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week 9 > Anatomy-hip & thigh > Flashcards

Anatomy-hip & thigh Flashcards

1
Q

ID

anterior

A
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2
Q

anterior

A
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3
Q

ID

xray

A
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4
Q
A
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5
Q

what are the two articular cartilage surfaces of the hip

A

head and the acetabulum

The head of the femur with the exception of the fovea (fovea capitis).

lunate surface of the acetabulum of the os coxa.

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6
Q

what are two ligaments of the head of the femur

A

transverse acetabular ligament

ligament of the head of the femur (teres)

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7
Q

what deepens the socket for the femoral head and helps resist dislocation

A

acetabular labrum

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8
Q

what is the strongest ligament in the body and the most important ligament of the hip and what is its function

A

iliofemoral ligament

When standing it fixes the head of the femur into the acetabulum. When the hip is flexed, the ligament is relaxed.

When standing, the iliofemoral ligament supports the body; it also limits extension (hyperextension) and lateral rotation.

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9
Q

ID the 2 anterior reinforcing ligaments of the hip

A

liofemoral ligament

pubo femoral ligam

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10
Q

ID

ID these 2 ligaments as well as the movements they allow or limit

A

iliofemoral ligament

  • When standing it fixes the head of the femur into the acetabulum. When the hip is flexed, the ligament is relaxed.
  • When standing, the iliofemoral ligament supports the body; it also limits extension (hyperextension) and lateral rotation.

pubo femoral ligament

-strengthens the anterior and inferior parts of the fibrous capsule.

  • This ligament limits over-abduction of the joint.
  • It arises from the pubic bone and attaches to the neck of the femur
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11
Q

when does anterior dislocation of the femur occur

A

due to the strong anterior ligaments, an acetabular margin fracture is usually required before the head of the femur can be dislocated anteriorly.

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12
Q

what ligament limits over-abduction of the joint

A

pubofemoralligament

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13
Q

ID

ID

A

All hip ligaments, with the exception of the ligament of the head of the femur, have a pronounced spiral orientation of collagen fibers. This provides stability in certain positions:

  • When the hip is flexed, the fibers “unwind” and loosen
  • When standing (and in extension), the fibers tighten and firmly hold the head of the femur into the acetabulum
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14
Q

what are the posterior ligaments reinforcing and internal ligaments

A
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15
Q

Are the majority of hip fractures anterior or posterior?

A

posterior

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16
Q

Due to the arrangement and strength of the ligaments of the hip the most common dislocation is posterior. Patients present with a lower limb that is adducted and internally rotated. why?

A

In a posterior dislocation, the affected limb will be shortened, adducted, and the thigh will be medially rotated by the gluteus medius and minimus muscles. The foot is medially rotated by the position of the thigh. The ischiofemoral limit functions to limit medial rotation but is typically ruptured with dislocation

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17
Q

If the hip is dislocated (most commonly in a car accident) what ligament and nerve are typically injured

A

ischiofemoral ligament is usually ruptured

sciatic nerve is often injured

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18
Q

what is the weakest ligament of the hip

A

ischiofemoral ligament

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19
Q

what movements does the ischiofemoral ligament allow and limit

A

allow: It attaches to the ischialpart of the acetabular rim and extends laterally to the greater trochanter

limit: limits medial rotation

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20
Q

ID

ID this ligament

A
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21
Q

What is this ligaments and its function

A

contains obturator vessels and provides no structural support to the adult hip joint, may have been important in infant before walking

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22
Q

what are the 4 places you can dislocate your hip

A

iliac

ishcium

pubic

obtutrator

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23
Q

what is the most commonly inflamed hip bursa

A

Superficial trochanteric bursa

“trochanteric bursitis”

presents as pain along the lateral aspect of the thigh

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24
Q

ID these 2 bursa of the hip

A
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25
Q

fill in the functions

A
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26
Q

fill in the attachments

A
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27
Q

who is at high risk for avascular necrosis

A

1- femoral head fracture

history of alcoholism

corticosteroid use

SLE

hip dislocation

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28
Q

What is the primary source for the blood supply of the head of the femur and when disrupted often leads to avascular necrosis (AVN)

A

deep branch of the medial femoral circumflex artery via retinacularaa

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29
Q

Why is the thigh laterally rotated patients with fractures of the femoral neck

A

The short lateral rotators of the thigh at the hip and by the gluteus maximus.

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30
Q

ID

ID this arteries and ligament

A
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31
Q

what are the flexors of the hip

A

1. iliopsoas muscle (Iliacus and Psoas major)

Assisted by:

rectus femoris

sartorius

pectineus

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32
Q

what are the extensors of the hip

A

1. Gluteus maximus

2. Hamstrings: semitendinosus, semimembranosus, biceps femoris (long head only)

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33
Q

what are the abductors of the hip

A

1.Gluteus medius

2.Gluteus minimus

3.Tensor fascia lata

The principle hip abductors also function as medial rotators of the hip.

34
Q

what are the adductors of the hip

A

1.Adductor longus

2.Adductor brevis

3.Adductor magnus(adductor part)

These are assisted by:

gracilis

pectineus

obturator externus

35
Q

what are the medial rotators of the hip

A

1.Tensor fascia lata

2.Gluteus medius

3.Gluteus minimus

36
Q

what are the lateral rotators of the hip

A

1.Gluteus maximus

It is assisted by:

piriformis

superior gemellus

obturator internus

inferior gemellus

obteratoe externus

quadratus femoris

P-GOGO-Q.

37
Q

what arteries anastomize around the femur

A

First perforating branch of the deep artery of the thigh

Inferior gluteal artery

Medial and lateral circumflex femoral arteries

superior gluteal

obturator

38
Q

where do retinacular arteries branch from

A

medial circumflex

39
Q

what is the primary blood supply to the femoral head in adults

in children

A

medial femoral circumflex capitis femoris

artery of the ligamentum teres (from obturator)

40
Q

disruption to what artery via fracture of the femoral neck, thromboses, or certain medications would lead to AVN

A

medial femoral circumflex artery

41
Q

ID

A
42
Q

what innervates the Iliacus, the principle flexors

A

femoral nerve

innervates the anterior hip

43
Q

what innervates the hamstrings

A

tibial nerve

44
Q

what are the principle adductors/ lateral rotators innervated by

A

obturator

innervates the inferior hip

45
Q

what innervates the principle abductors and medial rotators

A

superior gluteal nerve

46
Q

what are the circular zones of the hip

A
47
Q

ID

ID this muscle

A

iliopsoas

48
Q

ID

ID this muscle

A

rectus femoralis

49
Q

ID

ID this muscle

A

sartorius

50
Q

ID

ID this muscle

A

pectineus

51
Q

ID

ID this muscle

A

Semimembranosus

52
Q

ID

ID this muscle

A

Semitendinosus

53
Q

ID

ID this muscle

A

Biceps Femoris

54
Q

ID

ID this muscle

A

adductor longus

55
Q

ID

ID this muscle

A

adductor brevis

56
Q

ID

ID this muscle

A

adductor magnus

57
Q

ID

ID this muscle

A

gracilis

58
Q

ID

ID this muscle

A

pectineus

59
Q

ID

ID this muscle

A

obturator externus

60
Q

ID

ID this muscle

A

inferior and superior gemellus above the obturator int and above the quadratus femoralis

61
Q

ID

ID these muscles

A
62
Q

ID

ID these muscles

A
63
Q

ID

ID these muscles

A
64
Q

ID

ID these muscles

A
65
Q

ID

ID these muscles and bursa

A
66
Q

Thigh

what is the longest muscle in the body and upon contraction results in an ankle-on-knee cross-legged position

A

sartorius

67
Q

Thigh

what is the largest, most inferior and most important of the adductor magnus muscles and through which the femoral artery travels from the thigh into the popliteal fossa

A

adductor hiatus

68
Q

ID

ID

A
69
Q

ID

ID

A
70
Q

Thigh

what does the angle of inclination of the femur neck allow

A

the knees to be directly under the hip joint, which is important for bipedal walking.

-common site of fracture (“breaking a hip”), especially with decreased bone density

71
Q

Thigh

what vein is labeled and what is its significance

A

great saphenous

‣longest vein in the body, runs up the medial aspect of the leg and thigh

‣enters the saphenous opening in the fascia lata

‣empties into the femoral vein

72
Q

Thigh

what is the cruciate anastomosis and what does it allow

A

formed by thee lateral and medial circumflex femoral arteries and the first perforating branch of the deep femoral artery anastomose with the inferior gluteal artery

‣this is therefore an anastomosis between the external iliac artery (via branches of the femoral artery) to the internal iliac artery (via the inferior gluteal artery)

‣If blood flow through the external iliac or femoral artery is blocked, blood may still reach the popliteal artery (and therefore the lower leg) by flowing through the internal iliac artery and into the inferior gluteal artery, then continuing through the cruciate anastomosis into branches of the femoral artery.

73
Q

ID

ID these arteries

A
74
Q

Thigh

what is the significant of the adductor hiatus

A

where the femoral a. and v. course to become the popliteal a. & v.

75
Q

Thigh

where do the deep and inguinal nodes drain toward

A

iliac nodes

76
Q

Thigh

where does the popliteal node drain

A

‣drain into the popliteal fossa and then into deep lymphatic vessels

77
Q

Thigh

what is the cutaneous innervation of the leg by compartmemt

A

anterior thigh: anterior cutaneous branches of the femoral nerve

-posterior thigh: posterior cutaneous nerve of the thigh

lateral thigh: lateral cutaneous nerve of thigh

medial thigh: cutaneous branches of obturator nerve

78
Q

Thigh

where does the posterior femoral cutaneous nerve branch from

where does the lateral cutaneous nerve of thigh branch from

A

The sacral plexus via the greater sciatic foramen.

The lumbar plexus

79
Q

Thigh

which nerves are serviced by the sacral versus the lumbar roots

A

lumbar roots- Anterior, lateral, and medial thigh are serviced by lumbar roots

sacral roots- Posterior thigh

80
Q

Thigh

what are the myotomes of the leg

L2-S2

A

-L2: hip flexion

-L3: knee extension

-L4: ankle dorsiflexion

-L5: hallux (“big toe”) extension

-S1: ankle plantarflexion

-S2: knee flexion

81
Q

Thigh

what are the borders of the femoral triangle

A

-superior border: inguinal ligament

-medial border: adductor longus muscle

-lateral border: sartorius muscle

-floor (deep surface): iliopsoas and pectineus muscles

82
Q

Thigh

what are the contents of the femoral triangle

A

listed lateral to medial

-femoral nerve & its branches

-femoral artery

-femoral vein & its tributaries

-inguinal lymph nodes & vessels

femoral nerve, femoral artery, femoral vein, and lymphatic structures.

A mnemonic for this is NAVL

week 9 (6 decks)

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