Thigh/Gluteal Region - Rob

Question 1

What three bones make up the pelvis?

Answer 1

Ischium, ilium, pubis

Question 2

What type of joint is the hip joint?

Answer 2

Synovial, ball-and-socket

Question 3

What is the function of the acetabular labrum?

Answer 3

To deepen the area of articulation in the acetabulum, thereby stabilising the joint

Question 4

What factors stabilise the hip joint?

Answer 4

Acetabular labrum
Intracapsular ligaments
Extracapsular ligaments
Muscule attachments

Question 5

What are the three extra capsular hip ligaments?

Answer 5

Iliofemoral
Pubofemoral
Ischiofemoral

One to each bone of the pelvis

Question 6

What makes up the vascular supply to the hip joint?

Answer 6

Artery to head of femur

Medial and lateral circumflex arteries

Question 7

In what direction is the hip more likely to dislocate? And why?

Answer 7

Posteriorly, due to the weaker posterior support (only the ischiofemoral ligament)

Question 8

What signs indicate a posterior dislocation may have occurred?

Answer 8

The affected limb is shortened and internally rotated

Question 9

Why is an intracapsular NoF fracture more severe?

Answer 9

Increased risk of AVN due to interrupted blood supply

Question 10

How may the gluteal muscles be divided?

Answer 10

Deep group vs. superficial group

Question 11

What are the deep muscles of the gluteal region?

Answer 11

Piriformis
Obturator internus
Gemellus superior and inferior
Quadratus femoris

Question 12

What are the superficial muscles of the gluteal region?

Answer 12

Gluteus minimus, medius and maximus

Question 13

What nerve innervates the obturator internus and gemellus superior?

Answer 13

Nerve to obturator internus

Question 14

What nerve innervates the gemellus inferior and quadratus femoris?

Answer 14

Nerve to quadratus femoris

Question 15

What innervates piriformis?

Answer 15

Branches from L5, S1 and S2 (nerve to piriformis in sheffield)

Question 16

What are the functions of the 4 deep muscles apart from quadratus femoris?

Answer 16

Abduction of flexed femur

Lateral rotation

Question 17

What is the function of quadratus femoris?

Answer 17

Lateral rotation only

Question 18

What innervates gluteus medius minimus?

Answer 18

Superior gluteal nerve

Question 19

What innervates gluteus maximus

Answer 19

Inferior gluteal nerve

Question 20

What is the function of the tensor fascia lata?

Answer 20

Stabilises the knee joint in extension

Question 21

What is a safe location for IM injection over the gluteal region?

Answer 21

Upper lateral quadrant, to avoid damage to the sciatic nerve, or other nerves and vessels in the region

Question 22

What are the three compartments of the thigh?

Answer 22

Anterior, medial and posterior

Question 23

What is the general function of the anterior compartment?

Answer 23

Flexion at the hip joint and extension at the knee joint

Question 24

What are the muscles of the anterior compartment?

Answer 24

Psoas major
Iliacus
Vastus lateralis, medialis and intermedius
Rectus femoris
Sartorius

Question 25

What innervates the muscles of the anterior compartment?

Answer 25

Femoral nerve

Question 26

What forms quadriceps femoris?

Answer 26

The three vastus muscles and rectus femoris

Question 27

What tests reflex activity at L3 and L4?

Answer 27

Tapping the patellar ligament as quad femoris is innervated mainly by L4/L4

Question 28

How many muscles are in the medial compartment of the thigh?

Answer 28

6

Question 29

What are the muscles of the medial compartment of the thigh?

Answer 29

Gracilis Pectinius Obturator externus Adductor brevis, longus and magnus

Question 30

What innervates gracilis?

Answer 30

Obturator nerve

Question 31

What innervates the adductor muscles?

Answer 31

Obturator nerve

Question 32

What innervates pectineus?

Answer 32

Femoral nerve

Question 33

What is the general function of the muscles in the medial compartment?

Answer 33

Adduction | also some rotation and flexion

Question 34

What is the function of obturator externus?

Answer 34

Lateral rotation of the thigh

Question 35

What is the function of the adductor muscles?

Answer 35

Adduction | Longus and magnus also medially rotate the thigh

Question 36

What is the function of pectinius?

Answer 36

Adduction | Flexion of thigh at hip joint

Question 37

What is the function of gracilis?

Answer 37

Adducts thigh at hip | Flexes leg at knee joint

Question 38

What is the general function of the posterior compartment?

Answer 38

To flex at the knee joint and extend the thigh at the hip joint

Question 39

How many muscles are in the posterior compartment?

Answer 39

3

Question 40

What are the muscles of the posterior compartment?

Answer 40

Biceps femoris Semimembranosus Semitendinosus

Question 41

What innervates the posterior compartment?

Answer 41

Sciatic nerve

Question 42

In addition to flexion of the knee and extension of the thigh what is the function of biceps femoris?

Answer 42

Lateral rotation of the leg at the knee joint

Question 43

In addition to flexion of the knee and extension of the thigh what is the function of semimembranosus and semitendinosus?

Answer 43

Medial rotation of the leg at the knee joint

Question 44

What are the boundaries of the femoral triangle?

Answer 44

``` Superior = inguinal ligaments Medial = adductor longus Lateral = sartorius ```

Question 45

What are the contents of the femoral triangle?

Answer 45

NAVY (Lateral to Medial) Femoral Nerve Femoral Artery Femoral Vein

Question 46

What is the apex of the femoral triangle continuous with?

Answer 46

Adductor canal

Question 47

What is the clinical significance of the femoral triangle?

Answer 47

Femoral hernias Femoral pulse Access to femoral artery e.g ABGs or catheterisation

Question 48

What are the contents of the femoral canal?

Answer 48

Femoral artery, vein and associated lymphatics

Question 49

What is the clinical significance of the femoral canal?

Answer 49

Hernias