Lecture 4 Gluteal Region and Posterior Thigh Flashcards
Hip Joint
Synovial joint (ball & socket) -________
Stability over wide range of movement
Flexion ____ joint capsule ligaments to increase mobility
Extension is ____ by ligaments
Synovial joint (ball & socket) -femoral head, acetabulum
Stability over wide range of movement
Flexion unwinds joint capsule ligaments to increase mobility
Extension is limited by ligaments
Femoral head is covered with ____
_____
(fibrocartilage) increases articular area
Transverse ____ bridges acetabular notch
More than half femoral head fits within ______
Femoral head is covered with **articular cartilage **
Acetabular labrum
(fibrocartilage) increases articular area
Transverse acetabular ligament bridges acetabular notch
More than half femoral head fits within acetabulum
3 intrinsic ligaments of the joint capsule
_____
(Lig. of Bigelow) -strongest, thickest
-prevents ______
____ ligament -prevents
______
____ ligament
Iliofemoral ligament
(Lig. of Bigelow) -strongest, thickest
-prevents hyperextension
Pubofemoral ligament -prevents
overabduction
Ischiofemoral ligament
Clinical note: ____ can occur when hip is flexed, adducted, and medially rotated.
Head of femur is driven ____, out of the ____
Endangers ____ n.
Clinical note: Posterior Dislocation can occur when hip is flexed, adducted, and medially rotated.
Head of femur is driven posteriorly, out of the acetabululm.
Endangers sciatic n.
Hip Join nerou
Medial Circumflex:
Obturator
Deep Femoral
Lateral Cirmcumflex
Coxa _____: decreased angle of inclination
functionally ____ limb: Typically caused by injury: ____
Coxa ____ : increased angle of inclination
functionally ____ limb: Typically caused by ____
Coxa vara: decreased angle of inclination
functionally shorter limb: Typically caused by injury: fracture, bone disorders
Coxa valga: increased angle of inclination
functionally longer limb: Typically caused by slipped epiphysis of femoral head
Arterial supply: Gluteal
____ aa.
Nerve supply:
____ nn.
(except hip stabilizers: ____ L5-S2)
Main actions: ____
Superior & inferior gluteal aa.
Nerve supply:
Superior & inferior gluteal nn.
(except hip stabilizers: lumbosacral plexus L5-S2)
Main actions: Hip Extension, Hip abduction, Hip lateral roation and hip Medial Roation
Gluteal minimas and Max
PA
DA
ACT
INN
PA
DA
ACT
INN
PA: Ilium between posterior and anterior gluteal lines
DA: Greater trochanter (lateral)
Act: Abduct thigh; medial rotation of thigh
Inn: Superior gluteal n. (L5, S1)
PA: Ilium between anterior and inferior gluteal lines
DA: Greater trochanter (anterior)
Act: Abduct thigh; medial rotation of thigh
Inn: Superior gluteal n. (L5, S1)
Piriformis
PA: Anterior surface of sacrum
DA: Greater trochanter (superior)
Act: Lateral rotation of extended thigh,
abduct flexed thigh Inn: Ant. rami S1, S2
Superior gemellus
Inferior gemellus
Obturator internus
Quadratus femoris
Clinical note: Repetitive hip extension can lead to ____ Causes localized pain.
Clinical note: Repetitive hip extension can lead to bursitis (inflammation of bursa). Causes localized pain.
Sciatic nerve
Tibial (division) nerve (____)
-motor: posterior thigh & leg, plantar foot
Common fibular (peroneal) nerve (____)
-motor: anterior & lateral leg, dorsal foot
Sciatic nerve (L4-S3)
Tibial (division) nerve (**anterior **division)
-motor: posterior thigh & leg, plantar foot
Common fibular (peroneal) nerve (posterior division)
-motor: anterior & lateral leg, dorsal foot
Clinical note: ____ – Avoid ____ n. damage
by injecting in upper outer quadrant.
Clinical note: Intragluteal injection – Avoid gluteal & sciatic n. damage
by injecting in upper outer quadrant.
Awks lecture 18
____ joint (hinge)
Distal femur, proximal tibia
Patella: sesamoid bone (pulley, protection)
Mechanically weak: ____
Stability provided predominantly by ____, also ligaments
-most stable when ______ (“”)
Synovial joint (hinge)
Distal femur, proximal tibia
Patella: sesamoid bone (pulley, protection)
Mechanically weak: poor congruence
Stability provided predominantly by muscles, also ligaments
-most stable when fully extended (“locked”)
Awks lecture 18
Taut during full extension Permit knee rotation when slack
Named for their distal attachment
Tibial (medial) ____
Medial femoral epicondyle to tibial condyle
Attached to medial meniscus
Fibular (lateral) ____
Lateral femoral epicondyle to fibular head Cord-like
Taut during full extension Permit knee rotation when slack
Named for their distal attachment
Tibial (medial)** collateral lig. (TCL)**
Medial femoral epicondyle to tibial condyle
Attached to medial meniscus
Fibular (lateral) collateral lig. (FCL)
Lateral femoral epicondyle to fibular head Cord-like
Awks lecture 18
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Medial-lateral course from tibia to femur Limits anterior movement of tibia Weaker, poor blood supply
BLANK
Lateral-medial course from tibia to femur Limits posterior movement of tibia Stronger
Anterior cruciate ligament (ACL)
Medial-lateral course from tibia to femur Limits anterior movement of tibia Weaker, poor blood supply
Posterior cruciate ligament (PCL)
Lateral-medial course from tibia to femur Limits posterior movement of tibia Stronger
Awks lecture 18
lateral and Medial Meniscus
Lateral meniscus
Nearly circular Attached to the PCL More mobile
Medial meniscus
C-shaped, deeper Attached to the TCL
Superficial gluteal tissues drain to ______
Deep gluteal tissue drainage follows ______
Superficial gluteal tissues drain to superficial inguinal nodes
Deep gluteal tissue drainage follows** gluteal vessels**
Posterior Thigh
Arterial supply to compartment: ______
Nerve supply to compartment: ______
Main actions of compartment muscles: ______
Arterial supply to compartment:
Deep femoral a. (via perforating branches)
Nerve supply to compartment: Sciatic n. (mostly tibial division)
Main actions of compartment muscles: **Hip Extesnion and Knee Flexion **
Semitendinosus
Biceps femoris, long head
PA: Ischial tuberosity
DA: Tibia (superior medial) Act: Extend thigh; flex leg Inn: Tibial n. (L5, S1, S2)
Semimembranousus:
PA: Ischial tuberosity
DA: Medial condyle of tibia
Act: Extend thigh; flex leg
Inn: Tibial n. (L5, S1, S2)
Biceps femoris, long head
PA: Ischial tuberosity
DA: Head of fibula
Act: Extend thigh; flex leg
Inn: Tibial n. (L5, S1, S2)
Biceps femoris, short head
PA: Lateral lip of linea aspera
DA: Head of fibula
Act: Flex leg
Inn: Common fibular n. (L5, S1, S2)
Clincial Note
The “hamstrings” (____) can be injured when the hip is ___
____ avulsion occurs near the common proximal attachment and can cause associated ____
Clincial Note
The “hamstrings” (semitendinosus, semimembranosus, and biceps femoris long head) can be injured when the hip is flexed and knee extended.
Tendon avulsion occurs near the common proximal attachment and can cause associated avulsion fracture of the ischial tuberosity
Pes anserinus (“Goose’s foot”)
Common attachment on superior medial tibia of:
Sartorius (anterior compartment) Gracilis (medial compartment) Semitendinosus (posterior compartment)
Posterior thigh
Arterial supply: ____
Motor Innervation:
Tibial division of sciatic nerve:
_____
Common fibular division of sciatic nerve:
______
Arterial supply: Perforating branches of the deep femoral artery
Motor Innervation:
Tibial division of sciatic nerve:
semitendinosus semimembranosus biceps femoris long head
Common fibular division of sciatic nerve:
biceps femoris short head
