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Orthopedics > Pelvis/Hip/Thigh > Flashcards

Pelvis/Hip/Thigh Flashcards

1
Q

psoas major origin and insertion

A

O: T12-L5
I: Lesser trochanter

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2
Q

psoas major innervation

A

femoral nerve

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3
Q

psoas major action

A

flex hip

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4
Q

what muscle covers the lumbar plexus

A

psoas major

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5
Q

psoas minor origin and insertion

A

O: T12-L1
I: iliopubic eminence

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6
Q

innervation for psoas minor

A

L1 ventral ramus

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7
Q

psoas minor action

A

assist with hip flexion

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8
Q

iliacus origin and insertion

A

O: iliac fossa/sacral ala
I: lesser trochanter

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9
Q

iliacus innervation

A

femoral nerve

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10
Q

iliacus action

A

flex hip

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11
Q

name the pelvic hip flexors

A

psoas major
psoas minor
iliacus

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12
Q

tensor fasciae lata origin and insertion

A

O: iliac crest/ASIS
I: IT band, proximal tibial tuberosity

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13
Q

tensor fasciae lata innervation

A

superior gluteal

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14
Q

tensor fasciae lata action

A

abduct, flex, IR thigh

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15
Q

gluteus medius origin and insertion

A

O: ilium b/w anterior and posterior gluteal lines
I: greater trochanter (posterior)

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16
Q

gluteus medius innervation

A

superior gluteal

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17
Q

gluteus medius action

A

abduct and IR thigh

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18
Q

if _____ muscle is out, patient will have a trendelenburg gate

A

gluteus medius

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19
Q

gluteus minimus origin and insertion

A

O: ilium between anterior and inferior gluteal lines
I: greater trochanter (anterior)

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20
Q

gluteus minimus innervation

A

superior gluteal

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21
Q

gluteus minimus action

A

abduct and IR thigh

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22
Q

gluteus maximus origin and insertion

A

O: ilium, dorsal sacrum
I: ITB and gluteal tuberosity

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23
Q

gluteus maximus innervation

A

inferior gluteal

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24
Q

gluteus maximus action

A

extend and ER thigh

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25
Q

obturator externus origin and insertion

A

O: ischiopubic rami, obturator membrane
I: trochanteric/piriformis fossa

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26
Q

obturator externus innervation

A

obturator nerve

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27
Q

obturator externus action

A

ER thigh

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28
Q

pirformis origin and insertion

A

O: anterior sacrum
I: superior greater trochanter

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29
Q

pirformis innervation

A

nerve to piriformis

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30
Q

pirformis action

A

ER thigh

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31
Q

superior gemellus origin and insertion

A

O: ischial spine
I: medial greater trochanter

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32
Q

superior gemellus innervation

A

nerve to obturator internus

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33
Q

superior gemellus action

A

ER thigh

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34
Q

obturator internus origin and insertion

A

O: ischiopubic rami/obturator membrane
I: medial greater trochanter

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35
Q

obturator internus innervation

A

nerve to obturator internus

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36
Q

obturator internus action

A

ER and abduct thigh

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37
Q

inferior gemellus origin and insertion

A

O: ischial tuberosity
I: medial greater trochanter

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38
Q

inferior gemellus innervation

A

nerve to quadratus femoris

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39
Q

inferior gemellus action

A

ER thigh

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40
Q

quadratus femoris origin and insertion

A

O: ischial tuberosity
I: intertrochanteric crest

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41
Q

quadratus femoris innervation

A

nerve to quadratus femoris

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42
Q

quadratus femoris action

A

ER thigh

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43
Q

what muscle can be used as a landmark for the sciatic nerve

A

piriformis

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44
Q

what comprises the lumbar plexus?

A

L1-L4 ventral rami

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45
Q

what is the labrums function?

A

deeps socket
increases femoral head coverage

  • along the acetabular rim except inferiorly
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46
Q

which ligament provides strong anterior support to the hip and resists extension

A

Iliofemoral ligament (Y ligament of Bigelow

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47
Q

small artery to femoral head is within which ligament?

A

ligamentum teres/ligament to head of femur/foveal ligament

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48
Q

what are the attachments for the iliofemoral ligament?

A

Superior: ASIS/Ilium to greater trochanter

Inferior: ilium to intertrochanteric line/lesser trochanter

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49
Q

which ligament prevents hyperextension of the hip and provides inferior joint support?

A

pubofemoral ligament

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50
Q

attachments for pubofemoral ligament

A

Anterior pubic ramus to intertrochantic line

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51
Q

broad, relatively weak ligament that provides minimal posterior hip support

A

ischiofemoral ligament

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52
Q

which part of hip is extracapsular (due to inadequate coverage from ischiofemoral ligament)?

A

lateral posterior neck

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53
Q

in femoral neck fracture or intertrochanteric fracture how will the leg be positioned?

A

shortened and ER

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54
Q

Trendelenburg gate?

A

lean laterally to WB side

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55
Q

what can Trendelenburg gate indicate?

A

gluteus medius weakness

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56
Q

what can Lurch gait indication?

A

gluteus maximus weakness

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57
Q

Lurch gate?

A

lean posterior (keeping hip extended)

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58
Q

numbness and dysesthesias in lateral thigh can indicate entrapment of which nerve?

A

lateral femoral cutaneous nerve

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59
Q

what does genitofemoral nerve (L1-L2) provided sensory to?

A

proximal anteriomedial thigh

60
Q

what does obturator nerve (L2-L4) provide sensory to?

A

inferomedial thigh

61
Q

what does lateral femoral cutaneous nerve (L2-L3) provide sensory to?

A

lateral thigh

62
Q

what does femoral nerve provide sensory to?

A

anteromedial thigh

63
Q

what does posterior femoral cutaneous n (S1-S3) provide sensory to?

A

posterior thigh

64
Q

what nerve innervates muscles that do thigh/hip adduction?

A

obturator nerve (L2-L4)

65
Q

what nerve innervates muscles that do thigh abduction?

A

superior gluteal (L5)

66
Q

what nerve innervates muscles that do hip flexion/knee extension

A

femoral nerve (L2-L4)

67
Q

what nerve innervates muscles that do hip extension

A

Inferior gluteal (L5-S2)

68
Q

what nerve innervates muscles that do knee flexion

A

Sciatic

69
Q

articularis genus origin and insertion?

A

O: distal anterior fermoral shaft
I: synovial capsule

70
Q

articularis genus innervation

A

femoral

71
Q

articularis genus action

A

pulls capsule superiorly in extension

72
Q

sartorius origin and insertion

A

O: ASIS
I: proximal medial tibia (pes anserinus)

73
Q

sartorius innervation

A

femoral nerve

74
Q

sartorius action

A

flex, ER hip

75
Q

vastus lateralis origin and insertion

A

O: greater trochanter, lateral linea aspera

I: lateral patella, tibia tubercle

76
Q

vastus lateralis innervation

A

femoral

77
Q

vastus lateralis action

A

extend leg

78
Q

vastus intermedius origin and insertion

A

O: proximal femoral shaft
I: patella, tibia tubercle

79
Q

vastus intermedius innervation

A

femoral nerve

80
Q

vastus intermedius action

A

extend leg

81
Q

vastus medialis origin and insertion

A

O: intertrochanteric line, medial linea aspera
I: medial patella, tibia tubercle

82
Q

vastus medialis innervation

A

femoral

83
Q

vastus medialis action

A

extend leg

84
Q

rectus femoris origin and insertion

A

O: AIIS, superior acetabular rim
I: patella, tibia tubercle

85
Q

rectus femoris innervation

A

femoral

86
Q

rectus femoris action

A

flex thigh, extend leg

87
Q

adductor longus origin and insertion

A

O: body of pubis (inferior)
I: linea aspera (mid 1/3)

88
Q

adductor longus innervation

A

obturator

89
Q

adductor longus action

A

adducts thigh

90
Q

adductor brevis origin and insertion

A

O: body and inferior pubic ramus
I: pectineal line, linea aspera

91
Q

adductor brevis innervation

A

obturator

92
Q

adductor brevis action

A

adduct thigh

93
Q

adductor magnus origin and insertion

A

O: 1. pubic ramus. 2. ischial tuberosity
I: linea aspera, adductor tubercle on medial condyle

94
Q

adductor magnus innervation

A
  1. obturator

2. sciatic

95
Q

adductor magnus action

A

adduct and flex/extend thigh

96
Q

Gracilis origin and insertion

A

O: body and inferior pubic ramus
I: proximal medial tibia (pes anserinus)

97
Q

Gracilis innervation

A

obturator

98
Q

Gracilis action

A

adduct thigh
flex leg
IR leg

99
Q

Pectineus origin and insertion

A

O: pectineal line of pubis

I: pectineal line of femur

100
Q

Pectineus innervation

A

femoral n

101
Q

Pectineus action

A

flex and adducts thigh

102
Q

what hip adductor muscle can be used in ligament reconstruction

A

gracilis

103
Q

what are the hamstring muscles?

A

semitendinosus
semimembranosus
biceps femoris - long head and short head

104
Q

semitendinosus origin and insertion

A

O: ischial tuberosity
I: proximal medial tibia (pes anserinus)

105
Q

semitendinosus innervation

A

sciatic n. (tibial)

106
Q

semitendinosus action

A

extend thigh, flex leg

107
Q

semimembranosus origin and insertion

A

O: ischial tuberosity
I: posterior medial tibial condyle

108
Q

semimembranosus innervation

A

sciatic (tibial)

109
Q

semimembranosus action

A

extend thigh, flex leg

110
Q

biceps femoris long head origin and insertion

A

O: ischial tuberosity
I: fibular head

111
Q

biceps femoris long head innervation

A

sciatic n (tibial)

112
Q

biceps femoris long head action

A

extend thigh, flex leg

113
Q

biceps femoris short head origin and insertion

A

O: linea aspera, supracondylar line
I: Fibula, lateral tibia

114
Q

what landmark is used to measure the Q angle of the knee?

A

ASIS

115
Q

what muscles insert on pes anserinus?

A

sartorius, gracilis, semitendinosus

116
Q

how many vertebra make up the sacrum?

A

5 fused vertebra

117
Q

how many vertebra make up the coccyx?

A

4 fused vertebra

118
Q

Iliac crest is a common site for both tricortical and cancellous _______

A

bone graft harvest

119
Q

where does snapping hip occur?

A

tendons (psoas/iliacus) can snap over the lesser trochanter

120
Q

nerves/arteries/muscles that exit the greater sciatic foramen?

A

Piriformis muscle

POP’S IQ

  1. Pudendal n (and artery)
  2. (nerve to) Obturator internus
  3. Posterior cutaneous n of thigh
  4. Sciatic nerve
  5. Inferior gluteal nerve (and artery)
  6. nerve to (quadratus femoris)

Also superior gluteal nerve and artery

121
Q

what muscle is a reference point for the greater sciatic foramen?

A

piriformis

122
Q

where do most nerves exit the greater sciatic foramen relative to the piriformis?

A

inferiorly

Superior gluteal nerve and artery exit superior

Sciatic nerve may exit above or through

123
Q

what muscle is the landmark for posterior column of the pelvis?

A

obturator internus – you will not see externus in posterior approach

124
Q

what are the acetabular zones?

A
  1. Anterior superior
  2. Anterior inferior
  3. Posterior superior
  4. Posterior inferior
125
Q

what are the 2 lines that define the acetabular zones?

A
  1. ASIS to center of acetabulum

2. perpendicular to line 1

126
Q

what acetabular zone is considered the “safe zone” for putting screws?

A

Posterior superior

Posterior inferior is the secondary safe zone

127
Q

in the anterior superior acetabular zone what structures do you need to be aware of?

A

external iliac artery and vein

128
Q

in the anterior inferior zone acetabular zone what structures do you need to be aware of?

A

obturator nerve, artery, vein

129
Q

in the posterior superior acetabular zone what structures do you need to be aware of?

A

sciatic nerve

superior gluteal nerve, artery, vein

130
Q

in the posterior inferior acetabular zone what structures do you need to be aware of?

A

sciatic nerve
inferior gluteal artery, nerve, vein
internal pudendal nerve, artery, vein

131
Q

types of joints

A 
ball and socket
saddle
hinge
condyloid
pivot
gliding.
132
Q

body weight is transmitted through which joint

A

sacroiliac

133
Q

which ligament is strongest in the pelvis and is key to vertical stability

A

posterior sacroiliac

134
Q

what ventral rami comprise the lumbosacral plexus?

A

L4-S3(S4)

135
Q

where does the lumbosacral plexus lie?

A

anterior piriformis muscle

136
Q

blood supply to head/neck of femur

A

primarily the medial femoral circumflex artery (branch from profunda femoris)

(also lateral FCA and ligamentum teres artery)

137
Q

blood supply to shaft of femur

A

nutrient artery from profunda femoral artery

138
Q

which axis? - line drawn along the axis of the femur

A

anatomic

139
Q

which axis? - line drawn between center of femoral head and intercondylar notch

A

mechanical

140
Q

primary blood supply to the thigh

A

profunda femoris (branch from femoral artery)

141
Q

what would be seen on Xray if there is loosening of total hip arthoplasty?

A

radiolucent lines most often caused by osteolysis

142
Q

which muscle is the medial femoral circumflex artery located under?

A

quadratus femoris

143
Q

which vessels are located under the transverse acetabular ligament and may be injured by retractors/anterior inferior quad screws in total hip arthoplasty?

A

obturator vessels

144
Q

what is done if there is a periprosthetic fx?

A

Stable implant: ORIF

Unstable: replace w/ longer stem the passes fx site

145
Q

for total hip what structures are in danger of injury with the anterolateral approach?

A

descending branch of LFCA and femoral nerve (due to vigorous medial retraction)

Orthopedics (6 decks)

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