LOCO Anatomy1b: lower limb Flashcards
Which of the below does the inferior gluteal nerve & vessel exit the pelvis?
Greater sciatic foramen
Obturator foramen
Lesser sciatic foramen
Deep to inguinal ligament
Greater sciatic foramen
Which of the below does the sciatic nerve exit the pelvis?
Greater sciatic foramen
Obturator foramen
Lesser sciatic foramen
Deep to inguinal ligament
Greater sciatic foramen
Which of the below does the external iliac vessels exit the pelvis?
Greater sciatic foramen
Obturator foramen
Lesser sciatic foramen
Deep to inguinal ligament
Deep to inguinal ligament
Which of the below does the pudendal nerve & vessels exit the pelvis?
Greater sciatic foramen
Obturator foramen
Lesser sciatic foramen
Deep to inguinal ligament
Greater sciatic foramen
Which structures are at risk from this ‘open book’ pelvic fracture? [5]
ureter
bladder
pudendal nerves
external iliac vessels
rectum
obturator nerve
Describe the type of trauma that cause pelvic fractures [1]
Why is this clinically important? [1]
Pelvic fractures are often the result of high energy trauma
Therefore: can be associated with catastrophic injury to the pelvic organs and neurovasculature
What type of pelvic fracture causes bladder damage? [1]
Diastasis (seperation) of the pubic symphysis
What type of fracture causes superior gluteal nerve damage? [1]
sacroiliac joint disruption
Why are pelvic fractures dangerous? [1]
Remember the pelvis is highly vascular, and a patient can exsanguinate from pelvic fractures. This bleeding can be difficult to control, so early identification and restoration of the normal anatomy (e.g. using a pelvic binder) is essential.
There is an impacted, intracapsular fracture of the left neck of femur. Specifically, the position of this fracture can be described as ‘subcapital’, meaning directly below the femoral head.
What is the main blood supply to the head of the femur? [1]
Acceptable responses: circumflex femoral arteries, medial and lateral circumflex femoral arteries, circumflex arteries, medial and lateral circumflex arteries, lateral and medial circumflex femoral arteries, lateral and medial circumflex arteries, medial circumflex artery, medial circumflex femoral artery
Both extracapsular fractures: less risk of damaging vasculature
The joint capsule of the hip extends over the neck of the femur to attach on the [] line
The joint capsule of the hip extends over the neck of the femur to attach on the intertrochanteric line
How are fractures based depending on their proximity to the intertochanteric line?
Fractures of the neck of femur can be classified as either:
- Intracapsular: proximal to the intertrochanteric line, i.e. within the capsule
- Extracapsular: distal to the intertrochanteric line
How can you classify intracapsular neck of femur fractures? [3]
How can you classify extracapsular neck of femur fractures? [2]
Intracapsular fractures include subcapital, transcervical and basicervical.
Extracapsular fractures include intertrochanteric and subtrochanteric.
Which of the following is a subtrochanteric fracture?
A
B
C
D
E
E
Which of the following is a intertrochanteric fracture?
A
B
C
D
E
D
Which of the following is a transcervical fracture?
A
B
C
D
E
C
Which of the following is a subcapital fracture?
A
B
C
D
E
B
Which type of fracture is shown
subcapital
transcervical
basicervical
subtrochanteric
intertrochanteric
intertrochanteric fracture
Common extracapsular fractures of the proximal femur at the level of the greater and lesser trochanter
Which type of fracture is shown
subcapital
transcervical
basicervical
subtrochanteric
intertrochanteric
Basicervical fracture. There is a fracture at the base of the neck of the right femur, just proximal to the trochanters (white arrows). There is varus deformity (white line) of the femoral shaft.
Which type of fracture is shown
subcapital
transcervical
basicervical
subtrochanteric
intertrochanteric
Comminuted intertrochanteric fracture. There is a fracture from the greater to the
lesser trochanter (blue arrow). There are separate fragments of the greater trochanter (white arrow) and lesser trochanter (red arrow). There is varus deformity (white line) of the femoral shaft.
Which type of fracture is shown
subcapital
transcervical
basicervical
subtrochanteric
intertrochanteric
Sub-capital hip fracture. On the frontal view, there is a step-off in the cortex superiorly (red arrow) while there is abnormal overlapping of the femoral head and neck (white arrows) due to impaction. On the lateral view, the same step-off can be seen (red arrow) as well as the impaction (white arrow).
The main blood supply to the femoral head is via the [] and [] arteries.
What are the source of these arteries? [1]
The main blood supply to the femoral head is via the medial and lateral circumflex femoral arteries
Arise from retinacular arteries which pierce the joint capsule
