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Odd Numbered Conference > Conference 7 : Hip and Thigh > Flashcards

Conference 7 : Hip and Thigh Flashcards

(72 cards)

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1
Q

name the two groups of anterior thigh muscles

A

hip flexors and quadriceps/knee extensors

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2
Q

what are the quadriceps/knee extensors?

A

rectus femoris
vastus lateralis
vastus intermedius
vastus medialis

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3
Q

whats the BFD about the rectus femoris?

A

its the only quadricep/knee extensor that ALSO flexes the thigh; this is because it crosses the hip joint

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4
Q

name the medial compartment thigh muscles and their primary function

A

they are all ADductors

adductor brevis
adductor longus
adductor magnus
gracialis

*all innervated by obturator (BUT, note that the adductor magnus is also innervated by the tibial nerve on the posterior side)

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5
Q

What are the posterior thigh muscles, what do they do and what is their arterial blood supply?

A

they are all hip extensors/knee flexors, and they are all supplied by the peripheral branch of the deep femoral artery

biceps femoris
semi-tendinous
semi-membraneous

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6
Q

name the gluteal region muscles and whats their main function

A

main function is thigh ABduction and rotators

gluteus maximus
gluteus medius
gluteus minimus
tensor fascia latae
piriformis
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7
Q

describe the relationship between the top of the greater trochanter and the LATERAL margin of the acetabulum

A

forms a right angle. in injury to the hip, this angle will be disrupted

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8
Q

why is the hip joint stable?

A

there is a good bony fit thanks to the acetabulum being augmented (Aka deeper) by the presence of the acetabular labrum

strong iliofemoral and ischiofemoral ligaments

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9
Q

whats the BFD about the isciofemoral ligament

A

spirals around the femur and therefore draws the head of the femur into the acetabulum

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10
Q

when are the iliofemoral and ischiofemoral ligaments tense?

A

during extension

therefore, they RESIST hyperextension

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11
Q

the bottom of the fibula and tibia each have a weird name - what is it

A 
Lateral malleolus (fibuLa) 
medial malleolus (tibia)
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12
Q

What forms the roof of the femoral triangle

A

fascia lata, subcutaneous tissue, skin

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13
Q

what are the borders of the femoral triangle

A

adductor longus (medial)
sartorius (lateral)
inguinal ligament (base)
pectinous and iliopsoas (floor)

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14
Q

name the structures within the femoral triangle

A

femoral nerve, artery, vein, empty space, lacunar ligament

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15
Q

What does the great saphenous vein drain into?

A

femoral vein

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16
Q

what does the L of NAVEL stand for?

A

lacunar ligament

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17
Q

what direction does NAVEL run?

A

lateral to medial

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18
Q

whats the strongest flexor of the hip?

A

iliopsoas

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19
Q

how can we divide the adductor muscles?

A

three layers -anterior, middle, posterior

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20
Q

name the muscles in the anterior layer of the adductor muscles

A

pectinous, adductor longus

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21
Q

name the muscles in the middle layer of the adductor muscles

A

adductor brevis, gracili

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22
Q

name the muscles in the posterior layer of the adductor muscles

A

adductor magnus innervated by both obturator AND tibial nerves

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23
Q

Whats the test for trendelenberg sign

A

ask patient to stand on one leg; if OPPOSITE side of pelvis sags, patient is POSITIVE.

+ result = gluteus medium and minimum of the supporting leg are NOT fxn normally

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24
Q

whats the only muscle to insert on the lesser trochantor

A

iliopsoas

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25
skin innervation for anteromedial thigh
anterior cutaneous branches of femoral nerve (L2, L3, L4)
26
skin innervation for lateral thigh
lateral femoral cutaneous nerve
27
skin innervation for lower medial thigh
obturator nerve
28
whats the actual/full name for the IT band?
iliotibial tract
29
Name the structures that EMERGE from the GREATER sciatic foramen
``` superior gluteal n. piriformis inferior gluteal n. sciatic n. posterior femoral cutaneous n. pudendal n. ```
30
structures that pass through the *lesser* sciatic foramen
pudendal n. | obturator internus
31
where should gluteal injections be given?
upper outer quadrant of the gluteal region because you want to avoid the sciatic n. and the other neuromuscular structures in the gluteal region note that the lower lateral quadrant doesn't have a lot of nerves/arteries that you could damage, but it also doesn't have much muscle that you could inject into
32
Name two places where you have poor blood supply and explain why thats concerning
Head of the femur, distal tibia concerning because fracture healing is slower and have increased of necrosis because if the blood supply is knocked out you don't have much to compensate for it
33
Whats the most powerful EXTERNAL rotator of the hip?
Gluteus maximus
34
physiological splinting
when a fracture occurs, the muscles around the fracture in order to prevent any excessive motion / worsening of the fracture
35
What muscles accomplish medial / inward rotation of the thigh?
pectinous, gluteus minimus, gluteus medius, tensor fascia latae
36
What three vessels come off of the internal iliac artery?
superior gluteal artery, inferior gluteal artery and obturator artery
37
anastomosis
two vessels coming from two sources communicate with one another through the capillaries; not something we can see visually in lab
38
name some areas of the body where collateral circulation occurs
shoulder elbow hip (most clinically relevant)
39
3 sites of the hip where anastomoses can occur
1. ASIS 2. Cruciate (upper posterior thigh) 3. Obturator foramen
40
Anterior superior iliac spine
one of the anastomoses of the hip; includes - iliac branch of iliolumbar - superior gluteal - deep circumflex iliac - ascending branch of the lateral circumflex femoral
41
Cruciate anastomoses
one of the anastomoses of the hip; includes - inferior gluteal - medial circumflex femoral - transverse branch of the lateral circumflex femoral - ascending branch of the first perforator
42
Obturator foramen
one of the anastomoses of the hip; includes - obturator artery - medial circumflex femoral artery
43
What is the main external rotator of the thigh?
gluteus maximus
44
saphenous nerve
branch of the femoral nerve; runs with the femoral vessels through the adductor canal, which is deep to the sartorial and superficial to the adductor muscles
45
what do the superficial inguinal lymph nodes drain?
- entire lower limb - gluteal region - abdominal wall below umbilicus - perineum including lower vaginal and anal canal *exception: does not drain the testes
46
What innervates the tensor fascia lata
superior gluteal nerve
47
name the muscles that insert on the greater trochanter
gluteus medius gluteus minimus piriformis
48
name the muscles that insert on the lesser trochanter
common tendon of the psoas major and iliopsoas muscle | **iliopsoas is the only muscle that inserts here!!
49
where are the two places that the inguinal ligament attach?
anterior superior spine of the ilium to the pubic tubercle
50
how can you locate the femoral artery on a patient?
the inguinal ligament, which runs from the anterior superior spine of the ilium to the pubic tubercle, should be found first. find this by palpating either of these bony landmarks, if possible. then, approximately halfway between the two bony landmarks, go directly under the inguinal ligament, and you should be right on top of the femoral artery. note that the femoral artery is a great landmark for the rest of the NAVEL.
51
easy to see sign of gait abnormality
pelvic dip/sag | indicates trendelenberg
52
What muscle(s) and nerve(s) should you think of if patient has trendelenberg sign
gluteus medius and minimus | superior gluteal nerve
53
pes anserinus
goose foot; common tendon insertion of gracilis, sartoris and semitendinous muscles; all three tendons are webbed together
54
femoral hernia
herniation of the bowel can come into the femoral canal
55
describe the space next to the femoral vein
the "empty space" is a misnomer. he called it the "femoral canal" and emphasized that it is not a "space" but is actually filled with fat and lymphatics
56
fovea
center of the head of the femur; the ligament of the femoral head attaches here
57
where does the gluteus maximus insert?
gluteal tuberosity
58
is the hip more stable in extension or flexion?
extension
59
where does the external iliac artery become the femoral artery?
at the inguinal ligament
60
what does the femoral artery become ?
politeal artery
61
when does the femoral artery become the politeal artery?
after passing through the adductor hiatus
62
what does the politeal artery branch into?
anterior tibial artery and posterior tibial artery
63
Adductor canal
``` sartorius (roof) vastus medialis (anterolateral) adductor longs and adductor magnus (posterior) ```
64
adductor canal contents
femoral artery, femoral vein, saphenous nerve
65
clinical relevance of great saphenous vein
very resistant to plaque; therefore, used as graft in coronary artery bypass graft surgery
66
what does hamstring muscles refer to?
the posterior thigh muscles
67
what are the muscles in the posterior thigh
biceps femoris (most lateral) semitendinosus semimembranosus
68
Baker's cyst
enlargement of bursa between gastrocnemius and semi membranous muscle; caused by accumulation of fluid in the knee joint
69
are the biceps femoris innervated by the same nerve?
no, long head has tibial innervation | short head has common peroneal nerve innervation
70
what nerve is the tibial nerve a branch of?
sciatic nerve; the other branch is the common fibular (peroneal) nerve
71
explain the clinical relevance of the common fibular (peroneal) nerve
goes around the fibular neck; therefore, extremely vulnerable to injury; it is the most common site of PERIPHERAL NERVE INJURY in the lower limb; **foot drop** because paralyzes dorsiflexors
72
popliteal fossa
diamond shape depression; posterior to knee; from medial to lateral AVNN popliteal artery, popliteal vein, tibial nerve, common fibular nerve

Odd Numbered Conference (11 decks)

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