Orthopaedics Flashcards
What is the most superior landmark on the bony pelvis?
Iliac crest
The obturator foramen is positioned … to the acetabulum
Inferior
List some features of the male pelvis
Male: Narrow heart-shaped pelvic inlet Wide pubic arch Everted margins of the pubic arch Narrow and deep greater sciatic notch Ischial spines project more inward Ischial spines tuberosities less everted Smaller distance between the pubic tubercles Wider acetabulum Large and oval obturator foramen Absent pre auricular sulcus Coccyx projected anteriorly and is more fixed Sacrum is long, narrow and curved throughout it's length
List some features of the female pelvis
Female: Wide circular pelvic inlet Narrow pubic arch Not everted margins of the pubic arch Wide and shallow greater sciatic notch Ischial spines project more outwardly More everted ischial tuberosities Greater distance between the pubic tubercles Narrower acetabulum Pre auricular present Straight and flexible coccyx Short, wide and straighter sacrum
When does the ischial rams fuse to the inferior ramus of the pubis?
Between 5-8 years of age
When does the acetabulum fuse?
Between 11-15 years of age
What are the three primary centres of ossification associated with?
The ilium
The ischium
The pubis
How many secondary centres of ossification are there?
5
Where is the primary ossification centre of the femur located?
The midshaft
When does the primary ossification centre of the femur appear?
7th-8th week in utero
How many secondary ossification centres are there in the femur, and where are they?
1) Proximal femur - appears before birth
2) femoral head - 4-6 months old
3) Greater trochanter - 2-5 years old
4) Lesser trochanter - 11 years
What structure is attached around the margin of the acetabulum, but can not be seen on radiographs?
Acetabular labrum
What are the proximal and distal attachments of the iliofemoral ligament?
Proximal: anterior inferior iliac spine & margin of the acetabulum
Distal: intertrochanteric line
Name the 3 ligaments associated with the hip joint
Iliofemoral
Ischiofemoral
Pubofemoral
In what position is the hip most unstable, and why?
Flexion and medial rotation - the head of the femur is mostly out of the acetabulum and capsule, and the ligaments are all unwound so are ‘loose’
What is the embryological role of the ligament teres?
Transmits blood vessels to the femoral head
Recent research has suggested that the ligamentum treres plays a role in preventing …?
Dislocation of the femoral head, and initiating a reflex response to prevent excessive movements
Where does the major blood supply to the head of the femur enter?
The capsule at the base of the femoral neck
An intra-capsular fracture of the femoral head disrupts femoral head vessels and can result in…
Avascular necrosis
How is an intra-capsular fracture of the femoral head treated?
Replacement of the entire femoral head (usually a heme-arthroplasty), to prevent bleeding and avascular necrosis
Which action des iliopsoas perform?
Hip flexion
What gluteus muscles are involved in abduction?
Gluteus medius and Gluteus minimus
What action does gluteus maximums perform?
Hip extension
What action does performis perform?
Lateral rotation