Pelvic Girdle And Hip Joint

Question 1

Bones in pelvic girdle

Answer 1

Innominates and sacrum

Question 2

Innominate bones

Answer 2

Ilium, ischium, pubis

Question 3

Type of joint articulating sacrum and ilium POSTERIORLY

Answer 3

Fibrous

Question 4

Type of bone between the medial surfaces of the body of each pubic bone (pubic symphysis)

Answer 4

Secondary cartilaginous

Question 5

Functions of pelvic girdle

Answer 5

1. It supports and protects the pelvic viscera.
2. It supports body weight transmitted through the vertebrae, thence through the sacrum, across the
   sacroiliac joints to the innominate and then to the femora in the standing position, or to the ischial tuberosities when sitting.
3. During walking, the pelvis swings from side to side by a rotatory movement at the hip joint which occurs together with small movements at the lumbar intervertebral joints; when the hip joints are fused pelvic rotation is taken up by the thoracic spine enabling a patient to walk reasonably well.
4. As with all but a few small bones in the hand and foot, the pelvis provides attachments for muscle.
5. In females it provides bony support for the birth canal.

Question 6

Sacroiliac joint

Answer 6

Auricular surface of the ilium and the ala of the sacrum

Question 7

Classification of SI joint

Answer 7

Synovial plane joint

Question 8

Type of cartilage covering the sacrum

Answer 8

Hyaline cartilage

Question 9

Type of cartilage covering the ilium

Answer 9

Fibrocartilage

Question 10

Anterior sacroiliac ligament

Answer 10

Ala and pelvic surface of sacrum to auricular surface of the ilium

Question 11

Types of posterior sacroiliac ligaments

Answer 11

interosseus and long and short posterior sacroiliac ligaments

Question 12

Interosseus sacroiliac ligaments

Answer 12

Short but strong and runs from sacrum to ilium on the posterior side

Question 13

Long posterior sacroiliac ligament

Answer 13

Fibres run obliquely and medially
PSIS to the 3rd and 4th transverse tubercles of sacrum
Resist downwards movement of the sacrum with respect to the ilium

Question 14

Short posterior sacroiliac ligaments

Answer 14

1st and 2nd tubercles of the sacrum to the iliac tuberosity
Resist forward movement of the sacral promontory

Question 15

Sacrotuberous ligaments

Answer 15

Superiorly to the posterior border of the ilium between superior and inferior iliac spines to the back and side of the sacrum below the auricular surface and to the side of the upper part of the coccyx to the ischial tuberosity
Fibres pass inferolaterally towards the ischial tuberosity

Question 16

Sacrospinous ligaments

Answer 16

Edge of the lower sacral and upper coccygeal segments anterior to the sacrotuberous ligament to the ischial spine

Question 17

Blood supply to the SI joint

Answer 17

Branches of Iliolumbar artery anteriorly
Branches of superior gluteal artery posteriorly
Drained by iliolumbar vein anteriorly and drained by superior gluteal vein posteriorly to the internal iliac vein

Question 18

Lymphatics of the SI joint

Answer 18

Internal iliac group of nodes

Question 19

Nerve supply to the SI joint

Answer 19

Sacral plexus and dorsal rami of S1 and S2
Superior gluteal and obturator nerves as they pass close to the joint
Roots L4 to S2

Question 20

Movements of SI joint

Answer 20

Slight gliding and rotatory movement between the two bones
When standing the sacrum moves down 2mm and rotates in a forward direction 5 degrees

Question 21

Movements of SI joint in pregnancy

Answer 21

Movement of the sacrum due to the softening of SI ligament = diameters of the pelvic inlet and outlet increasing to facilitate passage to of the fetal head
The sacral promontory moves superiorly and posteriorly increasing the anterosuperior diameter of the pelvic inlet by between 3 and 13 mm.
After the fetal head has entered the pelvic canal the sacral promontory then moves inferoanteriorly increasing the anteroposterior diameter of the pelvic outlet by 15-18mm

Question 22

Hip joint

Answer 22

Articulation of the head of the femur and acetabulum of the innominate

Question 23

Classification of hip joint

Answer 23

Synovial ball and socket

Question 24

Articular surfaces

Answer 24

Acetabulum is formed by = 1/5 pubis, 2/5 ischium, 2/5 ilium
Femur = covered in hyaline cartilage

Question 25

Acetabular labrum

Answer 25

Continues across the acetabular notch as the transverse ligament giving attachment to the ligament of the head of the femur Fibrocartilaginous structure

Question 26

Iliofemoral ligament

Answer 26

Lower part of the ASIS and adjacent acetabular rim and base to the intertrochanteric line

Question 27

Pubofemoral ligament

Answer 27

Iliopubic eminence and superior pubic ramus to the lower part of the intertrochanteric line

Question 28

Ischiofemoral ligament

Answer 28

Body of the ischium to the superior part of the neck and root of the greater trochanter

Question 29

Ligamentum teres

Answer 29

Two bands that originate on the ischial and pubic sides of the acetabular notch and blend with the acetabular transverse ligament between the two attachment sites. The two bands insert on the fovea capitals of the femoral head.

Question 30

Blood supply to the hip joint

Answer 30

Medial and lateral circumflex femoral, obturator and superior and inferior gluteal arteries forming a periarticular anastamosis around the joint.

Question 31

Lymphatics to the hip joint

Answer 31

Arise from the synovial membrane and drain to the deep inguinal and iliac lymph nodes and then to the common iliac nodes.

Question 32

Nerve supply to the hip joint

Answer 32

Lumbar plexus branches - femoral and obturator nerves Sacral plexus - superior gluteal nerve and nerve to quadratus femoris (L2-S1)

Question 33

Hip flexor muscles

Answer 33

Flex the hip and raise the knee Iliopsoas - L2-L4 nerve roots Rectus femoris - femoral nerve Sartorius - femoral nerve Pectineus - femoral nerve

Question 34

Hip extensor muscle

Answer 34

Extend the hip Biceps femoris - sciatic nerve Semitendinosus - sciatic nerve Semimembranosus - sciatic nerve Gluteus maximus - inf. gluteal nerve

Question 35

Hip abductor muscles (away from midline)

Answer 35

Abducts the hip Gluteus minimum - superior gluteal nerve Gluteus medius - superior gluteal nerve Gluteus maximus - inferior gluteal nerve Tensor fascia lata - superior gluteal nerve

Question 36

Hip adductor muscles (towards the midline)

Answer 36

Adducts the hip Adductor longus - obturator nerve Adductor brevis - obturator nerve Adductor Magnus - obturator nerve Gracilis - obturator nerve Pectineus - femoral nerve

Question 37

Medial rotators of the hip

Answer 37

Medially rotate the hip Anterior part of gluteus medius - superior gluteal nerve Anterior part of gluteus minimus - superior gluteal nerve Tensor fascia lata - superior gluteal nerve Iliopsoas - L2-L4 nerve roots

Question 38

Lateral rotators of the hip

Answer 38

Laterally rotate the hip Gluteus maximus - inferior gluteal nerve Piriformis - anterior rami of sacral plexus Gemellus superior - nerve to obturator internus Gemellus inferior - nerve to quadratus femoris Obturator externus - posterior branch of obturator nerve Obturator internus - nerve to obturator nerve

Question 39

Type of joint articulating sacrum and ilium ANTERIORLY

Answer 39

Synovial plane

Question 40

SI Joint capsule

Answer 40

Complete fibrous capsule that surrounds the joint attaching to the articular margin

Question 41

Capsule of hip joint