Lecture 27 (14-7-14) Flashcards Preview

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Flashcards in Lecture 27 (14-7-14) Deck (39):
1

What is the demarcation betweent the gluteus and thigh?

gluteal fold.

2

Gluteal Dermatomes

3

What are the cutanteous nerves of gluteal

  • Superior L1-3 Dorsal Rami
  • Middle S1-3 dorsal rami
  • inferior cluneal ventral rami S2,S3

4

What are the superficial gluteal muscles and what do they do?

Extensors and aBductors 

all the glutes and tensor fasa lata

5

Gluteus maximus

  • illium, sacrum, coccyx, sacrotuberous lig--> gluteal tuberosity of femor and illiotibial track
  • inferior gluteal nerve L5-S2 
  • actions
    • forceful extension of hte hip
    • external rotation of extended thigh
    • stabilixe the exteneded knee

6

Gluteus Medius

  • Lateral side of illium--> grater trochanter
  • Superior gluteal nerve L4-S1
  • actions
    • abduction of hte hip
    • internal rotate the thigh 
    • Level pelvis during walking

7

Gluteus Minimis 

  • Inferior part of lateral illium-->greater trochanter
  • Superior gluteal nerve. 
  • actions
    • Abduct the hip
    • internal rotate the thigh
    • level pelvic during walking

8

What is gerdies tubericle

9

Tensor Fascia Lata

  • ASIS, iliac crest--> IT tract, gerdys tubercle
  • Superior gluteal n L4-S1
  • actions
    • abduction of the hip

10

Superior Gluteal nerve injury

cannt contract os the the hip will pop up on one side 

11

12

What are the deep Gluteal Muscles

EXXTERNAL HIP ROTATORS 

13

Piriformis Muscle

  •  --> greater trochanter 
  • Sacral plexus S1, S2
  • Lateral rotators of the thigh 

a deep gluteal muscle

14

Superior Gemellus Muscle

  • ischial spine--> medial side greater trochanter 
  • N. to obturator internus
  • Lateral hip rotation 

a deep gluteal muscle

15

Obturator internus 

  • obturator foramne, membrane on medial side--> out through foramen, 90 degree angle--> out lesser sciatic--> greater trochanter 
  • N. to obturator internus (L5, S1, S2) 
    • same nerve roots and inferior gluteal nerve
  • External thigh rotation 

deep gluteal muscle

16

Inferior Gemellus Muscle

  • Ischial tuberosity--> greater trochanter
  • N. to quadratus femoris (L4-L5-S1) 
    • same as superior gluteal nerve

a deep gluteal muscle

17

Quadratus Femoris Muscle

  • lateral border of ischial tuberos--> intertrochanteric crest
  • N. to guadratus femoris 
  • lateral rotation of thigh 

a deep gluteal muscle

18

Obturator externus muscles

  • obturator memebrane-->**trocanteric fossa 
  • obturatior posterior division L3-L4
  •  ER of hip

medial compartment 

19

Gluteal Bursae

  • Trochanteric bursa
    • between gluteus maximus and greater trochangter
    • B/c of repetitiev activities like climbing 
  • Ischial bursa
    • gluteus maximus and inscial tuberosity 
  • Gluteafemoral bursa
    • ​iliotibiial tract --> vastolateralis 

20

Pelvic Ligaments

  • transform greater and lesser sciatic notches into foramens
  • Sacrotuberous lig
    • ilium, sacrum and coccyx--> ischial tuberiosity 
  • Sacrospinous ligament
    • coccyx, sacrum--> ischial spine

21

Openings from pelivc cavity to gluteal region

  • greater sciatic foramen above and below piriformis  
  • Lesser sciatic foramen
  • obturator canal --> go to medial thigh

22

Gluteal Region Nerves and arteries where do they come from and go to (general) 

  • pelvic cavity-- (greater sciatic foramen)--> gluteal region
  • gluteal region-- (lesser sciatic foramen)--> perineum 

23

Lumbosacral plexus

  1. Superior gluteal L4-S1
    •  Gluteus medius
    • Gluteus minimus
    • Tensor fascia lata
  2. Inferior gluteal L5-S2
    • gluteus maximus
  3. L4,L5 S1-3 posteiror thigh leg foot plantar
  4.  l4-S1
    1. inferor gemellus 
    2. quadraus femorus
  5. dee 
    1. superior gemellus
    2. opturator internus 
  6. out w/ sciatic nerve
    1. inferior cluneal n nerves come off to go to cuteanous S2-S3 all somatic sensory nerve
  7. S2-4

24

Posterior divisionInternal iliac artery 

  1. Illiolimbar 
  2. illiosacral 
  3. sacrogluteal

25

Anterior branch of internal illiac artery

  1. umbilical a 
    1. superior vesicale--> sup bladder
  2. Obturatior a
  3. inferior vesicle a or vaginal (female)
  4. middle rectal 
  5. uterine a (females) or deferentila 
  6. inferior gluteal a
  7. internal pudendal a 

26

Where do gluteal shots go?

outer upper quadrant

27

Hip Joint is what kind of joint?

What is the articulation 

  • ball and socket
  • head of femur with acetabulum of hip bone
    • lunate surface: w/ articular cartlidge
      • transverse 
    •  
  • lined with synovial membrane 
  • zona orbicularis- thickened portion surrounding the femoral neck
  •  

28

Acetabulum 

  • Indintation is where the round ligament it attached 
  • transverse acetabular ligament --> across aetabular notch 

29

Ligaments of the hip joint

ligimentum terise--> fove capitis 

  • iliofemoral ligament
    • anterior ligament, strong, reinforece and streangthen joint 
    • twist and tightens when we extend
    • strong
  • pubofemoral ligament
    • prevents hyper abduction 
    • splits
  • ischiofemoral ligament
    • weakest one 
    • against excessive IR and Flexion

30

Where are hip fractures most common?

normally femoral neck 

31

Hip joint dislocation;

  • What are the two kinds 

  • Congentital:
    • acetabilium is shallow because it didnt form well
    • normall bilateral 
    • more common in femalle 
  • aquired: more agressive, painful 
    • posterior 
    • sciatic nerve vonerable
    • trendelengburg sign b/c femoral head is higher on affected side

32

Innervation of the hip joint:

  1. Superior part
  2. Inferior part
  3. anterior part
  4. Posterior part

  1. Superior gluteal (
  2. obturatior n (L2-L4)
  3. Femoral Nerve (L2-L4)
  4. N. to quadratus femoris (L4-S1)

33

Blood Supply to the hip

  • lateral and medial circumflex femoral
  • ​medial circumflex
    • retinacular br--> neck and head of femur
  • obturator--> head of the femor
    • important in kids 

​​

34

Hip Flexors

  • Anterior thigh muscles
    • sartorius
    • illopsoas
    • Pectinus
  • rectus femoris 
    • only quad muslce to do this
  • add magnus adductor part (helps)

35

Hip Extensors

  • Gluteal maximus

36

Hip Adductors

  • adductor longus
  • adductor brevis
  • adductor portion of adductor magnus
  • gracilis 
  • Sartrois 

37

Hip Abductors 

  • Gluteus medius
  • Gluteus minimus
  • Tensor fascilara

38

Hip Lateral Rotators 

  • Sartoris
  • gludeus maximus
  • deep gluteal mm
    • piriformis
    • superior gemellus
    • obturator internus
    • inferior gemellus
    • quadratus femors
  • obturatos externus 

39

Hip Internal Rotators

  • PEctinus
  • Gluteal medius
  • Gluteal minimus