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term 2 movement yr 2 > week 2. The pelvis and hip joint > Flashcards

week 2. The pelvis and hip joint Flashcards

1
Q

what is the purpose of the pelvic girdle?

A

connects the vertbral column to the femurs

protects the organs, vessels and nerves in the pelvic region

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2
Q

Compare the pelvic girdle to the shoulder girdle

A

It is much stronger but less flexible

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3
Q

what are the 3 joints that make up the pelvic gihirlde?

A

2 sacroiliac joints and the pubic symphysis joint

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4
Q

what is the hip bone (innominate bone) made of?

A

the ilium, the pubis and the ischium

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5
Q

How does the ilium, pubis and ischium develop?

A

The develop seperately but then fuse to form the acetabulum

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6
Q

what does the acetabulum do?

A

it is the socket that attatches and articulates with the femoral head –> forming the hip joint

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7
Q

what type of joint is the hip joint?

A

ball and socket

Synovial joint –> covered by synovial membrane

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8
Q

what provides stability to the hip joint?

A

Acetabular anatomy

Fibrous capsule

Ligaments :
Ileofemoral
Pubofemoral
Ischiofemoral

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9
Q

what are the features of the acetabulum that stables the hip joint?

A

The articular surface is smooth and crescent shaped – ‘lunate surface’

It is deficient inferiorly - acetabular notch

The acetabular notch is bridged by the transverse acetabular ligament

Acetabular labrum –> a rim / lip of cartilage –> deepens the articular surface

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10
Q

how does the fibrous capsule stable the hip joint?

A

The articular capsule is strong and dense. –> Loose enough to help the joint move

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11
Q

what are the attachments of the fibrous capsule of the hip joint?

A

Proximal attachment encircles rim of acetabulum

Distal attachment is to the femoral neck–> intertrochanteric line and greater trochanter

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12
Q

How do the hip ligaments stabalise the hip joint?

A

Spiral around the hip joint

Taut when hip is extended

Pull the femoral head into the acetabulum

Improves stability

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13
Q

what does the illeofemoral ligament do? What is its attachment?

A

Covers hip joint superiorly and anteriorly
Strongest ligament
Prevents hyperextension of the hip during standing - ‘screws in’ the femoral head

Attaches to the ilium proximally and femur distally

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14
Q

what does the pubofemoral ligament do? What are the attachments?

A

Covers hip joint inferiorly and anteriorly
Prevents excessive abduction

Attaches to the pubis proximally and femur distally

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15
Q

what does the ischiumfemoral ligament do? What are the attachments?

A

Covers hip joint posteriorly
Weakest ligament

Attaches to the ischium proximally and femur distally

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16
Q

what is the anatomical name of the hip bone?

A

innominate bone

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17
Q

what caues the fracture of the pubic rami?

A

lateral force –> large amount of force

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18
Q

how does the limb apear after a posterior dislocation?

A

Limb appears shortened and internally rotated

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19
Q

what type of incident would cause a posterior dislocation?

A

Anterior blow to the knee when the hip is –> flexed, internally rotated and adducted. So in the seat position

Car crash from behind –> knees hit the dashboard and push the femoral head out posteriorly from the acetabulum

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20
Q

what can be damaged by a posterior dislocation?

A

Sciatic nerve injury may result

May be associated acetabular fracture

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21
Q

how does anterior dislocation occur?

A

Occurs when force is applied during extreme abduction with external rotation of hip

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22
Q

what is the position of the femoral head after a anterior dislocation?

A

Femoral head is levered out anteriorly

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23
Q

how does the limb look after a anteiror dislocation?

A

Limb appears externally rotated, abducted and flexed

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24
Q

what is more common posterior or anterior dislocation?

A

posterior

25
Q

what can get damaged in anterior dislocation?

A

sciatic nerve is posterior so does not get damaged

However femoral artery and vein do get damaged as it is positioned anteriorly

26
Q

what occurs when there is lack of blood supply to the femoral head?

A

avascular necrosis occurs to the femoral head

27
Q

What occurs in development dysplasia of the hip?

A

Occurs in children
Umbrella term where there is sublaxation due to the loosening of the ligaments.
The ball can sometimes be slightly or completely dislocate from the socket.

28
Q

what is the problem with development dysplasia of the hip in children?

A

have trouble walking and get a kid with a limp

If the femoral head and acetabulum are not attached from the start –> neither one will develop properly
They need to articulate to develop properly –> Can cause later problems

29
Q

What does the pelvic girdle provide?

A

A stable ans stong support for the lower limbs

30
Q

What are the articulations of each of the innominate bones?

A

Each one articualtes with the sacrum posteriorly at the sacroiliac joint and with each other anteriorly at the pubic symphysis

31
Q

What is another name for the innominate bone?

A

Hip bone –> single

32
Q

What are the functions of pelvis

A

Contain and support bladder, rectum, anal canal and reproductive tract

Bear the weight of the upper body when sitting and standing

Provide attachment for powerful muscle invovled in locomotion, posture and those of adominal wall for standing.

Contains and protects the abdominopelvic and pelvic visera.
33
Q

What is the difference in male and female pelvis in terms of general stuctures and the greater and less pelvis?

A

General structure
M–> thick and heavy
F–> thin and light

Greater pelvis
M–> deep
F–> shallow

Lesser pelvis
M–> narrow and deep
F–> wide and shallow

34
Q

What is the difference in male and female pelvis in relation to the pelvic inlet/outlet?

A

Pelvic inlet

M–> heart shaped, narrow
F –> oval and rounded; wide

Outlet
M –> compartively small
F–> compartively large

35
Q

What What is the difference in male and female pelvis in relation to the pubic arch and greater sciatic notch?

A

Pubic arch

M –> narrow, it is between 50-60
F–> wide, it’s between 80-90

Greater sciatic notch

M–> narrow less than 70
F–> almost 90

36
Q

What ligaments strengthen the pelvic girdle?

What are there attachments

A

The sacrotuberois ligament –> Attach the sacrum to the ischial tuberosity

The sacrospinous ligament attaches the sacrum to the ischial spine

37
Q

Whata re the movements possible at the hip joint?

A

Flexion/extension

Abduction and adduction

External and internal rotation

Circumduction

38
Q

What are the chief abductor at the hip joint?

A

Gluteus medius and minmus

39
Q

Where does piriformis lie?

A

Deep to gluteus maximus

40
Q

Where is a safe site to do intramuscular injection?

A

Gluteal muscle is a large mass of muscle so therefore used.

Specifically the upper outer quadrant of the gluteal region is used to ensure not damaging the sciatic nerve

41
Q

Why is the location of piriformis important?

A

It is a key reference point for identification of vesels and nerve which are superior and inferior to piriformis and pass through the greater sciatic foramen

42
Q

What vessels and nerves pass superior to piriformis?

A

The superior gluteal nerves and vessels pass through the foramen above the piriformis.

43
Q

What vessels and nerves pass inferior to piriformis?

A

Passing through the foramen below the piriformis are: Inferior gluteal nerves and vessels
Sciatic nerve
Pudendal nerve
Internal pudendal vessels
Posterior femoral cutaneous nerves
The nerves to the obturator internus and quadratus femoris muscles.

44
Q

How many fractures can occur on the pubic rami?

A

2 –>Superiorly and inferiorly

45
Q

What occurs in the open book pelvic fracture?

A

There is disruption in the pubic symphysis joint.

46
Q

What is a medial dislocation/ acetabular fracture?

A

It is when the femoral head pierces through the acetebulum

47
Q

How is the acetabular fracture caused?

A

Caused by falling from a height –> the femur goe upwards need a lot of force

48
Q

What is the complications of a acetabular fracture

A

Can damage the bladder and/or uterus in females.
Damage to the plexus of arteries, nerves and veins.
Can cause bleeding and death

49
Q

Disruption of the blood supply to the femoral head can be caused by?

A

Blood vessels being torn or stretched

Some branches may remain kinked or compressed until the hip is reduced

50
Q

So what are the different severity of development dysplasia of the hio

A

Normal, sublaxation, low dislocation and high dislocation

51
Q

How does sublaxation and low/high dislocation occur in DDH?

A

The ligaments surrounding the hip joint are loosened allowing sublaxation of the hip joint. The femoral head is no longer in the center of the joint.

Get slight or complete dislocation of the socket.

52
Q

Other than strengthening the pelvic girdle what else do the sacrotuberous and sacrospinous ligament do?

A

They convert the greater and lesser sciatic notches into the greater and lesser sciatic foramen

53
Q

what is the Iliotibial Tract?

A

The iliotibial tract is a longitudinal thickening of the fascia lata, which is strengthened posteriorly by fibres from the gluteus maximus.
It is located laterally in the thigh
Extending from the iliac tubercle to the lateral tibial condyle.

54
Q

What are the functions of the iliotibal tract?

A

Movement: acts as an extensor, abductor and lateral rotator of the hip, with an additional role in providing lateral stabilisation to the knee joint.

Compartmentalisation: The deepest aspect of ITT extends centrally to form the lateral intermuscular septum of the thigh and attaches to the femur.

Muscular sheath – forms a sheath for the tensor fascia lata muscle.
55
Q

What are the chief abductors at the hip joint?

A

Gluteus medius and minimus

56
Q

Why is the gluteal region used for IM injection?

A

Gluteal muscles constitute a large mass of muscle

57
Q

What muscle divides the greater sciatic foramen into two parts?

A

Piriformis.

Structures run above or below the piriformis as they run through the greater sciatic foramen

58
Q

What passess through the lesser sciatic foramen?

A

Internal pudendal artery and vein
Pudendal nerve
Nerve to obturator internus
The tendon of obturator internus

term 2 movement yr 2 (9 decks)

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