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YR2: Limbs > Hip, buttock and thigh > Flashcards

Hip, buttock and thigh Flashcards

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1
Q

What happens to the lower limb during development?

A

It twists, resulting in permanent pronation at mid-thigh level

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2
Q

What specific words are given to the flexion and extension of the foot?

A

Dorsiflexion (pointing toes up)

Plantarflexion (pointing toes down)

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3
Q

What are the 3 parts of the pelvis (hip bone)?

A

Ilium
Ischium
Pubis

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4
Q

What marks the ends of the iliac crest?

A

ASIS + PSIS

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5
Q

What is the name given to the surface of the hipbone that articulates with the sacrum?

A

Auricular Surface

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6
Q

What lies in between the greater and lesser trochanters of the femur?

A

Intertrochanteric line

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7
Q

What short ridge is found just inferior to the lesser trochanter?

A

Gluteal tuberosity

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8
Q

A longer ridge downwards along the shaft of the femur and originates from the short ridge below the lesser trochanter. What is this long ridge called?

A

Linea aspera

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9
Q

Which tubercle is found just superior to the medial epicondyle of the femur?

A

Adductor tubercle

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10
Q

What is the anterior protrusion between the ilium and the pubis called?

A

Iliopubic eminence

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11
Q

What are the two notable parts of the ischium onto which ligaments attach?

A

Tuberosity + spine

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12
Q

Which pelvic bones make up the acetabulum?

A

All 3 (ilium, ischium + pubis)

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13
Q

What notches are present on the posterior aspect of the pelvis?

A

Greater sciatic notch + lesser sciatic notch

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14
Q

What is the angle of inclination?

A

The angle between the long axis of the shaft + long axis of the head + neck

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15
Q

What determines the size of the angle between the long axis of the shaft and the vertical plane?

A

Width of the hips

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16
Q

What structures form the greater and lesser sciatic foramina?

A

Sacrospinous ligament

Sacrotuberous ligament

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17
Q

What are the two fascia found in the thigh?

A

Superficial fascia e.g. subcutaneous tissue

Deep fascia- fascia lata

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18
Q

What is the name given to the lateral thickened area of the fascia lata?

A

Ilio-tibial tract

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19
Q

What are the 4 compartments of the thigh region?

A

Gluteal compartment
Anterior compartment of the thigh
Medial compartment of the thigh
Posterior compartment of the thigh

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20
Q

What movements are the muscles of the gluteal region responsible for?

A

Extension, abduction + external rotation of the hip

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21
Q

What are the gluteal muscles?

A

Gluteus maximus
Gluteus medius
Gluteus minimus
(tensor fasciae latae)

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22
Q

What are the short external rotators of the hip?

A

Piriformis
Obturator internus
Quadratus femoris
Gemelli (superior + inferior)

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23
Q

Describe the attachments of gluteus maximus.

A

Proximal: posterior part of the iliac crest + thick fascia of the sacrum + coccyx
Distal: gluteal tuberosity + ilio-tibial tract

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24
Q

What proportion of the gluteus maximum fibres attach to the gluteal tuberosity?

A

~ 25% attach to the gluteal tuberosity

The rest attach to the ilio-tibial tract

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25
What does the ilio-tibial tract insert into?
Anterolateral tubercle of the tibia
26
Describe the attachments of gluteus medius.
Proximal: broad attachment to the external surface of the ilium (between anterior + posterior gluteal lines) Distal: greater trochanter
27
Describe the attachments of gluteus minimus.
Proximal: broad attachment to the external surface of the ilium (between anterior+ inferior gluteal lines) Distal: greater trochanter
28
What movement are gluteus medius and gluteus minimus responsible for?
Abduction
29
What movement are the deep muscles of the gluteal region responsible for? What is their other function?
Lateral rotation | Also stabilise hip joint
30
Describe the attachments of tensor fasciae latae.
Proximal: ASIS Distal: ilio-tibial tract
31
Which compartment is tensor fasciae latae in?
Neurologically: a gluteal compartment muscle because it is innervated by the superior gluteal nerve Action= flexor of the hip so it functions more like an anterior compartment muscle
32
Describe the attachments of obturator internus.
Rim of the obturator foramen | Greater trochanter of the femur
33
What movement are the muscles of the anterior compartment of the thigh responsible for?
Hip flexion | Knee extension
34
Which muscles are in the anterior compartment of the thigh?
``` Pectineus Ilio-psoas (Tensor fasciae latae) Sartorius Quadriceps (rectus femoris, vastus medialis, vastus intermedius, vastus lateralis) ```
35
What is the most powerful flexor of the hip?
Ilio-psoas
36
Describe the attachments of Ilio-psoas.
Psoas major attaches to the lateral parts of the lumbar vertebrae + T12 + Iliacus attaches to the iliac fossa + crest The 2 muscles converge to form a common tendon that attaches to the lesser trochanter
37
Describe the attachments of Sartorius. What movement is it responsible for?
Sartorius comes off ASIS, descends inferiorly + medially. It crosses the knee + attaches to the upper part of the shaft of the tibia
38
Describe the arrangement of the quadriceps muscles.
Rectus femoris is most superficial with vastus medialis + vastus lateralis on either side of rectus femoris Vastus intermedius is deep to rectus femoris
39
Where do the quadriceps attach distally?
Join to form a quadriceps tendon, which attaches to the patella There is a patellar tendon between the patella + the tibial tuberosity on the anterior of the tibia The patellar tendon is part of the quadriceps tendon with the patella in between as a sesamoid bone
40
What small muscle is found underneath vastus intermedius?
Articularis genu
41
What bursa is found just above the knee joint?
Suprapatellar bursa
42
What movement are the muscles in the medial compartment of the thigh responsible for?
Adduction of the hip
43
Which muscles make up the medial compartment of the thigh?
``` Obturator externus Gracilis Adductor brevis Adductor longus Adductor magnus ```
44
Where do most of the muscles of the medial compartment attach proximally?
Pubic bone
45
Describe the structure of adductor magnus.
Broad attachment to shaft of the femur (medial lip of linea aspera) + a smaller attachment to adductor tubercle (just above medial epicondyle) Gap inbetween= Hiatus of adductor magnus
46
What movements are the muscles of the posterior compartment of the thigh responsible for?
Hip extension | Knee flexion
47
Which muscles make up the posterior compartment of the thigh?
Semitendinosus Semimembranosus Biceps femoris
48
Where do the muscles of the posterior compartment attach proximally?
Ischial tuberosity
49
Describe the attachments of biceps femoris.
Long head of biceps femoris comes from the ischial tuberosity + short head comes off the shaft of the femur (lateral lip of linea aspera) They cross over laterally to attach to the head of the fibula
50
What are the borders of the femoral triangle?
Superior: Inguinal Ligament Lateral: Sartorius Medial: Adductor Longus
51
What are the contents of the femoral triangle (lateral to medial)? What mnemonic can be used to remember this?
Femoral Nerve Femoral Artery Femoral Vein Deep inguinal lymph nodes NAVY
52
What is the name given to the opening in the fascia lata over the femoral triangle and what is its purpose?
Saphenous Opening: allows draining of the long saphenous vein into the femoral vein Margin of saphenous opening = Falciform Margin
53
What structures form the Adductor Canal?
Anterior: Vastus Medialis Posterior: Adductor Longus + Adductor Magnus Medial: Sartorius
54
What are some other names for the Adductor Canal?
Hunter’s Canal | Subsartorial Canal
55
What are the contents of the Adductor canal?
Femoral artery Femoral vein Saphenous nerve (major branch of femoral nerve)
56
Where does the sciatic nerve lie within the gluteal region?
Inferior medial quadrant
57
What two nerves does the sciatic nerve divide to form?
Tibial Nerve | Common Peroneal Nerve
58
Where would you perform an intramuscular injection into the gluteal region?
Superior lateral quadrant
59
What does the sciatic nerve supply?
All hamstring muscles | All muscles below the knee (supplied by the 2 branches of the sciatic)
60
What test is used to assess the function of the hip abductors?
Trendelenberg test Patient lifts 1 foot off the floor, their hip abductors (gluteus medius + minimus) should contract to keep the pelvis level despite the extra weight of the raised foot on the opposite side
61
Describe the structure of the acetabulum.
Acetabulum has a depression in the middle (acetabular fossa) + a lunate surface (surrounding the fossa) The acetabular notch is filled in by the transverse acetabular ligament
62
What runs within the capsule of the hip joint?
Blood supply to femoral head
63
What are the ligaments of the hip joint?
Iliofemoral ligament (Y shaped) Ischiofemoral ligament Pubofemoral ligament Transverse acetabular ligament
64
Describe how the arrangement of the hip ligaments changes when the hip is flexed and extended.
Flexed: ligaments relaxed Extended (e.g. when standing): ligaments spiral, which pulls the head of the femur into the acetabulum + helps stabilise the joint when standing
65
Describe the blood supply to the head of the femur.
Main blood supply is via the medial + lateral circumflex femoral arteries (from profunda femoris) Also a small blood supply from artery of the head of the femur (branch of obturator artery- more important in children)
66
What type of hip fracture is most likely to need a hip replacement and why?
Intracapsular: more likely to disrupt the blood supply + cause avascular necrosis of the head of the femur
67
When does the external iliac artery become the femoral artery?
As it passes under the inguinal ligament
68
What main branch does the femoral artery give off that gives rise to the medial and lateral circumflex femoral arteries?
Profunda femoris
69
At what point do the superficial femoral artery and the femoral vein become the popliteal artery and vein?
As they pass through the hiatus of adductor magnus from the anterior to posterior compartment
70
Which arteries, that supply the buttock and thigh, are branches of the internal iliac?
Superior + Inferior gluteal arteries | Obturator artery
71
What is the main superficial vein of the thigh?
Long saphenous vein
72
What other veins drain into the saphenous vein before it enters the sapheno-femoral junction?
Superficial circumflex iliac Superficial epigastric Superficial external pudendal Lateral cutaneous vein of thigh
73
What are the deep veins of the thigh?
``` Popliteal vein Femoral vein External iliac vein Sapheno-femoral junction Venae comitantes of the profunda femoris artery ```
74
What are the main groups of lymph nodes in the thigh?
Deep inguinal lymph nodes Superficial inguinal lymph nodes External iliac lymph nodes
75
Which nerve supplies the anterior compartment of the thigh and which division of the lumbosacral plexus gives rise to this?
Femoral nerve: posterior division of the lumbosacral plexus (L2,3,4)
76
Which nerve supplies the medial compartment of the thigh and which division of the lumbosacral plexus gives rise to this?
Obturator nerve: anterior division of lumbosacral plexus (L2,3,4)
77
``` State which roots are responsible for: Hip flexion Hip extension Knee extension Knee flexion ```
Hip flexion: L2,3 Hip extension: L4,5 Knee extension: L3,4 Knee flexion: L5, S1
78
Which nerve supplies the posterior compartment of the thigh, posterior and anterior leg and foot, and which nerve roots give rise to this nerve?
Sciatic nerve (L4,5 + S1,2,3)
79
Which nerves supply the gluteal muscles and which nerve roots give rise to these nerves?
Superior gluteal nerve (L4,5 + S1) | Inferior gluteal nerve (L5 + S12)
80
Which nerve roots are responsible for the sensory segmental supply to the: Front of the thigh Back of the thigh Buttock
Front of the thigh: T12, L1,2,3 Back of the thigh: S1,2,3 Buttock: S2,3,4
81
Which nerve roots give rise to the following sensory peripheral nerves:
Subcostal nerve: T12 Ilio-hypogastric nerve: L1 Ilio-inguinal nerve: L1 Genito-femoral nerve: L1,2 Lateral cutaneous nerve of the thigh: L2,3 Sensory branches of the femoral nerve: L2,3,4 Sensory branches of the obturator nerve: L2,3,4 Posterior cutaneous nerve of the thigh: S2,3 Saphenous nerve: L2,3,4 Buttock nerves from the sacral plexus: L1-S3
82
Where are the most common sites of fracture on the femur?
Femoral neck | Intertrochanteric fracture
83
How do the semimembranosus and semiteninosus differ in appearance?
Tendinosus: forms a more classic tendon (rope like) Membranosus: forms a flat, membranous, strap like tendon
84
Where odes the sciatic nerve usually enter the gluteal region?
Inferior to piriformis, but can be superior or pierce muscle itself
85
Which 2 actions can adductor Magnus perform?
Anterior portion: Hip flexion | Posterior portion: Hip extension
86
Where do dermatomes L3 and L4 extend?
L3 to the knee | L4 to the floor (foot)

YR2: Limbs (8 decks)

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