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43 Cards in this Set
- Front
- Back
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Common attachment of hip joint mm. |
Pelvis (i.e. cross the joint) |
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Lower Limb Components of Stance Posture and Lateral Stability |
Iliofemoral ligament, paraspinal muscels (multifidus and erector spinae mm.), quadratus lumborum m. psoas major m., tensor fascia, iliotibial tract, fibulocollateral ligment, tibialis anterior m. |
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Major Nerves of the Lower Limb |
-Femoral n. -Obturator n. -Sciatic n. Tibial n. Common Fibular n. |
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Femoral n. innervations |
Sensory -anterior/medial thigh -medial/posterior leg/foot (via saphenous n.)
Motor -anterior thigh mm. |
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Obturator n. innervations |
Sensory -medial thigh
Motor -adductor mm. of the thigh |
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Sciatic n. innervations |
Sensory -posterior leg -lateral foot (via sural n.)
Motor -all posterior thigh mm. |
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Tibial n. innervations |
Sensory -plantar foot (via medial & lateral plantar nn.)
Motor -posterior leg mm. -posterior knee joint -plantar foot mm. (via medial & lateral plantar nn.) |
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Common fibular n. innervations |
Sensory -lateral leg and dorsal foot
Motor -lateral leg mm. (via superficial branch) -anterior leg, dorsal foot mm. (via deep branch) |
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Cutaneous nn of anterior thigh |
-Lateral femoral cutaneous n (really lateral - wraps around) -iliohypogastric n. -genitofemoral n. -anterior cutaneous branch of femoral n. -obturator n. (really medial - wraps around) |
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Cutaneous nn of anterior leg |
-lateral sural cutaneous n. -saphenous n. |
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Cutaneous nn of dorsal foot |
-lateral, intermediate, and medial dorsal cutaneous nn. |
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Cutaneous nn of posterior thight |
-lateral femoral cutaneous n. (really lateral - wraps around) -posterior femoral cutaneous n. -obturator n. (really medial - wraps around) |
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What passes through Alcock's canal? |
AKA Pudendal canal (starts internally just distal of lesser sciatic foramen) -internal pudendal a. -internal pudendal vv. -pudendal n. |
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Components of hip joint (ball & socket) |
-acetabular labrum -lunate surface -transverse ligament -ligamentum teres (ligament of the head) -ischiofemoral lig. (Bertin) -pubofemoral lig. (pubocapsular) -iliofemoral lig. (Bigelow) -Zona orbicularis (annular ligament) -articular cartilage FYI - lateral one third to one half of posterior neck of femur is extrascapsular |
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Zona orbicularis AKA annular ligament |
a ligament on the neck of the femur formed by the circular fibers of the articular capsule of the hip joint. |
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Iliofemoral ligament AKA Y lig., AKA Biglow |
-attaches AIIS to intertrochanteric line -strongest lig. in body -anterior reinforcement -resists hyper-extension, prevents lateral rotation at the hip joint while standing |
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Ischiofemoral ligament AKA Bertin |
-Limits flexion and medial rotation of the thigh -attaches ischium inferoposterior to acetabulum to intertrchanteric line -posterior reinforcement |
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Pubofemoral ligament AKA pubocapsular |
-Limits extension and restricts abduction of the hip -attaches superior to obturator crest and pubic ramus to femoral neck -inferior reinforcement |
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Flexors of the Hip |
-Iliopsoas mm. (most powerful) - inserts into lesser trochanter -rectus femoris (only quadricep that crosses the hip) - aids flexion (kicking muscle) -Sartorius
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Extensors of the Hip |
-Gluteus maximus m. (most powerful) -Hamstring mm. |
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What passes through the suprapiriform foramens? |
Superior gluteal v.a.n. |
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What passes through the infrapiriform foramen? |
-inferior gluteal v.a.n. -pudendal n. -internal pudendal v.a. -sciatic n. posterior femoral cutaneous n. |
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Lateral/external hip/femur rotators |
-Gluteus maximus m. (inferior gluteal n. - L5,S1-2) -Piriformis m. (L5, S1-2 n. root) -Superior gemellus m. (S1-3 n. root) -Obturator internus m. (S1-3 n. root) -Inferior gemellus m. (L4-S1 n. root) -Obturator externus m. -Quadratus femoris m. (L4-S1 n. root) |
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Medial/internal hip/femur rotators |
-Gluteus medius m. (superior gluteal n. - L4-S1 n. roots) -Gluteus minimus m. (superior gluteal n. - L4-S1 n. roots) |
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Bursae in the Hip -Which more likely to have pathology associated? |
-Iliopsoas bursa -Trochanteric bursa - pathology = bursitis caused by compression by IT band -gluteus medius bursa -ischiogluteal bursa |
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Piriformis Syndrome |
Neuromuscular disorder involves a compressed sciatic n. or aggravaiton by the piriformis m. - causes pain, tingling, and numbness in the gluteal region and sciatic nerve path down lower thigh and leg. |
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Cutaneous innervation of the gluteal region |
-Superior cluneal nn. (L1-3) -Medial cluneal nn. (S1-3) -Inferior cluneal nn. Posterior femoral cutaneous n. (S1-3) |
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Meralgia paresthetica |
AKA Calvin Klein Syndrome Lateral thigh cutaneous n. compressed at inguinal ligament (e.g. tight jeans) causing tingling and/or numbness of lateral/anterior thigh |
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Gluteal Crush Compartment Syndrome |
-uncommon in thigh because of large-volume that the thigh requires to cause pathological increase in interstitial pressure -fascial compartments of thigh blend anatomically w/in mm. of the hip potentially allowing extravasation of blood outside compartment -copartment syndrome may be caused by decrease in comportmental volume, increase in compartmental contents, or external pressure |
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Persistant Ischiac Artery |
The embryonic ischiatic (sciatic) a. does not regress during development leading to problems later in life (e.g. aneurysm) |
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What structures need to be avoided for intramuscular injections? |
-Superior gluteal n. -Sciatic n. *Use the superolateral quadrant of buttock OR triangular area bounded by ASIS, tubercle of iliac crest, and greater trochanter to avoid the structures |
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Trendelenburg Test |
Tests gluteal gait (gluteus medius limp) -positive for superior glutea n. entrapment, femoral head dislocation, gluteus medius m. (and gluteus minimus m.) rupture or weakness -pt. stands on one leg -positive sign = significant drop of unsupported hip -suggests gluteus medius/minimus mm. on the SUPPORTED side are not working (allows unsupported side to drop) |
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Superior gluteal n. lesion |
-Trendelenburg Gait - marked downward tilting of hip on non-weight bearing side due to inability of gluteus medius/minimus mm. to actively abduct the hip during walking -Trendelendburg Sign - Clinical test to determine the integrity of the superior gluteal n. Pt. hip tilts down when the limb is non-weight bearing because of superior gluteal n. is damaged on weight bearing side |
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Iliotibial tract |
-Strong gluteal aponeurosis over gluteus medius m. continues inferior and become the iliotibial tract of the fascia lata. It attaches to Gerdy's tubercle. |
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When is gluteus maximus m. in use? |
-Powerful thigh extensor used when running, climbing, and rising from a sitting or stooped position. -Also paradoxically controls flexion at the hip |
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Action of gluteus minimus/medius |
-Abduct thigh at hip joint and rotate medially -Abducts pelvis (tilts it) attached to grounded limb during walking so swinging limb can clear the ground |
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Result of paralysis of gluteus minimus/medius (e.g. superior gluteal n. lesion) |
-Lurching or waddling gait in which the hip on the weak side deviates laterally when that foot is in contact w/ the ground. |
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Muscle that emerges from greater sciatic foramen |
Piriformis m. (sciatic n. appears at its inferior border) |
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What is Gerdy's tubercle and what's its function? |
It is the lateral tubercle of the tibia where the iliotibial tract attaches |
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Which bones fuse to form the acetabulum? |
Ilium, ischium, and pubis |
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Superior gluteal n. roots and innervations |
-L4-5, S1 roots -passes posterior through greater sciatic foramen immediately superior to piriformis m. to pass anterolaterally innervating gluteus medius, gluteus minimus, and tensor fasciae lata mm. |
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Inferior gluteal n. roots and innervations |
-L5, S1-2 roots -passes posterior through greater sciatic foramen just inferior to the piriformis m. and supplies the gluteus maximus m. |
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Pudendal n. roots and innervations |
-S2-4 roots -passes inferior to piriformis then re-enters pelvis via the lesser sciatic foramen to carry sensation to external genitalia, anus, and perineum and motor to external urethral sphincter and external anal sphincter mm. |
