Exam 4: Pelvic girdle and Hip

Question 0

intertrochanteric line

Answer 0

anterior femur, connects greater/lesser trochanter

Question 1

gluteal lines on ilium and gluteal muscles

Answer 1

posterior: vertical
anterior: oblique, anterior to posterior gluteal line
inferior: oblique, inferior to anterior gluteal line

glute max: posterior to gluteal line
glute med: attaches between anterior & posterior gluteal lines
glute min: attaches between anterior & inferior gluteal lines

Question 2

intertrochanteric crest

Answer 2

posterior femur, connects greater/lesser trochanter

Question 3

quadrate tubercle & line

Answer 3

tubercle: mid intertrochanteric crest
line: vertical line on inferior aspect of quadrate tubercle

Question 4

pectineal line & spiral line

Answer 4

pectineal: vertical line with superior end on inferior aspect of lesser trochanter
spiral: continuation of intertrochanteric line that continues inferiorly (anterior to pectineal line) and helps form medial lip of linea aspera

Question 5

gluteal tuberosity

Answer 5

superior end of lateral lip of linea aspera for attachment of glute max

Question 6

motions at hip joint

Answer 6

flex, ext, IR, ER, Abd, Add

Question 7

acetabulum

Answer 7

ilium, ischium, pubis
labrum: fibrocartilage
acetabular notch bridged by transverse acetabular lig

Question 8

round ligament (ligamentum teres)

Answer 8

• arises from transverse acetabular lig
• inserts into fovea capitis of femur
• carries blood vessels to head of femur
• also a conduit for obturator nerve (through obturator canal)
• limited stability role

**damage to round ligament (head of femur) –>avascular necrosis

Question 9

characteristics of hip joint capsule

Answer 9

• strong/dense: contributes to stability
• femoral neck = intracapsular
• greater and lesser trochanters extracapsular
• 2 sets of fibers
  
  • longitudinal fibers: superficial
  • circular fibers: zona orbicularis
• thickened anterosuperior

Question 10

iliofemoral ligament

Answer 10

• Y ligament of Bigelow
• AIIS to intertrochanteric line
• strongest in the hip
• Taut in: extension, ER
• Superior fibers: taut in adduction
• inferior fibers: taut in abd

Question 11

pubofemoral ligament

Answer 11

• pubic ramus to intertrochanteric fossa
• taut in abd, ext, ER

*iliofemoral & pubofemoral lig.’s form a “Z” on ant. capsule

Question 12

ischiofemoral ligament

Answer 12

• posterior acetabular rim & labrum to zona orbicularis and inner surface of Gr. Troch.
• tightens w/ IR, ER

Question 13

all hip joint ligaments tighten/relax when?

Answer 13

tighten w/ extension, relax in flexion

Question 14

blood supply of hip region

Answer 14

• med & lat femoral circumflex A (from profunda femoral A)

- obturator A, superior gluteal A, inferior gluteal A (all 3 are branches of internal iliac )

Question 15

profunda femoris artery

Answer 15

off femoral A below inguinal ligament
branches:
-med/lat femoral circumflex A (supply femoral head/neck from distal end)
-perforating branches

Question 16

intracapsular hip Fx

Answer 16

occurs @ femoral neck–>damages obturator A –>femoral head necrosis

Question 17

sensory innervation to hip

Answer 17

femoral N
Obturator N
sciatic N (through N to quadratus femoris)
*occasionally Sup & Inf Gluteal N from sacral plexus

Question 18

5 bursae of hip region

Answer 18

1. ob internus
2. ob externus
3. trochanteric (associated w/ glutes)
4. gluteofemoral (associated w/ glutes)
5. ischial bursa (associated w/ glutes)

Question 19

muscles of gluteal region (10)

Answer 19

1. glut max: ext, ER of femur; trunk ext
2. glut med: abd, IR (ant fibers), ER (post fibers); extend femur when hip is flexed
3. glut min: abd, IR of femur
4. piriformis: hip ER (when hip is extended); IR w/ hip flexed> 90
5. quadratus femoris: ER
6. sup gemellus: ER
7. inf gemellus: ER
8. obt internus: ER
9. obt externus: ER
10. TFL: ABD, flex, IR of femur

Question 20

short external rotators of hip (6)

Answer 20

1. piriformis
2. obturator internus
3. obt externus
4. sup gemellus
5. inf gemellus
6. quadratus femoris

Question 21

medial rotators of hip

Answer 21

No muscles dedicated for solely IR
Glut max may assist w/ IR in extreme hip flex
piriformis in hip flex >90
Ant portions of Glut med & glut min when hip flexed
TFL

Question 22

hip abductors

Answer 22

glut med, min

OKC:

• abduct
• ant fibers IR, flex
• post fibers ER (glut med)

CKC:
-stabilizes the pelvis

N: superior gluteal L4-S1

Question 23

muscles of iliac region

Answer 23

iliacus:

• femoral N L2,3
• flex femur

psoas maj
-femoral N (L1),L2,3,(L4)
-flex femur, flex and lateral bend L/S
psoas min
-L1, weak flex of LS

**iliacus + psoas maj = iliopsoas

Question 24

iliopsoas

Answer 24

small rotary component affects lumbar lordosis only flexor that flexes hip past 90 degrees femoral N L2-4

Question 25

Rectus Femoris

Answer 25

2 joint muscle - flexes hip and extends knee - femoral N L2-4

Question 26

TFL

Answer 26

hip flex, abd, IR decreases tensile stress on lat femur N: superior gluteal N L4-S1

Question 27

adductors (5)

Answer 27

1. pectineus (also a hip flexor) 2. gracilis 3. adductor brevis 4. add long 5. add magnus

Question 28

femoral triangle boundaries

Answer 28

``` ilioinguinal lig (superior) sartorius (lateral) add long (medial) ```

Question 29

hip extensors

Answer 29

glut max semimembranosus semitendinosus biceps femoris (long head)

Question 30

hip ROM

Answer 30

sagittal plane: - flex: 120-135 deg - ext: 10-30 deg frontal plane: - abd: 30-50 deg - add: 10-30 deg