Pelvis/Hip/Thigh Flashcards
(145 cards)
1
Q
psoas major origin and insertion
A
O: T12-L5
I: Lesser trochanter
2
Q
psoas major innervation
A
femoral nerve
3
Q
psoas major action
A
flex hip
4
Q
what muscle covers the lumbar plexus
A
psoas major
5
Q
psoas minor origin and insertion
A
O: T12-L1
I: iliopubic eminence
6
Q
innervation for psoas minor
A
L1 ventral ramus
7
Q
psoas minor action
A
assist with hip flexion
8
Q
iliacus origin and insertion
A
O: iliac fossa/sacral ala
I: lesser trochanter
9
Q
iliacus innervation
A
femoral nerve
10
Q
iliacus action
A
flex hip
11
Q
name the pelvic hip flexors
A
psoas major
psoas minor
iliacus
12
Q
tensor fasciae lata origin and insertion
A
O: iliac crest/ASIS
I: IT band, proximal tibial tuberosity
13
Q
tensor fasciae lata innervation
A
superior gluteal
14
Q
tensor fasciae lata action
A
abduct, flex, IR thigh
15
Q
gluteus medius origin and insertion
A
O: ilium b/w anterior and posterior gluteal lines
I: greater trochanter (posterior)
16
Q
gluteus medius innervation
A
superior gluteal
17
Q
gluteus medius action
A
abduct and IR thigh
18
Q
if _____ muscle is out, patient will have a trendelenburg gate
A
gluteus medius
19
Q
gluteus minimus origin and insertion
A
O: ilium between anterior and inferior gluteal lines
I: greater trochanter (anterior)
20
Q
gluteus minimus innervation
A
superior gluteal
21
Q
gluteus minimus action
A
abduct and IR thigh
22
Q
gluteus maximus origin and insertion
A
O: ilium, dorsal sacrum
I: ITB and gluteal tuberosity
23
Q
gluteus maximus innervation
A
inferior gluteal
24
Q
gluteus maximus action
A
extend and ER thigh
25
obturator externus origin and insertion
O: ischiopubic rami, obturator membrane
I: trochanteric/piriformis fossa
26
obturator externus innervation
obturator nerve
27
obturator externus action
ER thigh
28
pirformis origin and insertion
O: anterior sacrum
I: superior greater trochanter
29
pirformis innervation
nerve to piriformis
30
pirformis action
ER thigh
31
superior gemellus origin and insertion
O: ischial spine
I: medial greater trochanter
32
superior gemellus innervation
nerve to obturator internus
33
superior gemellus action
ER thigh
34
obturator internus origin and insertion
O: ischiopubic rami/obturator membrane
I: medial greater trochanter
35
obturator internus innervation
nerve to obturator internus
36
obturator internus action
ER and abduct thigh
37
inferior gemellus origin and insertion
O: ischial tuberosity
I: medial greater trochanter
38
inferior gemellus innervation
nerve to quadratus femoris
39
inferior gemellus action
ER thigh
40
quadratus femoris origin and insertion
O: ischial tuberosity
I: intertrochanteric crest
41
quadratus femoris innervation
nerve to quadratus femoris
42
quadratus femoris action
ER thigh
43
what muscle can be used as a landmark for the sciatic nerve
piriformis
44
what comprises the lumbar plexus?
L1-L4 ventral rami
45
what is the labrums function?
deeps socket
increases femoral head coverage
- along the acetabular rim except inferiorly
46
which ligament provides strong anterior support to the hip and resists extension
Iliofemoral ligament (Y ligament of Bigelow
47
small artery to femoral head is within which ligament?
ligamentum teres/ligament to head of femur/foveal ligament
48
what are the attachments for the iliofemoral ligament?
Superior: ASIS/Ilium to greater trochanter
Inferior: ilium to intertrochanteric line/lesser trochanter
49
which ligament prevents hyperextension of the hip and provides inferior joint support?
pubofemoral ligament
50
attachments for pubofemoral ligament
Anterior pubic ramus to intertrochantic line
51
broad, relatively weak ligament that provides minimal posterior hip support
ischiofemoral ligament
52
which part of hip is extracapsular (due to inadequate coverage from ischiofemoral ligament)?
lateral posterior neck
53
in femoral neck fracture or intertrochanteric fracture how will the leg be positioned?
shortened and ER
54
Trendelenburg gate?
lean laterally to WB side
55
what can Trendelenburg gate indicate?
gluteus medius weakness
56
what can Lurch gait indication?
gluteus maximus weakness
57
Lurch gate?
lean posterior (keeping hip extended)
58
numbness and dysesthesias in lateral thigh can indicate entrapment of which nerve?
lateral femoral cutaneous nerve
59
what does genitofemoral nerve (L1-L2) provided sensory to?
proximal anteriomedial thigh
60
what does obturator nerve (L2-L4) provide sensory to?
inferomedial thigh
61
what does lateral femoral cutaneous nerve (L2-L3) provide sensory to?
lateral thigh
62
what does femoral nerve provide sensory to?
anteromedial thigh
63
what does posterior femoral cutaneous n (S1-S3) provide sensory to?
posterior thigh
64
what nerve innervates muscles that do thigh/hip adduction?
obturator nerve (L2-L4)
65
what nerve innervates muscles that do thigh abduction?
superior gluteal (L5)
66
what nerve innervates muscles that do hip flexion/knee extension
femoral nerve (L2-L4)
67
what nerve innervates muscles that do hip extension
Inferior gluteal (L5-S2)
68
what nerve innervates muscles that do knee flexion
Sciatic
69
articularis genus origin and insertion?
O: distal anterior fermoral shaft
I: synovial capsule
70
articularis genus innervation
femoral
71
articularis genus action
pulls capsule superiorly in extension
72
sartorius origin and insertion
O: ASIS
I: proximal medial tibia (pes anserinus)
73
sartorius innervation
femoral nerve
74
sartorius action
flex, ER hip
75
vastus lateralis origin and insertion
O: greater trochanter, lateral linea aspera
I: lateral patella, tibia tubercle
76
vastus lateralis innervation
femoral
77
vastus lateralis action
extend leg
78
vastus intermedius origin and insertion
O: proximal femoral shaft
I: patella, tibia tubercle
79
vastus intermedius innervation
femoral nerve
80
vastus intermedius action
extend leg
81
vastus medialis origin and insertion
O: intertrochanteric line, medial linea aspera
I: medial patella, tibia tubercle
82
vastus medialis innervation
femoral
83
vastus medialis action
extend leg
84
rectus femoris origin and insertion
O: AIIS, superior acetabular rim
I: patella, tibia tubercle
85
rectus femoris innervation
femoral
86
rectus femoris action
flex thigh, extend leg
87
adductor longus origin and insertion
O: body of pubis (inferior)
I: linea aspera (mid 1/3)
88
adductor longus innervation
obturator
89
adductor longus action
adducts thigh
90
adductor brevis origin and insertion
O: body and inferior pubic ramus
I: pectineal line, linea aspera
91
adductor brevis innervation
obturator
92
adductor brevis action
adduct thigh
93
adductor magnus origin and insertion
O: 1. pubic ramus. 2. ischial tuberosity
I: linea aspera, adductor tubercle on medial condyle
94
adductor magnus innervation
1. obturator
| 2. sciatic
95
adductor magnus action
adduct and flex/extend thigh
96
Gracilis origin and insertion
O: body and inferior pubic ramus
I: proximal medial tibia (pes anserinus)
97
Gracilis innervation
obturator
98
Gracilis action
adduct thigh
flex leg
IR leg
99
Pectineus origin and insertion
O: pectineal line of pubis
I: pectineal line of femur
100
Pectineus innervation
femoral n
101
Pectineus action
flex and adducts thigh
102
what hip adductor muscle can be used in ligament reconstruction
gracilis
103
what are the hamstring muscles?
semitendinosus
semimembranosus
biceps femoris - long head and short head
104
semitendinosus origin and insertion
O: ischial tuberosity
I: proximal medial tibia (pes anserinus)
105
semitendinosus innervation
sciatic n. (tibial)
106
semitendinosus action
extend thigh, flex leg
107
semimembranosus origin and insertion
O: ischial tuberosity
I: posterior medial tibial condyle
108
semimembranosus innervation
sciatic (tibial)
109
semimembranosus action
extend thigh, flex leg
110
biceps femoris long head origin and insertion
O: ischial tuberosity
I: fibular head
111
biceps femoris long head innervation
sciatic n (tibial)
112
biceps femoris long head action
extend thigh, flex leg
113
biceps femoris short head origin and insertion
O: linea aspera, supracondylar line
I: Fibula, lateral tibia
114
what landmark is used to measure the Q angle of the knee?
ASIS
115
what muscles insert on pes anserinus?
sartorius, gracilis, semitendinosus
116
how many vertebra make up the sacrum?
5 fused vertebra
117
how many vertebra make up the coccyx?
4 fused vertebra
118
Iliac crest is a common site for both tricortical and cancellous _______
bone graft harvest
119
where does snapping hip occur?
tendons (psoas/iliacus) can snap over the lesser trochanter
120
nerves/arteries/muscles that exit the greater sciatic foramen?
Piriformis muscle
POP'S IQ
1. Pudendal n (and artery)
2. (nerve to) Obturator internus
3. Posterior cutaneous n of thigh
4. Sciatic nerve
5. Inferior gluteal nerve (and artery)
6. nerve to (quadratus femoris)
Also superior gluteal nerve and artery
121
what muscle is a reference point for the greater sciatic foramen?
piriformis
122
where do most nerves exit the greater sciatic foramen relative to the piriformis?
inferiorly
Superior gluteal nerve and artery exit superior
Sciatic nerve may exit above or through
123
what muscle is the landmark for posterior column of the pelvis?
obturator internus -- you will not see externus in posterior approach
124
what are the acetabular zones?
1. Anterior superior
2. Anterior inferior
3. Posterior superior
4. Posterior inferior
125
what are the 2 lines that define the acetabular zones?
1. ASIS to center of acetabulum
| 2. perpendicular to line 1
126
what acetabular zone is considered the "safe zone" for putting screws?
Posterior superior
Posterior inferior is the secondary safe zone
127
in the anterior superior acetabular zone what structures do you need to be aware of?
external iliac artery and vein
128
in the anterior inferior zone acetabular zone what structures do you need to be aware of?
obturator nerve, artery, vein
129
in the posterior superior acetabular zone what structures do you need to be aware of?
sciatic nerve
| superior gluteal nerve, artery, vein
130
in the posterior inferior acetabular zone what structures do you need to be aware of?
sciatic nerve
inferior gluteal artery, nerve, vein
internal pudendal nerve, artery, vein
131
types of joints
```
ball and socket
saddle
hinge
condyloid
pivot
gliding.
```
132
body weight is transmitted through which joint
sacroiliac
133
which ligament is strongest in the pelvis and is key to vertical stability
posterior sacroiliac
134
what ventral rami comprise the lumbosacral plexus?
L4-S3(S4)
135
where does the lumbosacral plexus lie?
anterior piriformis muscle
136
blood supply to head/neck of femur
primarily the medial femoral circumflex artery (branch from profunda femoris)
(also lateral FCA and ligamentum teres artery)
137
blood supply to shaft of femur
nutrient artery from profunda femoral artery
138
which axis? - line drawn along the axis of the femur
anatomic
139
which axis? - line drawn between center of femoral head and intercondylar notch
mechanical
140
primary blood supply to the thigh
profunda femoris (branch from femoral artery)
141
what would be seen on Xray if there is loosening of total hip arthoplasty?
radiolucent lines most often caused by osteolysis
142
which muscle is the medial femoral circumflex artery located under?
quadratus femoris
143
which vessels are located under the transverse acetabular ligament and may be injured by retractors/anterior inferior quad screws in total hip arthoplasty?
obturator vessels
144
what is done if there is a periprosthetic fx?
Stable implant: ORIF
Unstable: replace w/ longer stem the passes fx site
145
for total hip what structures are in danger of injury with the anterolateral approach?
descending branch of LFCA and femoral nerve (due to vigorous medial retraction)
