Lecture 3 Flashcards
What attaches the two hipbones together?
Pubic symphysis
Relaxes in birth to allow babies head out
What group of muslces attach to the lesser trochanter of the femur?
Medial: abductors
What is the insertion for the quads?
Tibial tuberosity
The linea aspera goes into what?
popliteal surface
What is the dimple region?
posterior superior illiac spine
What does the red line indicate?
indicate supracristal plane (high points of iliac crests) crossing L4 spinous process and L4/5 IV disc
What are the three parts of the hip bone?
Ilium: superior
Pubis: anterior
Ischium: posterior
What does the head of the femur fit into?
Acetabulum
What are the important ligaments that we care about?
What is a common site for intramuscular injections of drugs and why?
The gluteal region is a common site for
intramuscular injection of drugs because the gluteal muscles are thick and large, providing a large area for venous absorption of drugs.
Injections into the buttocks are safe only where? What can happen if not placed here?
- the superolateral quadrant of the buttocks
- Complications of improper technique include nerve injury, hematoma, and abscess formation.
What does trochanteric bursitis cause? What is it characterized by?
- Diffuse deep pain in the lateral thigh region, especially during stair climbing or rising from a seated position
- It is characterized by point tenderness over the greater trochanter; however, the pain often radiates along the iliotibial tract.
A commonly overlooked diagnosis that clinically mimics trochanteric bursitis is what?
a tear of the insertion of gluteus medius tendon on the trochanter.
What does the ischial bursitis result from?
Ischial bursitis results from excessive friction between the ischial
bursae and the ischial tuberosities (e.g., as from cycling).
Because the tuberosities bear the body weight during sitting, these pressure points may lead to what?
pressure sores in debilitated people, particularly paraplegic persons.
What are the ligaments of hip joint?
What are the flexors of the hip joints?
What are the adductors of the hip joints?
What are the lateral rotators of the hip joints?
What are the extensors of the hip joints?
What are the abductors of the hip joints?
- gluteus medius
- gluteus minimus
- tensor fasciae latae
What are the medial rotators of the hip joints?
gluteus medius, minimus and tensor fasciae latae
- The hip joint is subject to what?
The hip joint is subject to severe traumatic injury and degenerative disease.
Osteoarthritis of the hip joint, characterized by what?
Osteoarthritis of the hip joint, characterized by pain, edema, limitation of motion, and erosion of articular cartilage, is a common cause of disability.
During hip replacement, what happens?
During hip replacement, a metal prosthesis anchored to the person’s femur replaces the femoral head and neck and the acetabulum is often lined with a metal/plastic socket
Congenital dislocation of the hip affects who?
1.5 per 1,000 live births; affects more girls; bilateral in half the cases
What does the dislocation of hip joint look like (congenital)?
The affected limb appears (and functions as if) shorter because the dislocated femoral head is more superior than on the normal side, resulting in a positive Trendelenburg sign (hip appears to drop to one side during walking).
What is the action of the sartorius?
At the hip it flexes, weakly abducts, and rotates the thigh laterally.
* Sit crossed legged
What is the action of the tensor fasciae latae?
- Hip joint: Thigh internal rotation, (Weak abduction)
- Knee joint: Leg external rotation, (Weak leg flexion/ extension); Stabilizes hip & knee joints by Tightening the IT band
What is the attachment points and actions of rectus femoris?
knee extension; hip flexion
* Attach to ant. infer iliac spine
* All the quad muslces attach at the quadriceps tendon which then goes into the patella-> patellar ligament that attaches to the tibular trob.
What are the quad muscles?
Vatus lateralis, medalis and intermedius
* All attach to the greater trochanter
* Only work on knee
Retus femoris
quad muscles: hip flexion and knee extension
- What is the suprapatellar bursa?
- What does the articularis genu?
- Between articulatis genu and vastus intermedius
- Help joint cap tighten (synivol sac during contraction) and so there is no pitching of synivol membrane
What is most frequently fractured in the femur and why?
The neck of the femur is most frequently fractured, especially in females secondary to osteoporosis.
Fractures of the proximal femur can occur where?
at several locations— for example, transcervical and intertrochanteric
When can a femoral shaft be fractured?
Femoral shaft strong; however, a violent direct injury e.g. (automobile accident), may fracture it (e.g. spiral fracture)
Fractures of the distal femur may be complicated by what?
Fractures of the distal femur may be complicated by separation of the condyles, resulting in misalignment of the knee joint.
+ ligament damage
Fracture of the neck of the femur often what? Explain?
- often disrupts the blood supply to the head of the femur.
- The medial circumflex femoral artery supplies most of the blood to the head and neck of the femur. Its retinacular arteries often are torn when the femoral neck is fractured or the hip joint is dislocated.