Life Structure
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| In which structure so the ischium, ilium and pubis meet? | The acetabulum
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| In the juvenile hip what is the cartilage called? | Triradiate cartilage (hyaline)
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| What nerve in the hip area can be damaged in a car crash (considering the patient's legs are in the flexed position)? | The sciatic nerve is damaged if the femur is dislocated and pushed posteriorly
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| What is the function of the lunate surface and acetabulum fossa of the acetabulum? | Deepens the joint
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| Which muscles attach between the anterior, posterior and inferior gluteal lines? | Anterior: Origin of gluteus maximus
Posterior: Origin to a portion of the gluteus medius
Inferior: Origin to gluteus minimus
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| The location of what structure can be found using the ASIS and the umbilicus? | McBurney's point = The appendix
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| What structures pass through the sciatic notch/foramen? | Superior and inferior gluteal vessels and nerves
Sciatic nerve
Piriformis muscle
Internal pudendal vessels
Pudendal nerve
Nerves to obterator internis and quadratus femoris
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| What is important to remember if a breakage occurs in the pelvis? | The pelvis is a ring, if broken it is nearly always broken in two places
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| What muscles attach to the ishium tuberosity? | Adductor magnus
Inferior Gemellis
Quadratus femoris
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| What structures pass through the lesser sciatic foramen? |
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| What are the weaker areas of the pelvis, which more commonly fracture? | Pubic rami
Acetabulum
Sacroiliac joints
Alae of the ilia
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| Who more commonly suffers a femoral neck fracture? | Post menopausal women (because of osteoporosis)
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| What artery is vulnerable to damage when the neck of the femur fractures? | The retinacular arteries. They run parallel to the femoral neck?
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| What muscles attach to the greater trochanters of the femoral head? | Gluteus medius, gluteus minimum, piriformis, obturator internis, obturator externis, gemelli muscles
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| What muscles attach to the lesser trochanter of the femoral head? | Psoas major and iliacus muscles
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| What ligament attaches superiorly to the intertrochanteric crest/line? | Fibres of the Ischiocapsular ligament
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| What muscles attach to the linea aspera? | Adductor longus, brevis, magnus
Short head of biceps femoris
Vastus lateralis
Vastis medialis
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| What type of joint is the hip joint? | Synovial/ball and socket joint
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| In what position is the hip joint most vulnerable? | Flexed and adducted
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| What are the attachements of the fibrous capsule of the hip joint? |
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| What are the two sets of fibres that surround the femoral head? | Circular fibres form a collar = Zona orbicularis
Longitudinal retinacular fibres
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| What is significant about the retinacular fibres of the femoral head? | They carry blood vessels
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| What s significant about the ileofemoral ligament? | It is the strongest ligament in the body
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| What is the effect of the iliofemoral ligament on the movement of the hip bone? | It prevents hyperextension of the hip
It screws the head of the femur into the acetabulum to help strengthen and stabilise the joint.
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| What ligaments of the capsule surrounding the femoral head? | Pubofemoral ligament
Ischiofemoral ligament
Iliofemoral ligamnet
Orbicular zone
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| What ligament attaches the femoral head to the transverse acetabulum ligament? | The ligament teres femoris
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| What structure deepens the acetabulum? | The acetabulum labrum
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| What structure runs within the ligamentum teres? | Arteries that supply the femoral head
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| What arteries supply the femoral head? | Inferior gluteal
Deep femoral (profunda femoris)
medial circumflex femoral
lateral circumflex femoral
All contribute via THE CRUCIATE ANASTOMOSIS
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| What is the MAIN blood supply of the femoral head? | The medial circumflex artery
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| To what structures does the gluteus maximus attach on the hip bone and on the femur? | Origin: Sacrum, gluteal surface of the ileum, lumbar fascia, sacrotuberous ligament
Insertion: Gluteal tuberosity of the femur, iliotibial tract
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| The superficial 3/4 of the gluteus maximus is inserted into the iliotibial tract - how might this influence pain runners get from a 'tight IT band'? | Ilioturburosity -> tibial band
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| What important neurovascular structures emerge from the greater sciatic foramen? | superior gluteal nerves and vessels - superior to piriformis
Inferior gluteal nerves and vessels - inferior to piriformis
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| How is the sciatic nerve related to the piriformis? And what is the clinical significance of this in some people? | In 88% of people the sciatic nerve travels inferior to the piriformis
12% of people the common fibular division of the sciatic nerve passes through piriformis - this can become clinically important as it allows the muscle to compress the nerve
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| Half of all sciatic nerve injury indicates what? | Trauma of the buttock associated with hypertropy and spasm of the piriformis
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| Who is more likely to develop sciatic nerve problems? | People involved in sports that require excessive use of gluteal muslces - skaters, cyclists, mountain climbers
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| Why is the gluteal region the favourable site for intramuscular injections? | the muscles are thick and large
large surface area which is good for drug absorption
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| What is the action and innervation fo the gluteus medius muscle? | Action: Abduction of the hip and medial rotation of the thigh
Innervation: Superior gluteal nerve, L4, L5, S1
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| *What muscles make up the hamstring? | *Semitendinosus
Semimembranosus
Biceps Femoris - long and short head
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| *What is the origin of the hamstring muscles? | *Ischial tuberosity
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| What action does the hamstring have on the knee? | Flexes the knee
Extends the hip
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| What is the innervation, nerves and nerve roots of the hamstring? | innervation: tibial and short head of bicep = common fibular
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| What is the insertion of the short head of the bicep | linea aspera
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| What muscles make up the anterior compartment of the thigh? | Tensor fasciae latae
Sartorius
Rectus femoris
vastas medialis
Vastis lateralis
biceps femoris
Iliacus
Psoas major
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| In what compartment is the pectineus muscle located? | anterior compartment of the thigh(transitional between anterior and medial)
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| What is the innervation of the pectinious muscle? | superficial and deep, femoral and obturator nerves
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| What is the action of the pectinious muscle? | Adduction and flexion and assists in medical rotation of the hip
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| What action does the anterior compartment do? | Flexes the hip, extends the knee
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| What is the sartorius also knows as? | The tailors muscle
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| how does it sit in the body? | superficial anterior compartment of the thigh. Oblique, lateral to medial aspect of the knee
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| What is the action of the sartorius? | Flexes the hip and help in the extension of the knee.
Helps with crossing legs, it is weak and mainly synergistic
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| What forms the min bulk of the anterior compartment? | Quadraceps femoris
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| what 4 muscles make up the quadraceps femoris? | vastus lateralis
vastus medialis
vastus intermedialis
rectus femoris
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| What movments are the quadraceps femoris involved with? | Squating
Sitting
Climbing
Walking upstairs
Fixture during squating - skiing tennis
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| Where do the 4 muscles of hte quadraceps femoris unite? | Quadraceps tendon which inserts into the patella - all except the most inferior vastus medialis
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| What action is the iliopsoas muscles responsible for? | Chief thigh FLEXOR - it is one of the most powerful muscles oin the body. Also very important in fixation
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| What two muscles make up the iliopsoas muscle? | The iliacus and the psoas muscles
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| Where does the iliopsoas muscles attach/origin? | Vertebral column,Iliac fossa
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| What key movement is the iliopsoas responsible for? | Walking - flexion of the hip to initiate forward swing
Also sits ups
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| Where does the iliaposas muscle insert? | Lesser trochanter of the femur
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| What is the innervation of the iliocpsoas? | Femoral nerve (L!, L2)
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| When the femoral neck is broken, how may contraction of the iliopsoas muscle externally rotate the hip? | lateral rotation occurs as the iliopsoas muscle rotates the hip
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| what spinal segments/nerve roots are responsible for this action? | L2-L4 femoral nerve
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| what condition is associated with the quadriceps tendon? | Quadraceps tendon rupture
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| What is contained within the medial (adductor) compartment? | Pectinious
Adductor longus
Adductor magnus
Adductor brevis
Femoral and obturator nerve
Gracillis
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| What muscles is commonly strained in horse riders? | Adductor longus - ossification can sometimes occur in the tendons of this muscle as riders actively use the muscle to stop them form falling off the horse. The ossified tendons can be called riders bones
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| What muscle can be transplanted from themedial compartment? | Gracillis muslce - as it is a relatively weak adductor so can be removed without problems. Usually then placed in the hand.
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| What is the common action of muscles in the medial compartment? | Adduction of the hip
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| What is the main nerve supply of the medial compartment? | obturator nerve/femoral for pectinious
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| What is the main nerve supply to the anterior compartment? | Femoral nerve
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| Do the femoral and obturator nerves carry neurones form the same spinal segment? | Yes
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| What are the boundaries of the femoral triangle? | Superiorally by the Inguarnal cannel
Laterally by the Sartorius
Medially by the Adductor longus
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| Anachronim for the femoral triangle? | SAIL
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| What is the relationship between the femoral nerve artery and vein at the base of the femoral triangle? | They converge
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| There is a fibrous femoral sheath which contains what? | Femoral artery and vein
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| The femoral sheath is divided into 3 compartments, what are these and what do they contain? | Femoral canal - contains lymphatic vessels and the deep inguarnal lymphnode (cloquet's)
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| What is clinically significant about the femoral canal? | It is the site of femoral hernia's
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| The deep femoral artery has two principle braches - what are these? | The medial and the lateral CIRCUMFLEX FEMORAL ARTERIES
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| What does the deep femoral artery supply? | The thigh
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| What does the superficial femoral artery supply? | Knee and foot
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| Where can the femoral pulse be palpated? | Just inferior to the mid point of the inguinal ligament
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| How can compression of the femoral artery be achieved? | By pressing against the superior pubic ramus, psoas major and femoral head
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