Lab Quiz 1 Flashcards
1
Q
synarthrosis
A
no movement
2
Q
amphiarthrosis
A
slightly moveable
3
Q
diarthrosis
A
freely moveable
4
Q
joints w no joint cavity
A
fibrous and cartilaginous
5
Q
in a fibrous joint, what determines the amount of movement allowed
A
the length of the fibers
6
Q
syndesmoses joint
A
fibrous, amphiarthrosis
7
Q
joint that is united by hyaline cartilage
A
synchondroses
8
Q
synchondroses
A
temporary (usually)
synarthrosis (no movement)
ex: growth plates
9
Q
United by fibrocartilage
A
symphysis
10
Q
primary cartilaginous
A
synchondroses
11
Q
secondary cartilaginous
A
symphysis
12
Q
symphysis movement
A
amphiarthrosis (slightly)
13
Q
all synovial joints are __ joints
A
diarthrosis (freely moveable)
14
Q
the 2 layers of the articular capsule of the synovial joint
A
- outer fibrous capsule
- inner synovial membrane
15
Q
the inner synovial membrane
A
secretes fluid for synovial joint
16
Q
articular cartilage covering the ends of bone in synovial joints
A
hyaline cartilage
17
Q
accessory ligaments of synovial joints can be classified as:
A
-capsular
-intracapsular
-extracapsular
(some resources classify capsular and extracapsular the same)
18
Q
capsular
A
blend with joint capsule
19
Q
intracapsular
A
inside the joint capsule
20
Q
extracapsular
A
outside the joint capsule
21
Q
bursa
A
fluid filled sac (small amount of fluid)
decreases friction between joint structures
22
Q
how are synovial joints classified
A
according toe shape of articular surfaces
23
Q
which bones can use use for radiographical age determination
A
short bones
24
Q
the ossification center of a short bone is located
A
at bone center
25
the ossification center of a long bone is located
1. Around mid shaft (Primary)
| 2. Ends of bones (2nd)
26
Which type of bone (long/short) are always present at birth in the lower extremity
long bones, not all short bones will be present.
27
Endochondral Ossification
ossify from cartilage to bone
28
all lower extremity bones form by ____ with the exception if the Ungual process (distal phalanx)
endochondral ossification
29
Which ossification centers are present at birth in long bones?
Primary Ossification centers, secondary are not.
30
all long bones can have multiple (primary/secondary) ossification centers.
secondary
31
Epiphysis
secondary ossification center that contributes to a Joint
32
Apophysis
secondary ossification center that contributes to Ligament/muslce attachment
33
epipheseal plate is a cartilage plate between
diaphysis and epiphysis
34
what allows for bone lengthening
epiphysis
35
Epihyseal plate forms
the metaphysis and diaphysis
36
Pelvic Girdle is formed from
the coxal bones
1. Illium
2. Ishium
3. Pubis
37
the pelvic girdle articulate (posteriorly with the ___ to form the pelvic skeletal (pelvic ring)
sacrum
38
the coccyx (is/is not) apart of the pelvic skeleton
Is apart of
39
the sacrum is a ___ shaped bone formed from 5 fused vertebra
wedge
40
the male sacrum is ___ compared to females'
longer/narrower
41
female sacrum is ___ compared to males'
shorter/wider
42
the curvature of the sacrum is (primary/secondary)
primary
43
the base of the sacrum is (superior/inferior)
superior
44
the base of sacrum articulates with
L5 Vertebrae (weight bearing)
45
sacral promitory
base of the sacrum, anterior edge of S1
46
the apex of the sacrum is (superior/inferior)
inferior
47
the apex of the sacrum articulate with
the coccyx
48
how many sacral foramina are there
4 anterior, 4 posterior
49
what pases through the sacral foramina
ventral and dorsal rami
50
superior articular process facet faces
posteriorly
51
auricular surface (medial/lateral) aspect
lateral
52
the auricular surfaces of sacrum articulates with the
auricular surface of the illium (has ridges and depressions)
53
which part of the sacrum forms a synovial joint as part of the sacroiliac joint
the auricuar surface
54
sacral tuberosity (anterior/posterior) aspect of (medial/lateral) surface
posterior, lateral
55
which aspect of the sacrum forms a syndesmosis with the illium
sacral tuberosity
56
sight for ligament attachment on the sacrum
the sacral tuberosity
57
the bony landmarks of sacrum are remnants of
vertebral components
58
transverse ridges (lines)
fused bodies
59
Sacral crests are located (posterior/anterior)
posterior
60
median sacral crests
fused spinous processes
61
intermediate sacral crests
medial side of posterior foramina
| fused superior/inferior articular processes
62
lateral sacral crests
lateral to posterior sacral foramina
| fused transverse processes
63
the sacral crests are named based off of their anatomical relationship to
posterior sacral foramina
64
sacral alae
lateral projections
| remnant of S1 transverse processes
65
sacral groove
between median and intermediate crests, fused laminae
66
sacral hiatus opens into
sacral canal
67
the sacral hiatus is formed by
unfused S5 Lamina
68
S5 and Co1 spinal nerves exit through
the sacral hiatus
69
sacral cornu
lateral margins of sacral hiatus
70
the base of the coccyx articulates with
sacral apex (base of coccyx is superior, sacral apex inferior)
71
Coccygeal Cornu is remnant of
superior articular processes of Co1
72
the Coccygeal Cornu ligament connect with
sacral cornu
73
The Coccygeal Cornu is able to bear weight (True/False)
False, does not support weight
74
the coccygeal cornu functions as
area of muscle and ligament attachment
75
the 3 coxal bones are separated by ___ until they fuse
triadiate cartilage
76
the coxal bones articulate with the __ posteriorly
sacrum (sacroiliac joint)
77
the coxal bones articulate with the __ anteriorly
contralateral coxal bone (pubic symphysis)
78
the coxal bones articulate with the __ laterally
femur (acetabofemoral joint/hip)
79
the superior border of the ilium
illiac crest
80
palpable anterior end of iliac crest
ASIS (anterior superior Iliac spine)
81
palpable posterior end of iliac crest
PSIS (Posterior superior Iliac spine)
82
the PSIS can be found at the level of
S2
83
the visible dimple on the back is the
PSIS
84
the iliac tubercle is __ to the ASIS
posterior
85
posterior gluteal line is __ to the PSIS and extends to PIIS
anterior
86
the anterior gluteal line forms between
ASIS and Iliac tubercle to greater sciatic notch
87
the palpable posterior/inferior aspect of the ischium
ischial tuberosity
88
when does the ischial tuberosity bear weight
when sitting
89
the cup like depression formed by the 3 coxal bones is known as the
acetabulum
90
superior aspect of acetabulum
body of the ilium
91
the posterior inferior aspect of acetabulum
body of ischium
92
the anterior inferior aspect of the acetabulum
pubis
93
what is the crescent shaped articular surface within the acetabulum
the lunate surface
94
the central depression called the acetabular fossa is formed mostly by
body of ishium
95
contents of the acetabular fossa are:
1. fat
2. ligamentum teres femoris
(not articular)
96
the acetabular notch is found between
the inferior ends of the lunate surface
97
the raised edge of the acetabulum is called the
acetabular ridge
98
the iliopectineal eminence is the junction between
iliac body and superior pubic ramus (iliopubic)
99
the auricular surface of the ilium is inferior to
iliac tuberosity
100
the auricular surface of the ilium is posterior to
iliac fossa
101
greater sciatic foramen anterior boundary (anterolateral)
greater sciatic notch of ilium
102
the greater sciatic foramen superior boundary
anterior sacroiliac ligaments
103
inferior boundary of greater sciatic foramen
ishcial spine and sacrospinous ligament
104
posterior (posteromedial) boundary of greater sciatic foramen
sacrotuberous ligament
105
the lesser sciatic foramen anterior boundary
lesser sciatic notch (ischium)
106
the lesser sciatic foramen anterior inferior boundary
ischial tuberosity
107
the lesser sciatic foramen anterior superior boundary
ischial spine
108
the lesser sciatic foramen superior boundary
sacrospinous ligament
109
the sacrotuberous ligament is the ___ boundary of the lesser sciatic foramen
posterior
110
what covers the obturator foramen
obturator membrane
111
the obturator canal
superior opening between the obturator membrane and supeiror pubic ramus
112
the passageway to the gluteal region
the greater sciatic foramen
113
the passageway to the gluteal region and the perineum
the lesser sciatic foramen
114
the passageway to the medial thigh
obturator foramen
115
what separates the greater and lesser sciatic foramen
Ischial spine and Sacrospinous ligament
116
what part of the femur articulates with the lunate surface of the acetabulum
the head of the femur
117
fovea capitis femoris is the site of attachment for the
ligament of the head of the femur (contains artery)
118
the retinacular foramen are found
in the neck of the femur
119
the retinacular foramen are
openings for retinacular vessels from the trochantaric anastamosis
120
the (greater trochantar/lesser trochanter) is palpable
the greater trochanter
121
iliopsoas attaches where on the femur
the lesser trochanter
122
trochanteric fossa is a depression on the medial surface of the ____ which serves as an attachment site for ____.
greater trochanter, obturator externous
123
intertrochanteric line is on the ___ surface of the femur between the trochanters
anterior
124
intertrochanteric line serves as
attachment site for ligaments/capsule and muscle
125
quadrate tubercle on the intertrochanteric crest is the attachment site for
quadratus femoris
126
Which lip of the linea aspera is continuous with the spiral line
the medial lip
127
the inferior continuation of the medial lip of the linea aspera is called the
medial supracondylar line
128
the inferior continuation of the lateral lip of the linea aspera is called the
lateral supracondylar line
129
linea aspera is on the (anterior/posterior) shaft of femur
posterior
130
the adductor tubercle can be seen on the (lateral/medial) supercondylar line
medial
131
the nutrient foramen is most commonly found on the__ angles __
midshaft on linea aspera; superiorly
132
MCL attaches where on femur
medial epicondyle
133
ACL and PCL attach where on femur
the intercondylar notch (fossa) on posterior aspect of femur
134
the part of the femur that articulates with the patella
patellar surface
135
LCL attaches to the __ of the femur
the lateral epicondyle
136
primary ossification of ilium (ala) appears
9th fetal week
137
primary ossification of ischim (body) appears
4th fetal month
138
primary ossification of pubis (superior ramus) appears
4-5th fetal month
139
the 3 coxal bones begin to fuse at the acetabulum around age
13-18 years, complete by 18
140
when does the ischiopubic ramus complete fusion by
age 8
141
most secondary ossification centers of the pelvis appear around
puberty
142
secondary ossification will usually appear first in males or females
females
143
most secondary ossifcation centers of the pelvis fuse by
early 20s (15-25)
144
secondary ossification centers of the pelvis:
- AIIS
- Acetabulum
- Ischial tuberosity
- Iliac Crest
- Public Symphysis
145
Primary Ossification center of the femur appear
mid shaft about 7th fetal week
146
femoral condyle ossification centers appear
right after birth
147
femoral condyles fuse
about 20 years old
148
the femoral head appears
by first year
149
the femoral head fuses by
18-19 years old
150
greater trochanter appears
around age 4
151
greater trochanter fuses by
18 years old
152
lesser trochanter appears
between 12-14 (variable)
153
the lesser trochanter fuses
16-17 years old
154
Avulsion Fracture
bone fracture that occurs when fragment of bone is separated from the rest of the bone
155
avulsion fractures are more common when
in childhood and adolescents
156
apophysis (2nd ossification center) in children are generally
weaker than the tendons that attach to them
157
the weakest part of the immature skeleton is the
growth plate (physis) cartilage at the apophysis, has not completely fused with the rest of the developing bone
158
an avulsion fracture is caused by
strong muscle contraction and/or sudden passive lengthening the muscle
can also occur at site of ligament and capsule
159
the sacroiliac joint is designed for
force transmission and weight bearing
160
the sarcoiliac joint is found between
the L-shaped auricular surface of ilium and the sacrum (S1-3)
161
the articulating bony surfaces of the sacroiliac joint are irregular in order to
increase friction and congruency which limits motion
162
the sacroiliac joint rotation and translation
2 degrees rotation
| 2mm of translation
163
what type of cartilage covers the sacral surface of the sacroiliac joint?
hyaline
164
the ilium surface of the sacroiliac joint is covered by what type of cartilage
fibrocartilage
165
the 2 parts of the sacroiliac joint
Anterior planar and posterior syndesmosis
166
the anterior planar part of the sacroiliac joint is a ___ joint
synovial
167
the posterior syndesmosis part of the sacroiliac joint is a __ joint
fibrous
168
the anterior (ventral) sacroiliac ligament is a thickening of
anterior joint capsule
169
the interosseous sacroiliac connect
tuberosities of sacrum and ilium
| posterior/superior to synovial joint
170
the posterior (dorsal) sacroiliac ligament overlies
interosseous ligament posteriorly
171
what ligament connects the intermediate/lateral crest of sacrum (S1,2) to PSIS and internal lip of iliac crest?
posterior (dorsal) sacroiliac
172
the long posterior (dorsal) sacroiliac ligament connects from
S3,4 to PSIS
173
Sacrotuberous ligament has a broad attachment to
PSIS, posterior sacroiliac ligaments, dorsolateral sacrum and coccyx
174
the ___ ligament(s) attaches to the ischial tuberosity
sacrotuberous
175
what muscle attach to the sacrotuberous ligament
Glut Max
Piriformis
Biceps femoris
Semitendinosus
176
__ ligament attaches to Ischial spine
sacrospinous
177
__ ligament attaches to lateral margin of sacrum/coccyx
sacrospinous
178
the sacrospinous ligament is __ to sacrotuberous
anterior
179
the ligaments that resist nutation:
1. sacrospinous
2. sacrotuberous
3. Anterior
4. Interosseous
180
nutation
anterior/inferior motion of sacral base and posterior/superior motion of coccyx
181
counter nutation
opposite of nutation [posterior/superior motion of sacrum anterior, inferior motion of coccyx)
182
what ligaments resit counter nutation
long posterior (dorsal) sacroiliac ligament
183
blood supply to SI joint
Superior Gluteal
Iliolumbar
lateral sacral
184
innervation of SI Joint (can be variable)
Primary Dorsal Rami L4-S3(4)
Ventral Rami L5-S2
Superior gluteal nerve
185
the hip joint is a
ball and socket (spheroid)
Synovial
Diarthrosis
186
the hip joint has __ motion
triplanar
187
the triplanar motion of the hip joint movmeents inclue
flex/ex
abd/add
int/external rotation
circumduction
188
which movement is more limited in the hip joint (abduction/adduction) from anatomical position
adduction
189
which movement is more limited in the hip joint (inter/external rotation) from anatomical position
internal rotation
190
which movement is more limited in the hip joint (extension/flexion) from anatomical position
extension
191
is lateral or medial rotation stronger at the hip joint
lateral rotation
192
bony articulation between the femoral head and acetabulum
lunate surface/labrum
193
the articulation of the hip joint (acetabulum and femoral head) is
stable (more than half the head fits in a socket
194
where is the femoral head least covered by the acetabulum
anteriorly
195
the acetabular fossa is filled with
- fat
| - ligament to the head of the femur
196
the acetabular labrum is __ cartilage
fibrocartilage, attached to acetabular rim and tranverse acetabular ligament
197
the acetabular lacrum is important because it
deepens the socket, is a shock absorber, and decreases stress
-creates a negative pressure to seal the function for synovial joint
198
the acetabular labrum distributes
compressive loads
199
the labrum is most vascular where
at periphery; articular side less vascular
200
joint capsule of hip attaches proximally
acetabulum and transverse ligament
201
joint capsule of hip attaches distally
intertrochanteric line anteriorly and extends to mid neck posteriorly (not a firm attachment to the bone)
202
the lateral half of the neck of the femur is (capsular/extracapular/intracapsular) posterioly
extracapsular
203
Muscles that attche to the hip capsule
1. Glut Max
2. Iliocapsularis
3. Indiret head of Rectus Femoris
4. Obturator Externus
5. Triceps Coxae (conjoint tendon of hip)
204
Triceps Coxae/conjoint tendon of hip is composed of
Obturator internus, superior and inferior gemelli
205
synovium of the hip covers
```
part of femoral neck
femoral head articular surface
ligament teres
acetabular labrum
acetabular fossa
```
206
Capsular ligaments of the hip joint
Iliofemoral
Pubofemoral
Ischiofemoral
Zona Orbicularis
207
Anterior Capsular Ligaments
Iliofemoral
| Pubofemoral
208
Posterior Capsular Ligaments
Ischiofemoral
209
spiral shaped fibers of the ligaments
"screw head into acetabulum"
210
all capsular hip ligaments resist
hip extension and anterior translation of femoral head
211
Iliofemoral Ligament
Y Ligament, Ligament of IBigelow
212
the strongest ligament in the hip
Iliofemoral
213
Iliofemoral Ligament Proximal Attachment
AIIS and Iiac portion of acetabular rim
214
iliofemoral spilts into 2 bands
upper (lateral)
| Lower (medial)
215
Upper Band of Iliofemoral ligament attaches to
superior intertrochanteric line and greater trochanter
216
Lower Band of Iliofemoral Ligament attaches
to inferior intertrochanteric line
217
the upper band of the iliofermoal ligament resists
extension and external rotation (internal rotation in extension)
218
the lower band of iliofemoral ligament resists
extension and external rotation
219
pubofemoral ligament attaches to
pubic part of acetabular rib/obturator crest (superior pubic ramus)
220
the pubofemoral ligament blends with
joint capsule/iliofemoral ligament
221
pubofemoral ligament resists
extension and abduction /external rotation
222
ischiofemoral ligament attaches from
ischial part of acetabular rim to capsule around femoral neck, zona orbicularis, medial to base of greater trochanter
223
ischiofemoral ligament resists
extension and internal rotation
224
Zona Orbicularis
deep circular fibers of the capsule
225
the zona orbicularis blends with
capsular ligaments
226
which ligament forms a collar around the neck
zona orbicularis (locking ring)
227
the zona orbicularis is prominent where?
inferior and posterior capsule
228
the zona orbicularis attaches
it does not directly attach to bone
229
the zona orbicularis functions to /resists
aid in holding femoral head into acetabulum, resists distraction
230
intracapsular ligaments of the hip
ligament of head of the femur
| transverse acetabular ligament
231
function of ligament of the head of the femur
secondary stabilizer, more important stabilizer in fetal/neonates and pathological hip
proprioception
232
the ligament to the head of the femur is a conduit for
the artery to the head of the femur and nerves
233
the ligament of the head of the femur attaches
- margin of acetabular notch/transverse acetabular ligament
| - fovea capitis on the femur
234
what ligament is continuous with the labrum
transverse acetabular ligament
235
the transverse acetabular ligament attaches
to edges of acetabular notch
236
the transverse acetabular ligamrnt creates
a foramen for the passage of vessels
237
origin of the iliocapsularis
anterior inferior iliac spine (AIIS)
238
insertion of the iliocapsularis
below lesser trochanter /sometimes iliofemoral ligament/intertrochanteric line
239
innervation of iliocapsularis
femoral nerve
240
function of the iliocapsularis
raise the capsule with hip flexion and stabilize the hip
241
Iliocapsularis is hypertrophies with
dysplastic hips (insufficient acetabular coverage)
242
Trochanteric Bursa is between
gluteus maximus and lateral aspect of greater trochanter
243
bursa associated with hip bursitis
trochanteric bursa
244
hip bursitis
point tenderness, lateral thigh.gluteal pain, pain with external rotation and extension
245
Ischail bursa is betwwen
glut mac and ischial tuberosity
246
prolonged sitting in a postiotn that puts increased pressure on the tuberosity can irritate the
ischial bursa
247
glutealfemoral bursa is between
glut max (IT band) and vastus lateralis
248
gluteus medius bursa
between gluteus medius and superior greater trochanter
249
hip joint blood supplt
trochanteric anatamosis
250
trochanteric anastomosis
primarily from retinacular arteries from the ascending branchs of medial and lateral femoral circumflex arteries.
251
what artery is major supplier of hip joint in adult
medial femoral circumflex
252
high risk avascular necrosis with what type of fracture
femoral neck, effects medial femoral circumflex artery
253
artery to the head of the femur is a branch of
acetabular artery
254
acetabular artery is a branch of
posterior branch of obturator or MFC
255
what artery is important for the hip joint in children under 3 years old
acetabular
256
the acetabular artery in adults
not major supplier
257
nerve supply to hip joint
```
Posterior Division of femoral
Sciatic
superior gluteal
anterior branch of obturator nerve
accessory obturator nerve can innervate if it is present
nerve to quadratus femoris
```
258
avascular necrosis of femoral head
interruption of blood suppy to the femoral head resulting in ischemia, osteocyte death and necrosis of the tissue
259
what leads to femoral head collapse
avascular necrosis
260
avascular necrosis can be caused by
trauma resulting in hip dislocation or subluxation or femoral neck fracture
261
non traumatic avascular necrosis
- excessive corticosteroid and alcohol use most common
- hematological disease
- many others
262
inferior boundary of gluteal region
gluteal fold
263
hip region
area over greater trochanter
264
Superior Cluneal nerves branches of
posterior rami of L1-3
265
Superior cluneal nerves are susceptible to
entrapment passing through fascia and can be injured during iliac crest bone harvesting
266
middle cluneal nerves branches of
posterior rami S1-3
267
inferior cluneal nerves branches of
posterior femoral cutaneous
268
perforating cutaneous (S2,3) pierce what ligament
sacrotuberous
269
the perforating cutaneous (S2,3) supply
small area at the inferior/edial gluteal region
270
iliohypogastric nerve can innervate
gluteal region
271
all gluteal muscles attach
hip bone/sacrum (proximal) and femur (distal)
272
superfical gluteal muscles attach
posterolateral ala of ilium
273
superficial gluteal muscles function mostly as
hip extensors, abductors, medial (and lateral) rotators
274
Deep gluteal muscles function mostly as
hip lateral rotators, hip stabilizers
275
the facia over the gluteus maximus
is thin, thicker superior to glut max over glut medius (gluteus aponeurosis)
276
glut max origin
external ala of ilium behind posterior gluteal line, posterior iliac crest, sacrotuberous ligament, dorsolateral sacrum/coccyx, gluteal aponeurosis
277
glut max insertion
iliotibial tract (superior fibers) and gluteal tuberosity (inferior fibers)
278
glut max innervation
inferior gluteal nerve (L5-S2)
279
glut max blood supply
superior & inferior gluteal arteries, perforating branches of profunda femoris
280
glut max function
```
primary thigh (hip) extensor, also thigh lateral rotator; trunk extension
(Especially when more force is needed)
```
281
Gluteus medius
Primary thigh abductors. Deep to gluteus maximus
282
Gluteus medius origin
external ala between posterior and anterior gluteal lines, gluteal aponeurosis (fascia)
283
Gluteus medius insertion
lateral part of greater trochanter
284
Gluteus medius innervation
superior gluteal nerve (L4-S1)
285
Gluteus medius blood supply
superior gluteal artery
286
Gluteus medius function
abduction of thigh, medial rotation and lateral rotation of thigh
287
deepest gluteal muscle
Gluteus minimus
288
Gluteus minimus origin
external ala between anterior and inferior gluteal lines , superior edge of greater sciatic notch
289
Gluteus minimus innsertion
anterior part of greater trochanter; hip joint capsule
290
Gluteus minimus innervation
superior gluteal nerve
291
Gluteus minimus blood supply
superior gluteal artery
292
Gluteus minimus function
abduction, medial and lateral rotation of thigh
293
piriformis exits pelvis through
greater sciatic foramen
294
piriformis is important landmark for
identifying superior and inferior gluteal vessels/nerves
295
piriformis origin
pelvic surface of sacrum, superior margin of greater sciatic notch, SI joint capsule, sacrotuberous ligament
296
piriformis insertion
superior greater trochanter
297
piriformis innervation
S1, S2 (nerve to piriformis)
298
piriformis blood supply
gluteal arteries
299
piriformic function
lateral rotation of thigh, helps with abduction (when thigh is flexed)
300
Superior Gemellus
| origin
ischial spine & superior margin of lesser sciatic notch
301
Superior Gemellus
| inerstion
medial part of greater trochanter (with OI and Inf. Gem tendons)
302
Superior Gemellus
| innervation
nerve to obturator internus (L5-S2)
303
Superior Gemellus
| blood supply
inferior gluteal artery
304
Superior Gemellus
| function
lateral rotation
305
Inferior gemelli origin
superior ischial tuberosity; inferior margin of lesser scatic notch
306
Inferior gemelli
| insertion
medial greater trochanter (with Sup Gem and OI)
307
Inferior gemelli innervation
nerve to quadratus femoris (L4-S1)
308
Inferior gemelli
| blood supply
medial femoral circumflex, inferior gluteal
309
Inferior gemelli
| function
lateral rotation of thigh
310
Obturator internus leaves pelvic through
lesser sciatic foramen
311
Obturator internus tendon is covered by
gemelli muscles
312
Obturator internus origin
pelvic surface of obturator foramen and membrane
313
Obturator internus insertion
medial greater trochanter
314
Obturator internus innervation
nerve to obturator internus (L5-S2)
315
Obturator internus blood supply
Inferior gluteal artery, internal pudendal
316
Obturator internus function
lateral rotator of thigh, abduct thigh (when flexed)
317
Quadratus femoris
| origin
Ischial tuberosity
318
Quadratus femoris
| insertion
Quadrate tubercle of intertrochanteric crest
319
Quadratus femoris
| innervation
nerve to quadratus femoris (L4-S1)
320
Quadratus femoris
| blood supply
inferior gluteal, medial femoral circumflex
321
Quadratus femoris
| function
lateral rotator of thigh; adductor of thigh
322
Tendon is deep to the quadratus femoris muscle from posterior view, deep to pectineus from anterior view
Obturator externus
323
Obturator externus
| origin
external surface of obturator foramen/membrane
324
Obturator externus
| insertion
trochanteric fossa on the greater trochanter (passes below neck of femur)
325
Obturator externus
| innervation
obturator nerve (L2-4) *this is unique for a lateral thigh rotator*
326
Obturator externus
| blood supply
obturator artery, medial femoral circumflex
327
Obturator externus
| function
lateral rotator of thigh; also helps with adduction
328
all nerves of gluteal region and posterior thigh exit__ and pass __
- greater sciatic foramen (except nerve to obturator internous)
- pass inferior to piriformis (except superior gluteal)
329
Superior Gluteal (L4-S1)
Innervates gluteus medius, gluteus minimus, TFL
330
Inferior Gluteal (L5-S2)
Innervates gluteus maximus
331
Nerve to Quadratus Femoris (L4-S1)
Innervates quadratus femoris, inferior gemellus)
332
Nerve to Obturator Internus (L5-S2)
Lateral to pudendal nerve as it passes over sacrospinous ligament
333
Posterior Cutaneous Nerve of Thigh (S1-3) is __ to sciatic nerve
medial and deep to fascia lata
334
Posterior Cutaneous Nerve of Thigh (S1-3)
| branches supply
skin over
- posterior thigh, popliteal fossa, upper calf
- Perineum
- Gluteal region (Inferior cluneal nerves, pass around inferior edge of glut max)
335
Pudendal (S2-4)
Passes through lesser sciatic foramen to enter perineum
336
Perforating Cutaneous Nerve (S2,3)
Innervates skin at inferior/medial gluteal region
337
Perforating Cutaneous Nerve (S2,3) exits pelvis by
piercing through sacrotuberous ligament
338
the largest nerve
sciatic (2cm wide)
339
sciatic nerve passes midway between
- PSIS and ischial tuberosity
| - greater trochanter and ischial tuberosity
340
sciatic nerve travels deep to what muscle
long head of bicep femoris
341
where does the sciatic nerve separate
distal thigh/popliteal fossa
342
Tibial nerve (L4-S3)
To the posterior leg
343
Common fibular (L4-S2)
Passes below biceps femoris tendon, around head of fibula (palpable)
344
Innervates posterior thigh, leg, and foot muscles
sciatic nerve
345
Cutaneous innervation of most leg/foot
sciatic nerve
346
Piriformis syndrome
Compression of sciatic nerve due to spasm, fibrosis or hypertrophy of piriformis
(sciatic nerve varies in anatomic relationship to piriformis)
347
Superior gluteal nerve entrapment/injury
| Caused by
- Trauma (fall on buttocks, intragluteal injection)
- Entrapment between glut medius and minimus, superior border of piriformis
- Hip surgery
348
symptoms of Superior gluteal nerve entrapment/injury
- Weak hip abductors (gluteus medius and minimus, TFL)
| - Trendelenburg gait
349
Trendelenburg Test
Test the hip abductors (gluteus medius and minimus, TFL) innervated by the superior gluteal nerve
350
Negative Trendelenburg Test
- the pelvis remains level
- Muscle contraction of the gluteus medius/minimus/ TFL on the unsupported (stance) side pulls the pelvis down (This keeps the unsupported side from dropping)
351
Positive Trendelenburg Test (Trendelenburg sign)
Single leg standing on involved side, pelvis drops on unsupported (swing) side.
352
what can cause a postiive trendelenburg test
hip frx or dislocation
353
Trendelenburg Gait (Lurch):
excessive lateral lean to keep center of gravity over supported leg while walking
354
safe area of infragluteal injections
- superolateral quadrant
- above line from PSIS to greater trochanter tip
- Triangular area between ASIS, tubercle of crest, greater trochanter
355
Inferiorgluteal nerve entrapment/injury
| Caused by
- Hip surgery
| - Injection related injury
356
Inferiorgluteal nerve entrapment/injury symptoms
Weak hip extension
Weak lateral rotation
Gluteus maximus gait (Gluteal lurch or lurch gait)
357
Gluteus maximus gait (Gluteal lurch or lurch gait)
During gait, the trunk lurches backwards at heel-strike on the affected side
(Keep center of gravity behind the hip)
358
primary hip extensors during walking
hamstrings
359
Normally the___ contracts at heels-strike, this slows the forward motion of the trunk and the flexion movement caused by the hip flexors.
gluteus maximus
360
content passing through the greater sciatic foramen above piriformis
Superior gluteal artery, vein, nerve
361
content passing through the greater sciatic foramen below piriformis
1. Inferior gluteal artery, vein, nerve
2. Internal pudendal artery and vein
3. Pudendal nerve
4. Sciatic nerve
5. Posterior femoral cutaneous nerve
6. Nerve to obturator internus
7. Nerve to quadratus femoris
362
content passing through lesser sciatic foramen
1. Internal pudendal artery and vein
2. Pudendal nerve
3. Nerve to obturator internus
4. Tendon of obturator internus
363
gluteal arteries are branches of
internal iliac
364
the arteries of the gluteal region exit out the
greater sciatic foramen
365
Superior gluteal Branches to
glut max, glut medius, glut minimis, TFL, piriformis
366
Inferior pudendal artery travels with
pudendal nerve
367
what artery gives off artery to sciatic nerve
inferior gluteal
368
inferior gluteal artery branches to
glut max, deep gluteal muscles
369
inferior gluteal artery is inferior to
piriformis muscle
370
internal pudendal artery travels between
nerve to OI and pudendal nerve
371
internal pudendal artery passes over (posterior)
sacrospinous ligament, enters lesser sciatic foramen
372
perforating arteries branch off
deep artery of thigh (profunda femoris)
373
perforating arteries pierce what muscle
adductor magnus
374
perforating arteries supplies
Supplies posterior thigh compartment and inferior gluteus maximus
375
gluteal fat pad
fat between gluteus minimus and the ischiofemoral ligament
376
psoas fat pat
fat inferior to psoas major
