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appendicular muscoskeletal anatomy and pattern recognition > pelvis and hip > Flashcards

pelvis and hip Flashcards

1
Q

the pelvis description

A
  • THE PELVIC GIRDLE IS MADE UP OF TWO HIP/INNOMINATEBONES / HEMIPELVIS
  • SEPARATED POSTERIORLY BY SACRUM AND ANTERIORLY ATSYMPHYSIS PUBIS
  • BONY RING, STRONGLY HELD BY EXTENSIVE LIGAMENTOUS COMPLEX
  • EACH COMPRISED OF THREE PARTS:
    • ILIUM (ILIAC BONE)
    • ISCHIUM
    • PUBIS
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2
Q

pelvis

A

IN REGIONAL / SOFT TISSUE ANATOMY IS SPLIT INTO TWO PARTS:
* FALSE/GREATER PELVIS; SUPERIOR AND PART OF ABDOMEN
* TRUE/LESSER PELVIS; INFERIOR AND HAS AN INLET AND OUTLET
* OBLIQUE LINE FROM SYMPHYSIS PUBIS TO SACRAL PROMONTORY(L5S1)
* FOR MSK PURPOSES THIS IS LESS SIGNIFICANT

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3
Q

pelvis inlet/outlet

A

RING-SHAPED STRUCTURES WITHIN TRUE PELVIS
* INLET:
* SUPERIOR
* CIRCULAR/HEART-SHAPED BONY RING
* JUNCTION BETWEEN ABDOMEN/PELVIS
* ANGLED 50-60 DEGREES TO CORONAL PLANE
* OUTLET:
* INFERIOR
* DIAMOND-SHAPED BONY/LIGAMENTOUS
* JUNCTION BETWEEN PELVIS AND PERINEUM (PELVIC FLOOR)
* ANTERIOR FORMED BY INFERIOR PUBIC RAMI, POSTERIOR BYLIGAMENTS
* HORIZONTAL PLANE

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4
Q

male pelvis

A

shape: narrow, long
structure: heavy
sacrum: narrow, long and curved
pelvic inlet: heart shaped/ triangular
ischial tuberosities: closer together
pubic arch: acture <90 degrees
greater sciatic notch: acute/narrower

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5
Q

female pelvis

A

shape: wide, short
structure: light
sacrum: wide, short, straighter
pelvic inlet: circular
ischial tuberosities: obtuse >90 degrees
greater sciatic notch: obtuse/wider

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6
Q

functions of the pelvis

A

bearing the weight of individuals superior to the pelvis
stabilizing them, and allowing them to sit
stand as the legs located inferiorly move

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7
Q

hip bones/hemipelvis

A

ALSO CALLED INNOMINATE BONES
* PAIRED BONES (USEFUL IN IMAGE INTERPRETATION)
* COMPRISED OF 3 PRIMARY OSSIFICATION CENTRES (PARTS):
* ILIUM (NOT ILEUM)
* ISCHIUM
* PUBIS
* FORMED SEPARATELY BUT FUSE IN ADOLESCENCE (15-25)

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8
Q

OC pelvis

A

PRIMARY:
* ILIUM (8TH WEEK IN UTERO)
* ISCHIUM (4 MONTHS)
* PUBIC (4-5MONTHS)
* SECONDARY (COMMON SITES FOR AVULSION) FRACTURE):
* ILIUM: ILIAC CRESTS AND AIIS (PUBERTY)
* ISCHIAL TUBEROSITY (PUBERTY)
* SYMPHYSIS PUBIS (PUBERTY)
* FUSION BETWEEN ~15-25 YEARS

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9
Q

illiac bone/ilium

A
  • MEDIAL ASPECT ADJOINS ABDOMEN, LATERAL ISLOWER LIMB (RELATES TO ORIGIN OF STRUCTURES)
  • FAN-SHAPED
  • KEY FEATURES/SOFT TISSUE ATTACHMENTS:
    * ILIAC CREST/TUBERCLE
    * ILIAC FOSSA (INTERNAL)
    * GLUTEAL SURFACE (EXTERNAL)
    * ANTERIOR SUPERIOR ILIAC SPINE (ASIS)
    • POSTERIOR SUPERIOR ILIAC SPINE (PSIS)
    • ANTERIOR INFERIORS ILIAC SPINE (AIIS)
    • SUPERIOR RIM OF ACETABULUM
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10
Q

ilium attachments

A
  • ILIAC CREST – QUADRATUSLUMBORUM/TRANSVERSUSABDOMINUS
  • ILIAC FOSSA – ILIACUS
  • GLUTEAL SURFACE – GLUTEUSMEDIUS/MINIMUS
  • ASIS – SARTORIUS
  • AIIS – RECTUS FEMORIS
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11
Q

ischium

A
  • POSTERO-INFERIOR PART OF THE PELVIC BONE
  • FORMS LARGE PART OF OBTURATOR FORAMEN ANDACETABULUM
  • ISCHIAL TUBEROSITY ORIGIN FOR HAMSTRINGMUSCLES
  • ISCHIAL SPINE – ATTACHMENT SITE
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12
Q

pubic bone

A

INFERO-ANTERIOR PART OF THE PELVIC BONE
* C-SHAPED, BODY AND SUPERIOR AND INFERIOR PUBIC RAMI
* BODY FLATTENED MEDIALLY TO FORM SYMPHYSIS PUBIS
* PUBIC TUBERCLE INSERTION FOR INGUINAL LIGAMENT
* FORMS OBTURATOR FORAMEN WITH INFERIOR ISCHIUM
* PRIMARY ATTACHMENT FOR ADDUCTOR MUSCLE GROUP

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13
Q

symphsis pubis

A
  • CARTILAGINOUS JOINT BETWEEN LEFT ANDRIGHT PUBIC BONES – FUNCTION??
  • ARTICULAR SURFACES COVERED BY HYALINE(ARTICULAR) CARTILAGE
  • JOINED BY FIBROCARTILAGE
  • MORE MOVEMENT IN WOMEN THAN MEN,CHANGES RELATED TO PREGNANCY/POST-PARTUM
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14
Q

the hip joint

A
  • SYNOVIAL JOINT
  • BALL-AND-SOCKET BETWEEN FEMORAL HEAD AND ACETABULUM
  • DESIGNED TO BE STRONG AND STABLE (IN COMPARISON TO OTHER JOINTS)
  • RELATIVELY LIMITED MOVEMENT (WHEN COMPARED TO SHOULDER)
  • MOVEMENTS:
    * FLEXION/EXTENSION
    * ABDUCTION/ADDUCTION
    * INTERNAL-EXTERNAL ROTATION
    * CIRCUMDUCTION
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15
Q

acetabulum

A

. FORMED BY COMBINATION OF ILIUM, ISCHIUM, AND PUBIC BONES
* LARGE-DEEP CUP SURROUNDS FEMORAL HEAD
* DEEPENED BY RIM OF FIBROCARTILAGE CALLED LABRUM
* PERIPHERAL ARTICULAR SURFACE COVERED BY HYALINE CARTILAGE;THICKEST SUPERIORLY – WHY?
* CENTRAL ACETABULAR FOSSA IS ROUGHENED ATTACHMENT POINT
* INFERIOR NOTCH ALLOWS PASSAGE OF NEUROVASCULARSTRUCTURES

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16
Q

proximal femur

A

CHARACTERISED BY FOUR STRUCTURES (OSSIFICATIONCENTRES):
* FEMORAL HEAD (ARTICULAR SURFACE)
* FEMORAL NECK (METAPHYSIS)
* GREATER AND LESSER TROCHANTERS
* PRONE TO CLINICALLY SIGNIFICANT FRACTURES WITHHIGH LEVELS OF MORBIDITY/MORTALITY

17
Q

femoral head

A

FEMORAL HEAD ROUND AND SMOOTH, COVEREDWITH ARTICULAR CARTILAGE
* CENTRAL DEPRESSION CALLED FOVEA CAPITIS;ATTACHMENT FOR LIGAMENTUM TERES
* VARIABLE MINIMAL BLOOD SUPPLY TO FEMORALHEAD THROUGH THIS FOVEA; IMPORTANT IN FRACTURES

18
Q

femoral neck

A

APPROXIMATELY 125 DEGREE ANGLE WITH DIAPHYSIS
* SLIGHT ANTERIOR ANGULATION
* INTRA-CAPSULAR
* TENSILE/COMPRESSIVE TRABECULAR PATTERN
* IMPORTANT TO DIAGNOSE FRACTURES HERE

19
Q

trochanteric region

A

GREAT TROCHANTER LATERALLY:
* EXTENDS ANTERIORLY AND POSTERIORLY
* SEVERAL RIDGES AND DEPRESSIONS FOR ATTACHMENTS
* GLUTEUS MEDIUS/MINIMUS, OBTURATOR AND GEMELLIMUSCLES
* LESSER TROCHANTER POSTERO-MEDIALLY:
* TENDON OF PSOAS AND ILIACUS MUSCLES
* INTER-TROCHANTERIC LINE (ANTERIORLY) AND CREST(POSTERIORLY)

20
Q

hip joint description

A

SURROUNDED BY SYNOVIAL MEMBRANE
* CAPSULE EXTENDS DISTALLY TO BASE OF NECK OFFEMUR (INTRA-CAPSULAR)
* COVERED BY STRONG FIBROUS JOINT CAPSULE
* REINFORCED BY 3 SETS OF LIGAMENTS FROM 3PARTS OF PELVIC BONE

21
Q

blood supply

A
  • COMPLEX BLOOD SUPPLY
  • MAJORITY COMES FROM BRANCHES FROM THE FEMORALARTERY
  • INSERTS AT BASE OF NECK AND EXTENDS PROXIMALLYINTO HEAD
  • KEY PRINCIPLE BEHIND HIP FRACTURE MANAGEMENT; RISKOF AVASCULAR NECROSIS
22
Q

the femur

A

LONG BONE:
* EPIPHYSIS (X2)
* METAPHYSIS (X2)
* DIAPHYSIS
* OTHER BONY FEATURES PROXIMALLY (HIP) ANDDISTALLY (KNEE)
* STRONGEST/LONGEST IN THE SKELETON
* DIAPHYSIS VERY STRONG; RELATIVELY RARELYFRACTURED WITHOUT SIGNIFICANTTRAUMA/PATHOLOGY

23
Q

femoral diaphysis

A

MAIN FEATURE IS THE LINEA ASPERA (ROUGH LINE)POSTERIORLY
* RIDGE ALONG POSTERIOR DIAPHYSIS
* MAJOR SITE OF MUSCLE ATTACHMENT; ADDUCTORS

24
Q

musculature

A

3 COMPARTMENTS PLUS ACCESSORY MUSCLES
* ANTERIOR (QUADRICEPS FEMORIS):
* VASTUS MEDIALIS, INTERMEDIUS, LATERALIS
* RECTUS FEMORIS
* MEDIAL (ADDUCTORS):
* ADDUCTOR MAGNUS, LONGUS,BREVIS
* PECTINEUS
* GRACILIS
* POSTERIOR (HAMSTRINGS):
* BICEPS FEMORIS (LONG/SHORT HEAD)
* SEMIMEMBRANOSUS
* SEMITENDINOSUS

25
Q

neurovascular structures

A

LARGE VASCULAR AND NERVOUS STRUCTURES
* FEMORAL ARTERY, VEIN, AND NERVE
* SCIATIC NERVE RUNS BETWEEN HAMSTRINGS
* SIGNIFICANT ROLE IN HIGH VELOCITY INJURIES

appendicular muscoskeletal anatomy and pattern recognition (8 decks)

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