yr 4 orthopaedics- hip and knee anatomy Flashcards
5 bones of the pelvic girdle
iliac ischium pubis saccruum coccyx
other name for hip bone and what 3 bones make it up
innominate/ os coxa
- ischium
- iliac
- pubis
what age does the ischiopubic ramus fuse
2-5 years
what are the lateral markings of the hip (label)
Iliac crest Anterior superior iliac spine anterior inferior iliac spine anterior gluteal line posterior gluteal line inferior gluteal line acetabulum ischial tuberosity pubic tubercle posterior superior iliac spine greater sciatic notch posterior inferior iliac spine lesser sciatic notch obturator formaen ischiopubic ramus superior pubic ramus inferior pubic ramus
label the acetabulum
- lunate surface
- acetabular fossa
- acetabular labrum
- ligamentum teres
what are the anterior features of the hip
iliac fossa
auricular surface
pubic symphysis
what are the anterior features of the femur
- femoral head
- femoral neck
- greater trochanter
- lesser trochanter
- interochanteric line
- foeva capitis
- patellar surface
- lateral epicondyle
- adductor tubercle
- medial epicondyle
- intercondylar notch
- gluteal tuberosity
posterior features of the femur
- interochanteric crest
- linea aspera
- popliteal fossa
- medial and lateral condyle
- interconylar fossa
label the anterior surface of the tibia
lateral and medial condule
tibial tuberosity
medial surface
intercondylar eminence
label the posterior surface of the tibia
medial condyle
intercondylar eminence
lateral condyle
soleal line
what 6 structures support the hip
3 external: iliofemoral ligament, pubofemoral ligament, ischiofemoral ligaement
3 internal:
ligamentum teres
transverse acetabular ligament
acetabular labrum
what 7 movements can the hip do
flex and extension
medial and lateral rotation
abd and add
circumduction
label the 3 external ligaments of the acetabulum
posterior isciofemoral
anterior 2 heads iliofemoral
inferior pubofemoral
what nerve and action goes with each compartment of the thigh
anterior: femoral, extension of the hip, and flexion of the knee
medial: adductor and obturator nerve
posterior: flexion at hip and extension at knee=sciatic nerve
label the 4 main bum muscles and what action do they have and what lines do they insert into
- gluteus maximum: extension of hip and posterior to posterior gluteal line and gluteal tuberosity
- gluteus medius:abduction, medial rotation/ between posterior and anterior gluteal line to greater trochanter
- gluteus minimus: between anterior and inferior gluteal lines to greater trochanter= abduction and medial rotation
- piriformis: from anterior surface of sacrum to greater trochanter= lateral rotation
why are the piriformis related to sciatic nerve pain
because the sciatic nerve through, above or below this muscle
what other muscles are deep to the glutes- external rotators
piriformis superior germellus obturator internus inferior germellus - quadratus femoris (lateral rotation of hip)
what gait abnormality is related to the glutes
trendelenburg gait
what muscles are in the anterior thigh compartment
rectus femoris vastus medialis vastus intermedius vastus lateralis sartorius iliopsoas pectineus
action of gluteus maximus
extension of hip
action of gluteus medius
abduction and medial rotation of hip
action of gluteus minimus
abduction and medial rotation
action of piriformis
lateral rotation
what muscles form the iliopsoas
psoas major, psoas minor and iliacus
what actions do the anterior muscle compartments have and what are the 2 exceptions
flex the hip extend the knee
(except the sartorius that flexes the knee)
(pectineus doesnt affect the knee but also adducts
what actions does the sartorius have
flexes the hip and flexes the knee
abduction and medially rotation at the knee
what actions does the pectineus have
flexes the hip and adductor the hip
label the psoas major and minor and what action do they have
come down from vertebra
they are for hip flexion
what muscles are in the thigh medial compartment and what nerve innervates and what is their action
adductor longus adductor brevis adductor magnus gracilis adductors obturator nerve
what are the attachment points of the adductor longus
from body of pubis to middle 1/3 linea aspera
attachment points of adductor brevis
from anterior of ischiopubic ramus to lesser trochanter and proximal 1/3 linea aspera
attachment points of adductor magnus
from ischiopubic ramus and ischial tuberosity to linea aspera and adductor tubercle
attachment point of gracilis
from ischiopubic ramusa and body of pubis to medial surface of proximal tibia
what muscles are in the posterior compartment of the leg and what nerve supplies them and what is their action
biceps femoris (long head and short head) semitendinous semimembranous sciatic nerve flex the knee extend the hip
where do all the posterior compartment of the thigh originate
ischial tuberosity (except short head of bf from distal 1/3 linea aspera)
insertion of biceps femoris
on head of fibula
insertion of semimembranous
inserts on posterior aspect of medial tibial condyle
insertion of semitendinous
inserts onto medial aspect of proximal tibia
what are the borders of the femoral triangle and the acronym to remember
NAVEL nerve, artery, vein, empty, lymphatics lateral= sartorius top= inguinal ligament medial= adductor longus floor= profunda femoris
what are the 5 key supporting structures of the knee
quadriceps tendon (patellar) patellar ligament medial collateral ligament oblique popliteal ligament (posterior) lateral collateral ligament
where do all quadriceps insert into
become the quads tendon that becomes the patellar ligament and goes into the tibial tuberosity
what is the unhappy triad and why
medial collateral ligament
anterior cruciate ligament
medial meniscus as the medial collateral is attached very firmly
what are the deep structures of the knee 4
meniscus
intercondyle eminence
cruciate ligaments (label by insertion point)
transverse ligament of the knee
function of mensci
dont slide off and shock absorbers
what do the meniscus insert into and what shape are they both
the intercondylar eminence
medial=c
lateral= circular
what muscle unlocks the knee and how
the popliteus muscle pulls on tibia to medially rotate it and unlock the knee
what is the popliteal fossa and what are its 4 contents and there order
rhomboid space in posterior of knee medial to lateral 1. popliteal artery 2. pop vein 3. tibial nerve 4. common peroneal nerve
blood supply to thigh order and bifurcation / anatomical points
- abdominal aorta l4 to form common iliac arteries
- external iliac
- femoral artery at inguinal ligament
- profunda femoris branch
- popliteal artery when goes past knee/ adductor hiatus
when does the popliteal artery begin
at the adductor hiatus
label the 3 nerves on the hip
femoral
inferior
obturator nerve
then sciatic nerve off sacral plexus
what nerves does the sciatic nerve become
tibial and common peroneal (superficial and deep)
label a knee
meniscus ligaments intercondylar notch intercondylar fossa medial and alteral condyle and (epicondyle) front of femur
what are some differences between the male and female pelvis
male= narrow heart shaped, everted pubic arch, narrow sciatic notch, larger and oval obturator foramen female= wider circular, not everted pubic arch, wider sciatic notch, narrower acetabulum, wide and shorter sacrum, smaller and triangular obturator foramen
where is the tubercle of the iliac crest located
lies opposite the 5th lumbar vetebrae
5cm posterior to the ASIS on the iliac crest
what is the highest point of the iliac crest
at the 4th lumbar vertebrae
what level does the posterior superior iliac spine lie at
level of the 2nd sacral spine at level of sacroiliac joint
what age does the ischial ramus fuse to the inferior ramus of the pubus
5-8 years
what age does the acetabulum fuse
11-15
how many primary centres of ossification are there for the inominnate and what are they
3
ilium ischium and pubis
what are the 5 additional secondary centres of ossificaiton
2 with the iliac crest
one for the anterior inferior iliac spine
pubic symphysis
ischial tuberosity
how many primary and secondary centres of ossification does the femur have
one primary centre in the midshaft 4 secondary centres -the femoral head -the greater trochanter -lesser trochanter -the distal epiphysis forms both condules
what age do the epiphysis and diaphysis begin fusing and finish
at 12
20 years
what are the proximal and distal attachment points of the iliofemoral ligament
anterior inferior iliac spine and margin acetabulum to distal to interotrochanteric line
in what position is the hip most unstable
when fixed and medially rotated ie in flexion (as the ligaments uncoil when not in extension eg standing)
function of the ligamentum teres 3
prevent dislocation of the femoral head and to initiate a reflex action to prevent excessive movements and transmits blood vessels to the femoral head
what are the two parts and function of the adductor magnus
hamstring portion of adductor magnus= sciatic nerve and is an adductor and hip extensor
adductor portion of adductor magnus= obturator nerve and is an adductor and flexion of hip`
what is the primary ossification centre for the tibia and the 3 secondary centres
primary=diaphysis shaft
secondary= proximal epiphysis, distal epiphysis and for the ischial tuberosity
what is the primary ossification centre of the fibula and the 2 secondary
primary= shaft dipahysis secondary= distal and proximal epiphysis
where is the suprapatellar bursa
under the quads tendon
Adductor tubercle sits where
Proximally posteriorly medially on femur
