Lecture 5: Small Animal Coxofemoral Joint and Pelvis Flashcards
What four bones make up the pelvis
Ilium, pubis, acetabulum, ischium
identify bones 1-4
- Ilium
- Ischium
- Acetabulum
- Pubis
What is the purpose of the box like structure of the pelvis
To provide integrity to the caudal half of the body
What important structure runs over the greater ischiatic notch
Sciatic
Why are bone fractures/injuries to the pelvis more dangerous than other bones
Many structures pass through the pelvis so there can be further damage internally
Identify #1
Greater ischiatic notch
What structure is easily palpable on the proximal end of the femur
Greater trochanter
Where does the ligament of the femoral head attach
Fovea on femur and acetabulum on pelvis
Identify structures 1-7
- Head of femur
- Neck of femur
- Lesser trochanter
- Greater trochanter
- Trochanteric fossa
- Fovea
7.neck of femur
Identify 1-12 and what is indicated by the red arrow
- Iliac crest
- Sacroiliac joint
- Body of ilium
- Acetabulum
- Ischium
- Ischiatic tuberosity
- Pubis
- Obturator foramen
- Femoral head
- Greater trochanter
11.intertrochanteric crest - Dorsal rim of acetabulum
Red arrow: colon with feces
What is indicated by arrows 1-3
- Sacroiliac joint
- Sacrum
- Obturator foramen
What is indicated by the red, green and blue circles
red: femoral head- capital physis
Green: greater trochanter growth plate
Blue: distal femur growth plate
What 3 structures stabilize the coxofemoral joint
Joint capsule, muscular sling, ligament of the head of the femur
If the ligament of the head of the femur is torn is the joint still stable?
Yes, the muscular sling and joint capsule can stabilize the coxofemoral joint
Ex: FHO
identify 1-3
- Acetabulum
- Femoral head
- Ligament of the head of the femur
What is indicated by 1-2 yellow arrows
- Greater trochanter
- Fovea
What muscles are the hip extensors
- Hamstrings (bicep femoris, semimembranosus, semitendinosus)
- Deep gluteal
- Middle gluteal
What muscles are hip flexors
- Iliacus, iliopsoas, rectus femoris
Where does the iliacus cross over and insert
Crosses over: cranioventral ilium
Insert: lesser trochanter
What nerve innervates the iliacus
Femoral
Where does the iliopsoas originate and insert
Origin: 4-6th vertebrae
Insert: lesser trochanter
What nerve innervates the iliopsoas
Femoral
Identify 1-4
- Middle gluteal
- Semimembranosus
- Semitendinosus
- Bicep femoris
identify 1-2
- Psoas major
- Iliacus
identify #1
- Rectus femoris
Rectus femoris is typically a stifle extensor but what other movement does it perform and how is that achieved
Flexes hip, able to do so due to high attachment of muscle
What are the hip rotators
- Quadratus femoris
- Gemellus
- Internal Obturator
- External Obturator
Case example: Macbeth 7yr, NM Siamese HBC at 2yr no sx performed, obstinate for past 6 months. Follow X-ray was taken, what is wrong
Build up of feces in the colon.
Acetabulum abnormality result of HBC at 2yr, healing fairly well given no surgery but there is a closing of the pelvic canal not allowing for feces to pass through
Not all pelvic fractures need to be fixed, what are the 3 scenarios in which a pelvic fracture requires surgery
- Affecting weight bearing structures like the femur, acetabulum, wing of ilium, and SI joint
- Pelvic canal narrows > 45%
- Evidence of neurological injury
identify the problem in this X-ray does this require surgery
Fracture of ischium
Does not require surgery since non weightbearing
What is wrong here and does this require surgery
Acetabulum fracture, requires surgery because weight bearing
What is wrong here and what caused it
Coxofemoral luxation due to a torn ligament of femoral head and joint capsule
Case example: 3mo, FI kitten, stray. Presents in shock, severely hypotensive, can’t palpate peripheral vessels well due to hypotension and small size. What is an alternative way to administer fluid
Intraosseous catheter placement
What structure are you aiming for when placing an IO catheter
Trochanteric fossa
Case example: 4yr, FS, Golden with chronic stiffness getting up from rest, improves after few minutes, sore after long activity, NSAIDs help. following X-ray was taken, what is the problem
Hip dysplasia
What factors contribute to hip dysplasia
Genetics, nutrition, body weight, rate of growth
Too much movement/laxity in hip dysplasia can cause what
Secondary OA
What are some characteristics commonly seen on X-rays of patients with hip dysplasia
- Flattening of the femoral heads
- Thickening of femoral neck
- Acetabular remodeling
- Osteophytes
What abnormality is present that would be indicative of hip dysplasia
Neck connecting to femur is thickened, less pronounced
Identify the abnormalities present here
subluxated coxofemoral joint but also hip dysplasia, degenerative joint changes
Identify abnormalities
No abnormalities present, femoral head is round and smooth, ligament and acetabulum are healthy
identify the abnormalities
Femoral head is flattening/straight edge from rubbing against acetabulum
Identify the abnormalities
Aggressive flattening of femoral head, also danger active changes along the distal aspect of the femoral head
Subluxation, hip dysplasia
Case example: 8mo, FS, Doberman got LHL caught and acutely non-weight bearing lame, pain and crepitus on manipulation of left hip. The following X-ray was taken wha this the problem
Capitis physeal fracture
Notice the head of the femur is not perfectly aligned with the rest
What are some treatment options for a capitis physeal fracture
Pin or can do FHO as the muscles and joint capsule can stabilize hip
Case example: 1yr, FS, West Highland Terrier with stiffness on RHL for 2-3 days, no known trauma, painful with crepitus on manipulation of right hip. The following X-ray was taken, what is the problem
aseptic necrosis of the femoral head
When does aseptic necrosis of femoral head typically occur and in what breeds
Between 4-11 months in mini poodles, Westies and other terriers
What is the treatment for aseptic necrosis of the femoral head
FHO
Case example: 1yr, NM, DSH acutely lame LHL, unknown if any trauma, painful on manipulation of both hips. The following X-ray was taken what is the problem
Capital physeal dysplasia
What is wrong in this X-ray
capital physeal dysplasia
What causes capital physeal dysplasia
Persistently open growth plates that become weak and disorganized
Where is an appropriate spot for a forelimb bone marrow aspirate
Deltoid tuberosity
What is an appropriate spot for a hindlimb bone marrow aspirate
Wing of ilium
