Workbook - The gluteal region and hip joint Flashcards
Which bones form the pelvic girdle? (3)
- 2 hip bones
- Sacrum
What is another name for the hip bone?
Innominate bone.
What are the articulations within the pelvic girdle?
- Sacroiliac joints (posteriorly, between sacrum and hip bone)
- Pubic symphysis (anteriorly, between 2 hip bones)
What parts is each innominate bone derived from as it develops? (3)
- Ilium
- Ischium
- Pubic
What is the point where the ilium, the ischium and the pubic bones fuse?
The acetabulum.
What are the main differences between the male and female pelvis?
- PEVLIC INLET - heart shaped in males
- circular in females (less distinct promontory)
- ANGLE FORMED BY PUBIC ARCH ARMS - smaller in males (50-60) than females (80-85)
- ISCHIAL SPINES - project further medially into pelvic cavity in males
Why does the pelvis differ between males and females?
Mainly due to childbirth.
What type of joint is the pubic symphysis?
2* cartilaginous joint.
What are the main functions of the pelvis? (4)
- Contains and protects organs
- Weight bearing for upper skeleton
- Root of external genitalia are anchored to it
- Attachment for muscles
Which ligament strengthen the pelvic girdle? (2)
- Sacrotuberous ligament
- Sacrospinous ligament
What does the sacrospinous ligament run between?
Sacrum and ischial spine.
What does the sacrotuberous ligament run between?
Sacrum and ischial tuberosity.
What do the sacrospinous and sacrotuberous ligaments convert the greater and lesser sciatic notches into?
Greater and lesser sciatic foramen.
Which bones form the hip joint? (2)
- Hip (innominate) bone
- Head of the femur
What movements are possible are the hip joint? (4)
- Flexion/extension
- Abduction/adduction
- Medial and lateral rotation
- Circumduction
What structures stabilise the hip joint? (5)
- Acetabulum anatomy (encompasses femur)
- Hyaline cartilage (cover femur head)
- Transverse acetabular ligament
- Articular fibrous capsule
- Ligaments
Where is the hyaline cartilage of the hip joint broadest?
Superiorly.
Which ligaments help to stabilise the hip joint?
- ILIOFEMORAL ligament (sup/ant. Strongest, prevent hyperextension)
- PUBOFEMORAL ligament (inf/ant. Prevents excessive abduction)
- ISCHIOFEMORAL ligament (post. Weakest)
What are the main muscles at the hip joint? (3)
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
What is the iliotibial tract?
Lateral thickening of fascia lata into a longitudinal band.
-descends along lateral leg from tubercle of iliac crest to bony attachment below knee
What is the function of the iliotibial tract?
- Holds the leg in extension at knee
- Stabilises hip joint»_space; prevents lateral displacement of femur
What are the main abductors at the hip? (2)
Gluteus medius and minimus.
What muscles lies deep to gluteus maximus?
Piriformis.
How does piriformis exit the pelvis to enter the gluteal region?
Through the greater sciatic foramen.
-crosses post/sup hip joint
Which nerve emerges from the lower border of piriformis?
Sciatic nerve.
Where is a safe area for intermuscular injection in the gluteal region? What structure must be avoided?
Upper outer quadrant of gluteal region.
-must avoid sciatic nerve
Why is piriformis a key reference point?
For identification of vessels and nerves which pass through the greater sciatic foramen.
What structures leave the greater sciatic foramen superior to piriformis? (3)
- Superior gluteal nerve
- Superior gluteal artery
- Superior gluteal vein
What structures leave the greater sciatic foramen inferior to piriformis? (8)
- Inferior gluteal nerves
- Inferior gluteal artery
- Inferior gluteal vein
- Sciatic nerve
- Pudendal nerve
- Post femoral cutaneous nerves
- Nerve to obturator internus
- Nerve to quadratus femoris
What structures pass through the lesser sciatic foramen? (4)
- Tendon of obturator internus
- Pudendal nerve
- Internal pudendal vessels
- Nerve to obturator internus
What is significant about the pudendal nerve?
Passes through greater sciatic foramen first and then through the lesser sciatic foramen.
What muscles are in close proximity to the sciatic nerve in the posterior thigh? (4)
- Obturator internus
- Superior gemellus
- Inferior gemellus
- Quadratus femoris
What is the common distal attachment of piriformis, obturator internus and the gemelli?
Greater trochanter of femur.
What are the common actions of piriformis, obturator internus and the gemelli?
- Lateral rotation of extended hip
- Abduction of flexed hip
What is the major blood supply to the thigh?
Femoral artery.
What is the femoral artery a continuation of?
External iliac artery.
Where does the external iliac artery become the femoral artery?
As it passes under the inguinal ligament into the femoral triangle.
What does the femoral artery supply?
Most of thigh and all of leg.
How many gluteal arteries are there?
Two.
- superior (from post trunk of internal iliac)
- inferior (from ant trunk of internal iliac)
Where do the gluteal arteries originate, and from what?
In the pelvic cavity.
-branches of internal iliac artery
How does the superior gluteal artery leave the pelvic cavity?
Through the greater sciatic foramen above piriformis with superior gluteal nerve.
What does the superior gluteal artery divide into in the gluteal region, and where do these branches go?
Superficial branch»_space; deep surface of gluteus maximus
Deep branch»_space; passes between gluteus medius and minimus
How does the inferior gluteal artery leave the pelvic cavity?
Through the greater sciatic foramen inferior to piriformis with inferior gluteal nerve.
Where does the inferior gluteal artery go, and what does it supply?
Descends into posterior thigh and anastomoses with perforating branches of femoral artery.
-supplies a branch of the sciatic nerve
What is the obturator artery a branch of?
Internal iliac artery.
Where is the obturator artery located?
Passes through the obturator canal to the medial thigh.
