Joints & Gluteal Region Flashcards

1
Q

What are 6 key features of synovial joints?

A
  1. articular cartilage
  2. synovial cavity
  3. synovial fluid
  4. joint capsule:
    a. fibrous layer (external)
    b. synovial membrane (inner = makes synovial fluid)
  5. Reinforcing ligaments
  6. Nerves and blood supply
    Other features:
  7. fatty pads - between fibrous layer and synovial membrane or membrane
    2.articular discs (menisci) - fibrocartilage separating articular surfaces to stabilize joint and create cushion to reduce wear and tear
  8. bursae = sac containing synovial fluid, lined with synovial membrane, reduce friction
  9. tendon sheaths = cushioning, reinforcement with bones = elongated bursa wrapped around a tendon subjected to friction
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2
Q

What part of the synovial joint makes synovial fluid?

A

synovial membrane

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3
Q

What makes up the synovial joint capsule aka articular capsule?

A

fibrous layer and synovial membrane

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4
Q

What type of cartilage is the articulate cartilage of the synovial joint?

A

hyaline

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5
Q

Most joints in the body (including ALL limb joints) are what type of joints? They increase mobility at the expense of stability.

A

Synovial joints

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6
Q

Synovial joints are made of bones separated by________, are _________, and include _______ limb joints.

A

fluid-filled joint cavities,
diarthrotic,
ALL

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7
Q

In the synovial joint, what’s the cushioning between the fibrous layer and synovial membrane or bone called?

A

Fatty pads

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8
Q

What are the tendon sheaths of synovial joints?

A

elongated bursa (sacs lined with synovial membrane) surrounding a tendon to prevent negative effects of friction

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9
Q

What type of cartilage are the articular discs (menisci) of the synovial joint?

A

fibrocartilage

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10
Q

Are synovial joints named based on the shape of articular surfaces?

A

Yes!

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11
Q

What are the 6 types of synovial joints?

A

1, plane

  1. hinge
  2. pivot
  3. condylar
  4. saddle
  5. ball-and-socket
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12
Q

Which type of synovial joints have the most mobility, least stability?

A

ball-and-socket (e.g. shoulder, hips)

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13
Q

Intercarpal, intertarsal joints and joints between vertebral articular surfaces are examples of what type of synovial joint? These are FLAT articular surfaces.

A

plane joint (allows for SLIGHT movement)

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14
Q

Synovial joints that allow for only slight movement are called what?

A

plane joints (FLAT shaped)

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15
Q

What type of synovial joints allow for flexion and extension movement in 1 plane only? These are CYLINDER and TROUGH shaped.

A

hinge joints (cylinder shaped) e.g. elbow joints, interphalangeal joints

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16
Q

What type of synovial joints allow for rotation in 1 plane only? These are sleeve (bone and ligament) and axle (rounded bone) shaped.

A

Pivot joint e.g. proximal radioulnar joints, atlantoaxial joint

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17
Q

Which type of synovial joints allow for uniaxial movement?

A
hinge joints (flexion, extension along medial/lateral axis
pivot joints (rotation along vertical axis)
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18
Q

Which type of synovial joints allow for biaxial movement?

A

Condylar joints, Saddle joints

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19
Q

Which type of synovial joint allows for multi-axial movement?

A

Ball and Socket (e.g. shoulder, hip joints): flexion, extension along medial/lateral axis
abduction, adduction along anterior/posterior axis, rotation along vertical axis

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20
Q

What type of synovial joint has oval shaped articular surfaces that can do flexion and extension along medial/lateral axis and abduction,adduction along anterior/posterior axis?

A

Condylar joint e.g. metacarpophalangeal (knuckle) joints, wrist joints

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21
Q

What type of synovial joint allows for non-axial (gliding) movement?

A

plane joint

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22
Q

What type of synovial joint is involved in opposable thumbs?

A

saddle joint

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23
Q

What type of synovial joint has articular surfaces that are both concave and convex shaped and allows for biaxial movement?

A

saddle joint (can do abduction, adduction along medial/lateral axis and flexion, extension along anterior/posterior axis) e.g. carpomeacarpal joints of thumbs

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24
Q

What type of synovial joint has a spherical head that fits into a cap?

A

Ball and Socket

spherical head = ball (humerus), cap = socket (scapula)

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25
Q

What types of synovial joints do rotation?

A

pivot joints, ball-and-socket joints

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26
Q

What type of synovial joints do flexion and extension?

A

hinge, condylar, saddle, ball-and-socket joints

27
Q

What type of synovial joints do abduction and adduction?

A

condylar, saddle, ball-and-socket joints

28
Q

What anchors the lower limb to the axial skeleton?

A

sacroiliac joint and ligaments

29
Q

The lower limb is divided into what 4 sections?

A

Gluteal region
Thigh
Leg
Foot

30
Q

The lower limb is innervated by branches of the __________ plexus? There are 12 nerves.

A

lumbosacral plexus
12 nerves: “I.G. FOSSILPP”
1. illio-inguinal (L1) - sensory only! innervates skin over anteromedial thigh and adjacent perineum
2. genitofemoral (L1-L2) - sensory only! femoral part: innervates skin on anterior central thigh, genital part: innervates skin on anterior perineum
3. femoral (L2, L3, L4) - MOTOR innervation of muscles in thigh’s anterior compartment, branches supply iliacus and pectineus, SENSORY innervation to skin over anterior thigh, anteromedial knee, medial leg, medial foot
4. obturator (L2, L3, L4) - MOTOR innervation of muscles in thigh’s medial compartment (except pectineus and part of adductor magnus), obturator externus, SENSORY innervation of skin over upper medial thigh
5. sciatic (L4-S3) MOTOR innervation of muscles in posterior thigh, part of adductor magnus (ischium); leg and foot muscles, SENSORY innervation to skin over leg and foot, sole, dorsal surface of foot
6,7: superior (L4-S1) and inferior gluteal (L5-S2) - motor only - innervation of gluteus medius, gluteus minimus, tensor fascia lata, INFERIOR GLUTEAL: gluteus maximus
8,9: lateral (L2-L3)and posterior (S1-S3) cutaneous nerves of thigh - sensory only! LATERAL = parietal peritoneum in iliac fossa, skin over anterlateral thigh, POSTERIOR = skin over upper medial aspect of thigh and adjacent perineum, post thigh and upper post leg
10. nerve to quadratus femoris (L4-S1) - motor only to quadratus femoris & inferior gemellus
11. nerve to obturator internus (L5-S2) - motor only to obturator internus & superior gemellus
12. perforating cutaneous nerve - sensory only! (S2-S3) to skin over medial gluteal fold

31
Q

Which nerves innervating the lower limb do not include motor info there? (i.e. are only sensory!)

A

Ilio-inguinal (L1), genitofemoral (L1-L2)

Lateral and Posterior Cutaneous nerves of thigh, perforating cutaneous nerve

32
Q

Which nerves innervating the lower limb are motor only?

A

superior (L4-S1) and inferior (L5-S2) gluteal nerves, nerve to quadratus femoris (L4-S1), nerve to obturator internus (L5-S2)

33
Q

What are the superficial muscles of the gluteal region that abduct and extend hip?

A

gluteus maximus, gluteus medius, gluteus minimus, tensor fascia latae

34
Q

What muscles of the gluteal region abduct and extend hip?

A

superficial group of larger muscles in gluteal region

35
Q

Gluteus minimus O, I, N, A?

A

O: Posterior ilium between anterior, inferior gluteal lines
I: Greater trochanter
N: Superior gluteal nerve
A: abduct femur, stabilizes pelvis during single leg stance

36
Q

Gluteus medius O, I, N, A?

A

O: Posterior ilium between anterior, posterior gluteal lines
I: Greater trochanter
N: Superior gluteal nerve
A: abduct femur, stabilize pelvis during single leg stance

37
Q

Gluteus minimus O, I, N, A?

A

O: fascia covering gluteus medius, posterior ilium, fascia of erector spinae, dorsal surface of sacrum, coccyx, sacrotuberous ligament
I: Posterior iliotibila tract and gluteal tuberosity
N: Inferior gluteal nerve
A: extension, lateral rotation, hip abduction

38
Q

Tensor fascia lata O, I, N, A?

A

O: lateral crest of ilium between ASIS and tubercle of crest
I: iliotibila tract and gluteal tuberosity
N: Superior gluteal nerve
A: stabilizes knee in extension

39
Q

What are the deep muscles of the gluteal region?

A

Deep muscles (smaller than superficial muscles):

  1. piriformis
  2. obturator internus
  3. superior gemellus
  4. inferior gemellus
  5. quadratus femoris
40
Q

Piriformis O, I, N, A?

A

O: Anterior surface of sacrum
I: Greater trochanter
N: branches S1-S2
A: Laterally rotate extended hip, abduct flexed femur

41
Q

Obturator internus O, I, N, A?

A

O: Anterolateral wall of true pelvis, obturator membrane
I: Greater trochanter
N: nerve to obturator internus
A: laterally rotate extended hip, abduct flexed femur

42
Q

Superior gemellus O, I, N, A?

A

O: External surface of ischial spine
I: Superior surface of obturator internus tendon and greater trochanter
N: nerve to obturator internus
A: laterally rotate extended hip, abduct flexed femur

43
Q

Inferior gemellus O, I, N, A?

A

O: upper aspect of ischial tuberosity
I: inferior surface of obturator internus tendon and greater trochanter
N: nerve to quadratus femoris
A: laterally rotate extended hip, abducts flexed femur

44
Q

Quadratus femoris O, I, N, A?

A

O: lateral aspect of ischium anterior to ischial tuberosity
I: quadrate tubercle on intertrochanteric crest
N: nerve to quadratus femoris
A: Laterally rotate femur

45
Q

Which of the deep muscles in the gluteal region can ONLY laterally rotate the femur?

A

Quadratus femoris

*All other deep muscles can laterally rotate extended hip and abduct flexed femur

46
Q

Which 2 of the deep muscles insert into the greater trochanter (have the same insertion)?

A

piriformis, obturator internus

47
Q

Which 2 deep muscles are innervated by the nerve to obturator internus?

A

Obturator internus, superior gemellus

48
Q

What does a positive Trendelenburg sign indicate?

A

abnormal gait

49
Q

What nerves are above and under piriformis?

A

above: superior gluteal nerve, under: sciatic (directly underneath) and inferior gluteal nerves

50
Q

What nerve passes through the greater sciatic foramen below piriformis to innervate gluteus maximus?

A

inferior gluteal nerve

51
Q

What nerve passes through the greater sciatic foramen below pirformis, goes down between superficial and deep gluteal muscles to enter posterior thigh and innervates all of the posterior thigh muscles and muscles moving the ankle and foot?

A

Sciatic nerve

52
Q

What nerve passes through the greater sciatic foramen above piriformis, travels between gluteus medius and minimus and supplies both gluteus medius nd minimus?

A

superior gluteal nerve

53
Q

What nerve passes through the greater sciatic foramen below piriformis and deep to sciatic nerve, innervates quadratus femoris and inferior gemellus?

A

nerve to quadratus femoris

54
Q

What nerve passes through greater sciatic foramen below piriformis between post cutatneous and pudendal nerves to innervate obturator internus and superior gemellus?

A

nerve to obturator internus

55
Q

What nerve passes through greater sciatic foramen below piriformis and medial to sciatic nerve, innervating skin over gluteal fold, posterior thigh and parts of perineum?

A

posterior cutaneous nerve of thigh

56
Q

What nerve passes through greater sciatic foramen below piriformis and medial to sciatic nerve, somatic innervation of perineum but does NOT innervate gluteal region?

A

pudendal nerve *Remember does somatic innervation for all perineal muscles!

57
Q

What nerve exits the pelvic cavity by piercing the sacrotuberous ligament and innervating skin over medial gluteus maximus?

A

perforating cutaneous nerve

58
Q

Which artery originates from the anterior trunk of the internal iliac artery, exits the greater sciatic foramen BELOW piriformis with nerve, and supplies surrounding muscles where it goes into posterior thigh and anastomoses with branches of the femoral artery?

A

Inferior gluteal artery

59
Q

What artery divides into the superficial and deep branch?

A

Superior gluteal artery

*Remember: SUPERFICIAL BRANCH = passes onto dep surface of gluteus maximus, DEEP BRANCH = passes between gluteus medius and minimus

60
Q

What artery originates from the posterior trunk of the internal iliac artery and exits the greater sciatic foramen above the piriformis with nerve and divides in the gluteal region into superficial and deep branches?

A

Superior gluteal artery

61
Q

Both the inferior gluteal and superior gluteal originate from the ________ _______ artery?

A

INTERNAL ILIAC

62
Q

What are the veins draining gluteal region?

A

Inferior and superior gluteal veins

63
Q

What are the lymphatics of the gluteal region?

A

DEEP vessels are next to veins, drain into INTERNAL ILIAC NODES

SUPERFICIAL drain into SUPERFICIAL INGUINAL NODES