Mod 3: Lecture 2 - Gluteal Region and Hip Joint Flashcards Preview

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Flashcards in Mod 3: Lecture 2 - Gluteal Region and Hip Joint Deck (43)
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Pelvic Bone/ Innominant Bone

- Fusion of three bones
---- ilium
---- ischium
---- pubis
---- fusion occurs between 15-17 years of age
- Acetabulum
---- where the 3 bones unite
---- the circle at the bottom of the pelvis
---- location of femoral head articulation



- big round flat top part
- Iliac Crest: top curve of the bone
---- at the L4 vertebral level
- ASIS: anterior superior iliac spine
---- the front end of the iliac curve
- AIIS: anterior inferior iliac spine
----- below the iliac curve, the bump after the inward curve
- PSIS: posterior superior iliac spine



- bottom and back of the inferior circle
- Ischial Tuberosity: a bump at the posterior inferior part
---- supports you when you sit
- Ischial Spine: a pointy projection at the back of the pelvis
- Ramus of Ischium: extends from the ischial tuberosity to inferior pubic ramus
---- contributes to the ischiopubic ramus



- top and center of the inferior circle
- Infer Pubic Ramus: contributes to the ischiopubic ramus
- Super Pubic Ramus: the top part of the inferior circle
- Pubic Tubercle: a little jutting out right before the pubic symphysis


Pelvis/ Pelvic Girdle

- formed by two pelvic bones and the sacrum
---- each pelvic bone consists of three fused bones
---- the sacrum is five fused bones
- False Pelvis/ Pelvis Major: contains abdominal viscera
---- the space between the ilium
- True Pelvis/ Pelvis Minor: contains pelvic viscera
---- the stuff in the giant circle below the ilium
- Pelvic Brim: separates true from false pelvis


Joints within the Pelvis

- Pubic Symphysis: syndesmosis
---- a cartilaginous disc between the right and left pubis
----- anterior
- Sacroiliac (SI) Joint: synovial joint
---- between the sacrum and the ilium
---- posterior


Obturator Foramen

- formed by the ischium and pubis
---- inferior circle
---- directly below the acetabulum
- nearly closed by the obturator membrane


Greater Sciatic Notch

- superior to ischial spine
---- curved indent in the ilium, right above the ischium
---- seen in a lateral view
- converted to a foramen by the sacrospinous ligament


Lesser Sciatic Notch

- inferior to the ischial spine
---- curved indent in the ischium
---- seen in a lateral view
- converted to a foramen by the sacrospinous and sacrotuberous ligaments


Ligament Attachments
1. Sacrospinous
2. Sacrotuberous

1. sacrum and coccyx to ischial spine
2. PSIS and sacrum to ischial spine


Greater Sciatic Foramen

- further divided by piriformis muscle
- Above piriformis: superior gluteal nerves
- Below piriformis:
---- inferior gluteal nerves
---- sciatic and pudendal nerves
---- cutaneous nerves
---- nerves to lateral rotators


Lesser Sciatic Foramen

- tendon of obturator internus
- pudendal nerves to perineum


Obturator Canal

- obturator nerve and vessels


Proximal Femur

- Femoral Head: fits deep within the acetabulum
- Femoral Neck: frequent site of fractures
- Greater and Lesser Trochanter: both are the site of multiple muscle attachments
- Intertrochanteric Line: located anteriorly between the greater and lesser trochanters, the site of ligaments support the hip joint (iliofemoral)


Proximal/Body of the Femur

- Linea Aspera: vertical ridge of bone which serves as an area for multiple muscle attachments
- Gluteal Tuberosity: ridge of bone between greater trochanter and linea aspera
---- bumps out more than the linea aspera
- Pectineal Line (posterior): ridge of bone between the lesser trochanter and linea aspera
---- kind of diagonal


Distal Femur

- Linea Aspera: vertical ridge of bone which serves as an area for multiple muscle attachments
- Medial and Lateral Supracondylar Ridge: posterior, extend down from the aspera to the medial and lateral condyles
- Adductor Tubercle: site of muscle attachment
---- found above the medial condyle


Hip Joint

- formed by the acetabulum of the pelvic bone and head of the femur
- ball and socket joint


Acetabulum (bony)

- formed by ilium, pubis, and ischium right above the obturator foramen
- bony cup does not extend inferiorly
---- this area is closed by the transverse acetabular ligament (which is important for stability)
---- this is where the acetabulum runs into the obturator foramen


Acetabular Labrum

- fibrocartilagenous structure
- attaches to bony rim of acetabulum
---- continuous with the transverse acetabular ligament
- deepens the acetabulum and contributes to joint stability
- Lunate Surface: acetabular hyaline cartilage on the ridge of the labrum
---- horseshoe shaped, does not cover the ligament
---- fat is located centrally


Movements of the Femur

- Flexion/Extension
- Abduction/Adduction
- Medial/Lateral Rotation


Pelvic Motion

- Anterior and Posterior Tilt
---- sagittal plane around coronal axis
---- anterior: hip flexion, pubic symphysis forward, ilium back
---- posterior: hip extension, pubic symphysis back, ilium forward
- Lateral Tilt
---- frontal plane around sagittal axis
---- produces hip abduction: ilium tilts down
---- produces hip adduction: ilium tilts up


Ligaments of the Hip

- Anterior and Posterior Sacroiliac Ligament
- Iliofemoral
- Pubofemoral
- Ischiofemoral


Anterior and Posterior Sacroiliac Ligament

- support sacroiliac joint
---- in between the ilium and sacrum
- synovial plane
- one in the front (anterior) and one in the back (posterior) per side
---- so there is a left set and a right set


1. Iliofemoral Ligament
2. Pubofemoral Ligament
3. Ischiofemoral Ligament

1, 2, 3. - connect the femur to the pelvis
- wrap around the femur head and the hip by the acetabulum
- reinforce and stabilize the hip joint
- fibers are oriented in a spiral and are taut in extension
1. anterior - seen from the front
2. anteroinferior - same spot as 1, just lower, also seen from the front
3. posterior - seen from the back


A. Iliacus Muscle
B. Psoas Major
1. Attachments
2. Action
3. Innervation

A ,B. - posterior abdominal wall
- paired
- often referred to as the iliopsoas
1 A. - top of ilium, - proximal femur
1 B. - lumbar spine, - proximal femur
2 A, B. - together, they are the strongest flexors in the hip
3 A, B. femoral nerve


A. Psoas Minor
B. Quadratus Lumborum
1. Attachments
2. Action
3. Innervation

A, B. - posterior abdominal wall
- paired
- does not cross the hip joint
1 A. - lumbar spine, - ilium
1 B. - lower rib, - ilium
3 A, B. ventral rami of upper lumbar levels


Gluteal Muscles

- Gluteus Maximus
- Gluteus Medius
- Gluteus Minimus
- Tensor Fascia Latae


Gluteus Maximus
1. Attachments
2. Action
3. Innervation

- superficial
1. - butt cheek
3. inferior gluteal nerve


A. Gluteus Medius
B. Gluteus Minimus
1. Attachments
2. Action
3. Innervation

A. deep
B. deepest, directly under A
1 A, B. superior and lateral diagonal of butt cheek
2 A, B. when walking, constriction on stance side of the hip prevents excessive pelvic tilt during swing phase of the leg on the opposite side of the hip
3 A, B. superior gluteal nerve


Tensor Fascia Latae
1. Attachments
2. Action
3. Innervation

- small muscle in the gluteal region
1. - the connective tissue on the lateral side of the thigh