Hip and gluteal joint

Question 1

What bone does NOT contribute to the knee joint?

Answer 1

Fibula

Question 2

What arteries does the internal iliac artery feed?

Answer 2

Superior gluteal artery
Inferior gluteal artery
Obturator artery

Question 3

What arteries does the external iliac artery?

Answer 3

Femoral artery

Question 4

When does the external iliac artery become the femoral artery?

Answer 4

When it passes deep to the inguinal ligament

Question 5

Where are the lymphatics concentrated in the lower limb?

Answer 5

Popliteal nodules
Superficial inguinal nodules
Deep inguinal nodules

Question 6

What are the spinal nerves of the lumbar plexus?

Answer 6

L1-L4

Question 7

What are the spinal nerves of the sacral plexus?

Answer 7

L4-S4

Question 8

What important nerves come from the lumbar plexus?

Answer 8

Femoral nerve

Obturator nerve

Question 9

What important nerves comes from the sacral plexus?

Answer 9

Superior gluteal nerve
Inferior gluteal nerve
Sciatic nerve

Question 10

What stabilizes the pubic symphysis?

Answer 10

Pubic ligaments

Question 11

What kind of joint is the sacroiliac joint?

Answer 11

Synovial

Question 12

What things stabilize the the sacroiliac joint?

Answer 12

Articular surfaces with interlocking elevations/depressions

Sacrospinous ligament
Sacrotuberous ligament

Question 13

What does the sacrospinous ligament create?

Answer 13

The greater sciatic notch becomes the greater sciatic foramen.

(ligament goes from ischial spine to sacrum)

Question 14

What does the sacrotuberous ligament create?

Answer 14

Lesser sciatic foramen

ligament goes from ischial tuberosity to sacrum

Question 15

Most of the obturator foramen is covered with a membrane except _____.

Answer 15

the obturator canal

Question 16

What bones make the acetabulum (hip socket)?

Answer 16

Ilium, ischium, pubis

Question 17

What are the parts of the acetabulum?

Answer 17

Acetabular fossa (filled with fat) surrounded by lunate surface (covered with hyaline cartilage) with an acetabular notch (closed with transverse acetabular ligament) on the inferior point

Question 18

What is the divot on the head of the femur? What attaches there?

Answer 18

Fovea, the ligamentum teres attaches there and goes into the transverse acetabular ligament

Question 19

What are the 3 ligaments of the hip joint stability?

Answer 19

Iliofemoral ligament (Y ligament on anterior side, most strong)
Pubofemoral ligament
Ischiofemoral ligament

Question 20

What does the iliofemoral ligament do?

Answer 20

Prevents hyperextension of the hip

Question 21

What does the pubofemoral ligament do?

Answer 21

Limits hip abduction

Question 22

What does the ischiofemoral ligament do?

Answer 22

Limits hip hyperextension

Question 23

What is a trendelenburg gait? What causes it?

Answer 23

Unilateral pelvic drop

Weakness in gluteus medius/minimus

Question 24

What are the muscles of the gluteal region?

Answer 24

Gluteus maximus
Gluteus medius
Gluteus minimus

Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris

Question 25

What is the innervation of the gluteus maximus?

Answer 25

Inferior gluteal nerve

Question 26

What muscles does the superior gluteal nerve innervate?

Answer 26

Gluteus medius Gluteus minimus Tensor fascia lata

Question 27

What is the action of the gluteus maximus?

Answer 27

Hip extension AND External rotation (it is oblique!)

Question 28

Where do gluteus medius and minimus attach?

Answer 28

More laterally on the pelvis to the greater trochanter

Question 29

What is the action of gluteus medius and minimus?

Answer 29

Abduction and internal rotation

Question 30

What space does the piriformis go through?

Answer 30

Greater sciatic foramen

Question 31

What are the muscles of external rotation? What about their innervation?

Answer 31

``` Piriformis Superior gemellus Obturator internus Inferior gemellus Quadratus femoris ``` All except the gemelli have their own nerves (e.g. nerve to piriformis)

Question 32

What is at risk in a lateral approach to a THR?

Answer 32

Superior gluteal nerve (medius and minimus)

Question 33

What nerve innervates the superior gemellus?

Answer 33

Nerve to obturator internus

Question 34

What nerve innervates the inferior gemellus?

Answer 34

Nerve to quadratus femoris

Question 35

Does the sciatic nerve innervate muscles in the gluteal region?

Answer 35

no!! Just passes below (inferior) piriformis but does not innervate muscles here

Question 36

What provides sensory info from the skin of the gluteal region?

Answer 36

Posterior cutaneous nerve which branches into clunial nerves

Question 37

What provides blood supply to gluteal region?

Answer 37

Superior and inferior gluteal arteries from internal clinical artery (barrier is piriformis)

Question 38

Where should gluteal injections go?

Answer 38

Upper lateral quadrant Using left hand, between 2nd and 3rd digit