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Anatomy Class MD1 > The Hip, Buttock + Thigh > Flashcards

The Hip, Buttock + Thigh Flashcards

1
Q

Sacroiliac Joint

A

articulation with sacrum

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2
Q

Hip

A

Ilium+ ischium +pubis

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3
Q

Pubic symphysis

A

articulation with the corresponding hip bone

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4
Q

Hip joint

A

Articulation with the head of the femur

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5
Q

At what age does the hip bones begin to fuse?

A

Age 15-17yrs

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6
Q

At what age does complete fusion of the hip bone takes place?

A

20-25 years

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7
Q

Ilium

A
  • superior part of hip bone

- largest

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8
Q

Wing of the ilium

A
  • iliac fossa surface(superior-concave)
  • ala
  • superior
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9
Q

Attachement/ origin of the iliac muscle

A

iliac fossa

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10
Q

Attachment of the gluteal muscles

A
  • External surface of ilia fossa
  • convex
  • gluteal surface
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11
Q

What is the name of the superior margin of the wind of the ilium called ?

A

iliac crest

-extends from the ASIS to the PSIS

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12
Q

Muscles attaching to the ilium

A
  • gluteal muscles

- iliacus muscle

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13
Q

Palpation of the femoral artery

A
  • mid-inguinal point

- halfway between the ASIS and the pibic symphysis

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14
Q

Location of the Mid-point of the inguinal ligament

A

halfway between the ASIS and the pubic

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15
Q

Pubis

A
  • anterior portion of the hip bone

- body+superior rami+inferior rami

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16
Q

Obturator foramen

A

obturator nerve , artery and vein passes through

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17
Q

superior ramus

A
  • extends laterally from the body

- forms part of the acetabulum

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18
Q

inferior ramus

A

projects towards and joins the ischium

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19
Q

Ischium

A
  • posterioinferior part of hip bone

- inferior rams +superior ramus

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20
Q

What is the part of the hip bone we sit on ?

A

ischial tuberosity

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21
Q

Greater Sciatic Notch

A

nerve + vessels running from the pelvis to the thigh

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22
Q

Sacrospinous ligament

A
  • runs from the ischial spine to the sacrum

- creates the sciatic foramen

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23
Q

Sacrotuberous Ligament

A
  • runs from the sacrum to ischial tuberosity

- lesser sciatic foramen

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24
Q

Direct trauma

A

fracture to the pelvic bones from or example vehicular accident

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25
Q

Forces transmitted from the lower limb

A

example a heavy fall on the feet

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26
Q

What are common sites of fracture of the hip bone

i.eweaker points of the bones.

A
  • pubic rami
  • acetabulm
  • sacroiliac joint
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27
Q

What is the site of attach,emt for the inguinal ligament?

A

Anterior Superior Iliac spine

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28
Q

What is the arcuate line?

A

A ridge projected anteriorly and inferiorly form the articular surface

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29
Q

Pubis symphysis

A

a joint between the two pubes of the hip bone which consist of a disc of fibrocartilage .

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30
Q

Acetabulum

A

along with the femoral head it forms the hip joint

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31
Q

Acetabular Notch

A
  • forms a foramen through which blood vessels and nerves pass
  • point of attachment for ligaments of the femur
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32
Q

Femur

A
  • long bone
  • longest bone in the body
  • transmits forces from the tibia to the hip joint
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33
Q

Head of the femur

A

-articulates with the acetabulum of the pelvis

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34
Q

Neck of the femur

A

connects the head of the femur with the shaft

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35
Q

Greater Trochanter

A

originates from the anterior aspect just lateral to the neck

-site of attachment for the gluteus medium , gluteus minimum and piriformis

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36
Q

Lesser trochanter

A

-projects from the posteromedial side of the femur

site of attachment for the posts major and iliac muscles

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37
Q

intertrochanteric line

A
  • connects the two trochanters together

- site of attachment for the iliofemoral ligament

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38
Q

intertrochanteric crest

A

-located on the posterior surface of the femur

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39
Q

At what point does the intertrochanteric line becomes the pectineal line?

A

Afters ot passes the lesser trochanter of the posterior surface

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40
Q

Quadrate tubercle

A
  • rounded tubercle on the superior half of the femur

- attachment of the quadrates femoris

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41
Q

Intracapsular Fracture

A
  • elderly women
  • minor trip or stumble
  • occurs within the capsule
  • medial femoral circumflex artery
  • avascular necrosis of femoral head
  • shorter leg, toes pointing lateral
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42
Q

Extra- capsular Fracture

A
  • Common in young and middle age
  • blood supply to the head of the femur is intact
  • leg shortened and laterally rotated .
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43
Q

Linea aspera

A
  • posterior surface of the femoral shaft

- roughened ridges of bone

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44
Q

which border of the line aspera becomes the pectineal line?

A

medial

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45
Q

When the line aspera widens , what does it become?

A

-forms the floor of the popliteal fossa

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46
Q

Fracture of the femoral shaft

A
  • e.g. vehicular accident
  • spiral fracture–> leg shortening
  • ma have possible disruption of neuromuscular supply.
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47
Q

Medial and lateral condyles

A
  • the posterior and inferior surface articulates with the tibia and menisci of the knee
  • anterior surface articulates with the patella
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48
Q

Medial and lateral epicondyles

A
  • Bony elevations

- attachment of some muscles and collateral ligaments of the knee joint

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49
Q

Intercondylar fossa

A
  • depression on the posterior surface

- lies between the two condyles

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50
Q

Facet for attachment of the posterior cruciate ligament

A

-medial wall of the intercondylar fossa

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51
Q

Facet for attachment of anterior cruciate ligament

A

-Lateral Wall of the intercondylar fossa

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52
Q

To which part of the femur do the lateral rotators of the lower limb attach to?

A

Greater trochanter

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53
Q

Which strong ligament attaches to the intertrochanteric line?

A

Iliofemoral

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54
Q

On which part of the femur can you find the intertrochanteric crest?

A

Posterior aspect

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55
Q

What is the name of the structure to which adductor magnus attaches?

A

Adductor tubercle

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56
Q

Which two structures at the distal end of the femur articulate with the tibia to create the knee joint?

A

Condyles

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57
Q

what is the safest place for giving inter muscular injection in the buttock from the stand point of safe guarding the sciatic nerve ?

A

-upper left quadrant of buttock

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58
Q

Which gluteal muscle is a medial rotator of the femur?

A

Gluteus medius

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59
Q

The sciatic nerve can get irritated and or compressed by which muscle in the gluteal region in certain pathological situation and produce a syndrome with the same name?

A

Piriformis

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60
Q

Which structure in the hip joint helps to increase the depth of the acetabulum and increases its stability ?

A

Acetabular Labrum

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61
Q

A trans-cervica; fracture of femoral neck. What is the most likely complication in the hip?

A

avascular necrosis of femoral head

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62
Q

Which of the following thigh anterior compartment muscle has a dual nerve supply and therefore dual function?

A

Pectineus

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63
Q

Which thigh medial compartment muscle forms the immediate posterior wall of adductor canal?

A

adductor longus

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64
Q

where does the femoral artery become the popliteal artery ?

A

at the end of the adductor canal

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65
Q

Which ligament of the knee joint is a flat band and is attached at its middle to the capsule of knee joint and one of th menisci of the knee joint?

A

Tibial Collateral Ligament

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66
Q

Clergyman’s knee refers to what inflammation of which bursa of the knee?

A

subcutaneous infra-patellar bursa

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67
Q

Fovea Capitis

A

Site of attachment of ligament of head of femur

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68
Q

Greater and lesser trochanter

A

-points of attachment for the tendons of some of the thigh and buttock muscles

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69
Q

What is the prominence felt on the widest part of your hip and its function(clinical) ?

A
  • greater trochanter

- used to locate the site of attachment for IM injection

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70
Q

What is supplied by the medial femoral circumflex artery ?

A

Femoral neck

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71
Q

Femoral neck fractures

A
  • intracpauslar
  • avascular necrosis
  • hemiarthroplasty
  • total hip replacment
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72
Q

Intertrochanteric Fracture

A
  • does not involve the femoral head
  • blood supply preserved
  • does not render femoral head ishaemic
  • repair usually a femoral plate and pin
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73
Q

What type of joint is the hip joint ?

A

Ball & socket synovial joint

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74
Q

Describe the hip joint.

A

Articulation between the pelvis acetabulum and the head of the femur.

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75
Q

What fibrocartilaginous collar is the acetabulum deepened by ?

A

Acetabular Labrum

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76
Q

What is covered in articular cartilage ?

A

Acetabulum and head of femur

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77
Q

Ligament of head of femur

A
  • runs from acetabular fossa to the fovea of the femur
  • encloses a branch of the obturator artery
  • Intracapsular
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78
Q

Iliofemoral Ligament

A
  • Y-shaped

- prevents hyperextension of hip joint

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79
Q

Pubofemoral

A
  • Triangular shape

- prevents excessive abduction and extension

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80
Q

Ischiofemoral

A
  • spiral orientation

- prevents excessive extension

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81
Q

Arterial supply to the hip joint

A

-medial and lateral circumflex femoral arteries

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82
Q

Damage to the medial circumflex artery causes what ?

A

-Avascular necrosis

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83
Q

What is the hip joint innervated by ?

A

Femoral Nerve, Obturator nerve , Superior Gluteal nerve and nerve to quadrates femoris

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84
Q

What are the Flexors of the hip ?

A

-Iliopsoas ,rectus femoris ,sartorius

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85
Q

What are the extensors of the hip?

A

gluteus maximus, semimembranosus, semitendinosus and biceps femoris

86
Q

What are the abductors of the hip?

A

gluteus medius, gluteus minimus and the deep gluteals (piriformis, gemelli etc.)

87
Q

What are the adductors of the hip?

A

adductors longus, brevis and magnus, pectineus and gracillis

88
Q

What muscles laterally rotates the hip?

A

biceps femoris, gluteus maximus, and the deep gluteals (piriformis, gemelli etc.)

89
Q

What muscles medially rotate the hip?

A

gluteus medius and minimus, semitendinosus and semimembranosus

90
Q

Posterior Dislocation of the hip

A
  • femoral head moved posteriorly
  • tearing of the inferior and posterior joint capsule
  • limb shortened and medially rotated
  • sciatic nerve at risk
91
Q

Anterior dislocation of the hip

A
  • traumatic extension , abduction and lateral rotation
  • femoral head displaced anteriorly
  • fractures of the femoral head
92
Q

Superficial Fascia

A

Blends with the reticular layer beneath the dermis

93
Q

Deep fascia

A

envelops muscles , bones and neuromuscular structures

94
Q

Visceral fascia

A

Provides membranous investments that suspend organs within their cavities

95
Q

Where does the fascia lata become the deep fascia of the leg ?

A

bony prominences of the tibia

96
Q

where is the fascia lata thickest ?

A
  • Along the superolateral aspect of the thigh

- Around the knee

97
Q

Where is the fascial investment thinnest?

A

-Where it covers the adductor muscles of the medial thigh

98
Q

What does the deepest aspect of fascia lata give rise to ?

A

Intermusclar Septa

99
Q

What is the function of the Intermuscular Septa ?

A

Divides the thigh musculature into three compartment :

1) anterior
2) medial
3) lateral

100
Q

Which is the strongest compartment and why ?

A
  • Lateral compartment

- receives reinforcement from the iliotibial tract

101
Q

Saphenous opening

A

An ovoid hiatus present in the fascia lata just inferior to the inguinal ligament

102
Q

What is the purpose of the saphenous opening ?

A

An entry point for lymphatic vessels and the great saphenous vein

103
Q

What covers the hiatus ?

A

Cribriform Fascia

104
Q

Iliotibial Tract

A

-Longitdinal thickening of the fascia lata

105
Q

What strengthens the ITT?

A

Posteriorly by fibers of the gluteus maximus

106
Q

Location of the ITT

A

Located laterally in the thigh extending from the iliac tubercle to the lateral tibial condyle

107
Q

Functions of the ITT

A
  • acts as an extensor, abductor and lateral rotator of the hip
  • form the lateral intermuscular septum of the thigh and attaches to the femur.
  • forms a sheath for the tensor fascia lata muscle.
108
Q

Tensor Fascia Lata

A
  • Gluteal muscle

- acts as a flexor, abductors and internal rotator of the hip

109
Q

Functions of the tensor fascia lata muscle.

A

autens the iliotibial band and braces the knee, especially when the opposite foot is lifted.

110
Q

Proximal Attachments of the Fascia lata

A
  • Posterior: sacrum and coccyx
  • Lateral: iliac crest
  • Anterior: inguinal ligament, superior pubic rami
  • Medial: inferior ischiopubic rami, ischial tuberosity, sacrotuberous ligament
111
Q

What does the widen band of fibers of the Fascia aa attach to ?

A

The widened band of fibres descends the lateral thigh and attaches to the lateral tibial condyle on the anterolateral (Gerdy) tubercle.

112
Q

Inferior Attachment

A

The fascia lata ends at the knee joint where it then becomes the deep fascia of the leg (the Crural fascia).

113
Q

Superficial abductors and extenders of the gluteal region

A

gluteus maximus, gluteus medius, gluteus minimus and tensor fascia lata.

114
Q

Deep lateral rotators of the gluteal region

A

quadratus femoris, piriformis, gemellus superior, gemellus inferior and obturator internus.

115
Q

Gluteus maximus

A
  • Largest gluteal muscle
  • most superficial
  • produces the shape of the buttocks
116
Q

Actions of the gluteus maximus

A
  • Main extensor of the thigh
  • assist with lateral rotation
  • Used when running or climbing
117
Q

Innervation of the Gluteus Maximus

A

Inferior gluteal nerve

118
Q

Gluteus medius

A
  • fan-shaped

- lies between the G.maximus and minimus

119
Q

Actions of the gluteus medius

A

abducts and medially rotates the lower limb

120
Q

Innervation of the gluteus medius

A

superior gluteal nerve

121
Q

Gluteus Minimus

A

-deepest and the smallest

122
Q

Actions of the gluteus minimus

A

Abduct and medially rotates the lower limb

123
Q

Innervation of the gluteus minimus

A

superior gluteal nerve

124
Q

Actions of the tensor fascia lata

A

Assists the gluteus medius and minimus in abduction and medial rotation of the lower limb.

125
Q

Innervation of the tensor fascia lata

A

superior gluteal nerve

126
Q

Damage to the superior gluteal nerve

A
  • paralysis of the g.medius and minimus
  • stabilizing the pelvis
  • steady pelvis
127
Q

Trendelenburg sign

A
  • pt asked to stand on unassisted on each leg in turn

- pelvic drop will occur on unsupported side

128
Q

Deep muscles of the gluteal region

A

Piriformis, gemelli, obturator interns , quadrates femoris

129
Q

Piriformis

A
  • landmark in the gluteal region

- can be used to locate the sciatic nerve

130
Q

Actions of the piriformis

A

Lateral rotation and abduction

131
Q

Innervation of the piriformis

A

Nerve to piriformis

132
Q

Obturator Internus

A

forms the lateral walls of the pelvic cavity

133
Q

Action of obturator internus

A

lateral rotation and abduction

134
Q

Innervation of the obturator interns

A

Nerve to obturator internus

135
Q

Superior Gemelli

A

-triangular muscle
-lateral rotation and -abduction
nerve to obturator internus

136
Q

Inferior Gemelli

A
  • triangular muscle
  • lateral rotation nd abduction
  • nerve to quadrates femoris
137
Q

Quadratus femoris

A
  • flat, square shaped muscle
  • lateral rotation
  • nerve to quadrates femoris
138
Q

Whatives the insertion of gluteus maximus?

A

Gluteal Tuberosity

139
Q

Damage to which nerve gives a positive Trendelenburg sign?

A

Superior gluteal

140
Q

Which muscle lies between the gemilli?

A

Obturator internus

141
Q

Which of these muscles is innervated by nerve to obturator internus?

A

Superior Gemellus

142
Q

What is a positive trendelenburg sign when standing on the right leg?

A

Drop of left hip

143
Q

The sciatic nerve normally runs directly beneath which deep gluteal muscle?

A

Piriformis

144
Q

Innervation of the anterior thigh

A

femoral nerve (L2-L4)

145
Q

Major muscles in the anterior thigh

A

Pectineus, sartorial and quadriceps femoris

146
Q

Iliopsoas

A

-made up of two muscles the poses major and the iliacus

147
Q

Actions of the iliopsoas

A

Flexes the lower limb at the hip joint and assists in lateral rotation at the hip joint.

148
Q

Innervation of the Iliopsoas

A

The psoas major is innervated by anterior rami of L1-3, while the iliacus is innervated by the femoral nerve.

149
Q

Quadriceps Femoris

A

-consist of three muscles vastus muscles and the rectus femoris

150
Q

Vastus muscles

A

Vastus lateralis , vastus intermedius , vastus medialis

151
Q

Vastus lateralis

A

-extends the knee joint and stabilizes the patella

152
Q

Innervation of the Vastus Lateralis

A

Femoral nerve

153
Q

Vastus intermedius

A
  • extends the knee joint and stabilizes the patella

- femoral nerve

154
Q

Vastus medialis

A
  • extends the knee joint and stabilizes the patella

- femoral nerve

155
Q

Rectus Femoris

A
  • cross both the hip and knee joints
  • flexes the leg at the hip joint
  • extends at the knee joint
  • femoral nerve
156
Q

Sartorius

A
  • longestest muscle in the body
  • runs across the thigh in a inferomedial direction
  • At the hip joint, it is a flexor, abductor and lateral rotator. At the knee joint, it is also a flexor.
  • femoral nerve
157
Q

Pectineus

A
  • dual innervation
  • adduction and flexion at the hip joint
  • Femoral nerve . May receive a branch from the obturator nerve
158
Q

Testing the quadriceps

A
  • position the pt supine with knee slightly flexed
  • ask pt to extend knee against resistance
  • if femoral nerve is damaged, contractions of quadriceps femoris will era absent
159
Q

Which muscle of the quadriceps crosses both the hip and the knee joint?

A

Rectus Femoris

160
Q

Which of the following best describes the function of sartorius at the hip?

A

Flexion-abduction-lateral rotation

161
Q

Damage to which of these nerve roots would affect the function of the femoral nerve?

162
Q

What are the nerve roots of the nerve which innervates the quadriceps muscles

163
Q

What muscle lays directly on top of the iliac fossa?

164
Q

Hamstrings

A
  • posterior compartment of the thigh

- biceps femoris, semitendinous and semi membranous

165
Q

sciatic nerve

166
Q

Biceps femoris

A
  • two head( long and short)
  • flexion at the knee
  • extends the keg at the hip
  • laterally rotates at the hip and knee
  • long head= tibial part of sciatic nerve
  • short head =common fibular
167
Q

Semitendinous

A
  • Flexion of the leg at the knee joint. Extension of thigh at the hip. Medially rotates the thigh at the hip joint and the leg at the knee joint.
  • Tibial part of the sciatic nerve
168
Q

Semimembranous

A
  • underneath the semitendinous
  • Flexion of the leg at the knee joint. Extension of thigh at the hip. Medially rotates the thigh at the hip joint and the leg at the knee joint
  • tibial part of the sciatic nerve
169
Q

Damage to the hamstrings

A

-excessive stretch
-tearing or muscle fibers
-athletes involved in running or kicking
haematoma

170
Q

Avulsion fracture of the ischial tuberosity

A
  • hamstrings tendons ‘tear off’

- sprinting , football and hurdling

171
Q

Which is the most medial muscle of the hamstrings?

A

Semimembranosus

172
Q

Which of these is the correct function of ALL the hamstrings at the knee?

173
Q

Which muscle of the hamstrings causes lateral rotation at the hip and knee?

A

Biceps femoris

174
Q

From which nerve plexus does the obturator nerve arise?

175
Q

Which two nerves innervate adductor magnus?

A

Tibial and obturator

176
Q

Which of these is the most superior of the muscles of the medial thigh?

A

Obturator externus

177
Q

Which of the following muscles has a role in adducting at the hip?

A

Gracilis , obturator externes, adductor brebis , adductor longs, adductor magnus

178
Q

Adductor Magnus

A
  • largest muscle
  • lies posteriorly to the other msucles
  • adductor part and hamstring part
  • adduct the thigh
  • adductor component flexes the thigh, with the hamstring portion extending the thigh.
179
Q

Innervation of adductor magnus

A

Adductor part is innervated by the obturator nerve (L2-L4), the hamstring part is innervated by the tibial nerve (L4-S3).

180
Q

Adductor longus

A
  • medial border of femoral triangle
  • adduction and medial rotation of thigh
  • obturator nerve (L2-L4)
181
Q

Adductor brevis

A
  • short muscle
  • lies in between the anterior and posterior divisions of the obturator nerve.
  • adduction of thigh
  • Obturator nerve (L2-L4
182
Q

Obturator Externus

A
  • laterally rotates the thigh

- obturator nerve (L2-L4)

183
Q

Gracilis

A
  • crosses at both the hip and the knee joints
  • -adduction of the thigh at the hip and flexion of the leg at the knee
  • obturator nerve (L2-L4)
184
Q

Which muscle is sometimes transplanted into the hand or the forearm to replace damage muscles ?

185
Q

Injury to the adductor Muscles

A
  • Groin strain
  • proximal part of muscle affected
  • extreme stretching sports etc
186
Q

Femoral triangle superior border

A

Inguinal Ligament

187
Q

Femoral Triangle lateral border

A

Medial border of the sartorius muscle

188
Q

Femoral triangle medial border

A

medial border of the adductor longs muscle

189
Q

Roof of the femoral triangle

A

fascia lata

190
Q

Base of the femoral triangle

A

Pectineus , iliopsoas and adductor longs muscles

191
Q

Contents of the Femoral triangle (Lateral to medial )

A

NAVeL

Nerve . Artery , vein,Lymphatic canal

192
Q

Femoral vein

A

The great saphenous vein drains into the femoral vein within the triangle.

193
Q

Femoral pulse

A

Just inferior to where the femoral artery crosses the inguinal ligament

194
Q

Femoral Hernia

A
  • part of the bowel pushes into the femoral canal underneath the inguinal ligament
  • lump of budge in the area of the femoral triangle
195
Q

function of the inguinal ligament?

A

Acts as a flexor retinaculum

196
Q

Where would you place a needle to draw blood from the femoral artery?

A

Midway between ASIS and pubic symphysis (mid inguinal point)

197
Q

What is the main function of the empty space in the femoral triangle?

A

Allow the femoral vein to distend when venous return is high

198
Q

What can be found at the mid-point of the inguinal ligament

A

Femoral nerve

199
Q

What structure exits the femoral triangle through the saphenous opening?

A

Saphenous vein

200
Q

Medial border of the femoral canal

A

Lacunar ligament

201
Q

Lateral border of the femoral canal

A

femoral vein

202
Q

Anterior border of the femoral canal

A

inguinal ligament

203
Q

Posterior border of the femoral Canal

A

Pectineal ligament, superior ramus of the pubic bone, and the pectineus muscle

204
Q

Femoral ring

A

opening to the femoral canal

205
Q

Contents of the femoral canal

A

lymphatic vessels , deep lymph node, empty space , loose connective tissue

206
Q

explain why femoral hernias can become strangulated

A
  • Lucnar ligament is relatively firm
  • The rigid structure does not allow for distension or movement and does not allow for easy return to the abdominal cavity. This increases the risk for strangulation of the hernia.
207
Q

What superficial vein enters the femoral canal to drain into the femoral vein?

A

Long saphenous vein

208
Q

Where is the femoral ring found in relation to the canal?

A

Superiorly

209
Q

Adductor Canal

A
  • Hunter’s canal

- passageway from structures moving between the anterior thigh and the posterior leg

210
Q

Borders of the adductor canal

A
  • Anterior: Sartorius.
  • Lateral: Vastus medialis.
  • Posterior: Adductor longus and adductor magnus.
211
Q

Adductor hiatus

A
  • Apex of the adductor canal

- gap between the adductor and hamstring attachments of the adductor Magnus

212
Q

Contents of the adductor canal

A

femoral artery , femoral vein , nerve to vastus medialis , saphenous nerve

Anatomy Class MD1 (10 decks)

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