nerve and function of posterior leg

Answer 9

Nerve: tibial (L5-S3)
Function: ankle plantar flexion, digit flexion

Question 10

What kind of nerves make up lumbosacral plexus? What is the scope of the plexus? At what level do they sync up?

Answer 10

ventral rami, scoping from L2 to S3. they sync at L4/L5

Question 11

At the hip, what rami levels innervate the motor anterior side? Motor posterior side?

Answer 11

Motor anterior: L2-L3. Causes flexion

Motor posterior: L5, S1. Causes Extension

Question 12

At the knee, what rami levels innervate the motor anterior side? Motor posterior side?

Answer 12

Motor anterior: L3-L4. Causes extension

Motor posterior: L5, S1. Causes Extension

Question 13

At the knee, what rami levels innervate the motor anterior side? Motor posterior side?

Answer 13

S1, S2: Plantar flexion

Question 14

What is the blood supply for the hip?

Answer 14

Femoral and internal iliac

Question 15

What is the blood supply for the thigh?

Answer 15

deep femoral

Question 16

What is the blood supply for the knee?

Answer 16

popliteal

Question 17

What is the blood supply for the leg?

Answer 17

Anterior and posterior tibial

Question 18

What is the blood supply for the foot?

Answer 18

plantar archers

Question 19

What are the two major veins of the lower limb?

Answer 19

1. Greater saphenous (runs in anterior thigh area)

2. Lesser saphenous (runs in posterior leg area)

Question 20

What is a deep vein thrombosis, and why is it so lethal? How would you prevent thrombose formaition?

Answer 20

Condition resulting from formation of blood clot thrombus i deep vein. Prevent thrombose formation nby inserting IVC filter

Question 21

Where are the main lympatic drainages of the lower limb?

Answer 21

1. Superficial inguinal
2. Popliteal
3. Deep inguinal nodes drain to external iliac nodes

Question 22

Where is center of gravity in the human body?

Answer 22

In front of S2

Question 23

What is the biggest extensor at the hip?

Answer 23

Glutes

Question 24

What ligament connect so the anterior superior ileac spine?

Answer 24

inguninum ligament

Question 25

What level of the vertebral column marks the ileac crest?

Answer 25

L4

Question 26

What bone connects to the acetabulum?

Answer 26

Head of the femur

Question 27

List all of the pelvic ligaments

Answer 27

1. Sacrospinous 2. Sacrotuberous 3. Lesser sciatic foramen 4. greater sciatic foramen 5. Obturator membrane * Sacroiliac ligament: connect sacrum to anterior inferior iliac spine*

Question 28

What runs through intertubercular groove?

Answer 28

Long head of the bicep

Question 29

What are the hip abductors and medial rotators of the thigh? What nerve?

Answer 29

Glutius maximus, medius, and minimus + tensor fascia latae. operating off of superior gluteal nerve

Question 30

What are the medial rotators of the thigh?

Answer 30

GLuteus maximus, piriformis, gemellus superior, obturator, and gemellus inferior, and quadratus femoris

Question 31

What is the major hip extensor? What nerve?

Answer 31

Gluteus maximus, innervated by the INFERIOR gluteal nerve. Note that it is the most powerful hip extensor. Gets you out of chairs

Question 32

What are the different variations to the sciatic nerve?

Answer 32

1. United tibial and common fibular nerves stream inferior to piriformis. 2. 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)

Question 33

Describe components of hip joint

Answer 33

Joint capsule and labrum keep socket in place. It's a synovial joint, but it's deeper than that of the glenohumeral

Question 34

What are the 4 hip ligaments? What is their job?

Answer 34

1. Iliofemoral 2. Ischiofemoral 3. Pubofemoral 4. Round ligament of femur (ligamentum teres of the femur) (useless ligament) Their job is to resist hip EXTENSION

Question 35

Blood supply to the hip joint/head and neck of femor? Movements at the hip? What could go wrong at the hip?

Answer 35

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

Question 36

How to spot a congenital hip dislocation? A car accident hip location?

Answer 36

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

Question 37

What are likely causes of hip fracture? Who is usually effected?

Answer 37

1. Trauma resulting from fall 2. Fracture results in the fall Normally effects 65+ yr old women

Question 38

What is osteoarthritis? How will you know from looking at an x-ray? Options for treatment?

Answer 38

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.)