FT2: w7 notes Flashcards by Natasha Liberopoulos

Boundaries of gluteal region

Superiorly
Iliac crest

Inferiorly
Gluteal fold

Medially
Gluteal cleft (natal cleft)

Laterally
Greater trochanter

Anteriorly
Anterior superior iliac spine (ASIS)

How well did you know this?

Not at all

Perfectly

ITB - iliotibial band/tract

Proximal attachment
Distal attachment

Iliotibial band/tract (ITB) - a lateral thickening (superficial structure) of the fascia lata
* Extends from the ilium, descends all the way down to the tibia

Proximal attachment
Gluteus maximus

Distal attachment
Lateral intermuscular septum (IMS) of the thigh
Then attaches to the linea aspera of the femur

How well did you know this?

Not at all

Perfectly

Medial rotation =

internal rotation

How well did you know this?

Not at all

Perfectly

Lateral rotation =

external rotation

How well did you know this?

Not at all

Perfectly

4 muscles that are considered content of the pelvis (either true or false)

iliacus, psoas major (iliopsoas), piriformis, obturator internus

How well did you know this?

Not at all

Perfectly

Superficial muscles of the gluteal region

Extensors, abductors and medial rotators of the hip
* Iliotibial tract (not a muscle, but is a superficial structure)
* Tensor fasciae latae (TFL)
* Gluteus maximus
* Gluteus medius
* Gluteus minimus

How well did you know this?

Not at all

Perfectly

Tensor fasciae latae (TFL)

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Superior gluteal nerve
(L4-S1)

Proximal attachment
Iliac crest b/n ASIS & iliac tubercle

Distal attachment
Lateral condyle of tibia via ITB

Position & orientation in relation to joint(s) crossed
Lateral to hip jt
Oblique orientation

Lateral to knee jt
Vertical orientation

Function
Abduction
Medial rotation
Lateral stability of knee

How well did you know this?

Not at all

Perfectly

Gluteus maximus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Inferior gluteal nerve
(L4, L5, S1)

Proximal attachment
External/post ilium posterior to posterior gluteal line, dorsal sacrum & coccyx, sacrotuberous lig.

Distal attachment
Gluteal tuberosity & lateral tibial condyle via ITB

Position & orientation in relation to joint(s) crossed
Posterior to hip jt
Oblique orientation

Lateral to knee jt
Vertical orientation

Function
Extension
Lateral rotation
Lateral stability of knee

How well did you know this?

Not at all

Perfectly

Gluteus medius

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Superior gluteal nerve
(L4, L5, S1)

Proximal attachment
Posterolateral ilium, between posterior & anterior gluteal lines

Distal attachment
Greater trochanter (lat)

Position & orientation in relation to joint(s) crossed
Lateral to hip jt
Oblique orientation

Function
Abduction
Medial rotation of hip jt

How well did you know this?

Not at all

Perfectly

Gluteus minimus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Superior gluteal nerve
(L4, L5, S1)

Proximal attachment
Posterolateral ilium, between posterior & anterior gluteal lines

Distal attachment
Greater trochanter (ant)

Position & orientation in relation to joint(s) crossed
Lateral to hip jt, slightly anterior
Oblique orientation

Function
Abduction
Medial rotation of hip jt

How well did you know this?

Not at all

Perfectly

Deep muscles of the gluteal region

lateral rotators of the hip, all deep to the gluteus maximus
* Piriformis
* Tricep coxae (obturator internus, superior gemellus, inferior gemellus)
* Quadratus femoris
Obturator externus - obturator externus is also a lateral rotator, but is grouped with the adductor muscles in the medial compartment

How well did you know this?

Not at all

Perfectly

deep muscles in order from most superior to most inferior

Piriformis
Most superior

Superior gemellus

Obturator internus

Inferior gemellus

Quadratus femoris
Most inferior

Obturator externus
Deep to OI & IG

How well did you know this?

Not at all

Perfectly

Piriformis
Most superior

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Sacral plexus
S1 & S2

Proximal attachment
Anterior surface of sacrum

Distal attachment
Greater trochanter

Position & orientation in relation to joint(s) crossed
Posterior to hip jt
Almost horizontal orientation

Function
Lateral rotation of hip jt
Assists in abduction of flexed hip

How well did you know this?

Not at all

Perfectly

Superior gemellus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Branches from sacral plexus
(L5, S1)

Proximal attachment
Ischial spine

Distal attachment
Greater trochanter

Position & orientation in relation to joint(s) crossed
Posterior to hip jt
Horizontal orientation

Function
Lateral rotation of hip jt

How well did you know this?

Not at all

Perfectly

obturator internus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Sacral plexus
Nerve to obturator internus
(SN L5-S2)

Proximal attachment
Obturator membrane (internal surface)

Distal attachment
Greater trochanter

Position & orientation in relation to joint(s) crossed
Posterior to hip jt
Horizontal orientation

Function
Lateral rotation of hip jt

How well did you know this?

Not at all

Perfectly

Inferior gemellus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Branches from sacral plexus
(L5, S1)

Proximal attachment
Ischial tuberosity (upper aspect)

Distal attachment
Greater trochanter

Position & orientation in relation to joint(s) crossed
Posterior to hip jt
Horizontal orientation

Function
Lateral rotation of hip jt

How well did you know this?

Not at all

Perfectly

Quadratus femoris

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Function

Innervation
Branches from sacral plexus
(L5, S1)

Proximal attachment
Ischial tuberosity (lateral border)

Distal attachment
Intertrochanteric crest

Position & orientation in relation to joint(s) crossed
Posterior to hip jt, slightly inferior
Horizontal orientation

Function
Lateral rotation of hip jt

How well did you know this?

Not at all

Perfectly

Obturator externus

Innervation
Proximal attachment
Distal attachment
Position & orientation in relation to joint(s) crossed
Functionx

Innervation
Obturator nerve
(L3, L4)

Proximal attachment
Obturator membrane (external surface)

Distal attachment
Trochanteric fossa of femur

Position & orientation in relation to joint(s) crossed
Posterior to hip jt
Horizontal orientation

Function
Lateral rotation of hip jt

How well did you know this?

Not at all

Perfectly

Muscle location crossing a joint will dictate the action produced at a joint

Flexors
Extensors
Adductors
Abductors
Rotators

Flexors
Anterior
*reverse at the knee & distal
Knee & below: flexors = posterior

Extensors
Posteriorly
*reverse at the knee & distal
Knee & below: extensors = anterior

Adductors
Medially

Abductors
Laterally

Rotators
Horizontally & obliquely

How well did you know this?

Not at all

Perfectly

Femoral neck

Acts as a strut & allows the head of the femur to sit inside the acetabulum whilst allowing and increased range of movement & leverage

How well did you know this?

Not at all

Perfectly

articular margin

Study These Flashcards

where the synovial membrane will attach
* Where hyaline cartilage stops & periosteum of the bone will continue

fovea capitis

Study These Flashcards

attachment site for the ligamentum teres

Hip joint
Histological classification

Study These Flashcards

Synovial

Hip joint
Functional classification

Study These Flashcards

Ball & socket

Ball = head of femur
Socket = acetabulum (concaved)
* Sacrificed mobility in order to gain stability - it’s a WB joint

Hip joint 3 degrees of movement

Ball & socket = triaxial Movement Plane Flexion/extension Sagittal Adduction/abduction Coronal Medial & lateral rotation Horizontal

Articulating surfaces of the hip bone

Lunate surface of acetabulum & head of femur (except fovea capitis) * It is a deep set articulation - its rather congruent as 2/3 of femoral head sit inside the acetabulum * Lined with hyaline articular cartilage

Acetabulum features

Articular part Non-articular part Acetabular labrum

Articular part of acetabulum

Crescentic lunate surface - only articular surface of the acetabulum * Surrounds the acetabular fossa * Tissue type: hyaline cartilage covers this

Non-articular part of acetabulum

Acetabular fossa - rough and non-articular * Surrounded by the crescentic lunate surface

Acetabular labrum

Acetabular labrum - deepens the articulation of the hip joint & allows it to receive more of the femoral head * Acts as a 'lip'

Bursa definition

Pouch of synovial membrane filled with synovial fluid Wherever there is friction = bursa will be present

function of bursa

Reduces friction between 2 structures that slide upon each other

types of bursa

* Trochanteric bursa (TB) * Gluteofemoral bursa (GFB) * Ischial bursa (IB)

Capsular ligaments

Capsular (extrinsic) Iliofemoral (anterior/superior) Pubofemoral (anterior/inferior) Ischiofemoral (posterior)

IF ligament (anterior/superior)

Iliofemoral ligament - y-shaped ligament attaching between the iliac bone & the intertrochanteric line of the femur * Strongest * Prevents hyperextension by screwing femoral head to acetabulum Line of gravity lies posterior to the hip joint = tendency for the trunk to extend posteriorly = strong ligaments are located anteriorly to prevent this (iliofemoral ligament)

PF ligament (anterior/inferior)

Pubofemoral ligament - attaches between the pubic bone & neck of the femur * Prevents over-abduction by tightening during abduction * Limits hip extension to 10-15° by tightening during extension

ISF ligament (posterior)

Ischiofemoral ligament - attaches to the articular margin of the acetabulum & greater trochanter * Weakest * Could prevent/limit hyperflexion

Intracapsular ligaments

Intracapsular (intrinsic) Ligamentum teres Transverse acetabular

Ligamentum teres

Ligamentum teres (ligament of the head of the femur) - includes fibres that blend with the labrum, attach to the inferior horns of the lunate surface & also attach to the transverse ligament * Sits on top of the fat pad, side the hip

Fat pad

Sits in acetabular fossa & covered with a layer of synovial membrane

Transverse acetabular ligament

bridges the acetabular notch & attaches to the inferior horns of the acetabulum

Most close packed position for hip

Extension and medial rotation * Stabilising ligaments come under maximum tension

Most congruent position of the hip

Flexed, abducted and laterally rotated

Neurovascular structures of the gluteal region

Superior gluteal nerve & artery Inferior gluteal nerve & artery

Superior gluteal nerve & artery Origin Anatomical relationships Distribution (branches)

Origin SGN - Posterior divisions of sacral plexus (L4, L5 & S1) SGA - Branches from inferior gluteal artery in true pelvis Anatomical relationships Travel as a neurovascular bundle from true pelvis, through GSF above piriformis to gluteal region Distribution (branches) Gluteus medius Gluteus minimus Tensor fasciae late Hip jt

Inferior gluteal nerve & artery Origin Anatomical relationships Distribution (branches)

Origin IGN - Posterior divisions of sacral plexus (L5, S1 & S2) IGA - Branches from the internal iliac artery in the true pelvis Anatomical relationships Travel as a neurovascular bundle from true pelvis, through GSF below piriformis to gluteal region Distribution (branches) Gluteus maximus

Nerves of the gluteal region

Femoral n Obturator n Superior gluteal n

Femoral nerve supplies

Femoral nerve lies anterior to the hip joint Supplies rectus femoris (of the quadriceps muscle group) & pectineus (adductor)

Obturator nerve supplies

Obturator nerve lies medial to the hip joint Supplies the adductor muscle group & lateral rotators (esp. obturator externus)

superior gluteal nerve supplies

Superior gluteal nerve lies posterosuperior to the hip joint Supplies abductors gluteus medius & minimus NOTE: the cutaneous nerves of the superior, inferior and medial gluteal region do no follow the above pattern * This area of skin is supplied by posterior primary rami (dorsal rami)

FT2: w7 notes Flashcards

(50 cards)