Joints Of The Lower Limb And Glutes Flashcards

1
Q

Type of joint for the hip?

A
  • ball and socket synovial joint

- head of the femur articulates with the acetabulum of the hip bone

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2
Q

Acetabulum rim

A

-has elevated rim (incomplete in vicinity of the obturator foramen)

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3
Q

Acetabulum articular cartilage

A
  • depression within the bony rim is smooth and covered with articulate cartilage
  • no articular cartilage at the acetabular notch where the rim is incomplete and extends to the center (acetabular fossa)
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4
Q

Labrum of the acetabulum

A

-acetabulum is deepened by the addition of a cartilaginous lip-the labrum on the bony rim, which continues across the acetabular notch as the transverse ligament

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5
Q

Ligament of the head of the femur (round ligament)

A
  • between the acetabular notch and the pit (fovea) in the head of the femur
  • transmits vessels and nerves to the head of the femur
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6
Q

Capsule of the joint (acetabulum)

A

-attaches to the bone around the rim of the acetabulum except at the notch where it attaches to the transverse ligament

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7
Q

Capsule of the joint (femur)

A
  • attaches laterally to the medical side of the greater trochanter, anteriorly to the intertrochanteric line, and medially just above the lesser trochanter
  • posteriorly it attaches to the neck of the femur so that the lower posterior part of the neck is extra capsular
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8
Q

Rentinacular folds

A
  • synovial membrane lining the capsule reflects off the capsule onto the neck of the femur in little folds
  • contain blood vessels which serve the neck and head of the femur
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9
Q

Iliopsoas muscle

A
  • capsule is frequently perforated/incomplete so that it communicates with a bursa under the iliopsoas muscle
  • has three thickenings which extend from the hip bone to the femur in a spiral fashion
  • iliofemoral lig, pubofemoral lig, ischiofemoral lig
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10
Q

Iliofemoral ligament

A
  • attaches to the ilium adjacent to the anterior inferior iliac spine as it goes toward the femur
  • divides into two limbs which attach high and low, respectively, to the intertrochanteric line, giving it a “Y” shape
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11
Q

Pubofemoral ligament

A
  • attaches to the pubis near the obturator canal and to the femur at the lower part of the neck
  • blends with the lower limb of the iliofemoral ligament
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12
Q

Ischiofemoral ligament

A
  • attaches to the ischium behind and below the acetabulum
  • spirals up and over the back of the capsule to attach to the greater trochanter
  • some fibers blend with the upper limb of the iliofemoral ligament and other fibers become circular to form the zona orbicularis
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13
Q

What can you palate in the gluteal region?

A
  • iliac crest (whole length)
  • posterior superior iliac spine and the dimple over it at the level of S3
  • natal cleft, 3rd sacral spine, and tip of coccyx
  • gluteal fold, ischial tuberosity, and sacrotuberous ligament
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14
Q

Hip/innomianate bones

A
  • two hip bones

- result of the fusion of three separate bones (ilium, pubis, and ischium)

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15
Q

Acetabulum

A
  • place of union of the three parts of the hip bone

- articulates with the head of femur

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16
Q

Acetabular notch

A

-prominent open area of the acetabular margin

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17
Q

Acetabular fossa

A

-circular depression in floor of acetabulum which is continuous with the acetabular notch

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18
Q

Ilium What are all the structures?

A
  • iliac crest
  • tubercle of the crest
  • ASIS/PSIS
  • AIIS/PIIS
  • greater sciatic notch
  • iliac fossa
  • inferior, anterior, posterior gluteal lines
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19
Q

Pubis What are the structures?

A
  • body
  • superior ramus and inferior ramus
  • pubic crest
  • pubic tubercle
  • pectineal line
  • obturator foramen
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20
Q

Ischium What are the structures?

A
  • body
  • ischial ramus
  • ischial tuberosity
  • ischial spine
  • lesser sciatic notch
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21
Q

Head of femur

A

-articulates proximally with the hip bone at the acetabulum

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22
Q

Fovea

A
  • pit on the medial surface

- attachment for ligament of the head which carries blood supply to the head of the femur

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23
Q

Neck of femur

A

-connects head to the shaft of the femur

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24
Q

Shaft of femur

A
  • proximally has a greater trochanter and lesser trochanter
  • important landmarks for muscle attachments
  • note trochanteric fossa and intertrochanteric line
25
Q

Mid-shaft

A
  • numerous lines for muscle attachments

- posterior aspect- gluteal tuberosity, pectineal line, Linda as-era

26
Q

Medial and lateral condyles of femur

A

-articulate with the tibia distally as well as with the patella anteriorly

27
Q

Superior cluneal nerves

A
  • from posterior primary rami of L1, 2 & 3

- supplies upper buttock

28
Q

Middle cluneal nerves

A
  • from posterior primary rami of S1, 2, 3

- supplies medial buttock

29
Q

Inferior cluneal nerves

A
  • branching from the posterior femoral cutaneous nerve and anterior primary rami of S1, 2, 3
  • supplies lower buttock
30
Q

Superficial fascia of the gluteal region

A

-is a little thicker and tougher than other areas of the body

31
Q

Deep fascia of the gluteal region

A
  • encloses the gluteus maximus and tensor fascia lata muscles between two layers
  • very tough above the gluteus maximus superficial to the gluteus medius, gives partial origin for gluteus medius
32
Q

Muscles of the gluteal region innervation

A
  • four largest muscles are referred to as the gluteal muscles
  • gluteus maximus, tensor fascia lata, gluteus medius, gluteus minimus
  • all are innervated by the gluteal nerves
33
Q
Gluteus maximus muscle
Origin?
Insertion?
Innervation?
Function?
A

O: from the back of the pelvis, erector spinae tendon, and sacrotuberous ligament
I: into the iliotibial tract and gluteal tuberosity of the femur
I: inferior gluteal nerve
F: extends and laterally rotates the thigh at the hip
-abductor-upper fibers
-adductor-lower fibers of the thigh at the hip joint

34
Q
Tensor fascia lata
Arises?
Inserts?
Innervation?
Function?
A

A: anterior part of the crest of the ilium
I: into the iliotibial tract and lateral condolences of the tibia
I: superior gluteal nerve
F: flexes and medially rotates the thigh at the hip and helps stabilize both hip and knee joints

35
Q
Gluteus medius 
Arises
Inserts
Innervation
Function
A

A: below the iliac crest and between the anterior and posterior gluteal lines
I: greater trochanter
I superior gluteal nerve
F: strong abductor and rotator of the thigh
-anterior fibers-medial rotator
-posterior fibers-lateral rotator

36
Q
Gluteus minimus
Arises
Inserts 
Innervation
Function
A

A: ilium beneath the gluteus medius
I: on the greater trochanter of the femur
I: superior gluteal nerve
F: strong abductor of the thigh at the hip

37
Q

Piriformis
Arises
Inserts
Function

A

A: front of the sacrum inside the pelvis, passes through the greater sciatic notch
I: greater trochanter of the femur
F: a lateral rotator of the thigh at the hip

38
Q

Obturator internus
Arises
Inserts
Function

A

A: inside the pelvis off the obturator membrane and surrounding bone–goes through the lesser sciatic notch, makes a 90* turn
I: greater trochanter
F: lateral rotator of the thigh at the hip

39
Q

Superior and inferior gemelli
Arises
Inserts
Function

A

A: superior and inferior margins of the lesser sciatic notch, respectively
I: the tendon of the obturator internus muscle
F: aid in lateral rotation

40
Q

Quadratus femoris
Origin
Inserts
Function

A

O: lateral side of the ischial tuberosity
I: intertrochanteric crest of the femur
F: laterally rotates the thigh

41
Q

Small lateral rotators

A

-of the hip and lie in a plane with the gluteus minimus above and the adductor magnus below

42
Q

Nerves of the gluteal region

A
  • branches of the sacral plexus

- all branches pass through the greater sciatic foramen

43
Q

Superior gluteal nerve

A
  • posterior branches of L4, 5, S1
  • emerges from greater sciatic foramen above the piriformis muscle in company with the superior gluteal vessels
  • supplies the gluteus medius, gluteus minimus, and tensor fascia lata muscles
44
Q

Inferior gluteal nerve

A
  • posterior branches of L5, S1, 2
  • appears below the piriformis muscle
  • supplies the gluteus maximus muscle
  • accompanied by the inferior gluteal vessels
45
Q

Posterior femoral cutaneous nerve

A
  • anterior branches S2, 3; and posterior branches S1, 2
  • overlies the sciatic nerve
  • gives off the inferior cluneal nerves and the perineal branch
  • continues down the back of the thigh under the deep fascia as far as the popliteal fossa
46
Q

Sciatic nerve

A
  • makes up tibial nerve: anterior branches L4, 5, S1, 2, 3
  • makes up common perineal/fibular nerve: posterior branches L4, 5, S1, 2
  • appears below the piriformis muscle
  • crosses the quadratus femoris muscle
47
Q

Pudendal nerve

A
  • crosses the sacrospinous ligament and re-enters the pelvis through the lesser sciatic foramen
  • lateral to the nerve are the internal pudendal vessels
48
Q

Nerve to the obturator internus muscle

A
  • anterior L5, S1, 2
  • appears lateral to the internal pudendal vessels
  • supplies the superior gemellus muscle
  • enters the pelvis through the lesser sciatic foramen to supply the obturator internus muscle
49
Q

Nerve to the quadratus femoris

A
  • anterior branches L4, 5, S1
  • lateral to the nerve to the obturator internus and passes deep to the gemelli and obturator internus muscles to reach the anaterior surface of the quadratus femoris muscle
  • innervates the inferior gemellus along its way, as well as the hip joint
50
Q

Nerve to the piriformis

A
  • posterior branches S1, 2

- given off in pelvis and appears in the gluteal region

51
Q

Nerves pelvic diaphragm (levator ani & coccygeus) (anterior branches)

A
  • Levator ani is innervated S3 and S4; coccygeus muscle by S4 and S5
  • given off in the pelvis and never appear in the gluteal region
52
Q

Pelvic spanchnic nerves

A
  • parasympathetic-preganglionic

- remain in the pelvis

53
Q

Superior gluteal vessels

A

-appears above the piriformis muscle in company with the superior gluteal nerve

54
Q

Inferior gluteal vessels

A

-appear below the piriformis muscle with the inferior gluteal nerve

55
Q

Medial femoral circumflex vessels

A

-appear between the quadratus femoris and adductor magnus near the hamstring muscles

56
Q

First perforating vessels

A

-pierce the adductor magnus muscle adjacent to the linea aspera

57
Q

Lateral femoral circumflex vessels

A

-appear above the neck of the femur and lateral to the shaft below the greater trochanter

58
Q

Which blood vessels anastomose in gluteal region?

A
  • inferior gluteal
  • superior gluteal
  • medial femoral circumflex
  • first perforating
  • lateral femoral circumflex
59
Q

Which blood vessels form the cruciate anastomosis?

A

-inferior gluteal, medial femoral circumflex, first perforating, lateral femoral circumflex