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Gross Anatomy > Mod 3: Lecture 2 - Gluteal Region and Hip Joint > Flashcards

Mod 3: Lecture 2 - Gluteal Region and Hip Joint Flashcards

1
Q

Pelvic Bone/ Innominant Bone

A
  • Fusion of three bones
  • — ilium
  • — ischium
  • — pubis
  • — fusion occurs between 15-17 years of age
  • Acetabulum
  • — where the 3 bones unite
  • — the circle at the bottom of the pelvis
  • — location of femoral head articulation
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2
Q

Ilium

A
  • big round flat top part
  • Iliac Crest: top curve of the bone
  • — at the L4 vertebral level
  • ASIS: anterior superior iliac spine
  • — the front end of the iliac curve
  • AIIS: anterior inferior iliac spine
  • —- below the iliac curve, the bump after the inward curve
  • PSIS: posterior superior iliac spine
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3
Q

Ischium

A
  • bottom and back of the inferior circle
  • Ischial Tuberosity: a bump at the posterior inferior part
  • — supports you when you sit
  • Ischial Spine: a pointy projection at the back of the pelvis
  • Ramus of Ischium: extends from the ischial tuberosity to inferior pubic ramus
  • — contributes to the ischiopubic ramus
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4
Q

Pubis

A
  • top and center of the inferior circle
  • Infer Pubic Ramus: contributes to the ischiopubic ramus
  • Super Pubic Ramus: the top part of the inferior circle
  • Pubic Tubercle: a little jutting out right before the pubic symphysis
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5
Q

Pelvis/ Pelvic Girdle

A
  • formed by two pelvic bones and the sacrum
  • — each pelvic bone consists of three fused bones
  • — the sacrum is five fused bones
  • False Pelvis/ Pelvis Major: contains abdominal viscera
  • — the space between the ilium
  • True Pelvis/ Pelvis Minor: contains pelvic viscera
  • — the stuff in the giant circle below the ilium
  • Pelvic Brim: separates true from false pelvis
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6
Q

Joints within the Pelvis

A
  • Pubic Symphysis: syndesmosis
  • — a cartilaginous disc between the right and left pubis
  • —- anterior
  • Sacroiliac (SI) Joint: synovial joint
  • — between the sacrum and the ilium
  • — posterior
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7
Q

Obturator Foramen

A
  • formed by the ischium and pubis
  • — inferior circle
  • — directly below the acetabulum
  • nearly closed by the obturator membrane
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8
Q

Greater Sciatic Notch

A
  • superior to ischial spine
  • — curved indent in the ilium, right above the ischium
  • — seen in a lateral view
  • converted to a foramen by the sacrospinous ligament
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9
Q

Lesser Sciatic Notch

A
  • inferior to the ischial spine
  • — curved indent in the ischium
  • — seen in a lateral view
  • converted to a foramen by the sacrospinous and sacrotuberous ligaments
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10
Q

Ligament Attachments

  1. Sacrospinous
  2. Sacrotuberous
A
  1. sacrum and coccyx to ischial spine

2. PSIS and sacrum to ischial spine

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11
Q

Greater Sciatic Foramen

A
  • further divided by piriformis muscle
  • Above piriformis: superior gluteal nerves
  • Below piriformis:
  • — inferior gluteal nerves
  • — sciatic and pudendal nerves
  • — cutaneous nerves
  • — nerves to lateral rotators
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12
Q

Lesser Sciatic Foramen

A
  • tendon of obturator internus

- pudendal nerves to perineum

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13
Q

Obturator Canal

A
  • obturator nerve and vessels
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14
Q

Proximal Femur

A
  • Femoral Head: fits deep within the acetabulum
  • Femoral Neck: frequent site of fractures
  • Greater and Lesser Trochanter: both are the site of multiple muscle attachments
  • Intertrochanteric Line: located anteriorly between the greater and lesser trochanters, the site of ligaments support the hip joint (iliofemoral)
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15
Q

Proximal/Body of the Femur

A
  • Linea Aspera: vertical ridge of bone which serves as an area for multiple muscle attachments
  • Gluteal Tuberosity: ridge of bone between greater trochanter and linea aspera
  • — bumps out more than the linea aspera
  • Pectineal Line (posterior): ridge of bone between the lesser trochanter and linea aspera
  • — kind of diagonal
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16
Q

Distal Femur

A
  • Linea Aspera: vertical ridge of bone which serves as an area for multiple muscle attachments
  • Medial and Lateral Supracondylar Ridge: posterior, extend down from the aspera to the medial and lateral condyles
  • Adductor Tubercle: site of muscle attachment
  • — found above the medial condyle
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17
Q

Hip Joint

A
  • formed by the acetabulum of the pelvic bone and head of the femur
  • ball and socket joint
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18
Q

Acetabulum (bony)

A
  • formed by ilium, pubis, and ischium right above the obturator foramen
  • bony cup does not extend inferiorly
  • — this area is closed by the transverse acetabular ligament (which is important for stability)
  • — this is where the acetabulum runs into the obturator foramen
19
Q

Acetabular Labrum

A
  • fibrocartilagenous structure
  • attaches to bony rim of acetabulum
  • — continuous with the transverse acetabular ligament
  • deepens the acetabulum and contributes to joint stability
  • Lunate Surface: acetabular hyaline cartilage on the ridge of the labrum
  • — horseshoe shaped, does not cover the ligament
  • — fat is located centrally
20
Q

Movements of the Femur

A
  • Flexion/Extension
  • Abduction/Adduction
  • Medial/Lateral Rotation
21
Q

Pelvic Motion

A
  • Anterior and Posterior Tilt
  • — sagittal plane around coronal axis
  • — anterior: hip flexion, pubic symphysis forward, ilium back
  • — posterior: hip extension, pubic symphysis back, ilium forward
  • Lateral Tilt
  • — frontal plane around sagittal axis
  • — produces hip abduction: ilium tilts down
  • — produces hip adduction: ilium tilts up
22
Q

Ligaments of the Hip

A
  • Anterior and Posterior Sacroiliac Ligament
  • Iliofemoral
  • Pubofemoral
  • Ischiofemoral
23
Q

Anterior and Posterior Sacroiliac Ligament

A
  • support sacroiliac joint
  • — in between the ilium and sacrum
  • synovial plane
  • one in the front (anterior) and one in the back (posterior) per side
  • — so there is a left set and a right set
24
Q
  1. Iliofemoral Ligament
  2. Pubofemoral Ligament
  3. Ischiofemoral Ligament
A

1, 2, 3. - connect the femur to the pelvis

  • wrap around the femur head and the hip by the acetabulum
  • reinforce and stabilize the hip joint
  • fibers are oriented in a spiral and are taut in extension
    1. anterior - seen from the front
    2. anteroinferior - same spot as 1, just lower, also seen from the front
    3. posterior - seen from the back
25
Q 
A. Iliacus Muscle 
B. Psoas Major 
1. Attachments 
2. Action 
3. Innervation
A 
A ,B. -  posterior abdominal wall 
- paired 
- often referred to as the iliopsoas 
1 A.  - top of ilium, - proximal femur
1 B. - lumbar spine, - proximal femur
2 A, B. - together, they are the strongest flexors in the hip 
3 A, B. femoral nerve
26
Q 
A. Psoas Minor 
B. Quadratus Lumborum 
1. Attachments 
2. Action 
3. Innervation
A 
A, B. - posterior abdominal wall
- paired 
- does not cross the hip joint 
1 A. - lumbar spine, - ilium 
1 B. - lower rib, - ilium 
2. 
3 A, B. ventral rami of upper lumbar levels
27
Q

Gluteal Muscles

A
  • Gluteus Maximus
  • Gluteus Medius
  • Gluteus Minimus
  • Tensor Fascia Latae
28
Q

Gluteus Maximus

  1. Attachments
  2. Action
  3. Innervation
A
  • superficial
    1. - butt cheek
    2.
    3. inferior gluteal nerve
29
Q 
A. Gluteus Medius 
B. Gluteus Minimus 
1. Attachments 
2. Action 
3. Innervation
A

A. deep
B. deepest, directly under A
1 A, B. superior and lateral diagonal of butt cheek
2 A, B. when walking, constriction on stance side of the hip prevents excessive pelvic tilt during swing phase of the leg on the opposite side of the hip
3 A, B. superior gluteal nerve

30
Q

Tensor Fascia Latae

  1. Attachments
  2. Action
  3. Innervation
A
  • small muscle in the gluteal region
    1. - the connective tissue on the lateral side of the thigh
    2.
    3.
31
Q

Hip Lateral Rotators

  1. Attachments
  2. Action
  3. Innervation
A
  • From superior to inferior:
  • —- Priformis - Gemellus Superior - Obturator Internus - Gemellus Inferior - Obturator Externus - Quadratus Femoris
    1. - anterior sacrum, ischium
  • greater trochanter of femur
    2. lateral rotation of hip
    3. sacral plexus
32
Q

Nerves to the Lower Extremity from the Lumbar Plexus

A
  • Femoral Nerve
  • — Saphenous Nerve
  • Obturator Nerve
  • Lumbosacral Trunk
33
Q

Femoral Nerve

A
  • emerges from the lateral border of the psoas major
  • —- innervates the iliacus
  • passes deep to the inguinal ligament/iliopubic tract to the anterior thigh
  • — supplies the flexors of the hip and extensors of the knee
34
Q

Saphenous Nerve

A
  • branches from the femoral nerve

- supplies the skin on the medial side of the ankle and foot

35
Q

Obturator Nerve

A
  • emerges from the medial border of the psoas major and passes into the pelvis
  • — passes through the obturator foramen, inferior to the superior pubic ramus
  • goes to the medial thigh
  • — supplies the adductor muscles
36
Q

Lumbosacral Trunk

A
  • associated with the sacral plexus
  • formed by the ventral rami of L4 and L5
  • participates in the formation of the sacral plexus with the anterior rami of the S1-S4 nerves
37
Q

Nerves to the Lower Extremity from the sacral plexus

A
  • Sciatic Nerve
  • —- Tibial Nerve
  • — Common Fibular (Common Peroneal) Nerves
  • Posterior Cutaneous Nerve of the Thigh
  • Superior and Inferior Gluteal Nerves
  • Nerve to the Quadratus Femoris
  • Nerve to the Obturator Internus
38
Q

Sciatic Nerve

A
  • largest nerve in the body

- gives rise to the Tibial nerve and the common fibular nerves

39
Q

Tibial Nerve

A
  • innervates all but one muscle of the posterior compartment of the thigh
  • — not the short head of the biceps femoris
  • innervates all muscles of the posterior compartment of the lower leg
  • — deep and superficial
  • the sural nerve arises from the tibial nerve
40
Q

Sural Nerve

A
  • arises from the tibial nerve
  • — though sometimes with a contribution from the common peroneal (common fibular) nerve
  • supplies the skin on the posterior and lateral aspects of the leg
41
Q

Common Fibular (Common Peroneal) Nerve

A
  • innervates only the short head of the biceps femoris muscle in the thigh
  • divides into the superficial and deep fibular nerves around the head of the fibula
  • — superficial: muscles in the lateral leg compartment
  • —- deep: muscles in the anterior leg compartment
42
Q

Clinical Correlation: Total Hip Replacement (THR)

A
  • Indications: done for arthritis or a fractured femur
  • Surgical Approach: the head of the femur is replaced with a prosthetic and a disk is put around the acetabulum
  • Post-Op Precautions
  • — don’t move the hip into extreme positions, such as extreme hip flexion or abduction
  • — OTs work with the patients to prevent dislocation of the new hip prosthesis
  • — OTs give adaptive equipment to prevent hip movements
43
Q

Adaptive Equipment for a Total Hip Replacement

A
  • Reacher
  • Long Handled Shoehorn
  • Dressing Stick
  • Sock-Aid
  • Long Handled Sponge
  • Elastic Shoelaces
  • help with dressing and washing of the lower extremity without excessive movement

Gross Anatomy (14 decks)

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