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othopaedics > yr 4 orthopaedics- hip and knee anatomy > Flashcards

yr 4 orthopaedics- hip and knee anatomy Flashcards

1
Q

5 bones of the pelvic girdle

A 
iliac
ischium
pubis
saccruum
coccyx
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2
Q

other name for hip bone and what 3 bones make it up

A

innominate/ os coxa

  • ischium
  • iliac
  • pubis
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3
Q

what age does the ischiopubic ramus fuse

A

2-5 years

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4
Q

what are the lateral markings of the hip (label)

A 
Iliac crest
Anterior superior iliac spine
anterior inferior iliac spine
anterior gluteal line
posterior gluteal line
inferior gluteal line
acetabulum
ischial tuberosity
pubic tubercle
posterior superior iliac spine
greater sciatic notch
posterior inferior iliac spine
lesser sciatic notch 
obturator formaen
ischiopubic ramus 
superior pubic ramus
inferior pubic ramus
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5
Q

label the acetabulum

A
  • lunate surface
  • acetabular fossa
  • acetabular labrum
  • ligamentum teres
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6
Q

what are the anterior features of the hip

A

iliac fossa
auricular surface
pubic symphysis

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7
Q

what are the anterior features of the femur

A
  • femoral head
  • femoral neck
  • greater trochanter
  • lesser trochanter
  • interochanteric line
  • foeva capitis
  • patellar surface
  • lateral epicondyle
  • adductor tubercle
  • medial epicondyle
  • intercondylar notch
  • gluteal tuberosity
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8
Q

posterior features of the femur

A
  • interochanteric crest
  • linea aspera
  • popliteal fossa
  • medial and lateral condyle
  • interconylar fossa
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9
Q

label the anterior surface of the tibia

A

lateral and medial condule
tibial tuberosity
medial surface
intercondylar eminence

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10
Q

label the posterior surface of the tibia

A

medial condyle
intercondylar eminence
lateral condyle
soleal line

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11
Q

what 6 structures support the hip

A

3 external: iliofemoral ligament, pubofemoral ligament, ischiofemoral ligaement

3 internal:
ligamentum teres
transverse acetabular ligament
acetabular labrum

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12
Q

what 7 movements can the hip do

A

flex and extension
medial and lateral rotation
abd and add
circumduction

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13
Q

label the 3 external ligaments of the acetabulum

A

posterior isciofemoral
anterior 2 heads iliofemoral
inferior pubofemoral

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14
Q

what nerve and action goes with each compartment of the thigh

A

anterior: femoral, extension of the hip, and flexion of the knee
medial: adductor and obturator nerve
posterior: flexion at hip and extension at knee=sciatic nerve

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15
Q

label the 4 main bum muscles and what action do they have and what lines do they insert into

A
  1. gluteus maximum: extension of hip and posterior to posterior gluteal line and gluteal tuberosity
  2. gluteus medius:abduction, medial rotation/ between posterior and anterior gluteal line to greater trochanter
  3. gluteus minimus: between anterior and inferior gluteal lines to greater trochanter= abduction and medial rotation
  4. piriformis: from anterior surface of sacrum to greater trochanter= lateral rotation
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16
Q

why are the piriformis related to sciatic nerve pain

A

because the sciatic nerve through, above or below this muscle

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17
Q

what other muscles are deep to the glutes- external rotators

A 
piriformis
superior germellus
obturator internus
inferior germellus
- quadratus femoris (lateral rotation of hip)
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18
Q

what gait abnormality is related to the glutes

A

trendelenburg gait

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19
Q

what muscles are in the anterior thigh compartment

A 
rectus femoris
vastus medialis
vastus intermedius
vastus lateralis
sartorius
iliopsoas
pectineus
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20
Q

action of gluteus maximus

A

extension of hip

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21
Q

action of gluteus medius

A

abduction and medial rotation of hip

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22
Q

action of gluteus minimus

A

abduction and medial rotation

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23
Q

action of piriformis

A

lateral rotation

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24
Q

what muscles form the iliopsoas

A

psoas major, psoas minor and iliacus

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25
Q

what actions do the anterior muscle compartments have and what are the 2 exceptions

A

flex the hip extend the knee
(except the sartorius that flexes the knee)
(pectineus doesnt affect the knee but also adducts

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26
Q

what actions does the sartorius have

A

flexes the hip and flexes the knee

abduction and medially rotation at the knee

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27
Q

what actions does the pectineus have

A

flexes the hip and adductor the hip

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28
Q

label the psoas major and minor and what action do they have

A

come down from vertebra

they are for hip flexion

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29
Q

what muscles are in the thigh medial compartment and what nerve innervates and what is their action

A 
adductor longus
adductor brevis 
adductor magnus
gracilis 
adductors
obturator nerve
30
Q

what are the attachment points of the adductor longus

A

from body of pubis to middle 1/3 linea aspera

31
Q

attachment points of adductor brevis

A

from anterior of ischiopubic ramus to lesser trochanter and proximal 1/3 linea aspera

32
Q

attachment points of adductor magnus

A

from ischiopubic ramus and ischial tuberosity to linea aspera and adductor tubercle

33
Q

attachment point of gracilis

A

from ischiopubic ramusa and body of pubis to medial surface of proximal tibia

34
Q

what muscles are in the posterior compartment of the leg and what nerve supplies them and what is their action

A 
biceps femoris (long head and short head)
semitendinous
semimembranous 
sciatic nerve 
flex the knee extend the hip
35
Q

where do all the posterior compartment of the thigh originate

A

ischial tuberosity (except short head of bf from distal 1/3 linea aspera)

36
Q

insertion of biceps femoris

A

on head of fibula

37
Q

insertion of semimembranous

A

inserts on posterior aspect of medial tibial condyle

38
Q

insertion of semitendinous

A

inserts onto medial aspect of proximal tibia

39
Q

what are the borders of the femoral triangle and the acronym to remember

A 
NAVEL
nerve, artery, vein, empty, lymphatics
lateral= sartorius
top= inguinal ligament
medial= adductor longus 
floor= profunda femoris
40
Q

what are the 5 key supporting structures of the knee

A 
quadriceps tendon (patellar)
patellar ligament 
medial collateral ligament
oblique popliteal ligament (posterior)
lateral collateral ligament
41
Q

where do all quadriceps insert into

A

become the quads tendon that becomes the patellar ligament and goes into the tibial tuberosity

42
Q

what is the unhappy triad and why

A

medial collateral ligament
anterior cruciate ligament
medial meniscus as the medial collateral is attached very firmly

43
Q

what are the deep structures of the knee 4

A

meniscus
intercondyle eminence
cruciate ligaments (label by insertion point)
transverse ligament of the knee

44
Q

function of mensci

A

dont slide off and shock absorbers

45
Q

what do the meniscus insert into and what shape are they both

A

the intercondylar eminence
medial=c
lateral= circular

46
Q

what muscle unlocks the knee and how

A

the popliteus muscle pulls on tibia to medially rotate it and unlock the knee

47
Q

what is the popliteal fossa and what are its 4 contents and there order

A 
rhomboid space in posterior of knee 
medial to lateral 
1. popliteal artery
2. pop vein
3. tibial nerve
4. common peroneal nerve
48
Q

blood supply to thigh order and bifurcation / anatomical points

A
  • abdominal aorta l4 to form common iliac arteries
  • external iliac
  • femoral artery at inguinal ligament
  • profunda femoris branch
  • popliteal artery when goes past knee/ adductor hiatus
49
Q

when does the popliteal artery begin

A

at the adductor hiatus

50
Q

label the 3 nerves on the hip

A

femoral
inferior
obturator nerve
then sciatic nerve off sacral plexus

51
Q

what nerves does the sciatic nerve become

A

tibial and common peroneal (superficial and deep)

52
Q

label a knee

A 
meniscus
ligaments
intercondylar notch
intercondylar fossa
medial and alteral condyle and (epicondyle) front of femur
53
Q

what are some differences between the male and female pelvis

A 
male= narrow heart shaped, everted pubic arch, narrow sciatic notch, larger and oval obturator foramen 
female= wider circular, not everted pubic arch, wider sciatic notch, narrower acetabulum, wide and shorter sacrum, smaller and triangular obturator foramen
54
Q

where is the tubercle of the iliac crest located

A

lies opposite the 5th lumbar vetebrae

5cm posterior to the ASIS on the iliac crest

55
Q

what is the highest point of the iliac crest

A

at the 4th lumbar vertebrae

56
Q

what level does the posterior superior iliac spine lie at

A

level of the 2nd sacral spine at level of sacroiliac joint

57
Q

what age does the ischial ramus fuse to the inferior ramus of the pubus

A

5-8 years

58
Q

what age does the acetabulum fuse

A

11-15

59
Q

how many primary centres of ossification are there for the inominnate and what are they

A

3

ilium ischium and pubis

60
Q

what are the 5 additional secondary centres of ossificaiton

A

2 with the iliac crest
one for the anterior inferior iliac spine
pubic symphysis
ischial tuberosity

61
Q

how many primary and secondary centres of ossification does the femur have

A 
one primary centre in the midshaft
4 secondary centres
-the femoral head
-the greater trochanter
-lesser trochanter 
-the distal epiphysis forms both condules
62
Q

what age do the epiphysis and diaphysis begin fusing and finish

A

at 12

20 years

63
Q

what are the proximal and distal attachment points of the iliofemoral ligament

A

anterior inferior iliac spine and margin acetabulum to distal to interotrochanteric line

64
Q

in what position is the hip most unstable

A

when fixed and medially rotated ie in flexion (as the ligaments uncoil when not in extension eg standing)

65
Q

function of the ligamentum teres 3

A

prevent dislocation of the femoral head and to initiate a reflex action to prevent excessive movements and transmits blood vessels to the femoral head

66
Q

what are the two parts and function of the adductor magnus

A

hamstring portion of adductor magnus= sciatic nerve and is an adductor and hip extensor
adductor portion of adductor magnus= obturator nerve and is an adductor and flexion of hip`

67
Q

what is the primary ossification centre for the tibia and the 3 secondary centres

A

primary=diaphysis shaft

secondary= proximal epiphysis, distal epiphysis and for the ischial tuberosity

68
Q

what is the primary ossification centre of the fibula and the 2 secondary

A 
primary= shaft dipahysis
secondary= distal and proximal epiphysis
69
Q

where is the suprapatellar bursa

A

under the quads tendon

70
Q

Adductor tubercle sits where

A

Proximally posteriorly medially on femur

othopaedics (21 decks)

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