Joints 1 - Glenohumeral and Hip Joints Flashcards Preview

MD2002 > Joints 1 - Glenohumeral and Hip Joints > Flashcards

Flashcards in Joints 1 - Glenohumeral and Hip Joints Deck (118):
1

What are the movements of the GH joint?

+ Flexion and extension
+ Abduction and adduction
+ Medial and lateral rotation
+ Circumduction

2

What are the movements of the hip joint?

+ Flexion and extension
+ Abduction and adduction
+ Medial and lateral rotation
+ Circumduction

3

What are the intrinsic, anterior ligaments of the GH joint?

+ Glenohumeral - weak
+ Transverse humeral - supports biceps tendon

4

What are the extrinsic, superior ligaments of the GH joint?

+ Coracoacromial - strong
+ Coracohumeral - strong

5

What does the coraco- acromial arch consist of?

+ Coracoid process
+ Acromion
+ Coraco-acromial ligament

6

What does the coraco-acromial arch do?

Prevents superior displacement of the humerus

7

Where does the GH joint capsule attach?

+ Medially to glenoid fossa margin and labrum

+ Laterally to anatomical neck of humerus

8

Where does the GH joint capsule enclose?

Proximal attachment of long head of biceps

9

What structures pass through the GH capsule?

+ Biceps tendon
+ Synovial membrane (anteriorly)

10

What does the synovial membrane form upon passing through the GH capsule anteriorly?

Subscapularis bursa

11

What does the subscapularis bursa do?

Protects the subscapularis tendon from being damaged by the edge of the glenoid

12

Where does dislocation of the GH joint most commonly occur, and during which movement?

Subcoracoid dislocation (anterior), usually during abduction

13

What structures are at risk during dislocation of the GH joint?

Axillary nerve and circumflex humeral artery

14

What are bursae?

Sac-like cavities containing synovial fluid which also helps facilitate movement

15

What can bursitis lead to?

Degenerative changes in the associated tendons resulting in difficulty initiating certain movements

16

What would degenerative changes in the supraspinatus tendon result in?

The inability to initiate abduction

17

What are the superficial muscles of the scapular region?

+ Latissimus dorsi
+ Trapezius

18

What are the deep muscles of the scapular region?

+ Rhomboids
+ Levator scapulae

19

What are scapular (intrinsic shoulder) muscles?

+ Deltoid
+ Teres major
+ Supraspinatus
+ Infraspinatus
+ Teres minor
+ Subscapularis

20

What muscles form the rotator cuff muscles?

SITS
+ Supraspinatus
+ Infraspinatus
+ Teres minor
+ Subscapularis

21

What do the rotator cuff muscles do?

They are short, powerful muscles that stabilise the GH joint by pulling the head of the humerus into the glenoid fossa

22

What movement is supraspinatus involved with?

First 15° of abduction (deltoid takes over up to 90°)

23

What movement is infraspinatus involved in?

Lateral rotation

24

What movement is teres minor involved in?

Lateral rotation

25

What movement is subscapularis involved in?

Medial roation

26

What are features of the first 3 muscles of SITS, supraspinatus, infraspinatus and teres minor?

Posterior scapular muscles that attach on posterior aspect of scapula (supra/infraspinus fossa) and attach to the greater tuberosity of the humerus

27

What nerve supplies supraspinatus and infraspinatus?

Suprascapular nerve

28

What nerve is teres minor supplied by?

Axillary nerve

29

What are features of subscapularis muscle?

Anterior scapular muscle that attached to the subscapular fossa and the lesser tuberosity of the humerus

30

What nerve supplies subscapularis?

Supscapular nerves (posterior cord)

31

Which muscles attach the UL to the scapula (scapulohumeral muscles)?

+ Deltoid
+ Teres major
+ Triceps
+ Rotator cuff muscles (SITS)

32

What are the landmarks of teres major?

Divides the axilla from arm

33

What is teres major?

A muscle of the posterior wall of the axilla

34

What are the attachments of teres major?

+ Lateral margin of scapula
+ Medial lip of bicipital groove of humerus

35

What nerve is teres major supplied by?

Lower subscapular nerve

36

What movement is teres major involved in?

It adducts and medially rotates the humerus

37

What are the attachments of the deltoid?

+ Clavicle
+ Acromion
+ Spine of scapula
+ Deltoid tuberosity of humerus

38

What nerve is the deltoid supplied by?

Axillary nerve

39

What movements are the deltoids involved in?

+ Abducting the arm (supraspinatus initiates first 15°)

+ Flexes and medially rotates arm (clavicular head)

+ Extends and laterally rotates the arm (spinal part)

40

Where does triceps brachii (long head) attach?

Infraglenoid tubercle of the scapula to the ulna

41

What is the role of triceps brachii (long head)?

Assists in stabilising the adducted GH joint

42

What are the attachments of the coracobrachialis?

Attached to coracoid process of scapula to middle 1/3 of humerus

43

What is the role of the coracobrachialis?

Resists dislocation of shoulder joint

44

What are the movements of the GH joint?

Flexion: pec. major + deltoid

Lat. rotation: infraspinatus

Med. rotation: subscapularis

Extension: deltoid

Adduction: pec. major + lat. dorsi

Abduction: deltoid

45

What are the gateways to the scapular region?

+ Suprascapular notch
+ Quadrangular space
+ Upper triangular space
+ Lower triangular (triangular interval)

46

What structures pass through the suprascapular notch?

+ Suprascapular nerve
+ Suprascapular artery
+ Branch of subclavian artery

47

What structures pass through the quadrangular space?

+ Axillary nerve
+ Posterior circumflex humeral artery

48

What structures pass through the upper triangular space?

+ Circumflex scapular artery

49

What structures pass through the lower triangular space?

+ Radial nerve
+ Profunda brachii artery

50

How is the acetabulum formed?

Fusion of ilium, pubis and ischium

51

What lines the rim of the acetabulum, and what can happen to it?

Acetabular labrum, may tear and cause pain

52

What are features of the acetabulum?

+ Deep socket
+ Weight bearing
+ Stable
+ Lunate lined articular surface

53

What are features of the femoral head?

+ Large, approx. 2/3 of sphere
+ Covered in hyaline cartilage except for fovea ligament

54

What are the features of the proximal femur?

+ Head, fovea
+ Neck
+ Greater trochanter
+ Intertrochanteric crest
+ Intertrochanteric line (capsular attachment)
+ Lesser trochanter

55

Why is the femoral shaft offset from the head by the femoral neck?

To enable movement

56

What is the femoral neck particularly susceptible to in osteoporotic women?

Fracture (avascular necrosis of femoral head)

57

What is the role of the trochanters?

For muscle attachment

58

What is the role of the intertrochanteric line?

Hip joint capsule and ligaments insert anteriorly into the line

59

When do the epiphyses of the two trochanters and the femoral head fuse?

By 18/19 years

60

What is the connection between the synovial layers of the capsule and retinacular fibres?

The synovial layers of the capsule sends retinacular fibres medially along the femoral neck towards the head

61

What are the 3 ligaments that reinforce the fibrous capsule of the hip joint?

+ Iliofemoral
- anterior and superior
- strongest

+ Pubofemoral
- anterior and inferior

+ Ischiofemoral
- posterior
- weakest

62

Where does the iliofemoral ligament attach?

From ant. iliac spine to intertrochanteric line

63

What does the iliofemoral ligament prevent?

Hyperextension of hip joint during standing

64

Where does the pubofemoral ligament attach?

Blends with iliofemoral; attaches from obturator crest of pubic bone to merge with fibrous capsule

65

What does the pubofemoral ligament prevent?

Overabduction of hip joint; tightens during abduction and extension of hip

66

Where does the ischiofemoral ligament attach?

From acetabular rim (ischialO to medial part of greater trochanter

67

Where are the ligaments of the hip joint weaker?

Posteriorly where the muscles (medial rotators of the hip) are placed to reinforce the joint

68

Where are the ligaments of the hip joint stronger?

Anteriorly where the muscles (medial flexors of the hip) are fewer and weaker than the rotators posteriorly

69

Where is the great trochanter in relation to the acetabulum

Opposite the middle of the acetabulum

70

Which part of the acetabulum is often the first part to radiologically show the changes of osteoarthritis?

Superolateral part

71

What does abnormal growth or movement of the epiphysis of the hip joint do?

Causes the femoral neck to move slightly anteriorly and into external rotation

72

Where are retinacular arteries derived from?

Circumflex femoral and the obturator arteries

73

In the hip joint, which structures are located laterally?

+ Gluteus med
+ TFL - tensor fascia latae
+ Iliotibial tract

74

In the hip joint, which structures are located anteriorly?

Femoral nerve and vessels

75

In the hip joint, which structures are located medially?

Branches of the obturator nerve and vessels

76

In the hip joint, which structures are located posteriorly?

Sciatic nerve (with post. fem. cutaneous nerve and inf. gluteal vessels adjacent)

77

What are the flexors (anterior thigh) of the hip joint?

+ Pectineus
+ Iliopsoas
+ Sartorius

78

What are the adductors (medial thigh) of the hip joint?

+ Adductor longus
+ Adductor brevis
+ Adductor magnus
+ Gracilis
+ Obturator externus

79

What are the extensors (posterior thigh - also flex knee) of the hip joint?

+ Semitendinosus
+ Semimembranosus
+ Biceps femoris

80

What are the abductors and rotators of the thigh (gluteal region)?

+ Gluteus maximus, medius, minimus
+ TFL - tensor fascia latae
+ Piriformis
+ Obturator internus
+ Superior and inferior gemelli
+ Quadratus femoris

81

Where does the flexor, pectineus attach?

From the pubis to the femur (pectineal line)

82

What movement is pectineus also involved in?

Adducts and assists with medial rotation of thigh

83

What nerve supplies pectineus?

Femoral nerve

84

What structures combine to form the flexor, iliopsoas?

Psoas major, psoas minor and iliacus

85

Where does iliopsoas attach to?

The vertebrae (psoas major and minor) OR iliac crest and SI ligaments (illiacus) where it attaches the femur (lesser trochanter - psoas major and iliacus or pectineal line psoas minor)

86

What is iliopsoas supplied by?

Femoral nerve or ant. rami L1-L3

87

What are the attachments of the flexor, sartorius?

From the ant. sup. iliac spine to sup. med. tibia

88

What movement is sartorius also involved in?

+ Abducts and laterally rotates thigh
+ Flexes legs at knees

89

What is sartorius supplied by?

Femoral nerve

90

Where does adductor longus attach?

From the pubis (body inf. to pubic crest) to the femur (mid 1/3 of linea aspera)

91

What is adductor longus supplied by?

Obturator nerve

92

Where does adductor brevis attach?

From the pubis (body and inf. ramus) to the femur (pectineal line and prox. linea aspera)

93

What is adductor brevis supplied by?

Obturator nerve

94

Where does adductor gracilis attach?

From the pubis ( bodya ndinf. ramus) to the sup. medial tibia

95

What movement is gracilis also associated with?

Flexes and partially medially rotates leg

96

What is adductor gracilis supplied by?

Obturator nerve

97

What are the two parts of adductor magnus?

+ Adductor
+ Hamstring

98

Where does adductor magnus attach for the hamstring part?

From ischial tuberosity attaching to the femur (adductor tubercle)

99

Where does adductor magnus attach for the adductor part?

From the inf. ramus of pubis and ischial ramus to femur (gluteal tuberosity, linea aspera med supracondylar line)

100

Post division/for the adductor part, what is adductor magnus supplied by?

Obturator nerve

101

What is the hamstring part of adductor magnus supplied by?

Sciatic nerve

102

Where does obturator externus attach to?

From the obturator foramen and membrane to femur (trochanteric fossa)

103

What movement is obturator externus also involved in?

+ Laterally rotates thigh
+ Steadies head of femur

104

What is obturator externus supplied by?

Obturator nerve

105

What are the flexors of the hip joint?

+ Pectineus
+ Iliopsoas
+ Sartorius

106

What are the adductors of the hip joint?

+ Adductor longus
+ Adductor brevis
+ Adductor magnus
+ Gracilis
+ Obturator externus

107

What are the extensors of the hip joint?

+ Semitendinosus
+ Semimembranosus
+ Biceps femoris

108

Where does semitendinosus attach?

From the ischial tuberosity to sup. medial tibia

109

Where does semimembranosus attach?

From ischial tuberosity to post medial condyle of tibia

110

What movements are semitendinosus and semimembranosus also involved in?

+ Flex leg
+ Medially rotate when knee flexed
+ When thigh flexed, they extend trunk

111

What is semitendinosus and semimembranosus supplied by?

Sciatic nerve

112

Where does the long head of biceps femoris attach?

From the ischial tuberosity to the fibula

113

Where does the short head of biceps femoris attach?

From the femur (linea aspera and lat. supracondylar line) to the fibula

114

What movement is biceps femoris also involved in?

Partially flexes leg when knee flexed

115

What is biceps femoris supplied by?

Sciatic nerve

116

What are the abductors and medial rotators of the thigh?

+ Gluteus maximus
+ Gluteus medius, minimus and tensor fascia latae
+ Piriformis, obturator internus, superior and inferior gemelli
+ Quadratus femoris

117

What is a dashboard injury?

Sitting with hips flexed - blow to the knee sends force proximally through the femur and dislocated the hip posteriorly

118

What structure is at risk in a dashboard injury/posterior dislocation?

Sciatic nerve

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