LECTURE 1: INTRODUCTION TO JOINTS AND THE GLUTEAL REGION

Question 1

What are the features of synovial joints?

Answer 1

cap, synovial cavity, synovial membrane, joint capsule, fibrous layer, outer layer, fatty pads,

Question 2

What is a bursae?

Answer 2

– miniature joint capsule
o Sacs lined with synovial membrane (Contain synovial fluid)
o Reduce friction where ligaments, muscles, skin, tendons, or bones rub together

Question 3

What are the 6 types of synovial joints?

Answer 3

plane, hinge, pivot, condylar, saddle, ball and socket

Question 4

What is the action of the plane joint?

Answer 4

2 solid flat structures that glide against one another (nonaxial movement). Limited mobility
 Examples: Intercarpal joints, intertarsal joints, joints between vertebral articular surfaces

Question 5

What is the action of the hinge joint?

Answer 5

Uniaxial (move in one plane), Flexion and extension only

 Examples: Elbow joints, interphalangeal joints

Question 6

What is the action of the pivot joint?

Answer 6

Flat round head of radius allows for supination and protonation rotation
 example: Atlantioaxial joint is in your neck, Proximal radioulnar joints

Question 7

What is the action of the condylar joint?

Answer 7

Bi-axial movement over sagittal plane, Extend/ flex, and abduct/adduct
 Examples: Metacarpophalangeal (knuckle) joints, wrist joints

Question 8

What is the action of the saddle joint?

Answer 8

flexion/extension, adduction/abduction

 Example: Carpometacarpal joints of the thumbs

Question 9

What is the action of the ball and socket joint?

Answer 9

most mobility and less stability; Extend/ flex, and abduct/adduct, and rotation
 Examples: Shoulder joints and hip joints

Question 10

What does the ilio-inguinal nerve innervate?

Answer 10

(no motor innervation in lower limb) innervates abdominal muscles

Question 11

What does the genitofemoral nerve innervate?

Answer 11

(no motor innervation in lower limb) genital branch innervates cremaster

Question 12

What does the femoral nerve innervate?

Answer 12

skin of the anterior thigh and muscles (quadriceps); branches supply iliacus and pectineus

Question 13

What does the obturator nerve innervate?

Answer 13

skin over upper medial thigh and muscles (except pectineus and part of adductor magnus); obturator externus

Question 14

What does the lateral cutaneous nerve innervate?

Answer 14

Parietal peritoneum in iliac fossa; skin over anterolateral thigh

Question 15

What does the sciatic nerve innervate?

Answer 15

 Innervates all of the muscles of the posterior compartment of thigh and muscles that move ankle and foot

Question 16

What does the inferior gluteal nerve innervate?

Answer 16

 Passes through greater sciatic foramen below piriformis

 Innervates gluteus maximus

Question 17

What does the superior gluteal nerve innervate?

Answer 17

 Passes through greater sciatic foramen ABOVE piriformis

 Supplies gluteus Medius and minimus

Question 18

What does the Posterior cutaneous nerve of the thigh innervate?

Answer 18

 Passes through greater sciatic foramen below piriformis and medial to sciatic
 Innervates skin over gluteal fold, posterior thigh and parts of perineum

Question 19

What does the nerve to quadratus femoris innervate?

Answer 19

 Passes through greater sciatic foramen below piriformis and deep to sciatic
 Innervates quadratus femoris and inferior gemellus

Question 20

What does the nerve to obturator internus innervate?

Answer 20

 Passes through greater sciatic foramen below piriformis between post cutaneous and pudendal
 Innervates obturator internus and superior gemellus

Question 21

What does the perforating cutaneous nerve innervate?

Answer 21

 Exits the pelvic cavity by piercing the sacrotuberous ligament
 Innervates skin over medial gluteus maximus

Question 22

What is the origin of the gluteus maximus?

Answer 22

Fascia covering gluteus Medius, posterior ilium, fascia of erector spinae, dorsal surface of sacrum, coccyx, sacrotuberous ligament

Question 23

What is the insertion of the gluteus maximus?

Answer 23

Posterior iliotibial tract and gluteal tuberosity

Question 24

What is the innervation and action of the gluteus maximus?

Answer 24

Innervation: Inferior gluteal nerve
Action: Extension, lateral rotation, abduction of hip

Question 25

What is the origin and insertion of the gluteus medius and minimus?

Answer 25

Origin: Posterior ilium between anterior and posterior gluteal lines Insertion: Greater trochanter

Question 26

What is the innervation and action of the gluteus medius and minimus?

Answer 26

Innervation: Superior gluteal nerve Action: Abduct femur: stabilization of pelvis during single leg stance

Question 27

What is the origin and insertion of the tensor fascia lata?

Answer 27

Origin: Lateral crest of ilium between ASIS and tubercle of crest Insertion: Iliotibial tract of fascia lata

Question 28

What is the action and innervation of the tensor fascia lata?

Answer 28

Innervation: Superior gluteal nerve Action: Abduct femur: stabilization of knee in extension

Question 29

what is IT Band Syndrome?

Answer 29

IT get tights and pulls on all your muscles

Question 30

What is the origin and insertion of the piriformis?

Answer 30

Origin: Anterior surface of sacrum Insertion: Greater trochanter

Question 31

What is the origin and insertion of the obturator internus?

Answer 31

Origin: Anterolateral wall of true pelvis, obturator membrane Insertion: Greater trochanter

Question 32

What is the origin and insertion of the superior gemellus?

Answer 32

Origin: External surface of ischial spine Insertion: Superior surface of obturator internus tendon and greater trochanter

Question 33

What is the origin and insertion of the inferior gemellus?

Answer 33

Origin: Upper aspect of ischial tuberosity Insertion: Inferior surface of obturator internus tendon and greater trochanter

Question 34

What is the origin and insertion of the quadratus femoris?

Answer 34

Origin: Lateral aspect of ischium anterior to ischial tuberosity Insertion: Quadrate tubercle on intertrochanteric crest

Question 35

What is the action and innervation of the piriformis?

Answer 35

Innervation: Branches S1- S2 Action: Laterally rotate extended hip; abduct flexed femur

Question 36

What is the action and innervation of the obturator internus?

Answer 36

Innervation: Nerve to obturator internus Action: Laterally rotate extended hip; abduct flexed femur

Question 37

What is the action and innervation of the superior gemellus?

Answer 37

Innervation: Nerve to obturator internus Action: Laterally rotate extended hip; abduct flexed femur

Question 38

What is the action and innervation of the inferior gemellus?

Answer 38

Innervation: Nerve to quadratus femoris Action: Laterally rotate extended hip; abduct flexed femur

Question 39

What is the action and innervation of the quadratus femoris?

Answer 39

Innervation: Nerve to quadratus femoris Action: Laterally rotate femur

Question 40

What is the Trendelenburg sign?

Answer 40

 Occurs in people with weak or paralyzed abductors  When patient stands on one leg, the pelvis severely drops on the standing leg side  Positive signs are seen in patients with superior gluteal nerve damage  Patients with a positive sign, gait is abnormal. On the single leg stance phase of walking, weakened abductor muscles allow pelvis to tilt, patient compensates by tilting the trunk the other way to maintain level of the trunk during gait

Question 41

What are the sight of intramuscular injections?

Answer 41

o Inject into the upper outer quadrant to avoid sciatic nerve and superior gluteal vessels and nerve o Inject into gluteus Medius anterosuperior to gluteus maximus

Question 42

What is the supply of the inferior gluteal artery?

Answer 42

Supplies surrounding muscles and descends into posterior thigh where it anastomoses with branches of femoral a.

Question 43

What is the origin of the inferior gluteal artery?

Answer 43

anterior trunk of internal iliac a.

Question 44

What is the origin of the superior gluteal artery?

Answer 44

Originates from posterior trunk of internal iliac a.

Question 45

What are the divisions of the superior gluteal artery?

Answer 45

Superficial branch- passes onto deep surface of gluteus maximus Deep branch- passes between gluteus Medius and minimus

Question 46

Where do the deep lymphatic vessels drain?

Answer 46

into internal iliac nodes

Question 47

Where do the superficial lymphatic vessels drain?

Answer 47

into superficial inguinal nodes