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Functional Anatomy > LE Hip Region > Flashcards

LE Hip Region Flashcards

1
Q

superficial fascia

A

subcutaneous fascia

  • lies deep to skin
  • loose connective tissue
  • contains fat, cutaneous nerves, superficial viens, and lymphatics
  • continuous with the fascia of inferior, anterolateral abdominal wall and buttocks
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2
Q

deep fascia

A

fascia lata

  • dense layer of CT b/t subcutaneous tissue and the muscle
  • non-elastic
  • especially strong in LE (encircles limb like stocking)
  • prevents bulging of muscle during contraction making more efficient
  • continuous with deep fascia of leg
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3
Q

bones of pelvis

A

ilium, ischium, pubis

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4
Q

gluteus maximus attachment

A

from: post. ilium to post, gluteal line, dorsal surface of sacrum and coccyx & sacrotuberous ligament
to: iliotibial tract (that inserts on lateral tibia condyle), some fibers to gluteal tuberosity of femur

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5
Q

gluteus maximus action

A

extend thigh, extension of trunk with LE are fixed, assists in lateral rotation of thigh

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6
Q

gluteus maximus innervation

A

inferior gluteal nerve (L5, S1, S2)

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7
Q

gluteus medius attachment

A

from: external surface of ilium b/t ant. and post. gluteal lines
to: lateral surface of greater trochanter of femur

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8
Q

gluteus medius action

A
  • abd thigh and rotates thigh (ant. fibers- IR, abd; post. fibers- ER, abd)
  • abd of pelvis
  • levels pelvis when opposite leg is raised
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9
Q

gluteus medius innervation

A

superior gluteal n. (L4, L5, S1)

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10
Q

trendelenburg

A

strength deficits of gluteus medius leading to a pelvis drop gait on the contralateral leg

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11
Q

gluteus minimus attachment

A

from: external surface of ilium b/t ant. and inf. gluteal lines
to: anterior surface of greater trochanter of femur

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12
Q

gluteus minimus action

A
  • abd and IR thigh

- abd pelvis

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13
Q

gluteus minimus innervation

A

superior gluteal n. (L4, L5, S1)

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14
Q

piriformis attachment

A

from: ant. surface of sacrum and sacrotuberous ligament
to: superior border of greater trochanter of femur

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15
Q

piriformis action

A
  • ER of extended/neutral thigh
  • abd flexed thigh
  • steadies the femoral head in acetabulum
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16
Q

piriformis innervation

A

N. to piriformis (S1*, S2)

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17
Q

piriformis syndrom etiology/some possibilities

A
  • hypertrophy, inflammation, or spasm of piriformis m.
  • direct trauma resulting in hematoma and scarring
  • females: males, 6:1
  • anatomical abnormalities like a split piriformis m.
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18
Q

referral pain location of piriformis syndrom

A

post. buttock and may radiate down post. thigh

- inc. by contraction of piriformis m., prolonged sitting, direct pressure applied to muscle

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19
Q

differential diagnosis of piriformis syndrome

A

lumbar radiculopathy or lumbar spine referred pain

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20
Q

obturator internus attachment

A

from: pelvis surface of obturator membrane and surrounding pelvic bones
to: medial surface of greater trochanter of the femur, blending with the gemelli ms. insertion at trochanteric fossa

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21
Q

obturator internus action

A
  • ER of extended thigh
  • abd flexed thigh
  • steadies femoral head
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22
Q

obturator internus innervation

A

N. to obturator internus & superior gemellus (L5, S1*)

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23
Q

superior gemelli attachment

A

from: ischeal spine
to: medial surface of greater trochanter with inf. gemelli & obturator internus at the trochanteric fossa

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24
Q

inferior gemelli attachment

A

from: ischeal tuberocity
to: medial surface of the greater trochanter with the inf. gemelli & obturator internus at the trochanteric fossa

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25
Q

gemeli ms. action

A
  • ER of extended thigh
  • abd flexed thigh
  • steadies the femur
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26
Q

superior gemelli innervation

A

N. to obturator internus & superior gemellus (L5, S1*)

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27
Q

inferior gemelli innervation

A

N. to quadratus femoris & inf. gemellus (L5, S1)

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28
Q

quadratus femoris attachment

A

from: lateral border of the ischial tuberosity
to: quadrate tubercle on intertrochanteric crest of femur (just inf. to it)

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29
Q

quadratus femoris action

A
  • ER of thigh

- Steadies femoral head

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30
Q

quadratus femoris innervation

A

N. to quadratus femoris & inf. gemellus (L5, S1)

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31
Q

obturator externus attachment

A

from: margins of obturator foramen & obturator membrane
to: trochanteric fossa of the femur

32
Q

obturator externus action

A
  • ER of thigh
  • steadies head of the femur
  • assists in add
33
Q

obturator externus innervation

A

obturator N. -post. division (L3, L4*)

34
Q

deep ER of the thigh

A
  • piriformis
  • obturator internus
  • superior gemelli
  • inferior gemelli
  • quadratus femoris
  • obturator externus
35
Q

femur head orientation

A

superomedially and slightly anterior

36
Q

femur neck orientation

A

attaches at the head to the femoral shaft/body at the intertrochanteric line

37
Q

intertrochanteric line

A
  • anterior line b/t greater and lesser trochanter
  • base of the neck of femur
  • transition from neck to the shaft
  • common fracture site
38
Q

angle of inclination

A

angel bt/t long axis of neck/head & long axis of shaft

  • normal angle average= 126 degrees (115-140)
  • carries with age (greater in toddlers until ambulation)
  • may be changed by pathology that weekend the neck
39
Q

coxa vera

A

angle of inclination is diminished (<126 degrees)

40
Q

coxa valga

A

angle of inclination is increased (>126 degrees)

41
Q

anterior femur orientation

A 
greater trochanter- extends laterally 
lesser trochanter- extends posteromedially 
intertrochanteric line- joins trochanters anteriorly 
trachanteric fossa- posteriorly 
body- bowed slightly anteriorly 
femoral condyles- medial and lateral 
patellar surface- on femoral condyles 
lateral and medial epicondyles
42
Q

posterior femur orientation

A

intertrochanteric crest- joins trochanters posteriorly
quadrate tubercle- rounded elevation on the intertrochanteric crest
gluteal tuberosity- gluteus maximus insertion
linea aspera- lateral/medial lip
spiral line- vast medialis
suprachondylar lines- lateral and medial
intercondylar fossa/notch
adductor tubercle

43
Q

angle of anterversion

A

the plane of the femoral neck and head lies anterior to the plane of the femoral condyles

44
Q

normal angle of anterversion

A

15 degrees in adults

31 degrees in infancy

45
Q

frequent cause of “in- toeing”

A

excessive femoral anterversion

46
Q

femoral anterversion

A
  • frequent cause of “in-toeing” in children ages 3-10
  • affected limb IR
  • more common in females
  • appears worse with running and at the end of the day (when fatigued)
  • will dec. naturally in 99% of cases
  • special shoes, twister cables, and braces make no difference in outcome
47
Q

hip joint characteristics

A
  • ball and socket
  • tri-axial
  • acetabular labrum (fibrocartilageinous ring deepends the cup)
48
Q

fovea

A

pit in the head of the femur where the ligament theres attaches
- contains a small artery to the head of the femur

49
Q

iliofemoral ligament

A
  • “Y” ligament
  • from AIIS to intertrochanteric line
  • strongest ligament
  • anterior
  • becomes taut with hyperextension of hip
50
Q

pubofemoral ligament

A
  • runs anterior and inferior
  • from superior rams of pubis to intertrochanteric line
  • becomes taut with hyperextension and abduction of hip joint
51
Q

ischiofemoral ligament

A
  • arises posteriorly
  • spirals superolaterally to anterior femoral neck
  • becomes taut with hyperextension of hip
52
Q

blood supply to the femoral head/neck

A
  • ligamentum teres acetabular branch of the obturator artery
  • medial circumflex femoral artery
53
Q

what ligament do parapledgic patients “stand” or hang on when using axillary crutches

A

iliofemoral ligaments

54
Q

posterior thigh muscles function

A
  • extension at the hip

- flexion at the knee

55
Q

bursa

A

membranous sacs lined with synovial membrane, located in areas that are subject to friction

56
Q

ischial bursa

A

separates glut max from ischial tuberosity

57
Q

iliopsoas bursa

A

separates joint from muscle

58
Q

trochanteric bursa

A

separates glut max from greater trochanter

59
Q

gluteofemoral bursa

A

separates the iliotibial band from superior portion of vests lateralis

60
Q

hamstring musculature

A
  • semitendinosis
  • semimembranosus
  • biceps femoris
61
Q

semitendinosis attachment

A

from: the ischial tuberosity
to: the medial surface of superior tibia (pes ancerinus)

62
Q

semimembranosus attachment

A

from: ischial tuberosity
to: posterior part of the medial tibial condyle and a reflected attachment to the oblique popliteal ligament

63
Q

biceps femoris long head attachment

A

from: ischial tuberosity
to: lateral head of fibula

64
Q

biceps femoris short head attachment

A

from: linea aspera and lateral supracondylar line of the femur
to: lateral head of fibula

65
Q

hamstrings action (semitendinosis and semimembranosis)

A
  • extends the hip
  • flexes knee
  • IR leg
  • extends trunk (in closed kinematic chain)
66
Q

biceps femurs long and short head action

A
  • extends the hip (long only)
  • flexes the knee
  • ER leg
67
Q

biceps femoris long head innervation

A

tibial portion of sciatic n. (L5, S1, S2)

68
Q

biceps femoris short head innervation

A

common fibular perennial portion of sciatic n. (L5, S1*, S2)

69
Q

popliteal fossa borders

A

superiorly- hamstrings
inferiorly- 2 heads of the gastrocnemius and plantaris muscle
posteriorly- skin and fascia
anteriorly- popliteal surface of femur, clique popliteal ligament, popliteal fascia over popliteus

70
Q

plantaris attachment

A

from: inferior end of lateral supracondylar line of femur and oblique popliteal ligament
to: posterior surface of calcaneus via calcanea tendon

71
Q

popliteal fossa contents

A
  • popliteal arteries and veins
  • lesser saphenous vein
  • tibial and common perennial nerves
  • posterior femoral cutaneous nerve (inn skin overlying fossa)
  • popliteal lymph nodes and lymphatic vessels
72
Q

when does the femoral artery change to the popliteal artery

A

when it passes through the adductor hiatus

73
Q

femoral artery

A
  • supplies ant. and anterolateral surface of thigh

- continuation of the external iliac after after crossing the inguinal ligament

74
Q

profunda femoral artery (deep femoral a.)

A
  • arises from femoral artery near inguinal ligament
  • gives rise to perforating branches throughout add magnus m.
  • supples post., lat., and ant. aspect of thigh
75
Q

medial femoral circumflex artery

A

arises from profunda femoral a. (can also arise form femoral a.)

  • supplies blood to head and neck of femur via posterior retinacular a.
  • terminates by dividing into ascending/transverse branches
76
Q

lateral femoral circumflex artery

A
  • arises from profunda femoral a. (but can arise from femoral a.)
  • supplies lateral hip muscles
  • ascending to gluteal region, transverse around femur, descending to the knee
77
Q

retinacular arteries

A
  • arising from medial femoral circumflex arteries

- main supply to the hip joint

Functional Anatomy (5 decks)

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