when does trirardiate cartilage fuse?
what type of joint is the pubic symphysis?
non-synovial amphiarthroidal joint
has fibrocartilagenous disc
what are the pubic symphysis ligaments? which is strongest?
superior pubic ligament (strongest)
inferior (arcuate) pubic ligament
coccyx points which way?
signs of sacral dysmorphism? clinical relevance?
sacralization of L5
lumbarization of S1
narrowed S1 tunnel (for SI screws)
recessed sacral ala puts L5 nerve root at risk when XRays appear to show intraosseous screws
what type of joint is the SI joint? when does it fuse?
diarthroidal, gliding synovial
fuses by age 50
list the SI joint ligaments
anterior SI ligs
posterior SI ligs
interosseous SI ligs
what ligament runs from:
sacrum to ischial spine
sacrum to ischial tuberosity
iliac crest to L5 transverse process
boundaries of greater sciatic notch?
greater sciatic notch contents SUPERIOR to piriformis muscle
superior gluteal n and a (and v, vena comitantes)
contents of greater sciatic notch INFERIOR to piriformis muscle
pudendal n and internal pudendal a (and v, vena comitantes)
nerve to Obturator internus
posterior femoral cutaneous n
inferior gluteal n and a (and v, vena comitantes)
nerve to Quadratus femoris
boundaries of the lesser sciatic notch
contents of lesser sciatic notch
nerve to obturator internus
internal pudendal a (and v)
what is the obturator canal and what does it contain?
opening at superior end of obturator membrane
obturator n,a,v pass thru it
normal femoral anteversion as adult and at birth?
15 deg. 30-40deg at birth
normal neck shaft angle of femur of adult and at birth?
127 deg. 150 at birth.
name the ligaments that make up the hip capsule. What is strongest?
iliofeoral lig (Y-lig of bigelow) - strongest lig in body. from AIIS to intertroch line
what is the zona orbicularis?
circular fibres forming a collar at femoral neck - like its own "annular ligament"
acetabular labrum is ____ with the cartilage posteriorly and _____ anteriorly
continuous, marginally attached
acetabular labrum functions: name 2
deepens socket by 30%
seals fluid - protects cartilage
adequate AP pelvis xray: list criteria
coccyx in-line with symphysis
symmetrical teardrops, obturator foramina, iliac wings
symphysis to sacro-coccygeal junction vertical distance (difficult to see): 32mm men, 47mm women
sympysis to tip of cocyx: 1-3cm
what is the utility of frog-leg lateral xray of hip?
profile of head/neck junction
see subtle SCFEs
How is the Dunn view taken?
what is its utility?
hip flexed to 45 or 90
20 deg abduction, neutral rotation
beam shot straight down at hip
utility: profiles head/neck junction to check alpha angle for FAI (<55 deg=CAM)
how do you take a false profile xray?
what is its utility?
ER body relative to cassette 65 deg
beam centred on fem head
utility: for anterior CEA: <20=dysplasia, >40=pincer
what spinal level is the aortic bifurcation?
common iliac bifurcation?
name the internal iliac artery branches
what is the corona mortis and where is it?
anastomosis between obturator artery and either external iliac or inf epigastric artery
ocurs variable distance from symphysis, behind sup pub ramus (40-96mm from symphysis)
what two major arteries supply the proximal femur?
they are branches of what?
MFCA and LFCA
branch of profunda femoris
describe the path of the superficial femoral artery
(start from external iliac artery)
external iliac artery crosses under inguinal ligament into femoral triangle
becomes common femoral artery
divides into profunda femoris and superficial femoral artery
SFA runs along anteromedial thigh under sartorius
in hunter's canal
between vastus med and adductor longus
exits through adductor hiatus
goes through adductor hiatus and becomes popliteal artery