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C&M Lower Limb > Week 1 L1: The Pelvis and Hip > Flashcards

Week 1 L1: The Pelvis and Hip Flashcards

(84 cards)

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1
Q

What are the two bones in the leg?

A

tibia and fibula

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2
Q

What are the 3 neurovascular regions in the lower limb?

A
  1. Femoral triangle (groin)
  2. Popliteal fossa (behind the knee)
  3. Tarsal tunnel (posterior to medial ankle)
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3
Q

Which joint is the most commonly replaced joint in the body?

A

the hip

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4
Q

Which 3 bones make up the pelvis?

A
  • the sacrum

- left and right innominate bones (‘hip’ bones)

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5
Q

How does the pelvis remain anchored to the axial skeleton?

A

via strong and stable joints between the sacrum and each innominate bone = the sacroilliac joint

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6
Q

What structure articulates with the acetabulum of the pelvis at the hip joint?

A

head of the femur

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7
Q

Where do the inomminate bones articulate with eachother?

A

anteriorly at the pubic symphysis

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8
Q

Which patent structure has the superior pubic ramus above, and the inferior pubic ramus below?

A

obturator foramen

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9
Q

What is the most distal part of the vertebral column?

A

sacrum

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10
Q

How is the inomminate bone formed in a foetus?

A

3 separate bones fuse at the acetabulum:

  1. The ilium (superior)
  2. The ischium (posterior)
  3. The pubis (anterior)
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11
Q

What is the acetabulum?

A

the socket for the head of the femur

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12
Q

What does the inguinal ligament attach to on the pelvis?

A

Anterior superior iliac spine

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13
Q

What is the line between the trochanters called?

A

intertrochanteric line

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14
Q

What bony landmarks are seen in the posterior aspect of the femur?

A
  • trochanteric fossa
  • gluteal tuberosity
  • intertrochanteric crest
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15
Q

What is the acetabular labrum?

A

a ring of cartilage that surrounds the acetabulum of the hip

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16
Q

What are the two pelvic ligaments?

A
  1. Sacrospinous ligament

2. Sacrotuberous ligament

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17
Q

Which two structures does the sacrospinous ligament sit between?

A

sacrum and ischial spine

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18
Q

Which two structures does the sacrotuberous ligament sit between?

A

sacrum to the ischial tuberosity

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19
Q

Which foramen does the sacrospinous ligament extend over?

A

greater sciatic foramen

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20
Q

Which foramen does the sacrotuberous ligament

A

lesser sciatic foramen

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21
Q

What are the 3 hip ligaments?

A
  1. Pubofemoral
  2. Iliofemoral
  3. Ischiofemoral
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22
Q

What is the function of the pubofemoral ligament?

A

prevents excessive abduction

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23
Q

What is the function of the iliofemoral ligament?

A

prevents hyperextension of the hip during standing - ‘screws’ in the femoral head

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24
Q

Which is the strongest hip ligament, and which is the weakest?

A

iliofemoral - strongest

ischiofemoral - weakest

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25
Which movements are possible at the hip joint?
- flexion and extension - abduction and adduction - medial and lateral rotation
26
What is the prime hip flexor?
iliopsoas
27
Other than the iliopsoas, what are the other flexors in the hip and where do they lie?
- lie anterior to the joint 1. Pectineus 2. Sartorius 3. Rectus femoris
28
What is the iliopsoas made up of?
psoas major + iliacus
29
Where does the iliopsoas insert
lesser trochanter
30
Which nerve also travels with the iliacus and psoas major, deep to the inguinal ligament, and inserts onto the lesser trochanter?
the femoral nerve
31
Where do the rest of the flexor muscles in the anterior thigh insert? 1. Pectineus 2. Rectus femoris 3. Sartorius 4. Tensor fascia latte
1. superior pubic ramus 2. AIIS --> tibial tuberosity 3. ASIS --> medial tibia 4. ASIS --> Iliotibial tract
32
Which nerve are the flexors of the hip innervated by?
femoral nerve
33
What are the two extensors of the hip?
1. Gluteus maximus | 2. Hamstrings
34
Where does the gluteus maximus insert?
gluteal tuberosity and iliotibial tract
35
Which nerve are the extensors of the hip innervated by?
inferior gluteal nerve
36
Where are the extensors of the hip located?
posterior to the joint/ posterior thigh
37
Where do the hamstrings originate?
ischial tuberosity
38
What are the two abductors of the hip?
gluteus medius | gluteus minimus
39
Which nerve innervates the abductors of the hip?
superior gluteal nerve
40
Where do the abductors of the hip insert?
onto the greater trochanter
41
Where do the adductors of the hip lie?
medial to the joint
42
Which nerve innervates the adductors of the hip?
obturator nerve
43
Which 3 muscles make up the adductor group? (3 of the adductors of the hip)
- adductor brevis - adductor longus - adductor magnus
44
Where do the muscles in the adductor group insert?
posteriorly on the femur
45
What are the other adductors of the hip?
- gracilis - pectineus (femoral nerve) - obturator externus
46
What are the 5 muscles that are able to laterally rotate the hip?
1. Piriformis 2. Superior and inferior gemelli 3. obturator internus 4. quadratus femoris 5. gluteus maximus
47
Explain the location of the piriformis?
- attached to the sacrum - travels through the greater sciatic foramen - inserts on the superior aspect of the greater trochanter
48
Where do the superior and inferior gemelli, and obturator internus insert?
trochanteric fossa
49
Where is the obturator internus located?
in between the superior and inferior gemelli
50
which muscles can medially rotate the hip?
- pectineus | - gluteus medius and minimus
51
Which two vessels supply the anterior thigh and hip joint?
obturator and femoral artery
52
Explain the pathway of the obturator artery?
internal iliac travels through obturator foramen into medial thigh
53
Explain the pathway of the femoral artery?
- continuation of the external iliac after it passes under the inguinal ligament - femoral nerve travels in the femoral triangle with the femoral vein and femoral nerve
54
Which arteries supply the posterior thigh?
internal iliac artery in the pelvis give rise to the superior and inferior gluteal arteries into gluteal region through greater sciatic foramen
55
Which nerve supplies the posterior thigh?
sciatic nerve
56
Which artery supplies the majority of the hip?
medial circumflex artery
57
Which nerve may be at risk if there is a femoral nerve fracture?
medial circumflex artery
58
Other than the medial circumflex, what other arteries supply the hip?
- lateral circumflex artery - profunda femoris - medial circumflex artery
59
Which artery gives off the lateral circumflex artery and the medial circumflex artery?
profunda femoris
60
What is DDH?
Developmental dysplasia of the hip -in children, ligaments around the hip joint are loose allowing the hip to subluxate --> this is when the ball is no longer centred in the socket
61
Which nerve network innervates the lower limb?
lumbosacral plexus
62
What are the 3 major branches of the lumbosacral plexus that innervates the lower limb?
- femoral - travels under inguinal ligament - obturator - sciatic
63
What is avascular necrosis?
complication of hip fracture whereby the hip joint as no blood supply so the bone dies
64
What is the definition of a hip fracture?
fracture of the femur distal to the femoral head and proximal to a level 5cm below the lesser trochanter
65
How are hip fractures classified?
1. Intracapsular (within the capsule) 2. Extracapsular (outside the hip capsule) - intertrochanteric - subtrochanteric
66
What are the risk factors a hip fracture?
- osteoporosis/osteopenia - age over 65 years - falls - low BMI - female - high energy trauma
67
What is the maximum angle at which: 1. The hip can flex 2. the hip can abduct 3. the hip can adduct 4. the hip can internally or externally rotate
1. Max 120 2. max 45 3. max 30 4. max 45
68
What are the complications of a hip fracture?
- reduction in mobility - thrombosis - pneumonia - respiratory failure - delirium - pressure sores - avascular necrosis - failure of fixation
69
Ideally how long should surgery be performed following the diagnosis of a hip fracture?
36 hours
70
What is the pubic symphysis?
Secondary cartilaginous joint between the two pubic bones. the articular surfaces are covered by a layer of hyaline cartilage and are connected by a fibrocarilaginous disc
71
What are the 3 superficial gluteal muscles?
- gluteus maximus - gluteus medius - gluteus minimus
72
What is the trendenlenburg sign?
- 'waddling gait' - if the hip abductors (gluteus medius and minimus) are paralysed on one side - the pelvis will tilt to one side
73
Where does the tensor fascia lata originate and insert?
originates: ASIS inserts: iliotibial tract
74
What is the function of the tensor fascia lata?
extension of knee and contribution to flexion of the hip
75
For the piriformis, what is: 1. Its origin 2. Its insertion 3. Its action 4. Its innervation
1. sacrum 2. greater trochanter 3. lateral rotator of hip 4. superior gluteal nerve
76
Why, when giving an intramuscular injection into the buttock, must you always place it in the upper, lateral quadrant of the buttock?
away from the sciatic nerve and superior gluteal artery
77
What is the obturator canal?
small gap in the obturator foramen that is not covered by muscle / membrane
78
What is a callous?
on an X-ray, when a broken bone heals and starts to reform, we see a cloudy region
79
What is an open book fracture?
fracture at the pubic symphisis
80
Which deep gluteal muscle travels through the greater sciatic foramen?
piriformis
81
Which nerve might be injured as a result of an acetabular fracture?
sciatic nerve
82
Which muscle is most superior in the group fo small lateral rotators?
piriformis
83
Which spinal nerves form the sciatic nerve?
L4 - S3
84
How does the obturator internus enter the gluteal region?
lesser sciatic foramen

C&M Lower Limb (4 decks)

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