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ALT > FT2: w5/6 notes > Flashcards

FT2: w5/6 notes Flashcards

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1
Q

parts of hip bone & position relative to the remainder of the bone

A

Pubis
Anteromedially

Ilium
Superolaterally

Ischium
Posteroinferiorly

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2
Q

Pelvis vs pelvic girdle

A

Pelvis
* 2 hip bones (ilium, pubis & ischium)
* Sacrum
* Coccyx

Pelvic girdle
* Hip bone only (ilium, pubis & ischium)

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3
Q

Pelvic inlet
location
boundaries

A

From false pelvis to true pelvis

Boundaries
Posteriorly - sacral promontory
Laterally - arcuate line of ilium
Anteriorly - superior ramus of pubis & pubic symphysis

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4
Q

Male pelvis vs female pelvis
overall shape

A

Overall shape
MALE
Taller in height
Narrower
Narrower pelvic outlet & inlet

FEMALE
Shallower in height
Broader
Wider pelvic outlet & inlet
* To allow for childbirth

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5
Q

Male pelvis vs female pelvis
subpubic angles

A

MALE
Smaller subpubic angle (<90°)

FEMALE
Larger subpubic angle (>90°)

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6
Q

Pelvic outlet
-location
-boundaries

A

from true pelvis to exterior

Boundaries
Posteriorly - tip of the coccyx
Posterolaterally - inferior margin of the sacrotuberous ligament (running b/n coccyx & ischial tuberosity)
Laterally - ischial tuberosities
Anteriorly - ischiopubic ramus & pubic symphysis

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7
Q

True (lesser) pelvis
-location
-boundaries
-contents

A

Location
True (lesser) pelvis - between the pelvic inlet & outlet

Boundaries
Posteriorly - sacrum & coccyx
Laterally - ischium
Anteriorly - superior pubic & ischiopubic rami

Contents
Reproductive, urinary & lower GIT organs + nerves & vessels

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8
Q

False (greater) pelvis
-location
-boundaries
-contents

A

False (greater) pelvis - superior to the pelvic inlet

Boundaries
Posteriorly - lumbar vertebra (anterosuperior aspect of S1 vertebra)
Laterally - ilium
Anteriorly - abdominal muscles

Contents
GIT organs + nerves & vessels

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9
Q

Openings of the pelvis

A

Under inguinal ligament

Obturator foramen & canal
Foramen - canal + membrane
Canal - space above membrane

Greater sciatic foramen

Lesser sciatic foramen

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10
Q

Under inguinal ligament

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening

A

Anterior (opening deep to the inguinal ligament)

Boundaries
Inguinal lig
Superior pubic ramus
Anterior ilium

External - anterior thigh
Internal - false pelvis (because it’s above the pelvic inlet)

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11
Q

Obturator foramen

A

Foramen - canal + membrane

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12
Q

Obturator canal

A

Canal - space above membrane

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13
Q

Obturator foramen & canal

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening
Vessels
Nerves
Muscles

A

Position of opening in relation to pelvis
Medial

Boundaries
Obturator membrane
Obturator foramen

Regions/spaces that communicate via opening
External - medial thigh
Internal - true pelvis (because it’s below the pelvic inlet)

Vessels
Obturator & lymphatics

Nerves
Obturator

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14
Q

greater sciatic foramen

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening
Vessels
Nerves
Muscles

A

Position of opening in relation to pelvis
Posterior

Boundaries
In an anatomical position:
Superior - greater sciatic notch
Anterior - Ischial spine
Posterior - Sacrotuberous lig
Inferior - Sacrospinous lig

Regions/spaces that communicate via opening
External - gluteal region (post thigh)
Internal - true pelvis (because it’s above the pelvic floor)

Vessels
Gluteal & lymphatics

Nerves
Spinal nerves derived from the sacral plexus
* Sciatic nerve
* Sup/inf gluteal
* N. obturator internus
* N. quadratus femoris

Muscles
Piriformis
* Powerful lateral rotator of the hip joint

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15
Q

Lesser sciatic foramen

Position of opening in relation to pelvis
Boundaries
Regions/spaces that communicate via opening
Vessels
Nerves
Muscles

A

Position of opening in relation to pelvis
Posterior

Boundaries
In an anatomical position:
Anterior - Lesser sciatic notch
Lateral - Ischial spine
Inferoposteiorly - ST lig
Superior - SS lig

Regions/spaces that communicate via opening
External - gluteal region
Internal - perineum (because it’s below the pelvic floor)

Nerves
-

Muscles
Obturator internus
* Powerful lateral rotator of the hip joint

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16
Q

Joints of the pelvis

A

Pubic symphysis
Sacroiliac joint

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17
Q

Pubic symphysis

Definition
Articulating surfaces
Histological classification
Function
Movements possible

A

Definition
Pubic symphysis - joins right & left pubic bones, made of a fibrocartilage disc
* Forms boundary of the true pelvis - contributes to the anterior boundary

Articulating surfaces
* Articulation between superior rami of left & right pubic bones
Attaches to the thin layer of hyaline cartilage that covers the end of both pubic bones

Histological classification
Secondary cartilaginous

Function
Relatively immobile to maintain pelvic stability, especially when standing on one limb

Movements possible
Nil
* Hormones soften the ligaments to allow for very little movement during child birth so pelvis can widen a little bit more

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18
Q

Sacroiliac joint

Definition
Articulating surfaces
Histological classification
Function
Movements possible
Position of the line of gravity in relation to SIJ, describe the effect this has on this joint

A

Definition
Sacroiliac joint - joins appendicular (ilium) to axial (sacrum) skeleton

Articulating surfaces
Oracular surface of ilium & oracular surface of sacrum

Histological classification
Synovial (anterior)
Fibrous (posterior)
* Highly congruent
* Significant ligamentous support (ligaments are dense, fibrous connective tissue)

Function
Very little movement in general

Movements possible
Nutation - anterior tilt movement of the upper sacrum (moves down & forward)
* Caused by bodyweight
* Anterior aspect of the sacrum moves inferiorly (and slightly anteriorly)
* Coccyx moves superiorly and posteriorly

Counter nutation - opposite movement of nutation, sacrum moves up & backward

Position of LOG: anterior
Effect of gravity at joint: pelvic tilt anteriorly (nutation)

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19
Q

Ligaments of the pelvis

A

Sacrotuberous ligament
Sacrospinous ligament

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20
Q

Sacrotuberous ligament

Attachments
Functions
Position in relation to the sacrum

A

Attachments
Ischial tuberosity & sacrum

Functions
Limits nutation of SIJ
Posterior ligament to help stabilise sacroiliac joint
Crosses sacroiliac joint, which limits mutation

Position in relation to the sacrum
Runs anterior & inferior to the sacrum
Openings - GSF & LSF

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21
Q

Sacrospinous ligament

Attachments
Functions
Position in relation to the sacrum

A

Attachments
Ischial spine & sacrum

Functions
Limits nutation of SIJ

Position in relation to the sacrum
Posterior ligament to help stabilise sacroiliac joint
Runs anterior & inferior to the sacrum

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22
Q

Vessels of the pelvis

A

Abdominal aorta

Common iliac artery (R + L)

Internal iliac artery
-Obturator - making their way to the lower limb
-Gluteal (super & inf) - making their way to the lower limb

External iliac artery

Femoral artery

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23
Q

Abdominal aorta

runs alongside
origin
course
termination

Study These Flashcards
A

Runs alongside the inferior vena cava (but is to the left)

Origin
Thoracic aorta

Course
Thoracic aorta, through lower abdomen, to top of false pelvis @L4/5

Termination
Branches into
* R common iliac
L common iliac - further divides

24
Q

Right vs left common iliac artery

Study These Flashcards
A

Right common iliac artery
* Pass more oblique across body of last lumbar vertebra
* Separated from the bodies of L4 & L5 by juncture of 2 common iliac veins & inferior vena cava

Left common iliac artery
* Rests on bodies of L4 & L5
* Partly medial to & partly in front of L common iliac vein

25
Common iliac artery Origin Termination
Origin Abdominal aorta @L4 vertebra Termination Left common iliac artery branches into * Internal iliac - goes into the true pelvis * External iliac - remains in the false pelvis
26
Internal iliac artery Origin Termination
Origin Left common iliac artery, goes into true pelvis Termination Branches into * 'Visceral' * Obturator - making their way to the lower limb * Gluteal (super & inf) - making their way to the lower limb
27
External iliac artery Origin Termination
Origin Left common iliac artery, goes into false pelvis & runs with external iliac vein Termination Femoral artery = name once it passes underneath the inguinal ligament and exits the pelvis, in the thigh where the femur is.
28
Femoral artery Origin
Origin Continuation of external iliac artery, under inguinal ligament
29
Pelvic vein names
Same name as arteries All tributaries of inferior vena cava Tributaries - drain into, supply blood to lower abdomen, pelvic region & lower limbs
30
External iliac vein Origin Termination Relationships
Origin Continuation of femoral vein proximal to inguinal ligament Termination Tributary of common iliac vein (L & R) Relationships Through false pelvis Accompanies external iliac artery & femoral nerve
31
Inferior vena cava
Inferior vena cava - formed by the junction of 2 common iliac veins at L5 * Runs alongside the inferior vena cava (but is to the right)
32
Spinal nerve
Spinal nerve - ventral & dorsal root combined, exits the vertebral canal via the intervertebral foramen Principle NP8 All spinal nerves divide into dorsal & ventral primary rami:
33
Ventral ramus
Ventral primary rami - anterior branch of the spinal nerve, leading to the spinal cord * Supply all other somatic structures including the limbs * forms plexus that makes up the nerves coming down to the lower limb * Each ventral ramus divides into anterior & posterior divisions
34
spinal cord vs corda equina
Spinal cord - spinal nerves above L2 Corda equina - spinal nerves below L2 & exit down at the lower lumbar & sacral levels
35
Structures attached to the spinal nerve
Sympathetic ganglion - enlarged bit of tissue Sympathetic trunk - length of neural tissue running inferiorly & superiorly down LS plexus, follows vertebral column
36
GSA, GSE & GVE
GSAs - travel towards CNS (spinal cord) from body e.g. Carrying sensory info from skin on the back GSEs - travel to body from CNS (spinal cord) e.g. Innervating muscle of the knee joint GVEs - travel to body from CNS (spinal) cord and in this case, via the sympathetic ganglion e.g. Pre- and post-ganglionic sympathetic GVE stimulating sweat glands in the armpit
37
Lumbosacral plexus
lumbar plexus & sacral plexus together, comes from L2-L4, L4/5 - S1-4
38
Lumbar plexus Formed by Major branches
Formed by Lumbar ventral rami (L2, L3 & L4) * L2-4 ventral rami Major branches * Femoral nerve * Obturator nerve * Lateral cutaneous nerve of the thigh (LCNT)
39
Sacral plexus Formed by Major branches
Formed by Lumbosacral trunk Lumbar ventral rami (L4, L5) Sacral ventral rami (S1, S2, S3) * L4-S3 ventral rami Major branches * Sciatic nerve (tibial + common peroneal) * Gluteal nerves (sup & inf) * Posterior cutaneous nerve of the thigh (PCNT)
40
Branches of the lumbar plexus
Obturator nerve Femoral nerve Lateral cutaneous nerve of the thigh (LCNT)
41
Obturator nerve Origin Course Location of innervated muscles Major action of innervated muscles
Branch of the lumbar plexus Origin Anterior divisions of the L2-L4 ventral rami Course Originates in lower abdomen, travels through false pelvis to the true pelvis Then, exits the pelvis anteriorly through the obturator canal into medial thigh Location of innervated muscles Medial thigh Major action of innervated muscles Hip adduction Flexion, adduction, internal rotation = anterior divisions of anterior primary rami
42
Femoral nerve Origin Course Location of innervated muscles Major action of innervated muscles
Branch of the lumbar plexus Origin Posterior divisions of the L2-L4 ventral rami Course Originates in lower abdomen, travels through false pelvis & under inguinal ligament w external iliac a&v Then, exits the pelvis anteriorly through the opening under (deep) inguinal ligament into anterior thigh Location of innervated muscles Anterior thigh Major action of innervated muscles Knee extension (from quadriceps) Extension, abduction, external rotation = posterior divisions of anterior primary rami
43
anterior divisions of anterior primary rami actions
FAI Flexion, adduction, internal rotation
44
posterior divisions of anterior primary rami
Extension, abduction, external rotation
45
Lateral cutaneous nerve of the thigh (LCNT)
origin is branches from L2 & L3 only
46
Branches of the sacral plexus
Sciatic (Common peroneal/fibular + Tibial) Superior gluteal nerve Inferior gluteal nerve Posterior cutaneous nerve of the thigh (PCNT)
47
Sciatic nerve
common peroneal/fibular + tibial nerves travelling together for a short time, but never innervates a particular muscle * Emerges in gluteal region, later divide in the lateral thigh separately
48
Common peroneal/fibular Origin Course Location of innervated muscles Major action of innervated muscles
Origin Posterior divisions of the L4-S3 ventral rami Course Originates in lower abdomen as sciatic nerve, exits the pelvis posteriorly through the GSF into the anterior leg Location of innervated muscles Anterior leg Major action of innervated muscles Dorsiflexion (true extension) ankle
49
Tibial Origin Course Location of innervated muscles Major action of innervated muscles
Origin Anterior divisions of the L4-S3 ventral rami Course Originates in lower abdomen as sciatic nerve, exits the pelvis anteriorly through the GSF into the posterior thigh/leg Location of innervated muscles Posterior thigh/leg Major action of innervated muscles Knee & ankle flexion
50
Superior gluteal nerve Origin Course Location of innervated muscles Major action of innervated muscles
Origin Posterior divisions of the L4-S1 ventral rami Course Originates in lower abdomen, exits the pelvis posteriorly through the GSF into the gluteal region (posterior) Location of innervated muscles Gluteal region Major action of innervated muscles Hip abduction - supplies the gluteus medius, gluteus minimus & TFL muscles
51
Inferior gluteal nerve Origin Course Location of innervated muscles Major action of innervated muscles
Origin Posterior divisions of the L5-S2 ventral rami Course Originates in lower abdomen, exits the pelvis posteriorly through the GSF into the gluteal region (posterior) Location of innervated muscles Gluteal region Major action of innervated muscles Hip extension - travels beneath the piriformis to supply the gluteus maximus
52
Posterior cutaneous nerve of the thigh (PCNT)
branches from S2 & S3 only
53
Muscles of the pelvis
Muscles of the pelvis - includes psoas & iliacus (iliopsoas) as the major muscles, also includes obturator internus & piriformis (notes in muscles of the gluteal region)
54
Iliacus Innervation Proximal attachment Distal attachment Position & orientation in relation to joint(s) crossed Function
Innervation Femoral nerve (L2, L3) Proximal attachment Iliac fossa Distal attachment Lesser trochanter of femur (join to form iliopsoas) Position & orientation in relation to joint(s) crossed Anterior & slightly medial to hip jt Vertical orientation Function Hip flexion Weak hip adduction
55
Psoas major Innervation Proximal attachment Distal attachment Position & orientation in relation to joint(s) crossed Function
Innervation Anterior rami L1-L3 Proximal attachment Lumbar vertebrae TPs Lateral bodies & intervening IVDs Distal attachment Lesser trochanter of femur (join to form iliopsoas) Position & orientation in relation to joint(s) crossed Anterior & slightly medial to hip jt Vertical orientation Function Hip flexion Weak hip adduction

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