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Lower Extremity Anatomy II > Lab Quiz 1 > Flashcards

Lab Quiz 1 Flashcards

1
Q

synarthrosis

A

no movement

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2
Q

amphiarthrosis

A

slightly moveable

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3
Q

diarthrosis

A

freely moveable

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4
Q

joints w no joint cavity

A

fibrous and cartilaginous

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5
Q

in a fibrous joint, what determines the amount of movement allowed

A

the length of the fibers

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6
Q

syndesmoses joint

A

fibrous, amphiarthrosis

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7
Q

joint that is united by hyaline cartilage

A

synchondroses

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8
Q

synchondroses

A

temporary (usually)
synarthrosis (no movement)
ex: growth plates

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9
Q

United by fibrocartilage

A

symphysis

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10
Q

primary cartilaginous

A

synchondroses

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11
Q

secondary cartilaginous

A

symphysis

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12
Q

symphysis movement

A

amphiarthrosis (slightly)

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13
Q

all synovial joints are __ joints

A

diarthrosis (freely moveable)

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14
Q

the 2 layers of the articular capsule of the synovial joint

A
  • outer fibrous capsule

- inner synovial membrane

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15
Q

the inner synovial membrane

A

secretes fluid for synovial joint

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16
Q

articular cartilage covering the ends of bone in synovial joints

A

hyaline cartilage

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17
Q

accessory ligaments of synovial joints can be classified as:

A

-capsular
-intracapsular
-extracapsular
(some resources classify capsular and extracapsular the same)

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18
Q

capsular

A

blend with joint capsule

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19
Q

intracapsular

A

inside the joint capsule

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20
Q

extracapsular

A

outside the joint capsule

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21
Q

bursa

A

fluid filled sac (small amount of fluid)

decreases friction between joint structures

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22
Q

how are synovial joints classified

A

according toe shape of articular surfaces

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23
Q

which bones can use use for radiographical age determination

A

short bones

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24
Q

the ossification center of a short bone is located

A

at bone center

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25
Q

the ossification center of a long bone is located

A
  1. Around mid shaft (Primary)

2. Ends of bones (2nd)

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26
Q

Which type of bone (long/short) are always present at birth in the lower extremity

A

long bones, not all short bones will be present.

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27
Q

Endochondral Ossification

A

ossify from cartilage to bone

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28
Q

all lower extremity bones form by ____ with the exception if the Ungual process (distal phalanx)

A

endochondral ossification

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29
Q

Which ossification centers are present at birth in long bones?

A

Primary Ossification centers, secondary are not.

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30
Q

all long bones can have multiple (primary/secondary) ossification centers.

A

secondary

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31
Q

Epiphysis

A

secondary ossification center that contributes to a Joint

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32
Q

Apophysis

A

secondary ossification center that contributes to Ligament/muslce attachment

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33
Q

epipheseal plate is a cartilage plate between

A

diaphysis and epiphysis

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34
Q

what allows for bone lengthening

A

epiphysis

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35
Q

Epihyseal plate forms

A

the metaphysis and diaphysis

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36
Q

Pelvic Girdle is formed from

A

the coxal bones

  1. Illium
  2. Ishium
  3. Pubis
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37
Q

the pelvic girdle articulate (posteriorly with the ___ to form the pelvic skeletal (pelvic ring)

A

sacrum

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38
Q

the coccyx (is/is not) apart of the pelvic skeleton

A

Is apart of

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39
Q

the sacrum is a ___ shaped bone formed from 5 fused vertebra

A

wedge

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40
Q

the male sacrum is ___ compared to females’

A

longer/narrower

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41
Q

female sacrum is ___ compared to males’

A

shorter/wider

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42
Q

the curvature of the sacrum is (primary/secondary)

A

primary

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43
Q

the base of the sacrum is (superior/inferior)

A

superior

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44
Q

the base of sacrum articulates with

A

L5 Vertebrae (weight bearing)

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45
Q

sacral promitory

A

base of the sacrum, anterior edge of S1

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46
Q

the apex of the sacrum is (superior/inferior)

A

inferior

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47
Q

the apex of the sacrum articulate with

A

the coccyx

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48
Q

how many sacral foramina are there

A

4 anterior, 4 posterior

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49
Q

what pases through the sacral foramina

A

ventral and dorsal rami

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50
Q

superior articular process facet faces

A

posteriorly

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51
Q

auricular surface (medial/lateral) aspect

A

lateral

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52
Q

the auricular surfaces of sacrum articulates with the

A

auricular surface of the illium (has ridges and depressions)

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53
Q

which part of the sacrum forms a synovial joint as part of the sacroiliac joint

A

the auricuar surface

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54
Q

sacral tuberosity (anterior/posterior) aspect of (medial/lateral) surface

A

posterior, lateral

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55
Q

which aspect of the sacrum forms a syndesmosis with the illium

A

sacral tuberosity

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56
Q

sight for ligament attachment on the sacrum

A

the sacral tuberosity

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57
Q

the bony landmarks of sacrum are remnants of

A

vertebral components

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58
Q

transverse ridges (lines)

A

fused bodies

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59
Q

Sacral crests are located (posterior/anterior)

A

posterior

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60
Q

median sacral crests

A

fused spinous processes

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61
Q

intermediate sacral crests

A

medial side of posterior foramina

fused superior/inferior articular processes

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62
Q

lateral sacral crests

A

lateral to posterior sacral foramina

fused transverse processes

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63
Q

the sacral crests are named based off of their anatomical relationship to

A

posterior sacral foramina

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64
Q

sacral alae

A

lateral projections

remnant of S1 transverse processes

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65
Q

sacral groove

A

between median and intermediate crests, fused laminae

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66
Q

sacral hiatus opens into

A

sacral canal

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67
Q

the sacral hiatus is formed by

A

unfused S5 Lamina

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68
Q

S5 and Co1 spinal nerves exit through

A

the sacral hiatus

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69
Q

sacral cornu

A

lateral margins of sacral hiatus

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70
Q

the base of the coccyx articulates with

A

sacral apex (base of coccyx is superior, sacral apex inferior)

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71
Q

Coccygeal Cornu is remnant of

A

superior articular processes of Co1

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72
Q

the Coccygeal Cornu ligament connect with

A

sacral cornu

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73
Q

The Coccygeal Cornu is able to bear weight (True/False)

A

False, does not support weight

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74
Q

the coccygeal cornu functions as

A

area of muscle and ligament attachment

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75
Q

the 3 coxal bones are separated by ___ until they fuse

A

triadiate cartilage

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76
Q

the coxal bones articulate with the __ posteriorly

A

sacrum (sacroiliac joint)

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77
Q

the coxal bones articulate with the __ anteriorly

A

contralateral coxal bone (pubic symphysis)

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78
Q

the coxal bones articulate with the __ laterally

A

femur (acetabofemoral joint/hip)

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79
Q

the superior border of the ilium

A

illiac crest

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80
Q

palpable anterior end of iliac crest

A

ASIS (anterior superior Iliac spine)

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81
Q

palpable posterior end of iliac crest

A

PSIS (Posterior superior Iliac spine)

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82
Q

the PSIS can be found at the level of

A

S2

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83
Q

the visible dimple on the back is the

A

PSIS

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84
Q

the iliac tubercle is __ to the ASIS

A

posterior

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85
Q

posterior gluteal line is __ to the PSIS and extends to PIIS

A

anterior

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86
Q

the anterior gluteal line forms between

A

ASIS and Iliac tubercle to greater sciatic notch

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87
Q

the palpable posterior/inferior aspect of the ischium

A

ischial tuberosity

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88
Q

when does the ischial tuberosity bear weight

A

when sitting

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89
Q

the cup like depression formed by the 3 coxal bones is known as the

A

acetabulum

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90
Q

superior aspect of acetabulum

A

body of the ilium

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91
Q

the posterior inferior aspect of acetabulum

A

body of ischium

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92
Q

the anterior inferior aspect of the acetabulum

A

pubis

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93
Q

what is the crescent shaped articular surface within the acetabulum

A

the lunate surface

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94
Q

the central depression called the acetabular fossa is formed mostly by

A

body of ishium

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95
Q

contents of the acetabular fossa are:

A
  1. fat
  2. ligamentum teres femoris
    (not articular)
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96
Q

the acetabular notch is found between

A

the inferior ends of the lunate surface

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97
Q

the raised edge of the acetabulum is called the

A

acetabular ridge

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98
Q

the iliopectineal eminence is the junction between

A

iliac body and superior pubic ramus (iliopubic)

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99
Q

the auricular surface of the ilium is inferior to

A

iliac tuberosity

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100
Q

the auricular surface of the ilium is posterior to

A

iliac fossa

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101
Q

greater sciatic foramen anterior boundary (anterolateral)

A

greater sciatic notch of ilium

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102
Q

the greater sciatic foramen superior boundary

A

anterior sacroiliac ligaments

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103
Q

inferior boundary of greater sciatic foramen

A

ishcial spine and sacrospinous ligament

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104
Q

posterior (posteromedial) boundary of greater sciatic foramen

A

sacrotuberous ligament

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105
Q

the lesser sciatic foramen anterior boundary

A

lesser sciatic notch (ischium)

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106
Q

the lesser sciatic foramen anterior inferior boundary

A

ischial tuberosity

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107
Q

the lesser sciatic foramen anterior superior boundary

A

ischial spine

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108
Q

the lesser sciatic foramen superior boundary

A

sacrospinous ligament

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109
Q

the sacrotuberous ligament is the ___ boundary of the lesser sciatic foramen

A

posterior

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110
Q

what covers the obturator foramen

A

obturator membrane

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111
Q

the obturator canal

A

superior opening between the obturator membrane and supeiror pubic ramus

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112
Q

the passageway to the gluteal region

A

the greater sciatic foramen

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113
Q

the passageway to the gluteal region and the perineum

A

the lesser sciatic foramen

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114
Q

the passageway to the medial thigh

A

obturator foramen

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115
Q

what separates the greater and lesser sciatic foramen

A

Ischial spine and Sacrospinous ligament

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116
Q

what part of the femur articulates with the lunate surface of the acetabulum

A

the head of the femur

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117
Q

fovea capitis femoris is the site of attachment for the

A

ligament of the head of the femur (contains artery)

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118
Q

the retinacular foramen are found

A

in the neck of the femur

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119
Q

the retinacular foramen are

A

openings for retinacular vessels from the trochantaric anastamosis

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120
Q

the (greater trochantar/lesser trochanter) is palpable

A

the greater trochanter

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121
Q

iliopsoas attaches where on the femur

A

the lesser trochanter

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122
Q

trochanteric fossa is a depression on the medial surface of the ____ which serves as an attachment site for ____.

A

greater trochanter, obturator externous

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123
Q

intertrochanteric line is on the ___ surface of the femur between the trochanters

A

anterior

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124
Q

intertrochanteric line serves as

A

attachment site for ligaments/capsule and muscle

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125
Q

quadrate tubercle on the intertrochanteric crest is the attachment site for

A

quadratus femoris

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126
Q

Which lip of the linea aspera is continuous with the spiral line

A

the medial lip

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127
Q

the inferior continuation of the medial lip of the linea aspera is called the

A

medial supracondylar line

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128
Q

the inferior continuation of the lateral lip of the linea aspera is called the

A

lateral supracondylar line

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129
Q

linea aspera is on the (anterior/posterior) shaft of femur

A

posterior

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130
Q

the adductor tubercle can be seen on the (lateral/medial) supercondylar line

A

medial

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131
Q

the nutrient foramen is most commonly found on the__ angles __

A

midshaft on linea aspera; superiorly

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132
Q

MCL attaches where on femur

A

medial epicondyle

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133
Q

ACL and PCL attach where on femur

A

the intercondylar notch (fossa) on posterior aspect of femur

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134
Q

the part of the femur that articulates with the patella

A

patellar surface

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135
Q

LCL attaches to the __ of the femur

A

the lateral epicondyle

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136
Q

primary ossification of ilium (ala) appears

A

9th fetal week

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137
Q

primary ossification of ischim (body) appears

A

4th fetal month

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138
Q

primary ossification of pubis (superior ramus) appears

A

4-5th fetal month

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139
Q

the 3 coxal bones begin to fuse at the acetabulum around age

A

13-18 years, complete by 18

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140
Q

when does the ischiopubic ramus complete fusion by

A

age 8

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141
Q

most secondary ossification centers of the pelvis appear around

A

puberty

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142
Q

secondary ossification will usually appear first in males or females

A

females

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143
Q

most secondary ossifcation centers of the pelvis fuse by

A

early 20s (15-25)

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144
Q

secondary ossification centers of the pelvis:

A
  • AIIS
  • Acetabulum
  • Ischial tuberosity
  • Iliac Crest
  • Public Symphysis
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145
Q

Primary Ossification center of the femur appear

A

mid shaft about 7th fetal week

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146
Q

femoral condyle ossification centers appear

A

right after birth

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147
Q

femoral condyles fuse

A

about 20 years old

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148
Q

the femoral head appears

A

by first year

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149
Q

the femoral head fuses by

A

18-19 years old

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150
Q

greater trochanter appears

A

around age 4

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151
Q

greater trochanter fuses by

A

18 years old

152
Q

lesser trochanter appears

A

between 12-14 (variable)

153
Q

the lesser trochanter fuses

A

16-17 years old

154
Q

Avulsion Fracture

A

bone fracture that occurs when fragment of bone is separated from the rest of the bone

155
Q

avulsion fractures are more common when

A

in childhood and adolescents

156
Q

apophysis (2nd ossification center) in children are generally

A

weaker than the tendons that attach to them

157
Q

the weakest part of the immature skeleton is the

A

growth plate (physis) cartilage at the apophysis, has not completely fused with the rest of the developing bone

158
Q

an avulsion fracture is caused by

A

strong muscle contraction and/or sudden passive lengthening the muscle
can also occur at site of ligament and capsule

159
Q

the sacroiliac joint is designed for

A

force transmission and weight bearing

160
Q

the sarcoiliac joint is found between

A

the L-shaped auricular surface of ilium and the sacrum (S1-3)

161
Q

the articulating bony surfaces of the sacroiliac joint are irregular in order to

A

increase friction and congruency which limits motion

162
Q

the sacroiliac joint rotation and translation

A

2 degrees rotation

2mm of translation

163
Q

what type of cartilage covers the sacral surface of the sacroiliac joint?

A

hyaline

164
Q

the ilium surface of the sacroiliac joint is covered by what type of cartilage

A

fibrocartilage

165
Q

the 2 parts of the sacroiliac joint

A

Anterior planar and posterior syndesmosis

166
Q

the anterior planar part of the sacroiliac joint is a ___ joint

A

synovial

167
Q

the posterior syndesmosis part of the sacroiliac joint is a __ joint

A

fibrous

168
Q

the anterior (ventral) sacroiliac ligament is a thickening of

A

anterior joint capsule

169
Q

the interosseous sacroiliac connect

A

tuberosities of sacrum and ilium

posterior/superior to synovial joint

170
Q

the posterior (dorsal) sacroiliac ligament overlies

A

interosseous ligament posteriorly

171
Q

what ligament connects the intermediate/lateral crest of sacrum (S1,2) to PSIS and internal lip of iliac crest?

A

posterior (dorsal) sacroiliac

172
Q

the long posterior (dorsal) sacroiliac ligament connects from

A

S3,4 to PSIS

173
Q

Sacrotuberous ligament has a broad attachment to

A

PSIS, posterior sacroiliac ligaments, dorsolateral sacrum and coccyx

174
Q

the ___ ligament(s) attaches to the ischial tuberosity

A

sacrotuberous

175
Q

what muscle attach to the sacrotuberous ligament

A

Glut Max
Piriformis
Biceps femoris
Semitendinosus

176
Q

__ ligament attaches to Ischial spine

A

sacrospinous

177
Q

__ ligament attaches to lateral margin of sacrum/coccyx

A

sacrospinous

178
Q

the sacrospinous ligament is __ to sacrotuberous

A

anterior

179
Q

the ligaments that resist nutation:

A
  1. sacrospinous
  2. sacrotuberous
  3. Anterior
  4. Interosseous
180
Q

nutation

A

anterior/inferior motion of sacral base and posterior/superior motion of coccyx

181
Q

counter nutation

A

opposite of nutation [posterior/superior motion of sacrum anterior, inferior motion of coccyx)

182
Q

what ligaments resit counter nutation

A

long posterior (dorsal) sacroiliac ligament

183
Q

blood supply to SI joint

A

Superior Gluteal
Iliolumbar
lateral sacral

184
Q

innervation of SI Joint (can be variable)

A

Primary Dorsal Rami L4-S3(4)
Ventral Rami L5-S2
Superior gluteal nerve

185
Q

the hip joint is a

A

ball and socket (spheroid)
Synovial
Diarthrosis

186
Q

the hip joint has __ motion

A

triplanar

187
Q

the triplanar motion of the hip joint movmeents inclue

A

flex/ex
abd/add
int/external rotation
circumduction

188
Q

which movement is more limited in the hip joint (abduction/adduction) from anatomical position

A

adduction

189
Q

which movement is more limited in the hip joint (inter/external rotation) from anatomical position

A

internal rotation

190
Q

which movement is more limited in the hip joint (extension/flexion) from anatomical position

A

extension

191
Q

is lateral or medial rotation stronger at the hip joint

A

lateral rotation

192
Q

bony articulation between the femoral head and acetabulum

A

lunate surface/labrum

193
Q

the articulation of the hip joint (acetabulum and femoral head) is

A

stable (more than half the head fits in a socket

194
Q

where is the femoral head least covered by the acetabulum

A

anteriorly

195
Q

the acetabular fossa is filled with

A
  • fat

- ligament to the head of the femur

196
Q

the acetabular labrum is __ cartilage

A

fibrocartilage, attached to acetabular rim and tranverse acetabular ligament

197
Q

the acetabular lacrum is important because it

A

deepens the socket, is a shock absorber, and decreases stress
-creates a negative pressure to seal the function for synovial joint

198
Q

the acetabular labrum distributes

A

compressive loads

199
Q

the labrum is most vascular where

A

at periphery; articular side less vascular

200
Q

joint capsule of hip attaches proximally

A

acetabulum and transverse ligament

201
Q

joint capsule of hip attaches distally

A

intertrochanteric line anteriorly and extends to mid neck posteriorly (not a firm attachment to the bone)

202
Q

the lateral half of the neck of the femur is (capsular/extracapular/intracapsular) posterioly

A

extracapsular

203
Q

Muscles that attche to the hip capsule

A
  1. Glut Max
  2. Iliocapsularis
  3. Indiret head of Rectus Femoris
  4. Obturator Externus
  5. Triceps Coxae (conjoint tendon of hip)
204
Q

Triceps Coxae/conjoint tendon of hip is composed of

A

Obturator internus, superior and inferior gemelli

205
Q

synovium of the hip covers

A 
part of femoral neck
femoral head articular surface 
ligament teres 
acetabular labrum 
acetabular fossa
206
Q

Capsular ligaments of the hip joint

A

Iliofemoral
Pubofemoral
Ischiofemoral
Zona Orbicularis

207
Q

Anterior Capsular Ligaments

A

Iliofemoral

Pubofemoral

208
Q

Posterior Capsular Ligaments

A

Ischiofemoral

209
Q

spiral shaped fibers of the ligaments

A

“screw head into acetabulum”

210
Q

all capsular hip ligaments resist

A

hip extension and anterior translation of femoral head

211
Q

Iliofemoral Ligament

A

Y Ligament, Ligament of IBigelow

212
Q

the strongest ligament in the hip

A

Iliofemoral

213
Q

Iliofemoral Ligament Proximal Attachment

A

AIIS and Iiac portion of acetabular rim

214
Q

iliofemoral spilts into 2 bands

A

upper (lateral)

Lower (medial)

215
Q

Upper Band of Iliofemoral ligament attaches to

A

superior intertrochanteric line and greater trochanter

216
Q

Lower Band of Iliofemoral Ligament attaches

A

to inferior intertrochanteric line

217
Q

the upper band of the iliofermoal ligament resists

A

extension and external rotation (internal rotation in extension)

218
Q

the lower band of iliofemoral ligament resists

A

extension and external rotation

219
Q

pubofemoral ligament attaches to

A

pubic part of acetabular rib/obturator crest (superior pubic ramus)

220
Q

the pubofemoral ligament blends with

A

joint capsule/iliofemoral ligament

221
Q

pubofemoral ligament resists

A

extension and abduction /external rotation

222
Q

ischiofemoral ligament attaches from

A

ischial part of acetabular rim to capsule around femoral neck, zona orbicularis, medial to base of greater trochanter

223
Q

ischiofemoral ligament resists

A

extension and internal rotation

224
Q

Zona Orbicularis

A

deep circular fibers of the capsule

225
Q

the zona orbicularis blends with

A

capsular ligaments

226
Q

which ligament forms a collar around the neck

A

zona orbicularis (locking ring)

227
Q

the zona orbicularis is prominent where?

A

inferior and posterior capsule

228
Q

the zona orbicularis attaches

A

it does not directly attach to bone

229
Q

the zona orbicularis functions to /resists

A

aid in holding femoral head into acetabulum, resists distraction

230
Q

intracapsular ligaments of the hip

A

ligament of head of the femur

transverse acetabular ligament

231
Q

function of ligament of the head of the femur

A

secondary stabilizer, more important stabilizer in fetal/neonates and pathological hip
proprioception

232
Q

the ligament to the head of the femur is a conduit for

A

the artery to the head of the femur and nerves

233
Q

the ligament of the head of the femur attaches

A
  • margin of acetabular notch/transverse acetabular ligament

- fovea capitis on the femur

234
Q

what ligament is continuous with the labrum

A

transverse acetabular ligament

235
Q

the transverse acetabular ligament attaches

A

to edges of acetabular notch

236
Q

the transverse acetabular ligamrnt creates

A

a foramen for the passage of vessels

237
Q

origin of the iliocapsularis

A

anterior inferior iliac spine (AIIS)

238
Q

insertion of the iliocapsularis

A

below lesser trochanter /sometimes iliofemoral ligament/intertrochanteric line

239
Q

innervation of iliocapsularis

A

femoral nerve

240
Q

function of the iliocapsularis

A

raise the capsule with hip flexion and stabilize the hip

241
Q

Iliocapsularis is hypertrophies with

A

dysplastic hips (insufficient acetabular coverage)

242
Q

Trochanteric Bursa is between

A

gluteus maximus and lateral aspect of greater trochanter

243
Q

bursa associated with hip bursitis

A

trochanteric bursa

244
Q

hip bursitis

A

point tenderness, lateral thigh.gluteal pain, pain with external rotation and extension

245
Q

Ischail bursa is betwwen

A

glut mac and ischial tuberosity

246
Q

prolonged sitting in a postiotn that puts increased pressure on the tuberosity can irritate the

A

ischial bursa

247
Q

glutealfemoral bursa is between

A

glut max (IT band) and vastus lateralis

248
Q

gluteus medius bursa

A

between gluteus medius and superior greater trochanter

249
Q

hip joint blood supplt

A

trochanteric anatamosis

250
Q

trochanteric anastomosis

A

primarily from retinacular arteries from the ascending branchs of medial and lateral femoral circumflex arteries.

251
Q

what artery is major supplier of hip joint in adult

A

medial femoral circumflex

252
Q

high risk avascular necrosis with what type of fracture

A

femoral neck, effects medial femoral circumflex artery

253
Q

artery to the head of the femur is a branch of

A

acetabular artery

254
Q

acetabular artery is a branch of

A

posterior branch of obturator or MFC

255
Q

what artery is important for the hip joint in children under 3 years old

A

acetabular

256
Q

the acetabular artery in adults

A

not major supplier

257
Q

nerve supply to hip joint

A 
Posterior Division of femoral 
Sciatic 
superior gluteal 
anterior branch of obturator nerve 
accessory obturator nerve can innervate if it is present 
nerve to quadratus femoris
258
Q

avascular necrosis of femoral head

A

interruption of blood suppy to the femoral head resulting in ischemia, osteocyte death and necrosis of the tissue

259
Q

what leads to femoral head collapse

A

avascular necrosis

260
Q

avascular necrosis can be caused by

A

trauma resulting in hip dislocation or subluxation or femoral neck fracture

261
Q

non traumatic avascular necrosis

A
  • excessive corticosteroid and alcohol use most common
  • hematological disease
  • many others
262
Q

inferior boundary of gluteal region

A

gluteal fold

263
Q

hip region

A

area over greater trochanter

264
Q

Superior Cluneal nerves branches of

A

posterior rami of L1-3

265
Q

Superior cluneal nerves are susceptible to

A

entrapment passing through fascia and can be injured during iliac crest bone harvesting

266
Q

middle cluneal nerves branches of

A

posterior rami S1-3

267
Q

inferior cluneal nerves branches of

A

posterior femoral cutaneous

268
Q

perforating cutaneous (S2,3) pierce what ligament

A

sacrotuberous

269
Q

the perforating cutaneous (S2,3) supply

A

small area at the inferior/edial gluteal region

270
Q

iliohypogastric nerve can innervate

A

gluteal region

271
Q

all gluteal muscles attach

A

hip bone/sacrum (proximal) and femur (distal)

272
Q

superfical gluteal muscles attach

A

posterolateral ala of ilium

273
Q

superficial gluteal muscles function mostly as

A

hip extensors, abductors, medial (and lateral) rotators

274
Q

Deep gluteal muscles function mostly as

A

hip lateral rotators, hip stabilizers

275
Q

the facia over the gluteus maximus

A

is thin, thicker superior to glut max over glut medius (gluteus aponeurosis)

276
Q

glut max origin

A

external ala of ilium behind posterior gluteal line, posterior iliac crest, sacrotuberous ligament, dorsolateral sacrum/coccyx, gluteal aponeurosis

277
Q

glut max insertion

A

iliotibial tract (superior fibers) and gluteal tuberosity (inferior fibers)

278
Q

glut max innervation

A

inferior gluteal nerve (L5-S2)

279
Q

glut max blood supply

A

superior & inferior gluteal arteries, perforating branches of profunda femoris

280
Q

glut max function

A 
primary thigh (hip) extensor, also thigh lateral rotator; trunk extension
(Especially when more force is needed)
281
Q

Gluteus medius

A

Primary thigh abductors. Deep to gluteus maximus

282
Q

Gluteus medius origin

A

external ala between posterior and anterior gluteal lines, gluteal aponeurosis (fascia)

283
Q

Gluteus medius insertion

A

lateral part of greater trochanter

284
Q

Gluteus medius innervation

A

superior gluteal nerve (L4-S1)

285
Q

Gluteus medius blood supply

A

superior gluteal artery

286
Q

Gluteus medius function

A

abduction of thigh, medial rotation and lateral rotation of thigh

287
Q

deepest gluteal muscle

A

Gluteus minimus

288
Q

Gluteus minimus origin

A

external ala between anterior and inferior gluteal lines , superior edge of greater sciatic notch

289
Q

Gluteus minimus innsertion

A

anterior part of greater trochanter; hip joint capsule

290
Q

Gluteus minimus innervation

A

superior gluteal nerve

291
Q

Gluteus minimus blood supply

A

superior gluteal artery

292
Q

Gluteus minimus function

A

abduction, medial and lateral rotation of thigh

293
Q

piriformis exits pelvis through

A

greater sciatic foramen

294
Q

piriformis is important landmark for

A

identifying superior and inferior gluteal vessels/nerves

295
Q

piriformis origin

A

pelvic surface of sacrum, superior margin of greater sciatic notch, SI joint capsule, sacrotuberous ligament

296
Q

piriformis insertion

A

superior greater trochanter

297
Q

piriformis innervation

A

S1, S2 (nerve to piriformis)

298
Q

piriformis blood supply

A

gluteal arteries

299
Q

piriformic function

A

lateral rotation of thigh, helps with abduction (when thigh is flexed)

300
Q

Superior Gemellus

origin

A

ischial spine & superior margin of lesser sciatic notch

301
Q

Superior Gemellus

inerstion

A

medial part of greater trochanter (with OI and Inf. Gem tendons)

302
Q

Superior Gemellus

innervation

A

nerve to obturator internus (L5-S2)

303
Q

Superior Gemellus

blood supply

A

inferior gluteal artery

304
Q

Superior Gemellus

function

A

lateral rotation

305
Q

Inferior gemelli origin

A

superior ischial tuberosity; inferior margin of lesser scatic notch

306
Q

Inferior gemelli

insertion

A

medial greater trochanter (with Sup Gem and OI)

307
Q

Inferior gemelli innervation

A

nerve to quadratus femoris (L4-S1)

308
Q

Inferior gemelli

blood supply

A

medial femoral circumflex, inferior gluteal

309
Q

Inferior gemelli

function

A

lateral rotation of thigh

310
Q

Obturator internus leaves pelvic through

A

lesser sciatic foramen

311
Q

Obturator internus tendon is covered by

A

gemelli muscles

312
Q

Obturator internus origin

A

pelvic surface of obturator foramen and membrane

313
Q

Obturator internus insertion

A

medial greater trochanter

314
Q

Obturator internus innervation

A

nerve to obturator internus (L5-S2)

315
Q

Obturator internus blood supply

A

Inferior gluteal artery, internal pudendal

316
Q

Obturator internus function

A

lateral rotator of thigh, abduct thigh (when flexed)

317
Q

Quadratus femoris

origin

A

Ischial tuberosity

318
Q

Quadratus femoris

insertion

A

Quadrate tubercle of intertrochanteric crest

319
Q

Quadratus femoris

innervation

A

nerve to quadratus femoris (L4-S1)

320
Q

Quadratus femoris

blood supply

A

inferior gluteal, medial femoral circumflex

321
Q

Quadratus femoris

function

A

lateral rotator of thigh; adductor of thigh

322
Q

Tendon is deep to the quadratus femoris muscle from posterior view, deep to pectineus from anterior view

A

Obturator externus

323
Q

Obturator externus

origin

A

external surface of obturator foramen/membrane

324
Q

Obturator externus

insertion

A

trochanteric fossa on the greater trochanter (passes below neck of femur)

325
Q

Obturator externus

innervation

A

obturator nerve (L2-4) this is unique for a lateral thigh rotator

326
Q

Obturator externus

blood supply

A

obturator artery, medial femoral circumflex

327
Q

Obturator externus

function

A

lateral rotator of thigh; also helps with adduction

328
Q

all nerves of gluteal region and posterior thigh exit__ and pass __

A
  • greater sciatic foramen (except nerve to obturator internous)
  • pass inferior to piriformis (except superior gluteal)
329
Q

Superior Gluteal (L4-S1)

A

Innervates gluteus medius, gluteus minimus, TFL

330
Q

Inferior Gluteal (L5-S2)

A

Innervates gluteus maximus

331
Q

Nerve to Quadratus Femoris (L4-S1)

A

Innervates quadratus femoris, inferior gemellus)

332
Q

Nerve to Obturator Internus (L5-S2)

A

Lateral to pudendal nerve as it passes over sacrospinous ligament

333
Q

Posterior Cutaneous Nerve of Thigh (S1-3) is __ to sciatic nerve

A

medial and deep to fascia lata

334
Q

Posterior Cutaneous Nerve of Thigh (S1-3)

branches supply

A

skin over

  • posterior thigh, popliteal fossa, upper calf
  • Perineum
  • Gluteal region (Inferior cluneal nerves, pass around inferior edge of glut max)
335
Q

Pudendal (S2-4)

A

Passes through lesser sciatic foramen to enter perineum

336
Q

Perforating Cutaneous Nerve (S2,3)

A

Innervates skin at inferior/medial gluteal region

337
Q

Perforating Cutaneous Nerve (S2,3) exits pelvis by

A

piercing through sacrotuberous ligament

338
Q

the largest nerve

A

sciatic (2cm wide)

339
Q

sciatic nerve passes midway between

A
  • PSIS and ischial tuberosity

- greater trochanter and ischial tuberosity

340
Q

sciatic nerve travels deep to what muscle

A

long head of bicep femoris

341
Q

where does the sciatic nerve separate

A

distal thigh/popliteal fossa

342
Q

Tibial nerve (L4-S3)

A

To the posterior leg

343
Q

Common fibular (L4-S2)

A

Passes below biceps femoris tendon, around head of fibula (palpable)

344
Q

Innervates posterior thigh, leg, and foot muscles

A

sciatic nerve

345
Q

Cutaneous innervation of most leg/foot

A

sciatic nerve

346
Q

Piriformis syndrome

A

Compression of sciatic nerve due to spasm, fibrosis or hypertrophy of piriformis
(sciatic nerve varies in anatomic relationship to piriformis)

347
Q

Superior gluteal nerve entrapment/injury

Caused by

A
  • Trauma (fall on buttocks, intragluteal injection)
  • Entrapment between glut medius and minimus, superior border of piriformis
  • Hip surgery
348
Q

symptoms of Superior gluteal nerve entrapment/injury

A
  • Weak hip abductors (gluteus medius and minimus, TFL)

- Trendelenburg gait

349
Q

Trendelenburg Test

A

Test the hip abductors (gluteus medius and minimus, TFL) innervated by the superior gluteal nerve

350
Q

Negative Trendelenburg Test

A
  • the pelvis remains level
  • Muscle contraction of the gluteus medius/minimus/ TFL on the unsupported (stance) side pulls the pelvis down (This keeps the unsupported side from dropping)
351
Q

Positive Trendelenburg Test (Trendelenburg sign)

A

Single leg standing on involved side, pelvis drops on unsupported (swing) side.

352
Q

what can cause a postiive trendelenburg test

A

hip frx or dislocation

353
Q

Trendelenburg Gait (Lurch):

A

excessive lateral lean to keep center of gravity over supported leg while walking

354
Q

safe area of infragluteal injections

A
  • superolateral quadrant
  • above line from PSIS to greater trochanter tip
  • Triangular area between ASIS, tubercle of crest, greater trochanter
355
Q

Inferiorgluteal nerve entrapment/injury

Caused by

A
  • Hip surgery

- Injection related injury

356
Q

Inferiorgluteal nerve entrapment/injury symptoms

A

Weak hip extension
Weak lateral rotation
Gluteus maximus gait (Gluteal lurch or lurch gait)

357
Q

Gluteus maximus gait (Gluteal lurch or lurch gait)

A

During gait, the trunk lurches backwards at heel-strike on the affected side
(Keep center of gravity behind the hip)

358
Q

primary hip extensors during walking

A

hamstrings

359
Q

Normally the___ contracts at heels-strike, this slows the forward motion of the trunk and the flexion movement caused by the hip flexors.

A

gluteus maximus

360
Q

content passing through the greater sciatic foramen above piriformis

A

Superior gluteal artery, vein, nerve

361
Q

content passing through the greater sciatic foramen below piriformis

A
  1. Inferior gluteal artery, vein, nerve
  2. Internal pudendal artery and vein
  3. Pudendal nerve
  4. Sciatic nerve
  5. Posterior femoral cutaneous nerve
  6. Nerve to obturator internus
  7. Nerve to quadratus femoris
362
Q

content passing through lesser sciatic foramen

A
  1. Internal pudendal artery and vein
  2. Pudendal nerve
  3. Nerve to obturator internus
  4. Tendon of obturator internus
363
Q

gluteal arteries are branches of

A

internal iliac

364
Q

the arteries of the gluteal region exit out the

A

greater sciatic foramen

365
Q

Superior gluteal Branches to

A

glut max, glut medius, glut minimis, TFL, piriformis

366
Q

Inferior pudendal artery travels with

A

pudendal nerve

367
Q

what artery gives off artery to sciatic nerve

A

inferior gluteal

368
Q

inferior gluteal artery branches to

A

glut max, deep gluteal muscles

369
Q

inferior gluteal artery is inferior to

A

piriformis muscle

370
Q

internal pudendal artery travels between

A

nerve to OI and pudendal nerve

371
Q

internal pudendal artery passes over (posterior)

A

sacrospinous ligament, enters lesser sciatic foramen

372
Q

perforating arteries branch off

A

deep artery of thigh (profunda femoris)

373
Q

perforating arteries pierce what muscle

A

adductor magnus

374
Q

perforating arteries supplies

A

Supplies posterior thigh compartment and inferior gluteus maximus

375
Q

gluteal fat pad

A

fat between gluteus minimus and the ischiofemoral ligament

376
Q

psoas fat pat

A

fat inferior to psoas major

Lower Extremity Anatomy II (12 decks)

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