the pelvis and gluteal region Flashcards

1
Q

what is the name of the boney structure that can be observed on the proximal head of the femur on the posterior side that projects medially?

A

lesser trochanter

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2
Q

what is the name of the small ridge of boney bumps found between the greater and lesser trochanter on the anterior side?

A

intertrochanteric line

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3
Q

what is the name of the small ridge of boney bumps found between the greater and lesser trochanter on the posterior side?

A

intertrochanteric crest

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4
Q

what is the function of the gluteal tuberosity?

A

attachement for gluteal muscle

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5
Q

describe the structure of the acetablum

A
  • acetabular labrum deepens the fossa
  • lunate surface: articulate with the femoral head
  • acetabular fossa: is a deep fossa found inside the acetabulum (think of hot tub)
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6
Q

what is the ligament that closes off the lunate surface?

A

transverse acetabular ligament

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7
Q

what ligament serves to keep the femoral head inside the acetabulum?

A

ligament of the head of the femur

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8
Q

onto what does the ligament to head of femur attach to?

A

fovea

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9
Q

what type of joint is the hip joint?

A

ball and socket
synovial
multiaxial

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10
Q

what movement is occurs during flexion of the hip joint?

A

leg advances forward

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11
Q

what type of movement causes the leg to move back (take a step back)

A

extension about the hip joint

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12
Q

while sitting, if you move your leg outwards what movement is that?

A

abduction about the hip joint

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13
Q

if sitting with both legs close to one another, what movement is that?

A

adduction about the hip joint

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14
Q

how could medial rotation about the hip joint be described?

A

heel of foot points outwards, hence femur rotates internally about hip joint

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15
Q

how could lateral rotation about the hip joint be described?

A

heel of foot points inwards, femur rotates externally about the hipojoint

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16
Q

what stabilizes the hip joint?

A
  • iliofemoral
  • pubofemoral
  • ischiofemoral
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17
Q

which stabilizer prevents hyperextension when standing and will limit lateral rotation?

A

-iliofemoral

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18
Q

which stabilizer prevents over-abduction of the hip joint?

A

-pubofemoral

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19
Q

which stabilizer limits medial rotation of the hip joint?

A

-ischiofemoral

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20
Q

what is the most common type of hip dislocation?

A

posterior hip dislocation

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21
Q

identifying the following dislocation based on symptoms

femur will be shortened, flexed, adducted and medially rotated about the hip joint?

A

posterior hip dislocation

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22
Q

identifying the following dislocation based on symptoms

femur is slightly flexed, abducted, and laterally rotated about the hip joint

A

anterior hip dislocation

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23
Q

what A. pierces through the obturator membrane?

A

obtrurator A

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24
Q

what A. wraps around the front of the femur?

A

lateral circumflex femoral A.

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25
Q

what A. anastomoses to the lateral circumflex femoral A.?

where does this A travel?

A

medial circumflex femoral A.

it travels posterior to the femur

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26
Q

the external illiac artery bifurcates into what branches inferior to the hip joint?

A

femoral and deep femoral A.

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27
Q

where do the medial and lateral circumflex A. originate from?

A

from the deep femoral A.

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28
Q

what may occur to the blood supply during a femoral neck fracture?

A

blood supply could possibly be cut off leading to avascular necrosis of the femoral head

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29
Q

in order to avoid necrosis of the head due to lack of blood supply how is the vascular system arranged?

A

the head an neck of the femur obtains its blood supply by multiple arteries that originate from different major arteries.

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30
Q

what may be the cause for the femoral neck to fracture?

A

hip dislocations

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31
Q

where does the obturator A. originate from?

A

internal iliac A.

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32
Q

what arteries supply the femoral head and neck

A

medial circumflex femoral A.
lateral circumflex femoral A.
Obturator A.

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33
Q

what arteries arise from the medial Circumflex femoral A?

A

retinacular (nutrient) arteries

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34
Q

what Artery arises from the obturator A.?

A

foveal A.

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35
Q

where is the foveal A. located?

A

it travels within the ligament of the head of femur

36
Q

the majority of the blood supply comes from which A?

A

from the medial circumflex femoral A.

37
Q

what ligaments function to prevent upward tilting of the distal sacrum and pulls the pelvis down? (anchors sacrum to hipbones)

A
sacrotuberous ligament (ST)
sacrospinous ligament (SS)
38
Q

what do the ST and SS ligaments form?

A

the greater and lesser sciatic foramina

39
Q

what is the function of the greater and lesser foramina?

A

it allows for structures that originate from inside to make their way out.

40
Q

what is the largest, most external muscles of the gluteal region?

A

gluteus maximus

41
Q

gluteus maximus
origin
insertion
function

A

origin: posterior sacroiliac ligament and sacrotuberous ligament
insertion: gluteal tuberosity and IT band
function: extends thigh at hip, lateral rotation

42
Q

what is the primary extensor?

A

gluteus maximus

43
Q

Tensor Facia Lata
origin
insertion
function

A

origin: ASIS

insertion: lateral tibial condyle via IT band
function: abducts and medially rotates thigh at the hip
stabilizes pelvis while standing
tenses IT band

44
Q

what is the IT band?

A

name: iliotibial band

its a lateral thickening of the fascia lata of the thigh

45
Q

what are the abductor muscles of the hip?

A

Gluteus medius

Gluteus minimus

46
Q

what is the common origin and insertion of the abductors of the hip?

A

stretch between the posterior surface of the ilium and the greater trochanter (the region will differ)

47
Q

which of the abductors inserts on the superior aspect of the greater trochanter?

A

gluteus medius

48
Q

which of the abductors inserts on the anterior aspect of the greater trochanter?

A

gluteus minimus

49
Q

which abductor is also involved in medial rotation, abduction and serves as an accessory hip flexor?

A

gluteus minimus

50
Q

what are the lateral rotators of the thigh?

A
piriformis
superior gemellus
inferior gemellus
quadratus femoris
obturator internus
obturator externus
51
Q

piriformis
origin
insertion
particularity?

A

origin: anterior sacrum
insertion: greater trochanter
particularity: exits through the greater sciatic foramen

52
Q

superior gemellus
origin
insertion

A

origin: iscial spine
insertion: greater trochanter

53
Q

inferior gemellus
origin
insertion

A

origin: ischium
insertion: greater trochanter

54
Q

what is known as the gemellus sandwich?

A

the tendon of obturator internus lays in between both gemellus muscles

55
Q

quadratus femoris
origin
insertion

A

origin: ischium
insertion: intertrochanteric crest

56
Q

what muscles share the common origin of ischium

A
  • quadratus femoris

- inferior gemellus

57
Q

what lateral rotator muscles commonly insert on the greater trochanter

A
  • piriformis
  • superior gemellus
  • inferior gemellus
  • -obturator internus
58
Q

obturator internus
origin
insertion
particularity?

A

origin: internal boney border of the obturator foramen inside the pelvis
insertion: greater trochanter
particularity: exits the pelvis through the lesser sciatic foramen

59
Q

obturator externus
origin
insertion
function

A

origin: bone of obturator forament external to the pelvis
insertion: intertrochanteric crest
function: lateral rotation of the thigh

60
Q

what nerve innervates the obturator externus?
what spinal levels are involved?
where does it travel?

A

obturator N.
L2-L4
travels inside of the pelvis

61
Q

what gluteal muscle serves as a landmark for neurovascular structures?

A

piriformis

62
Q

which nerve exits via the greater sciatic foramen above piriformis?

A

superior gluteal N.

63
Q

what nerve exits pelvis via the greater sciatic forament below piriformis?

A

inferior gluteal N.

64
Q

what nerve innervates the gluteus maximus?

A

inferior gluteal N.

65
Q

what does the superior gluteal N. innervate?

A

gluteus medius and gluteus minimus, tensor fascia lata

66
Q

what nerve innervates most of the lower limbs and is also the biggest nerve in our bodies?

A

sciatic nerve

L4-S3

67
Q

which nerve is responsible for the sensory innervation of the posterior thigh?

A

posterior femoral cutaneous n.

68
Q

what nerves innervates the lateral rotators?

A

sacral nerve

69
Q

what nerve will innervate gemellus superior and obturator internus?

A

nerve to obturator internus

70
Q

what nerve innervates piriformis?

A

nerve to piriformis

71
Q

what muscle pair does the nerve to quadratus femoris innervate?

A

gamellus inferior and quadratus femoris

72
Q

what is the common orientation of the sciatic N.

A

both components of the nerve pass below the piriformis

73
Q

what are some possible abnormal orientations for the sciatic N.

A

the tibial and common fibular N. split causing for the tibial N. to split the piriformis or pass above before joining the common fibular N.

74
Q

what spinal levels are involved in the posterior femoral cutaneous N.?

A

S1-S3

75
Q

what region of the skin is innervated by the inferior clundeal N.
what spinal levels are involved?

A

the lower part of the butt cheek and part of the lateral posterior thigh
S1-S3

76
Q

what nerve is responsible for the sensory innervation of the medial quarter of the butt cheek?

A

middle cluneal nerve

77
Q

what region does the superior cluneal N. innervate?

A

from the medial 1/4 to the lateral 1/4 of the but check from the top until the bottom part of the butt cheek covered by the inferior cluneal N.

78
Q

what branches originate from the interal illiac A.?

A

superior gluteal A.

inferior Gluteal A.

79
Q

what is the important vascular anastomosis that helps redirect blood of the lower limb in case of blockage between femoral and external Iliac A?

A

cruciate anastomosis

80
Q

how does the deep femoral A. terminate as?

A

4th perforating A

81
Q

what A are involved in the cruciate anastomosis?

A

Medial Cx. femoral A.
lateral Cx. femoral A.
1st perforating A

82
Q

how should gluteal intramuscular injections be administered?

A
  • superior lateral quadrant

- allign middle finger and thumb to quadrant and inject between index and middle finger

83
Q

why is it important to properly inject in the gluteal region?

A

avoids damaging the neuromuscular structures that are deep to gluteus maximus

84
Q

what is the cause of greater throchanteric pain syndrome?

A

inflammation of the trochanteric bursa

85
Q

what bursae(s) can be found in the gluteal region?

A
  • iliotibial bursa
  • trochanter bursa
  • ischial bursa