Lecture 1 - Pelvis and Hip Flashcards Preview

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Flashcards in Lecture 1 - Pelvis and Hip Deck (53)
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1
Q

What movements do the hips perform?

A

extension, flexion, abduction, adduction, medial and lateral rotation

2
Q

The hip bone is also called?

A

os coxae & the innominate (“unnamed”) bone

3
Q

What are the three parts of the coxal bone?

A

ilium, ischium and pubis - these fuse at the acetabulum

4
Q

Obturator Foramen is formed by?

A

Conjuction of ischium and pubis

5
Q

What makes up the pelvis and what are the three articulations formed?

A

The pelvis is the bony ring made up by the two os coxae and the sacrum.
The three articulations found within this ring are the
-two sacroiliac joints
-pubic symphysis

6
Q

What forms the sacroiliac joint?

A

auricular surfaces of ilium and sacrum form synovial part of the SI joint

7
Q

What type of joint in the sacroiliac joint?

A

The sacroiliac joint is actually 2 types of joints:

A synovial joint inferiorly and a syndesmosis joint posteriosuperiorly

8
Q

What can occur with the sacroiliac joint with age?

A

It may undergo stenosis (ossify)

9
Q

Sacroiliac Ligaments?

A

Ventral and Dorsal Sacroiliac
-thickened regions of the SI joint capsule
Iliolumbar
-from iliac crest to TVP of L5
Interosseus sacroiliac
-syndesmotic portion of the joint (fibrous) between the iliac tuberosity and sacrum
**Sacrotuberous
-sacrum to ischial tuberosity
**sacrospinous
-sacrum to ischial spine, which forms the greater and lesser sciatic foramina

10
Q

What limitations does the iliolumbar ligament create?

A

limits rotation and anterior gliding of L5 in relation to the sacrum.
limits side-bending of L5 in relation to the pelvis.

11
Q

The interosseus ligaments provide stability to the sacrum, how?

A

downward compression of the sacrum, due to the weight of the upper body cause the interosseus ligaments to pull the ilium bones together to tighten the joint.

12
Q

Anterior sacral rotation is limited by which ligaments?

A

sacrotuberous
sacrospinous
interosseus sacroiliac

13
Q

What is nutation?

A

Nutation is rotation or tilting of sacrum around axis through interosseus ligaments (horizontal axis - 2nd sacral segment)
Nutation brings the iliac crests together and the ischial tuberosities further apart - this increases the size of the pelvic outlet

14
Q

Anterior Nutation?

A

Promontory moves interior and anterior
Coccyx moves superior and posterior
-occurs during birth
(“Nutation” - generally refers to Anterior)

15
Q

Posterior Nutation?

A

“Counter nutation” - oppositve of Anterior Nutation
Promontoy moves posterior and superior
Coccyx moves interior and anterior

16
Q

Intertrochanteric line

A

separates the neck from the shaft of the femur, anteriorly.

17
Q

Linea aspera

A

Ridge on posterior aspect of the femural shaft

18
Q

Adductor tubercle

A

small prominence at superior part of the medical epicondyle (tagged on lab exams)

19
Q

What type of joint is the hip joint?

A

The hip joint is a ball and socket synovial joint between the head of the femur and the acetabulum of the coxal bone

20
Q

What connects the hip joint?

A

Transverse acetabular lig and acetabular labrum (c-shaped cartilage lining) - enlarges the articular surface
Ligamentum teres or ligament of femoral head - from head to transverse acetabular ligament

21
Q

What are the 3 main ligaments that make up the main stabilizers of the hip joint? What are their actions?

A

Iliofemoral (the Y ligament of Bigalow) - limits hypertension of femur
Ischiofemoral - reinforces hip capsule posteriorly
Pubofemoral - reinforces hip capsule inferiorly

22
Q

During extension what do the hip joint capsule ligaments do?

A

All 3 ligaments wind around the hip joint so that they tighten in extension

23
Q

pubofemoral ligament helps

A

limit abduction of the hip

24
Q

Flexion of the hip is limited primarily by?

A

The hamstring muscles

25
Q

Femoral Neck derives blood from?

A

Medial and lateral circumflex arteries

26
Q

The femoral head receives blood from?

A

Medical and lateral epiphyseal arteries

27
Q

What is another name for the medial epiphyseal artery?

A

The arter of the ligamentum teres

Not everyone has this

28
Q

What artery arises from the medial femoral circumflex artery?

A

the lateral epiphyseal artery

-this is easily disrupted by fracture and dislocation. This can lead to avascular necrosis of the femoral head.

29
Q

Psoas Major

A

A: Lateral Flexion of the vertebral column, flexion of the femur from the hip
O: Bodies and TVPs of T12-L5
I: lesser trochanter of femur
N: L1-4

30
Q

Psoas Minor

A

A: Weak flexor of the lumbar spine
O: Bodies of T12-L1
I: Pectineal line of the Pubis
N: L1

31
Q

Iliacus

A

A: Flex femur
O: Iliac Fossa
I: Lesser trochanter
N: femoral n.

32
Q

Gluteus Maximus

A

A: extend, laterally rotate the femur
O: Iliac crest and sacrum/coccyx
I: gluteal tuberosity and iliotibial tract
N: inferior gluteal n. (L5, S1-2)

33
Q

Gluteus Medius

A

A: abduct, medially rotate femur, during gait, supports body on one leg while the other leg swings forward
O: dorsal ilium
I: greater trochanter
N: superior gluteal n. (L5, S1)

34
Q

Gluteus Minimus

A

A: abduct, medially rotate femur; assists gluteus medius in supporting the body during gait.
O: dorsal ilium
I: greater trochanter
N: superior gluteal n. (L5, S1)

35
Q

Tensor Fascia Lata

A

A: abduct, medially rotate, flex femur while keeping knee extended
O: ASIS, anterior Iliac crest
I: Iliotibial tract which extends down to the lateral condyle of tibia
N: superior gluteal n. (L4, 5)

36
Q

Which two muscles insert onto the iliotibial tract?

A

Gluteus maximus and the tensor fascia lata

37
Q

Which muscles are innervated by the superior gluteal nerve?

A

Gluteus medius, gluteus minimus and tensor fascia lata

38
Q

Which muscles are considered the Lateral Rotators?

A

Piriformis, Superior and Inferior Gemelli, Obturator Internus (thick back of CT that splits gemelli), Quadratus femoris, Obturator externus (most deep, won’t see in lab)

39
Q

Obturator Internus

A

A: Laterally rotate femur
O: obturator membrane
I: greater trochanter
N: nerve to obturator internus (L5,S1)

40
Q

Superior and Inferior Gemelli

A

A: laterally rotate femur
O: ischium
I: greater trochanter
N: nerves to obturator inernus and quadratus femoris (L5,S1)

41
Q

Quadratus Femoris

A

A: laterally rotate femur
O: ischial tuberosity
I: quadrate tubercle
N: nerve to quadratus femoris (L5,S1)

42
Q

Obturator Externus

A

A: laterally rotate femur
O: obturator membrane (outer)
I: greater trochanter
N: obturator n. (L3,4)

43
Q

Piriformis

A

A: abduct, laterally rotate femur
O: anterior sacrum
I: greater trochanter
N: S1,2

44
Q

Which iliopsoas and gluteal muscles medially rotate and abduct the femur?

A

tensor fascia lata, gluteus medius, gluteus minimus

piriformis - abducts

45
Q

Which iliopsoas and gluteal muscles laterally rotate the femur?

A

piriformis, obturator internus and externus, superior and inferior gemelli, quadratus femoris
iliacus and psoas

46
Q

Which iliopsoas and gluteal muscles flex the femur?

A

tensor fascia lata, iliacus and psoas

47
Q

Which muscle extends the femur?

A

gluteus maximus

48
Q

Which muscles are innervated by the sciatic nerve?

A

hamstrings, 1/2 adductor magnus, muscles of leg/foot

49
Q

How does the sciatic nerve travel?

A

L4,5 S1,2,3 rami exit greater sciatic foramen with the piriformis.
It then enters the thigh between the hamstrings and adductor magnus
Dividing into the common fibular and tibial branches

50
Q

Which muscles are innervated by the superior gluteal nerve?

A

gluteus medius, gluteus minimus and tensor fascia lata

51
Q

Where does the superior gluteal nerve exit?

A

It exits superior to the piriformis

52
Q

Which muscle does the inferior gluteal nerve innervate?

A

Gluteus maximus

53
Q

Where does the inferior gluteal nerve exit?

A

It exits inferior to the piriformis