hip, buttock and thigh

Question 1

bones of region

Answer 1

pelvis, femur

Question 2

3 bones of pelvis which contribute to acetabulum (hip joint)

Answer 2

ischium, ilium, pubis

Question 3

2 layers of fascia in lower limb

Answer 3

superficial (subcutaneous tissue), deep (in thigh, called fascia lata)

Question 4

where does the fascia lata extend from and down

Answer 4

extends from the pelvis down the leg underneath

the skin like a stocking

Question 5

what is the thickened area laterally of the fascia lata called

Answer 5

ilio-tibial tract

Question 6

function of muscles in gluteal region

Answer 6

extensors, abductors, external rotators

Question 7

3 gluteal muscles (superficial to deep)

Answer 7

gluteus maximus (75% fibres merge with ilio-tibial tract, rest to gluteal tuberosity of femur; extension and adduction), gluteus medius, gluteus minimus (both cross laterally and attach to greater trochantar of femur; abduction), (tensor fasciae latae is neurologically gluteal but functions more like anterior thigh muscle, stabilising knee)

Question 8

4 short external (lateral) rotators of hip (similar to rotator cuff muscles, so stabilise hip joint as well)

Answer 8

piriformis (anatomical landmark; sacrum to greater trochanter of femur), obturator internus (from obturator foramen), gemellus (superior and inferior), quadratus femoris

Question 9

what compartment of the thigh is responsible for hip flexion

Answer 9

anterior compartment

Question 10

what compartment of the thigh is responsible for hip adduction

Answer 10

medial compartment

Question 11

what compartment of the thigh is responsible for hip extension

Answer 11

posterior (extensor) compartment

Question 12

what do ligaments in gluteal region do

Answer 12

connect bones and provide passageways for nerves and vessels

Question 13

what ligaments convert the greater and lesser sciatic notches (parts of ischial bone) to greater and lesser sciatic foramen

Answer 13

sacrotuberous (sacrum to ischial tuberosity) and sacro-spinous (sacrum to ischial spine) ligaments

Question 14

what does the greater sciatic notch transmit

Answer 14

structures leaving pelvis to lower limb, including sciatic nerve

Question 15

what does the lesser sciatic notch transmit

Answer 15

structure passing from pelvis to perineum

Question 16

course of sciatic nerve from pelvis to buttock and thigh

Answer 16

passes through greater sciatic notch to pass from pelvis into inferior medial quadrant of buttock -> passes through buttock (usually inferiorly to piriformis muscle in gluteal region, but sometimes superior) and on posterior aspect of thigh to divide at a very inconstant level

Question 17

what 2 nerves does the sciatic nerve divide into at knee

Answer 17

tibial nerve and common

peroneal nerve

Question 18

what does the sciatic nerve supply

Answer 18

posterior (extensor) muscles

Question 19

what does sciatic nerve divisions supply

Answer 19

all muscles below level of knee

Question 20

to avoid damage to the sciatic nerve, where are i.m. injections into the buttock administered

Answer 20

superior lateral quadrant (usually gluteus medius)

Question 21

hip joint type

Answer 21

synovial ball and socket

Question 22

where is the hip joint

Answer 22

between head of femur and acetabulum (all 3 pelvic bones contribute to this)

Question 23

what is around the rim of the acetabulum

Answer 23

rim of tissue called acetabular labrum (deepens fossa to increase stability)

Question 24

what ligament is within the acetabulum

Answer 24

transverse acetabular ligament

Question 25

where does the capsule of the hip joint extend down

Answer 25

neck of femur, extending further anteriorly than posteriorly

Question 26

what runs in the capsule of the hip joint

Answer 26

blood supply to head of femur

Question 27

2 types of hip fractures, and why

Answer 27

intracapsular and extracapsular, to differentiate if capsule blood supply disruption

Question 28

4 important ligaments at hip joint

Answer 28

ilio-femoral, pubo-femoral, ischio-femoral, ligament of head of femur (attaches to fovea of head of femur); spirally arranged so when extend hip, spiral and draw head towards pelvis to stabilise

Question 29

what is the blood supply of the hip joint derived from

Answer 29

medial and lateral circumflex arteries, and artery of head of femur (more significant in children)

Question 30

what fractures easily damage circumflex vessles

Answer 30

intracapsular fractures at proximal femur, leading to avascular necrosis of head (as circumflex so coming distally)

Question 31

8 muscles causing hip flexion

Answer 31

ilio-psoas, sartorius, tensor fascia lata, rectus femoris (part of quadriceps femoris), adductor longus, adductor brevis, anterior portion of adductor magnus, gracilis

Question 32

6 muscles causing hip adduction

Answer 32

adductor longus, adductor brevis, adductor magnus, gracilis, pectineus, obturator externus

Question 33

5 muscles causing hip extension

Answer 33

semitendinosus, semimembranosus, biceps femoris, posterior part of adductor magnus, gluteus maximus

Question 34

3 muscles causing hip abduction

Answer 34

gluteus medius, gluteus minimus, tensor fascia lata

Question 35

6 muscles causing hip external rotators

Answer 35

obturator internus, obturator externus, the gamelli, piriformis, quadratus femoris, gluteus maximus

Question 36

3 muscles causing hip internal rotators

Answer 36

anterior portion of gluteus medius, anterior portion of gluteus minimus, tensor fascia lata

Question 37

what spinal levels are hip flexors in general supplied by

Answer 37

L2,3

Question 38

what spinal levels are hip extensors in general supplied by

Answer 38

L4,5

Question 39

2 major regions of lower limb

Answer 39

gluteal region (part of trunk), free lower limb (thigh, leg and foot)

Question 40

2 important structures in ischium bone

Answer 40

ischial spine, ischial tuberosity

Question 41

interior and exterior parts of ilium

Answer 41

fossa interior, ala exterior

Question 42

describe the Trendelenberg test

Answer 42

abductors of thigh prevent tilting of pelvis when a limb is raised