Lecture 3 Gluteal region Flashcards
Main functions of lower extremity =
Improve stability and decrease muscle recruitment
Innominate bone is formed by the fused …
ilium, ischium, and pubis
The three topographic regions of the pelvic girdle from inferior to superior are
- convex –> concave
- convex –> concave
- concave –> convex
The anterior/posterior sacroiliac ligament is
syndesmoses
Obtuse vs acute pubic symphysis angles
Obtuse = female
Acute = male
Nutation =
Anterior pelvic tilt (bend back at hip joint); increases weight bearing, opens the symphysis and there is an outflare
Counternutation =
posterior tilt (flex at hip joint or bend foreward); decrease weight bearing, compresses symphysis, inflare
Unilateral innominate bone motion can show
SI pain and leg length discrepancy
How to tell L/R femur apart
Femoral head goes medially into acetabulum; intertrochantric crest more prominent posteriorly
Ligament of the femoral head=
ligament teres
Orientation of the acetabulum=
Anterior, inferior, lateral
Orientation of the femur =
Posterior, superior, medial
What is the labrum and where does it end
A fibrocartilage stabilizer that increase the depth of the socket and ends at the transverse ligament
What is ligament Y
Iliofemoral ligament (strongest in body)
Where does ilio,ischio, and pubofemoral ligaments attach
Intertrochantric line
Less than 120 degrees (knocked knees) coronal plane malalignment =
Coxa vara genu valga
More than 135 degrees (bow legged) coronal plane malalignment =
Coxa valga genu vara
Angle between the axes of femoral neck (coronal) and femoral condyles (transverse) =
Femoral angle of torsion
Femoral angle of torsion greater than 15 degrees =
Anteversion (internal rot)
Femoral angle of torsion less than 10 degrees =
Retroversion (external rotation)
Hip impingement types and the gold standard for diagnoses
Pincer: above femoral head
CAM: on femoral head
Gold standard= arthroscopy
retro-acetabulum =
Sagittal plane malalignment
Ventral divison of sacral plexus =
Tibial nerve
Pudendal nerve
Pelvic splanchnic nerve -(parasympathetic)
Dorsal division of sacral plexus =
Common fibular nerve
Superior gluteal nerve
Inferior gluteal nerve
Sciatic nerve = what two nerves
Common fibular nerve and tibial nerve
Obturator foramen is formed by which two bones
Pubis and ischium
Common iliac artery is on which nerve level
L4
What does the piriformis divide the greater sciatic foramen into
- Superior greater sciatic foramen
- Inferior greater sciatic foramen
Where does the internal pudendal artery course through
Lesser sciatic foramen
Name muscular fiber types and describe them
Type 1 (slow twitch): more mitochondira, for endurance, are oxidative (postural muscles like multifidi, soleus, transverse abdominis)
Type 2A (fast twitch oxidative): in between
Type 2B (fast twitch glycolytic): less mitochondria, more power, glycolysis used
Open chain elbow flx/closed chain elbow flx
Open: concentric contraction of agonists
Closed: eccentric contrction of antagonists
Cutaneous innervation: Superior/medial cluneal nerve vs Inferior
Sup/Med: dorsal rami not from sacral plexus
Inferior: posterior femoral cutaneous nerve
Gluetus maximus in open chain performs..
Abduction superiorly, adduction inferiorly
Main muscle compensation for hip flexor weakness
Tensor fascia latae
Contralateral hip drop =
Trendelenburgs sign
Bilateral hip side bending to maintain a level pelvis =
Duchenne limp/waddling gait
When the hip is flexed over 60 degrees, the piriformis does what and why
internally rotates because the proximal attachment is posterior to the distal attachment
Piriformis syndrome AKA.. ; which nerves, most common types
-Sciatica
-Common fibular and tibial nerve
- Piercing piriformis = 10-15%
- Superior greater sciatic foramen = 1-3%
The (blank) supports the pelvic floor with a tendinous area
Obturator internus
The obturator internus and quad femoris (blank) when the hip is flexed
Abduct
