MSK the hip Flashcards
muscles of the gluteal region
Which nerve is damaged when a positive Trendelenberg’s Sign is seen?
superior gluteal nerve
> supplies gluteus medius > responsible for the stabilisation of the pelvis.
Where do the gemellus muscles receive their nerve supply?
twinning theives
> steal nerve supply from muscle inferior to it
superior gemelli (nerve to obturator internus) inferior gemelli (nerve to Quadratus femoris)
To what does the gluteus maximus attach?
gluteal tuberosity.
This is the lateral ridge of the linea aspera of the femur, and runs inferiorly from the greater trochanter of the femur.
In osteoarthritis of the hip, to where does pain radiate?
knee
Which injury has the highest risk of damaging the sciatic nerve?
A posterior hip dislocation
>due to the position of the femoral head and its very close relationship to the sciatic nerve.
How do you locate the correct site for a gluteal intramuscular injection
palm over the greater trochanter of femur
thumb towards inguinal region
index finger towards ASIS
spread thumb and index apart to make V
> inject between PIP joints of fingers into gluteus medius muscle
which muscles do flexion at hip joint and there nerve supply?
Pectineus Iliopsoas: Iliacus Psoas major Psoas minor (very weak) Sartorius Rectus femoris
> femoral nerve supply for all
apart from psoas major and minor which is anterior rami of lumbar plexus.
which muscles do extension at hip joint and there nerve supply?
Gluteus maximus Biceps femoris (long head) Semimembranosus Semitendinosus (Hamstring part of adductor magnus)
> all tibial part of sciatic nerve
apart from gluteus Maximus which is inferior gluteal nerve
which muscles do abduction at hip joint and there nerve supply?
Gluteus medius
Gluteus minimus
Tensor fascia lata
Sartorius
> all superior gluteal nerve
apart from sartorius which is femoral
which muscles do adduction at hip joint and there nerve supply?
Adductor longus Adductor brevis Adductor magnus Gracilis Pectineus Obturator externus
> all obturator
apart from pectineus which is femoral
example causes of secondary arthritis?
obesity trauma malignancy infection inflammatory arthritis endocrine abnormalities e.g. diabetes mellitus
symptoms of patient with osteoarthritis?
- pain radiating to knee
- reduced mobility
- crepitus: crunching sound when bones grind on eachother
- joint stiffness after sitting for long period or when getting out of bed
four cardinal signs of Osteoarthritis on an X-ray?
osteophytes
loss of joint space
subchondral sclerosis (hardening of the bone)
subchondral bone cysts
symptoms of a NOF # (neck of femur fracture)
pain in hip/groin/knee
inability to weightbear
reduced mobility
what are the two components of sciatic nerve?
Tibial and common perineal (common fibular)
