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

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3

What are the cutanteous nerves of gluteal

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

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4

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

Extensors and aBductors 

all the glutes and tensor fasa lata

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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

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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

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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

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8

What is gerdies tubericle

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9

Tensor Fascia Lata

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

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10

Superior Gluteal nerve injury

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

11

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12

What are the deep Gluteal Muscles

EXXTERNAL HIP ROTATORS 

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13

Piriformis Muscle

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

a deep gluteal muscle

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14

Superior Gemellus Muscle

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

a deep gluteal muscle

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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

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17

Quadratus Femoris Muscle

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

a deep gluteal muscle

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18

Obturator externus muscles

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

medial compartment 

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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 

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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

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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

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24

Posterior divisionInternal iliac artery 

  1. Illiolimbar 
  2. illiosacral 
  3. sacrogluteal

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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 

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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

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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 

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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