LECTURE 1: INTRODUCTION TO JOINTS AND THE GLUTEAL REGION Flashcards
What are the features of synovial joints?
cap, synovial cavity, synovial membrane, joint capsule, fibrous layer, outer layer, fatty pads,
What is a bursae?
– miniature joint capsule
o Sacs lined with synovial membrane (Contain synovial fluid)
o Reduce friction where ligaments, muscles, skin, tendons, or bones rub together
What are the 6 types of synovial joints?
plane, hinge, pivot, condylar, saddle, ball and socket
What is the action of the plane joint?
2 solid flat structures that glide against one another (nonaxial movement). Limited mobility
Examples: Intercarpal joints, intertarsal joints, joints between vertebral articular surfaces
What is the action of the hinge joint?
Uniaxial (move in one plane), Flexion and extension only
Examples: Elbow joints, interphalangeal joints
What is the action of the pivot joint?
Flat round head of radius allows for supination and protonation rotation
example: Atlantioaxial joint is in your neck, Proximal radioulnar joints
What is the action of the condylar joint?
Bi-axial movement over sagittal plane, Extend/ flex, and abduct/adduct
Examples: Metacarpophalangeal (knuckle) joints, wrist joints
What is the action of the saddle joint?
flexion/extension, adduction/abduction
Example: Carpometacarpal joints of the thumbs
What is the action of the ball and socket joint?
most mobility and less stability; Extend/ flex, and abduct/adduct, and rotation
Examples: Shoulder joints and hip joints
What does the ilio-inguinal nerve innervate?
(no motor innervation in lower limb) innervates abdominal muscles
What does the genitofemoral nerve innervate?
(no motor innervation in lower limb) genital branch innervates cremaster
What does the femoral nerve innervate?
skin of the anterior thigh and muscles (quadriceps); branches supply iliacus and pectineus
What does the obturator nerve innervate?
skin over upper medial thigh and muscles (except pectineus and part of adductor magnus); obturator externus
What does the lateral cutaneous nerve innervate?
Parietal peritoneum in iliac fossa; skin over anterolateral thigh
What does the sciatic nerve innervate?
Innervates all of the muscles of the posterior compartment of thigh and muscles that move ankle and foot
What does the inferior gluteal nerve innervate?
Passes through greater sciatic foramen below piriformis
Innervates gluteus maximus
What does the superior gluteal nerve innervate?
Passes through greater sciatic foramen ABOVE piriformis
Supplies gluteus Medius and minimus
What does the Posterior cutaneous nerve of the thigh innervate?
Passes through greater sciatic foramen below piriformis and medial to sciatic
Innervates skin over gluteal fold, posterior thigh and parts of perineum
What does the nerve to quadratus femoris innervate?
Passes through greater sciatic foramen below piriformis and deep to sciatic
Innervates quadratus femoris and inferior gemellus
What does the nerve to obturator internus innervate?
Passes through greater sciatic foramen below piriformis between post cutaneous and pudendal
Innervates obturator internus and superior gemellus
What does the perforating cutaneous nerve innervate?
Exits the pelvic cavity by piercing the sacrotuberous ligament
Innervates skin over medial gluteus maximus
What is the origin of the gluteus maximus?
Fascia covering gluteus Medius, posterior ilium, fascia of erector spinae, dorsal surface of sacrum, coccyx, sacrotuberous ligament
What is the insertion of the gluteus maximus?
Posterior iliotibial tract and gluteal tuberosity
What is the innervation and action of the gluteus maximus?
Innervation: Inferior gluteal nerve
Action: Extension, lateral rotation, abduction of hip
What is the origin and insertion of the gluteus medius and minimus?
Origin: Posterior ilium between anterior and posterior gluteal lines
Insertion: Greater trochanter
What is the innervation and action of the gluteus medius and minimus?
Innervation: Superior gluteal nerve
Action: Abduct femur: stabilization of pelvis during single leg stance
What is the origin and insertion of the tensor fascia lata?
Origin: Lateral crest of ilium between ASIS and tubercle of crest
Insertion: Iliotibial tract of fascia lata
What is the action and innervation of the tensor fascia lata?
Innervation: Superior gluteal nerve
Action: Abduct femur: stabilization of knee in extension
what is IT Band Syndrome?
IT get tights and pulls on all your muscles
What is the origin and insertion of the piriformis?
Origin: Anterior surface of sacrum
Insertion: Greater trochanter
What is the origin and insertion of the obturator internus?
Origin: Anterolateral wall of true pelvis, obturator membrane
Insertion: Greater trochanter
What is the origin and insertion of the superior gemellus?
Origin: External surface of ischial spine
Insertion: Superior surface of obturator internus tendon and greater trochanter
What is the origin and insertion of the inferior gemellus?
Origin: Upper aspect of ischial tuberosity
Insertion: Inferior surface of obturator internus tendon and greater trochanter
What is the origin and insertion of the quadratus femoris?
Origin: Lateral aspect of ischium anterior to ischial tuberosity
Insertion: Quadrate tubercle on intertrochanteric crest
What is the action and innervation of the piriformis?
Innervation: Branches S1- S2
Action: Laterally rotate extended hip; abduct flexed femur
What is the action and innervation of the obturator internus?
Innervation: Nerve to obturator internus
Action: Laterally rotate extended hip; abduct flexed femur
What is the action and innervation of the superior gemellus?
Innervation: Nerve to obturator internus
Action: Laterally rotate extended hip; abduct flexed femur
What is the action and innervation of the inferior gemellus?
Innervation: Nerve to quadratus femoris
Action: Laterally rotate extended hip; abduct flexed femur
What is the action and innervation of the quadratus femoris?
Innervation: Nerve to quadratus femoris
Action: Laterally rotate femur
What is the Trendelenburg sign?
Occurs in people with weak or paralyzed abductors
When patient stands on one leg, the pelvis severely drops on the standing leg side
Positive signs are seen in patients with superior gluteal nerve damage
Patients with a positive sign, gait is abnormal. On the single leg stance phase of walking, weakened abductor muscles allow pelvis to tilt, patient compensates by tilting the trunk the other way to maintain level of the trunk during gait
What are the sight of intramuscular injections?
o Inject into the upper outer quadrant to avoid sciatic nerve and superior gluteal vessels and nerve
o Inject into gluteus Medius anterosuperior to gluteus maximus
What is the supply of the inferior gluteal artery?
Supplies surrounding muscles and descends into posterior thigh where it anastomoses with branches of femoral a.
What is the origin of the inferior gluteal artery?
anterior trunk of internal iliac a.
What is the origin of the superior gluteal artery?
Originates from posterior trunk of internal iliac a.
What are the divisions of the superior gluteal artery?
Superficial branch- passes onto deep surface of gluteus maximus
Deep branch- passes between gluteus Medius and minimus
Where do the deep lymphatic vessels drain?
into internal iliac nodes
Where do the superficial lymphatic vessels drain?
into superficial inguinal nodes
