Lecture 3 Gluteal region

Question 1

Main functions of lower extremity =

Answer 1

Improve stability and decrease muscle recruitment

Question 2

Innominate bone is formed by the fused …

Answer 2

ilium, ischium, and pubis

Question 3

The three topographic regions of the pelvic girdle from inferior to superior are

Answer 3

• convex –> concave
• convex –> concave
• concave –> convex

Question 4

The anterior/posterior sacroiliac ligament is

Answer 4

syndesmoses

Question 5

Obtuse vs acute pubic symphysis angles

Answer 5

Obtuse = female
Acute = male

Question 6

Nutation =

Answer 6

Anterior pelvic tilt (bend back at hip joint); increases weight bearing, opens the symphysis and there is an outflare

Question 7

Counternutation =

Answer 7

posterior tilt (flex at hip joint or bend foreward); decrease weight bearing, compresses symphysis, inflare

Question 8

Unilateral innominate bone motion can show

Answer 8

SI pain and leg length discrepancy

Question 9

How to tell L/R femur apart

Answer 9

Femoral head goes medially into acetabulum; intertrochantric crest more prominent posteriorly

Question 10

Ligament of the femoral head=

Answer 10

ligament teres

Question 11

Orientation of the acetabulum=

Answer 11

Anterior, inferior, lateral

Question 12

Orientation of the femur =

Answer 12

Posterior, superior, medial

Question 13

What is the labrum and where does it end

Answer 13

A fibrocartilage stabilizer that increase the depth of the socket and ends at the transverse ligament

Question 14

What is ligament Y

Answer 14

Iliofemoral ligament (strongest in body)

Question 15

Where does ilio,ischio, and pubofemoral ligaments attach

Answer 15

Intertrochantric line

Question 16

Less than 120 degrees (knocked knees) coronal plane malalignment =

Answer 16

Coxa vara genu valga

Question 17

More than 135 degrees (bow legged) coronal plane malalignment =

Answer 17

Coxa valga genu vara

Question 18

Angle between the axes of femoral neck (coronal) and femoral condyles (transverse) =

Answer 18

Femoral angle of torsion

Question 19

Femoral angle of torsion greater than 15 degrees =

Answer 19

Anteversion (internal rot)

Question 20

Femoral angle of torsion less than 10 degrees =

Answer 20

Retroversion (external rotation)

Question 21

Hip impingement types and the gold standard for diagnoses

Answer 21

Pincer: above femoral head
CAM: on femoral head
Gold standard= arthroscopy

Question 22

retro-acetabulum =

Answer 22

Sagittal plane malalignment

Question 23

Ventral divison of sacral plexus =

Answer 23

Tibial nerve
Pudendal nerve
Pelvic splanchnic nerve -(parasympathetic)

Question 24

Dorsal division of sacral plexus =

Answer 24

Common fibular nerve
Superior gluteal nerve
Inferior gluteal nerve

Question 25

Sciatic nerve = what two nerves

Answer 25

Common fibular nerve and tibial nerve

Question 26

Obturator foramen is formed by which two bones

Answer 26

Pubis and ischium

Question 27

Common iliac artery is on which nerve level

Answer 27

L4

Question 28

What does the piriformis divide the greater sciatic foramen into

Answer 28

- Superior greater sciatic foramen - Inferior greater sciatic foramen

Question 29

Where does the internal pudendal artery course through

Answer 29

Lesser sciatic foramen

Question 30

Name muscular fiber types and describe them

Answer 30

Type 1 (slow twitch): more mitochondira, for endurance, are oxidative (postural muscles like multifidi, soleus, transverse abdominis) Type 2A (fast twitch oxidative): in between Type 2B (fast twitch glycolytic): less mitochondria, more power, glycolysis used

Question 31

Open chain elbow flx/closed chain elbow flx

Answer 31

Open: concentric contraction of agonists Closed: eccentric contrction of antagonists

Question 32

Cutaneous innervation: Superior/medial cluneal nerve vs Inferior

Answer 32

Sup/Med: dorsal rami not from sacral plexus Inferior: posterior femoral cutaneous nerve

Question 33

Gluetus maximus in open chain performs..

Answer 33

Abduction superiorly, adduction inferiorly

Question 34

Main muscle compensation for hip flexor weakness

Answer 34

Tensor fascia latae

Question 35

Contralateral hip drop =

Answer 35

Trendelenburgs sign

Question 36

Bilateral hip side bending to maintain a level pelvis =

Answer 36

Duchenne limp/waddling gait

Question 37

When the hip is flexed over 60 degrees, the piriformis does what and why

Answer 37

internally rotates because the proximal attachment is posterior to the distal attachment

Question 38

Piriformis syndrome AKA.. ; which nerves, most common types

Answer 38

-Sciatica -Common fibular and tibial nerve - Piercing piriformis = 10-15% - Superior greater sciatic foramen = 1-3%

Question 39

The (blank) supports the pelvic floor with a tendinous area

Answer 39

Obturator internus

Question 40

The obturator internus and quad femoris (blank) when the hip is flexed

Answer 40

Abduct