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Flashcards in Hip And Pelvis Deck (90)
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1

List four dangers of the Stoppa approach

Corona Mortis (lateral 1/3 sup. pubic ramus)

Bladder (insert foley)

Obturator nerve and vessels (when exposing quad plate)

External iliac vessels (mobilize early)

2

What is the potential space of retzius ?

Anterior to bladder post to pubic symphisis

3

What muscle do you have to take down to see quadrilateral plate?

Rectus abdominus

4

What fascia separates the middle and lateral window of the ilioinguinal approach?

Iliopectineal fascia

5

List five contents of the Greater sciatic notch

piriformis

superior and inferior gluteal vessels and nerves

sciatic and posterior femoral cutaneous nerves

internal pudendal vessels

nerves to the obturator internus and quadratus femoris

6

List the structures that separate the windows in the ilioinguinal approach

Lateral: Iliac wing to Iliopsoas and femoral nerve

Middle: psoas to External iliac vessels

Medial: External iliac vesselst to rectus abdominus

7

What are the Denis zones of the sacrum?

1: lateral to foramen

2: middle

3: medial to foramina into spinal canal

8

What nerve root runs along the sacral ala?

L5

9

What is the sacral ala?

Top of sacrum forming iliosacral triangle

10

What is the importance of iliac cortical density?

On the lateral this parallels the alar slope, you want to be below this when inserting an SI screw

11

On an AP pelvis is the posterior wall lateral or anterior?

Lateral!

12

Judet views describe

Obturator oblique - AC (iliopectineal line), PW

Iliac oblique - AW, PC (ilioischial line)

 

13

What is a morale lavale lesion?

Internal degloving of subcutaneous tissue off of the lumbosacral fascia

14

What are key SI ligaments? What are the other three important ones?

Anterior, Posterior, Interosseous Sacrotuberous, Sacrospinous, Iliolumbar ligament

15

Name the Contents of the Sciatic Notch Relative to Piriformis

Contents of GSN

Above piriformis:

Superior Gluteal Nerve & Artery

Below Piriformis:

Pudendal nerve and internal pudendal artery

Nerve to obturator internus

Posterior femoral cutaneous nerve

Sciatic nerve

Inferior gluteal artery and nerve

Nerve to quadratus femoris

16

What travels through LSN?

Obturator internus muscle

Nerve to obturator internus

Pudendal nerve

Internal pudendal vein

17

What is the cruciate anastomosis made of?

First perforator of profunda

Inferior gluteal artery

MCFA

LCFA

Clinical Relevance:
The cruciate anastomosis is clinically relevant because if there is a blockage between the femoral artery and external iliac artery, blood can reach the popliteal artery by means of the anastomosis. The route of blood is:

Internal iliac --> inferior gluteal artery --> a perforating branch of the deep femoral artery --> lateral circumflex femoral artery --> its descending branch --> superior lateral genicular artery --> popliteal artery.

18

Nerves relative to psoas Lateral (3) Medial (2) Between iliac and psoas 1 Piercing than anterior

Lateral - iliohypogastric, lioinguinal, LFCN

Medial - obturator, lumbosacral trunk

Between - femoral

Piercing - genitofemoral

19

What nerve is at risk with a retractor under transverse acetabular ligament?

Obturator

20

How can we adduct after an obturator neurectomy

Pectineus, femoral

21

What nerve is above piriformis?

Superior gluteal nerve

22

What structure is most at risk of posterior ICBG harvest?

Superior gluteal artery, to a lesser extent cluneal nerves

23

Between What muscles does the posterior obturator nerve run between?

Adductor brevis and magnus

24

In the anterior Smith-Peterson approach the deep interval is between?

Rectus femoris and Gluteus medius

25

Name the ligaments connecting the pubic sympysis

Superior pubic ligament (stronger)

Inferior (arcuate) public ligament

26

What type of joint is the pubic symphysis?

Synovial amphiarthroidal joint

27

What do the medial sacral crest and alae of the sacrum represent embryologically?

Medial sacral crest: fused spinous processes

Alae and SI articular processes: fused TP and costal processes

28

What strucures are near the posterior sacral foramina?

Dorsal primary rami

29

What structures are near the anterior sacral foramina?

Ventral primary rami

30

In which direction are the coccyx of men and women directed?

Men: anteriorly towards pubis (like a penis)

Women: vertically