MSK3 L16 - Pelvic Girdle and Hip Flashcards
3 functions of the lower limb
- movement and bipedal locomotion
- weight bearing
- force transmission
4 regions of the lower limb
- gluteal
- thigh
- leg
- foot
What movements occur through this plane?
Sagittal
flexion and extension
What movements occur through this plane?
Coronal/frontal
abduction and adduction
What movements occur through this plane?
Transverse
rotation
internal/medial and external/lateral
What movements occur through this plane?
All
circumduction
What is the 1st tissue in the lower limb?
Superficial –> deep
skin
What is the 2nd tissue in the lower limb?
Superficial –> deep
Superficial fascia
layer of fibrous tissue
What is the 3rd tissue in the lower limb?
Superficial –> deep
deep fascia
What is the 4th tissue in the lower limb?
Superficial –> deep
muscle
What is the 5th tissue in the lower limb?
Superficial –> deep
bone
What do muscles in a compartment share?
- a common function
- common blood and nerve supply
Nervous system: three plexuses
- cervical
- brachial
- lumbosacral
What part of the body does this plexus supply?
Cervical
the neck
What part of the body does this plexus supply?
Brachial
the upper limb
What part of the body does this plexus supply?
Lumbosacral
lower limb
formed by anterior rami of L1-S4
All muscles need a nerve…
Three main nerves for lower limb?
- sciatic
- femoral
- obturator
plus gluteal nerves
Arterial supply
What names does the abdominal artery change to from approx the lumbar spine to the femur?
abdominal artery –> _____ –> _____ –> _____ –> _____
abdbominal artery –> common iliac artery –> internal iliac artery –> external iliac artery –> femoral artery
deep veins of the same name accompany the arteries, joints and skin also recieve vascular supplies
Veins function?
to return deoxygenated blood back towards the heart
Features of veins
- veins have _ blood pressure
- … blood in the lower limb needs to move … …
- veins have … to prevent … against …
- low
- venous, against gravity
- valves, backflow, gravity
Two mechanisms help venous blood movements
what are they called?
- arteriovenous pump
- musculovenous pump
What does the arteriovenous pump do?
arterial pulse helps warm and push blood in accompanying veins
What does the musculovenous pump do?
when skeletal muscles contract, muscle swells and the expansion helps propel venous blood
Limbs two venous systems
- superficial
- deep
Where is this venous system?
Superficial
outside of the deep fascia
Where is this venous system?
Deep
inside the muscle compartment
Two major superficial veins in the lower limb?
- great saphenous
- small saphenous
Two major superficial veins in the lower limb?
- great saphenous
- small saphenous
What vein does this major vein empty into?
Great saphenous
into the femoral vein
What vein does this major vein empty into?
Small saphenous
into the popliteal vein
What can happen when valves fail?
What condition
varicose vein
Pelvic girdle definition?
… … connected by … … and … …
osteoligamentous ring connected by sacroiliac joint (SIJ) and pubic symphysis
Pelvic girdle consists of?
3 things
- sacrum
- hip bones
- many ligaments
Pelvic girdle articulates with?
give anatomical direction
- laterally = femora x 2
- inferiorly = coccyx
- superiorly = L5 (disc and vertebral body)
Sacroiliac ligaments help stabilise the SIJ’s
Sacroiliac ligaments consist of
3
- anterior
- interosseous (between bone)
- posterior
Sacrum consists of
4 features
- 5 fused vertebrae
- sacral canal (superior)
- sacral hiatus (inferior)
- contains spinal nerves
What vertebrae does the spinal cord end at?
L1/L2
Look at an unlabeled image of a lateral view of the pelvis
Features of pelvis
lateral view (4)
- gluteal lines
- ischial spine
- ischial tuberosity
- acetabulum
look at an unlabeled image of a medial view of the pelvis
Features of pelvis
medial view (6)
- articular surface
- iliac crest
- iliac fossa
- anterior superior iliac spine
- anterior inferior iliac spine
- obturator foramen
Pelvis consists of 3 bones
- ilium
- ischium
- pubis
Ischial tuberosity
attaches? movements caused? (2)
hamstrings
- extends thigh
- flexes knee
What is the obturator foramen covered by?
obturator membrane
What passes through the obturator foramen?
Obturator nerve vessels
What is superior to the inguinal ligament?
relevance?
inguinal canal
relevance to inguinal hernia
What is inferior to the inguinal ligament?
what happens here?
femoral artery
location for catheterisation
functions of sacrospinous and sacrotuberous ligaments
2
- resists rotation of sacrum between hip bones
- forms boundaries of greater and lesser sciatic foramina
What structures exit through the greater sciatic foramen?
3
- piriformis muscle
- superior and inferior gluteal nerves and associated blood vessels
- sciatic nerve
What do the inferior gluteal nerves supply?
gluteal muscles
What does the sciatic nerve supply?
2
- posterior muscles of the thigh
- all leg and foot muscles
What muscles attach to the greater trochanter?
2
- gluteus medius
- gluteus minimus
What muscles attach to the lesser trochanter?
2
- psoas major
- iliacus
Bony components of hip joint?
2
- head of femur
- acetabulum
Functions of hip joint?
4
- links lower limb to pelvis
- transmits upper body weight to lower limb
- designed for stability (most stable joint)
- 2nd most movable joint in the body
Two layers of joint capsule?
name, tissue
- outer, fibrous layer
- inner, synovial membrane
Where does the joint capsule attach?
- margin of the acetabulum
- femoral neck
Joint capsule is reinforced by ligaments
Functions of capsular ligaments?
3
- stabilises and strengthens the joint
- all ligaments are tight with hip extension e.g. in standing
- energy efficiency
Capsular ligaments?
3, identify which is strongest
- iliofemoral (Y-shaped, strongest)
- ischiofemoral
- pubofemoral
What is the acetabular labrum?
fibrocartilage structure, attached to the rim of the acetabulum
What does the acetabular labrum do?
it increases the articular area by ~10%, thus helps to fit the femoral head to the acetabulum
