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Gross Anatomy > Lecture 4: Lower Limb Pt. 1 Hip/Gluteal Thigh > Flashcards

Lecture 4: Lower Limb Pt. 1 Hip/Gluteal Thigh Flashcards

1
Q

Femoral Triangle Borders (3)

A
  1. superior: inguinal ligament
  2. Lateral: medial border of the sartorius
  3. Medial: medial border of adductor longus muscle
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2
Q

Femoral Triangle

A

wedge shaped area located within superiomedial aspect of the anterior thigh that acts as a channel for structures entering and leaving anterior thigh

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3
Q

Contents of Femoral Triangle (5)

A

NAVEL (pneumonic device)

  1. femoral Nerve
  2. femoral Artery
  3. femoral Vein
  4. Empty space- for veins and lymph vessels to distend to accommodate different levels of flow
  5. Lymph nodes
  • nerve and vessles pass beneath inguinal ligament and gain access to anterior thigh + femoral sheath of fascile sleeve
  • femoral canal and ring are weak point and site for femoral hernias
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4
Q

Femoral Sheath

A

fascial sleeve within femoral triangle

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5
Q

Femoral hernias occur where?

A

femoral canal and ring are weak site

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6
Q

Femoral Hernia

definition
clinical manifestation
treat

A

Hernia: part of an organ is displaced and protruding through the wall of the cavity containing it

Femoral Hernia: part of bowel pushes into femoral canal underneath inguinal ligament

  • clinically presents as lump or buldge in femoral triangle
  • req. sx intervention to treat
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7
Q

Bones of the Thigh (6)

A
  1. Sacrum
  2. coccycx
  3. Ilium
  4. Ischium
  5. Pubis
  6. femur
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8
Q

Sacrum

A

large bone located at end of vertebral comumn and forms posterior aspect of pelvis

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9
Q

Coccyx

A

terminal part of vertebral columns, compromized of 4 vertebra which fuse to produce traingular shape

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10
Q

Ilium

A

widest and largest bone, superior

anterior iliac spine ASIS: true leg lenth is measures from ASIS to medial mallelolus

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11
Q

Pubis

A

most anterior portion of pevlic girdle

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12
Q

femur

A

only bone in the thigh, longest bone in body

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13
Q

Bones of the Hip (3)

**note

A
  1. Ilium : upper margin characterized by iliac crest
    - lateral surface exhibits 3 gluteal lines for attachment of gluteal muscles
  2. Ischium contributes to acetabulum and forms the ischial spine and ischial tuberosity
    - ischial tuberosity-= sits bone
  3. Pubis- formes anterior and medial aspects of each hip bone
    - forms “c” upper limb being the superior pubic ramus and lower limb being inferior pubic ramus

*all three contribute to site of articulation with the femoral head

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14
Q

Hip Joint and Ligaments (3)

type joint
3 ligaments involved

A

*ball and socket
-ball=head of femur
-socket=acetabulum of hip
~~both covered in articular cartilege

  1. Iliofemoral ligament
  2. pubofemoral ligament
  3. Ischiofemoral ligament
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15
Q

Ilio femoral ligament

shape
location
purpose

A

Y-shaped

spans from anterior inferior iliac spine to intertrochanteric line

prevents hyperestension of hip joint

*anterior

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16
Q

Pubofemoral ligament

location
purpose

A

spans from inferior pubic ramus to blend with capsule of the hip joint

prevents excessive abduction of joint

*medial

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17
Q

Ischiofemoral ligament

A

arises from acetabular rim poertiorly and attaches laterally to greater trochanter

*posterior

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18
Q

ROM of hip (6) and the muscles that cause the movement ** (starred slide)

A
  1. Flexion
  2. Extension
  3. Abduction
  4. Adduction
  5. External Rotation
  6. internal rotation
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19
Q

Congenital/developmental hip dislocation

special pop.
how does this occur?
2 tests/what they do

A

10 in 10,000 infants born with developmental dislocation

girls > boys

when acetabulum is shallow as result or failure to fevelop properly in utero

ortolani’s test of hib adbcution confirms dx

barlow pops hip out

early detection lead to 96% children gaining normal hip function

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20
Q

Brusitis - three main

2 types
treatments of each type

A
  1. sciatic
  2. trochanteric **most common cause hip pain, causes tenderness on the outer hip
  3. iliopectineal

tx: ice, medicaion for inflammation and pain

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21
Q

tensor fascia latae

I
2 movements

A

inserts on iliotibial tract, attached to lateral condyle of tibia

internal rotation, abduction

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22
Q

Iliopsoas (2)

Origin
movement

A

1) psoas major- originates from T12-L4 -> medial, inner aspect of femur
2) Iliacus- originates form iliac fossa and blends with tendon of psoas major -> medial, inner aspect femur

flexion of hip

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23
Q

Hamstring (3 muscles)

A
  1. semitendinosis
  2. Biceps femoris
  3. Semimebranosis
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24
Q

Quadriceps femoris (4 musces)

A
  1. Rectus femoris
  2. Vastus lateralis
  3. Vastus Medialis
  4. Vastus intermedius
    * all quadricep muscles unite at quadriceps tendon, which attaches to the patella
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25
Q

Satroius

O
I
M

A

O: from the anterior superior iliac spine

I:onto the medial tibia as part of pes anseriunus

M: flexor

26
Q

Gracillis

A

O: body of pubis
I: medial tibia
M: adductor

also part of pes snseriunus

27
Q

Lumbar Plexus

A
  1. lumbar formed by spinal nerves L1-L4
28
Q

Nerves of Thigh ** (4)

A
  1. Femoral Nerve
  2. Obturator Nerve
  3. Sciatic Nerve
  4. Pudendal Nerve
29
Q

Sciatic Nerve: clinical correlation

IM must be given where?

A
  1. must be considered when admistering intramuscular innjections onto gluteal region **
    a. one line descends vertically from the highest point on the iliac crest
    b. the other horizontal line passes through the vertical line halfway between the highest point on the iliac crest and ischial tuberosity

nerve passes through the lower medial quandrant

  1. to avoid damaging the sciatic nerve, IM injections given only in UPPER LATERAL QUADRANT OF THE GLUTEAL REGION
30
Q

Sciatica

A
  1. Pain the radiates along path of sciatic nerve
  2. herniated disc may compress nerve on one side, causing symptoms in one leg
  3. OR disc may bulge or herniate from both sides, causing symptoms in both legs
    - DD, Spinal stenosis, sponfylolitheses, OA, traumra, tumprs, piriformis syndrom

burnign sennsation or sharp, shooting pain- can be constant or intermittent

leg pain commonly occurs more in calf region below the knee

31
Q

Blood Supply/ Lymph

2 arteries
nodes where?

A
  1. femoral artery
  2. Obtruator artery: branch of internal iliac artery
    - descends via obtruator canal to enter medial thigh
    a. anterior branch
    b. posterior branch
  3. inguinal nodes in femoral triangle
32
Q

Femoral artery gives rise to… (3) arteries

A
  1. superficial epigastric
  2. superifical cirumflex iliac
  3. external pudental
33
Q

Landmarks of Femur (4)

A
  1. head of femur: articulares with acetabulum of hip bone
  2. neck of femur extends to intertrochanteric line
  3. intertrocanteric line: between greater and lesser trochanters and it site where neck and shaft of femur join
  4. Medial and lateral condyles: articulates with meiscis and tibial condyles to form knee joint
34
Q

Flexion of Hip (4 muscles)

*starred slide

A
  1. iliopsoas
  2. rectus femorus
  3. sartorius
  4. pectineus
35
Q

Extension of Hip (4 muscles)

*starred slide

A
  1. gluteus maximus
  2. semimembranosus
  3. semitendinosus
  4. biceps femoris (hamstrings)
36
Q

Abduction of the Hip (4 muscles)

*starred slide

A
  1. gluteus medius
  2. gluteus minimus
  3. piriformis
  4. tensor fascia latae
37
Q

Adduction of the Hip (5 muscles)

*starred slide

A
  1. adductor longus
  2. adductor brevis
  3. adductor magnus
  4. prectineus
  5. gracilis
38
Q

External Rotaton of the Hip (6 muscles)

*stared slide

A
  1. biceps femoris
  2. gluteus maximus
  3. piriformis
  4. Asst. obtruators
  5. asst. gemeli
  6. asst. quadrates femoris
39
Q

Internal rotation fo the hip (3)

A
  1. anterior fibers gluteus medius
  2. anterior fibers gluteus minimus
  3. tensor fascia latae
40
Q

Barlow’s test

A

hip displocation of infants

  1. examiner adducts the hip while applying posterior force on the knee to promote dislocation
41
Q

Ortolani

A

hip dislocation of infants

  1. examiner abducts the hip while applying an anterior force on the femur to reduce the hip joint
42
Q

infectious bursitis

tx(3)

A
  • uncommon

- if it does occur, tx with abx, aspirin, sx

43
Q

semitinosus muscle

origin
insertion
movement

A

Member of hamstring

O: ischial tuberosity
I: upper media tibia
M: extension hip

+ inserts with sartorial and gracilis for four pes anserinus

44
Q

pes anserinus (3 muscles)

A

semitendinosus + sartorius + gracillis

45
Q

Biceps femoris

Origin
inserition

A

Member of hamstring

O: ischial tuberosity
(long head)
-linea aspera and supracondylar line femur (short head)

I: lateral aspect fibular head

M: extension hip

46
Q

Semimembranosus

Origin
Insertion

A

member of hamstring

O: ischial tuberosity
I: posterior side of medial tibial condyle

M: extension hip

47
Q

Rectus femoris

origin
insertion

A

member of quadriceps

O: anterior inferior iliac spine
M: flexion hip

Attached to other quadriceps muscles -> unite as quadriceps tendon -> attach to patella

48
Q

Vastus Lateralis

origin
insertion

A

member of quadriceps

O: greater tochanter

Attached to other quadriceps muscles -> unite as quadriceps tendon -> attach to patella

49
Q

Vastus Medialis

origin
insertion

A

member of quadricepts

O: intertrochanteric line

Attached to other quadriceps muscles -> unite as quadriceps tendon -> attach to patella

50
Q

Vastus intermedius

origin
insertion
movement

A

member of quadriceps

O: anterolateral shaft of femur

Attached to other quadriceps muscles -> unite as quadriceps tendon -> attach to patella

51
Q

adductors of the hip/thigh (3)

A
  1. adductor longus
  2. adductor brevis
  3. adductor magnus
52
Q

Sacral Plexus

A

from by anterior rami of S1, S2, S3, S4

-received contribution form lumbar and spinal nerved L4 and L5

53
Q

Plexus of the thigh (2)

A
  1. lumbar

2. sacral

54
Q

Femoral nerve

roots
innvervation

*stared

A

R: L2-L4

I: hip flexors and knee extensors

55
Q

Obturator nerve

roots
innervation

*stared

A

r: L2-L4

I: all muscles in the medial compartment of the thigh

56
Q

Sciatic Nerve

roots

*stared

A

r: L4-S3
* combination of tibial and common fibular nerve
* largest nerve in the body

57
Q

Pudental Nerve

Roots
Innvervation

A

R: S2-S4

I: internal genitalia, skin around anus, anal canal, perineum

58
Q

Femoral Artery

gives rise to (3)
largest branch

A

continuation of external iliac artery distal to the inguinal ligament

  • gives rise to
    1. superficial apigastric
    2. superficial circumflex iliac
    3. external pudendal arteries

*largest branch is profunda femoris artery (branches from femoral artery posteriorly)

59
Q

Obtruator Artery

2 branches

A
  1. branch of internal iliac artery
  2. descends via obtruator canal to enter medial thigh
    a. anterior branch:
    b. posterior branch
60
Q

Anterior Branch obturator artery

supplies (4)

A

Supplies

  1. pectinous
  2. obtruator externes
  3. adductor muscles
  4. gracilis
61
Q

Posterior branch obturator artery

supplies

A

supplies some of deep gluteal muscles

Gross Anatomy (14 decks)

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