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69 Cards in this Set

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The acetabular fossa is made deeper by the..
acetabular labrum
What ligament bridges the acetabular notch?
transverse acetabular ligament
The ____________________ attaches to the margins of the acetabular notch and to the transverse acetabular ligament.
ligamentum capitis femoris
The main function of the ligamentum capitis femoris is to...
carry the artery to the head of the femur, a branch of the obturator artery
The head of the femur is covered by hyaline cartilage except for the small central depression called the ________________, in which you can find the _________________.
-fovea capitis femoris

-ligamentum capitis femoris
The normal angle of inclination between the femoral neck and shaft is...
about 126 degrees (from 115 to 140)
Abnormal femoral angle of inclination: coxa vara...
is a decrease in the angle (less than 120 degrees, looks like an "r")
Abnormal femoral angle of inclination: coxa valga...
is an increase in the angle (more than 135 degrees, looks like an "l")
shortened leg, limp; pain free gait abnormality; congenital or acquired (infection, tumor, post-traumatic fracture, metabolic)--coxa vara or coxa valga?
coxa vara
slipped epiphysis of femoral head; genu varum (bow legged)--coxa vara of coxa valga?
coxa valga
The angle of torsion/declination is normally ____ in females and ____ in males.
12 degrees females
7 degrees males
_______________ is an abnormal increase in the angle of torsion; equals _________________.
-anteversion
-internal femoral torsion
_______________ is an abnormal decrease in angle of torsion; equals ______________
-retroversion (retro - decrease)
-external femoral torsion (ER - external:retro)
What is the main blood supply to the head of the femur?
retinacular branches of the medial femoral circumflex artery
What is the secondary blood supply to the head of the femur?
retinacular branches of the lateral femoral circumflex artery
What artery supplies blood to the head of the femur and is important in children, but not so much in adults?
artery to the head of the femur (remember, it's enclosed in the ligamentum capitis femoris)
What are the trochanteric anastomoses?
Lat. fem. circumflex a.
Inferior gluteal a.
Medial fem. circumflex a.
Superior gluteal a.

(LIMS)
What is a consequence of a femoral neck fracture?
torn retinacular branches of femoral circumflex arteries, causing avascular necrosis of the femoral head
What are the 4 causes of avascular necrosis to the femoral head?
-chronic alcohol
-steroid use
-femoral neck fracture
-posterior hip dislocation
The _______________ fracture runs from the greater trochanter of the femur to the lesser trochanter and (does/does not) involve the femoral neck. It (does/does not) cause avascular necrosis of the femoral head.
-intertrochanteric
-does not involve neck
-does not cause avascular necrosis
_______________ is a line drawn from the neck of the femur through the _______________ and is important in monitoring changes in the head/neck of the femur (ex. femoral neck fracture).
-Shenton's line
-lower margin of the superior pubic ramus
What three ligaments form the fibrous capsule around the hip joint?
-iliofemoral ligament ("ilYofemoral")
-pubofemoral ligament
-ischiofemoral ligament
Where does the iliofemoral ligament attach?
What action does it prevent?
-anterior inferior ilaic spine and acetabular rim to the intertrochanteric line
-prevent hyperextension
Where does the pubofemoral ligament insert?
What action does it prevent?
-obturator crest and blends with iliofemoral ligament
-limits extension and abduction
What separates the pubofemoral ligament and the iliofemoral ligament?
-gap covered by the iliopsoas muscle and iliopsoas bursa
Where does the ischiofemoral ligament attach?
What action does it prevent?
-spirals from the ischial part of the acetabular rim to the neck of the femur medial to base of greater trochanter
-prevents hyperextension (NOTE: Both the ischiofemoral and iliofemoral ligaments prevent hyperextension. Pubofemoral prevents extension and abduction).
Posterior hip luxation (dislocation) is easiest in what position?
-during flexion and adduction of thigh (ligaments prevent extension, so they are relaxed when thigh is flexed)
90% of hip dislocations is in what direction?
posterior
Anterior dislocation of hip joint are caused by what action?
This accounts for what percent of hip dislocations?
-forceful abduction and external rotation
-5%
Congenital hip dislocation/developmental dysplasia of the hip occurs in 1.5/1000 live births and is more common in ____
Some of the risk factors include:
-girls

Risk factors:
-family history
-generalized ligamentous laxity
-breech birth
This dislocation, which is occurs prior to skeletal maturity, causes the head and neck to separate where they are located at the epiphyseal plate
slipped capital femoral epiphysis
The trochanteric bursa is between what two structures?
gluteus maximus and the greater trochanter
A person with trochanteric bursitis may produce pain where?
pain usually radiates distally along iliotibial tract
What bursa is found under the iliopsoas muscle
iliopsoas bursa
The iliopsoas bursa may be inflamed (iliopsoas bursitis) in cases of ____, causing pain in the ____ area
-rheumatoid arthritis or overuse injury
-anteromedial thigh pain
Branches of what two nerves innervate both the hip and knee joints, allowing hip pain to be referred to the knee and vertebral/sacroiliac/prostate pain to the hip?
femoral and obturator nerves
Hip pain is often referred to the ____
knee
Vertebral column, sacroiliac joint, or prostate pain may be referred to the ____
hip
The gluteus maximus does what actions?
-powerful extensor
-laterally rotates thigh
-abducts thigh
What muscles are innervated by the superior gluteal nerve?
-tensor fascia lata
-gluteus medius
-gluteus minimus
(everything except the gluteus maximus)
What muscles are innervated by the inferior gluteal nerve?
gluteus maximus
What is the function of the tensor fascia lata?
stabilizes knee during extension
What is the function of the gluteus medius and gluteus minimus?
-most important action - stabilize pelvis
-abducts and medially rotates femur at hip joint
What are the deep muscles of the gluteal region that cause lateral rotation?
-Piriformis (+abd)
-Gemellus superior (+abd)
-Obturator internus (+abd)
-Gemellus inferior (+abd)
-Obturator externus (not abd)
-Quadratus femoris (not abd)
The attachments of the last two muscles are a bit more distal on the femur--does not cause abduction. However, all muscle laterally rotate the thigh as they attach on the posterior surface of the femur
Clarify slide about nerve
slide 27
What are the two arteries of the gluteal region?
-superior gluteal artery
-inferior gluteal artery
The superior and inferior gluteal arteries are a branch of _____
internal iliac artery
The superior gluteal artery enters the gluteal region through the _____ and is ____ to the piriformis muscle
-upper part of the greater sciatic foramen
-superior
The inferior gluteal artery enters the gluteal region through the ____ and is _____ to the piriformis muscle
-lower part of the greater sciatic foramen
-inferior
The cruciate anastomoses provide alternate blood supply to the lower limbs due to occlusion of the ______________.
femoral artery
The cruciate anastomoses are:
Inferior gluteal artery
Medial femoral circumflex artery
Lateral femoral circumflex artery
First perforating branch of profunda femoris artery

"I Got My First and Last Chia Pet"
The pudendal canal is formed by the _____ in the _____
-obturator interus fascia
-ischioanal fossa
What are the nerves of the gluteal muscles?
-superior gluteal nerve
-inferior gluteal nerve
-nerve to piriformis
-nerve to obturator internus
-nerve to quadratus femoris
A patient has a hard time rising from a seated position, climbing stairs, and running and jumping. What nerve may be damaged? What muscles does this nerve innervate?
-inferior gluteal nerve (L5-S2)
-gluteus maximus
A patient comes in with weakness in abducting his thigh. Tests show trendelenburg sign and gluteus medius gait. What nerve may be damaged? What muscle does this innervate?
-Superior gluteal nerve (L4-S1)
-gluteus medius and minimus
Paralysis of the gluteus medius and minimus result in a positive ____ test
Tredelenburg
Describe the trendelenburg sign
-patient is asked to raise knee
-the "normal side" drops when its knee is lifted and "affected side" supports the body
*when standing with both feet, patient leans towards affected side
Sciatic nerve damage may be due to:
-badly placed gluteal intramuscular injection
-posterior hip dislocation
-traction on baby's legs during difficult childbirth
Damage to sciatic nerve can cause:
-hamstring muscle paralyzed
-all muscles below the knee paralyzed
-flail foot
One or more roots of the sciatic nerve may be damaged in the vertebral canal due to:
This can cause damage to what nerve?
-protruding or herniated intervertebral disc
-common fibular (peroneal) nerve - foot drop
Damage to the common fibular nerve can cause:
-FOOTDROP
-paralysis of muscles in anterior and lateral leg compartments
Sciatic nerve may be compressed by what muscle, resulting in...
This may cause:
-piriformis muscle
-pain and/or paresthesia in gluteal region and posterior thigh
Piriformis syndrome is more likely to happen if:
-if the common fibular nerve pierces the piriformis
What are the actions of the semimembranosus and semitendinosus muscles?
-flex knee
-extend hip
-medially rotate lower limb

seMi's are Medial rotators
What are the actions of the biceps femoris muscles?
-flex leg at knee
-extend thigh at hip (only long head)
-laterally rotate lower limb (remember, the seMi's Medially rotate)
What are the hamstring muscles?
Where do the originate?
What never innervates them?
-Semitendinosus
-Semimembranosus
-Biceps femoris long head
-Adductor magnus, hamstring part

-Ischial tuberosity

-tibial nerve of sciatic nerve (except short head of bicep femoris)
-short head of bicep femoris - common fibular nerve
What artery supplies the posterior thigh?
profunda femoris artery (Posterior = Profunda)
*also largest branch of femoral artery
The posterior thigh muscles (biceps femoris, semitendinosus, semimembranosus) divide into what two divisions in the distal thigh (popliteal fossa)?
-tibial division
-common fibular division
Trochanteric anastomoses provide collateral circulation to the head of the femur when the _________________ are blocked.
femoral or medial femoral circumflex arteries