Unit 2 Lecture 1 Flashcards
The main purposes of the lower limbs for:
- Weight bearing;
- Standing;
- Balance;
- Locomotion/Propulsion/Ambulation
What does the pelvic girdle join?
The axial skeleton to the lower limb
What 4 bones makes up the pelvic girdle?
- 2 coxal bones(aka hip bones) (form the pelvic walls)
- sacrum and coccyx (form the posterior wall)
What is the intergluteal (natal) cleft?
the crease between the two buttocks or gluteal masses
What is the clunes?
The part of the butt that sometimes hangs out bottom of bikini
The hipbones aka the acetabulum is the result of its fusion of 3 different bones:
The lium, ischium and pubis
The ilium, ischium and pubis fuse at the _____.
The acetabulum (aka the hip joint socket)
When we are children, the ischium, ilium, and pubis are separated by:
Triradiate Cartilage
Ilium:
The ilium is the larger, upper part of the hipbone and forms the upper part of the acetabulum
Ischium
The ischium forms the postero-inferior part of the hipbone and acetabulum
Pubis
The pubis forms the anteromedial part of the hipbone and the acetabulum
pelvic inlet vs pelvic outlet
pelvic inlet is looking superiority down into the pelvic region, looking from the feet straight up is called the pelvic outlet
sacral promontary
center of gravity and start of pelvis
greater / false pelvis
everything above the iliopectinial line (contains the intestines) Iliac fossa and Ala are above
lesser / true pelvis
everything below the iliopectinial line (pelvic organs- colon, bladder, reproductive organs)
differences between male and female pelvis’
females pelvis is broader
What part of the femur articulates with the acetabulum?
the head of the femur
The head of the femur is covered in hyaline (thick) cartilage except for the sphere thumbprint in the center called the
fovea capitis
What is inside the fovea capitis?
a ligament that carries nutrients from femur area to the acetabulum
What is the angle of inclination?
the angle that the line of the neck of the femur is to the line through the middle of the shaft of the femur. It should be about 120-135 degrees
the acetabulum is ____ and ___ to the head of the femur
superior and medially attached
Coxa Vara
angle of inclination is less than 120 degrees
Coxa Valga
angle of inclination is greater than 135 degrees
Our normal alignment of femur leads us to have our femur face slightly _____ into our patella
medially
Coxa vara usually leads to ____
The femur facing medially SO
Genu VaLgus- the leg being more lateral.
Coxa valga usually leads to
the femur facing more laterally SO
Genu varus- the leg being more medial
The lumbosacral joint
articulates lumbar spine with the sacrum. (L5-S1).
Joins axial skeleton with pelvic body
The sacrococcygeal joint
the articulation with the coccyx with the sacrum above it
-It has anterior (sometimes called lateral) and posterior sacroccygeal ligaments
interpubic joint
attaches the two coxals in the front (pubic symphysis). Each end is covered in hyaline cartilage and between the two ends is a fibrocartilaginous disk.
NOT intended for mobility.
SI joint- Sacroilliac joint
Connects the left and right sides of the sacrum to each ilium.
It is a gliding joint (synovial natures but doesn’t move much)
great for STABILITY! Interlocking surfaces between (puzzle like)
The SI joint has many ligaments including
The joint has a posterior ligament as well as a very strong interosseous sacroiliac ligament. The anterior sacroiliac ligament is thin and situated on the anterior aspect of the joint. THERE ARE MORE SI LIGAMENTS WITH MORE DETAILS ON OTHER CARDS
iliolumbar ligament
an assisting SI ligament- it is a strong ligament observed running between the transverse processes of the 3rd and 4th lumbar vertebrae and the posterior portion of the iliac crest
The sacrotuberal ligament
big Y shape ligament. It covers the greater sciatic notch and lesser sciatic notch posteriorly.
AKA
It goes from PSIS down medially to attach to the sacrum/coccyx and then it continues down laterally to attach to the ischial tuberosity.
the sacrospinous ligament
it runs from the lateral part of the sacrum and coccyx to the ischial spine.
it separates the greater sciatic notch from the lesser sciatic notch.
the sacrospinous ligament and the sacrotuberal ligament together
convert the greater sciatic and lesser sciatic notches into the greater and lesser sciatic foramina
the boundaries of the greater sciatic notch
anterosuperior: rim of the great sciatic notch
b. posteromedial: sacrotuberous ligament
c. inferior: sacrospinous ligament and ischial spine
d. The piriformis muscle exits out of the pelvis through the greater sciatic foramen. The superior gluteal nerves and vessels exit the greater sciatic foramen above the piriformis
structures that exit below the piriformis:
inferior gluteal nerves and vessels
- internal pudendal vessels
- pudendal nerve
- sciatic nerve
- posterior femoral cutaneous nerve
- nerve to obturator internus
- nerve to quadratus femoris
the piriformis
externally rotates femur when it contracts
The boundaries of the lesser sciatic foramen are:
a. anterior: body of ischial tuberosity
b. superior: ischial spine and sacrospinous ligament
c. posterior: sacrotuberous ligament
the sciatic nerve runs down the
posterior thigh and into leg
pudendal nerve
potty training nerve
obturator internus
the last structure to exit the pelvis via the lesser sciatic foramen
The structures entering the pelvis through the lesser sciatic foramen are:
P - pudendal nerve
I -internal pudendal vessels
N- nerve to obturator internus
sciatica
when someone has pain at central buttocks or down the posterior thigh - symptoms: burning, shooting, stabbing…
pisiforms syndrome
when the pisiform irritates the sciatic nerve
the hip joint is also called the
femoroacetabular joint
what kind of joint is the hip joint?
ball and socket - designed for flexibility
the 2 parts of the hip joint?
- a very deep acetabulum
2. femoral head
the hip joint is designed for ___ whereas the shoulder joint is designed for ___
hip joint - stablility
shoulder joint - mobility
The head of the femur and the surface of the acetabulum are covered by a____________ (except for the fovea capitis).
thick hyaline cartilage
acetabular labrum
A fibrocartilaginous rim that is attached to the acetabulum. It deepens and increases stability of the hip joint
The acetabulum has a ____ shape
horseshoe
The acetabular notch provides a ________
passage for the vessels and the nerves to the joint.
The acetabular labrum, continuous with the transverse ligament of the acetabulum, bridges over _____ to close the acetabulum
bridges over the acetabular notch
zona orbicularis and zona longitudinalis
- articular capsule ?* thick and strong?
orbicularis forms a ring that prevents dislocation say if someone pulls your leg
longitudinalis- when we go from flexion to extension, these fibers are pulled and they seat the femoral head into the acetabulum for stability
ligamentum capitas femoris (also can be called ligament teres)
from the acetabular notch to the fovea capitis - provides blood vessels to the head of the femur. It also has some proprioceptors and nociceptors!
pubofemoral ligament
prevents hip abduction. its underneath the femoralacetabular joint
Iliofemoral ligament (anteriorly) or Y-shaped ligament of Bigelow
prevents overextension of the joint - (becomes taut).
Ischiofemoral ligament (posteriorly)
limits medial/ internal rotation
slouching person is
hanging on his ligaments
the gluteus maximus
supplied by the inferior gluteal nerve, is a large superficial muscle that is primarily responsible for the prominence of the buttock
gluteus maximus function
primarily a hip extender - so it takes your leg/ thigh behind you
the gluteus Maximus has two bursa. The trochanteric bursa and the ischiogluteal bursa. Describe these
The trochanteric bursa is found between the muscle and the greater trochanter. The ischiogluteal bursa is between the gluteus maximus and the ischial tuberosity.
gluteus medias is partially covered posteriorly by the glut max. The gluteus medias’ functions( the deltoid of the gluts) are:
anterior portion- flex the thigh or internal rotation of thigh
middle portion - powerful hip/thigh abducter
posterior portion- extend the thigh or external rotation
the gluteus medias is innervated by the
the superior gluteal nerve
gluteus minimus
also supplied by the superior gluteal nerve, is the smallest and the deepest of the 3 gluteal muscles. Its insertion on the anterior border of the greater trochanter blends with the capsule of the hip joint
tensor fasciae latae
supplied by the superior gluteal nerve, is enclosed by the fascia latae. It inserts and ends in the iliotibial tract between the middle and upper third of the thigh.
-TSL FLEX’S THE HIP AND EXTENDS THE KNEE- it also helps with hip adduction and internal rotation. It also helps with knee extension
gerdie’s tuburcle
the insertion point for the IT band. It’s the lateral part of upper tibia
the 6 little rotators of the hip- P
GO
GO
Q
- the piriformis
- obturator internus
3&4. superior and inferior gemellus - quadratus femoris
- obturator externus produce
Gluteus medius & minimus insert on the ________
Trendelenburg sign=
Gluteus medius & minimus insert on the greater trochanter
Trendelenburg sign= Gluteus medius weakness
the old lady walking video
The piriformis
supplied by the nerve to the piriformis, lies next to the gluteus minimus. It exits the pelvis through the greater sciatic foramen to insert into the upper border of the greater trochanter.
The obturator internus
supplied by the nerve to the obturator internus and superior gemellus, after it emerges from the lesser sciatic foramen, crosses the hip joint and inserts via its tendon into the medial surface of the greater trochanter.
The tendon of the obturator internus is joined by
the superior and inferior gemellus muscles.
The gemellus superior and gemellus inferior
are small muscles lying adjacent to the tendon of the obturator internus. Both insert into the tendon of the obturator internus. For the innervation to these two muscles, see obturator internus (above) and quadratus femoris (below) innervation descriptions
The quadratus femoris supplied by the nerve to the _____ and ____, is a flat muscle covering the external surface of the _______. It crosses the posterior aspect of the neck of the femur and ends on the quadrate tubercle of the femur
The quadratus femoris , supplied by the nerve to the QUADRATIC FEMORIS AND INFERIOR GEMELLUS, is a flat muscle covering the external surface of the POSTERIOR PELVIC WALL.
The obturator externus arises from the external surface of the
_____ and _______, It passes underneath the hip joint and courses deep to the quadratus femoris to insert into the medial side of the greater trochanter at the _________. The obturator externus is the only muscle of the gluteal region innervated by the ________
The obturator externus (Netter: 481) arises from the external surface of the OBTURATOR FORAMEN AND OBTURATOR MEMBRANE, It passes underneath the hip joint and courses deep to the quadratus femoris to insert into the medial side of the greater trochanter at the TROCHANTERIC FOSSA. The obturator externus is the only muscle of the gluteal region that is innervated by the OBTURATOR NERVE
The 6 rotators of the hip produce external rotation and abduction EXCEPT
the quadratus femoris because it does not insert on the greater trochanter and lies inferior to the axis of movement of the hip, produces hip adduction
