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1
Q

what are the ten muscles of the posterior hip?

A
tensor fascia lata
gluteus maximus
gluteus medius
gluteus minimus
piriformis
superior gemellus
obturator internus
inferior gemellus
obturator externus
quadratus femoris
2
Q

what is the muscle that lies along the lateral border of the femur, between two layers of the lateral aspect of the fascia lata (illiotibial tract). the muscle forms a superficial elevation below and lateral to the iliac crest?

A

tensor fascia lata

3
Q

what is the origin of the tensor fascia lata?

A

crest of the ilium

4
Q

what is the insertion of the tensor fascia lata?

A

iliotibial tract

5
Q

what muscle flexes, abducts, and medially rotates femur and helps to stabilize the knee joint?

A

tensor fascia lata

6
Q

what is the nerve supply of the tensor fascia lata?

A

superior Gluteal (L4,L5,S1)

7
Q

what is the largest and most supeficial muscle of the hip region?

A

gluteus maximus

8
Q

what is the muscle that is conspicuous in humans for its great bulk, which together with a variable amount of adipose tissue forms the?

A

gluteus maximus and forms the buttocks

9
Q

what is the muscle that is the largest by weight in human body and is associated with the assumption of the erect posture and bipedal locomotion?

A

gluteus maximus

10
Q

what are the two gluteal bursae?

A

trochanteric bursae

ischial bursae

11
Q

there are a number of bursae that separate the gluteus maximus from bone and are collectively known as?

A

gluteal bursae

12
Q

what are the three origin points of the gluteus maximus?

A

posterior gluteal line
sacrum and coccyx
posterior ligaments of the sacroiliac joint

13
Q

what are the two insertion points of the gluteus maximus?

A
gluteal tuberosity (line) of femur
iliotibial tract
14
Q

what are the three actions of the gluteus maximus?

A
  1. extends and laterally rotates femur
  2. helps to stabilize the pelvic bone
  3. stabilizes the knee joint
15
Q

what is the nerve for the gluteus maximus?

A

inferior gluteal (L5,S1,S2)

16
Q

when patients experience a difficulty in getting from a sitting to a standing position (may have to actively push themselves to the standing position), this is due to weakness of what muscle?

A

gluteus maximus

17
Q

weakness of what muscle will cause difficulty straightening from a bending position, walking uphill or up stairs?

A

gluteus maximus

18
Q

Atrophy of the gluteus maximus does not seriously affect walking on?

A

level ground or standing still

19
Q

what is the muscle which is partly deep to the gluteus maximus, but its superior portion remains superficial?

A

Gluteus medius

20
Q

origin of the gluteus medius?

A

external surface of the ilium

21
Q

insertion of the gluteus medius?

A

greater trochanter of the femur

22
Q

what is the smallest of the gluteal muscles and deep to the gluteus medius?

A

gluteus minimus

23
Q

origin of the gluteus minimus?

A

external surface of ilium

24
Q

insertion of gluteus minimus?

A

greater trochanter of femur

25
Q

what are the three actions of the gluteus minimus?

A
  1. abducts femur
  2. medially rotates femur
  3. helps to keep the pelvic bone steady when the foot on the opposite side is raised off the ground.
26
Q

nerve of the gluteus minimus?

A

superior gluteal (L4,L5,S1)

27
Q

what is the simple test which is used if one suspects atrophy and weakness of the gluteus medius and minimus muscles?

A

trendelenburg test

28
Q

(trendelenburg test) the supportive effect of the pelvis when the foot is raised off the ground is dependent partly on what two muscles?

A

gluteus medius

gluteus minimus

29
Q

(trendelenburg test) when the muscles are weak, the pelvis will drop on the ____________ side when the foot is raised off the ground

A

unaffected side

30
Q

during a trendelenburg test the best observed place to watch is the folds of the?

A

buttocks

31
Q

trendelenburg test- the pelvis and buttock fold will fall on the sides that the foot is raised off the ground and this would be a __________ result?

A

postive trendelenburg sign

this indicates that the muscles on the side opposite from where the foot is raised are not functioning properly

32
Q

the type of abnormal locomotion due to atrophy and weakness of the gluteus medius and minimus?

A

gluteal Gait
Trendelenburg Gait
with this type of locomotion, there is displacement of the body (falling of the pelvis) on the unaffected side

33
Q

weakness of the gluteus medius and minimus muscles will also cause _________ deviations.

A

postural deviation

34
Q

when there is a gluteus based postural deviation it will result in the vertebral column deviating toward the side where the pelvis is?

A

low

giving rise to what is known as C curve of the column

35
Q

weakness of the ______ gluteus medius and minimus will give rise to a ____ “C” curve of the vertebral column with the opening of the “C” toward the side where the muscle is weak.

A

right muscles give rise to left C curve

36
Q

all the muscles of the posterior hip besides the gluteus group all share a common action of what?

A

lateral rotation of the femur

37
Q

the muscle which originates within the pelvic cavity and emerges through the greater sciatic notch?

A

piriformis

it is deep to the gluteus maximus and parallel to the gluteus medius

38
Q

origin of the piriformis?

A

anterior surface of the sacrum (within pelvic cavity)

39
Q

insertion of the piriformis?

A

greater trochanter of femur

40
Q

nerve of piriformis?

A

S1 and S2

41
Q

a common cause of pain in the gluteal region (sciatica) due to compression of the sciatic nerve by what muscle?

A

piriformis

42
Q

the syndrome that causes deep pain in the buttocks which may refer along course of the sciatic nerve (posterior leg and thigh)?

A

piriformis muscle syndrome

43
Q

the syndrome that is common for athletes in sports that require extensive lateral rotation of the femur?

A

piriformis muscle syndrome

44
Q

how id pirifomris muscle syndrome diagnosed?

A

diagnosed primarily on symptoms, since there are no tests that accurately confirm the diagnosis

45
Q

what may help piriformis muscle syndrome?

A

stretching and correcting biomechanical abnormalities of the lower extremity and vertebral column

46
Q

what is the small muscle that is situated between the pirifomis and the obturator internus and deep to the gluteus maximus.

A

superior gemellus

47
Q

what muscle’s tendon of insertion fuses with that of the obturator internus and inferior gemellus?

A

superior gemellus

48
Q

origin of superior gemellus?

A

spine of ischium

49
Q

insertion of superior gemellus?

A

greater trochanter of femur

50
Q

nerve of superior gemellus?

A

L4,L5,S1,S2

51
Q

what s the small muscle which takes its origin within the pelvic cavity and whose tendon emerges through the lesser sciatic notch?

A

obturator internus

52
Q

what is the muscle situated between the two gemellus muscles?

A

obturator internus

53
Q

what muscle derives its name from its origin on the internal aspect of the membrane which covers the obturator foramen?

A

obturator internus

54
Q

origin of obturator internus?

A

internal surface of the obturator membrane

55
Q

insertion of the obturator internus?

A

greater trochanter of the femur

56
Q

nerve of obturator internus

A

L4,L5,S1,S2

57
Q

what is the muscle situated between the obturator internus and the quadratus femoris?

A

inferior gemellus

58
Q

origin of inferior gemellus?

A

tuberosity of ischium

59
Q

insertion of inferior gemellus?

A

greater trochanter of femur

60
Q

nerve of inferior gemellus?

A

L4,L5,S1,S2

61
Q

what is the quadrant shaped muscle which is found inferior to the inferior gemellus?

A

Quadratus Femoris

62
Q

origin of quadratus femoris?

A

tuberosity of ischium

63
Q

insertion of quadratus femoris?

A

quadrate tubercle of femur

64
Q

nerve of quadratus femoris?

A

L4,L5,S1,S2

65
Q

what is the muscle that derives its name from its origin of the external surface of the obturator foramen?

A

obturator externus

66
Q

what is the muscle found deep to the inferior gemellus and the quadratus femoris?

A

obturator externus

67
Q

origin of obturator externus?

A

external surface of the obturator membrane

68
Q

insertion of the obturator externus?

A

trochanteric fossa of the femur

69
Q

nerve of the obturator externus?

A

obturator (L2,L3,L4)

70
Q

__________ rotation of the femur is important in the control of the body’s balance and posture.

A

lateral rotation

71
Q

the lateral rotators as a group are stronger than the medial rotators of the?

A

femur

72
Q

when standing normally the front of your foot should point slightly more?

A

lateral

this position helps to achieve better balance and posture

73
Q

what are the three posterior thigh muscles?

A

semitendinosus
semimembranosus
Biceps Femoris

74
Q

what muscles make up the hamstrings?

A

semitendinosus
semimembranosus
Biceps Femoris

75
Q

the hamstrings all have a common origin point of?

A

ischial tuberosity

except for short head of biceps femoris

76
Q

all the hamstrings share what nerve as their supply?

A

sciatic nerve (L4-S3)

77
Q

what is the muscle situated on the medial-posterior aspect of the femur?

A

semitendinosus

78
Q

what muscle is medial to the biceps femoris and is superficial to the semimembranosus?

A

semitendinosus

79
Q

how does the semitendinosus get its name?

A

its tendon of insertion is very long and thus gives the muscles its name

80
Q

what is the insertion of the semitendinosus?

A

medial condyle and proximal posterior shaft of tibia

81
Q

what is the name to describe the tendons of insertion of the semitendinosus, gracilis, and sartorius?

A

Pes Anserinus

there is a bursa which separates the tendons from the skin

82
Q

what is the muscle named for its flattened nature of its proximal attachment. proximally it lies deep to the semitendinosus?

A

semimembranosus

83
Q

what is the insertion of the semimembranosus?

A

medial condyle of tibia

84
Q

what is the most laterally situated of the hamstring muscles?

A

biceps femoris

85
Q

the short head of the biceps femoris originates where?

A

linea aspera of the femur

86
Q

what is the insertion of the biceps femoris?

A

head of fibula

lateral condyle of tibia

87
Q

actions of all the hamstring muscles?

A

-flexion of the leg at the knee joint

88
Q

actions of all the hamstrings except the short head of biceps femoris?

A
  • stabilize hip joint

- extension of the femur

89
Q

actions of the semitendinosus and semimembranosus hamstring muscles?

A

-medially rotates the leg (tibia)

90
Q

actions of the biceps femoris?

A

laterally rotates the knee (tibia)

91
Q

the _______ of hamstrings will vary considerably from individual to individual.

A

length of hamstrings

92
Q

what is the other name for a hamstring strain?

A

pulled hamstring

93
Q

a pulled hamstring is _____ as common as a strain of the quadriceps?

A

twice

94
Q

a pulled hamstring will be seen in athletes who run very hard and have?

A

quick starts

95
Q

the strong muscular contractions required to excel in sports that run hard or quick start, may lead to a tearing of the muscle , which are classified as what?

A

grade 1,2,3

96
Q

many hamstring tears are accompanied by painful hemorrhaging which can lead to?

A

painful hematomas

97
Q

pulled hamstrings can become _______ in some individuals.

A

chronic

98
Q

running style, over developed quadriceps, biomechanical factors, and inadequate warming up and stretching may contribute to what?

A

pulled hamstrings

99
Q

what may result from a forcible flexion of the hip when the knee is extended?

A

avulsion of the ischial tuberosity

100
Q

if you have weak or tight hamstrings muscles, the body may compensate by changing the position of what bone?

A

pelvic bone

this can place stress on other muscles in the area by compression on spinal nerves

101
Q

what is found in the pelvic cavity embedded for the most part in the psoas major muscle?

A

lumbar plexus

102
Q

what forms the lumbar plexus?

A

ventral rami of L1-L4 although T12 may contribute

103
Q

what is the term given to the nerve axons of L4 and L5 that allow communication between the lumbar plexus and sacral plexus?

A

lumbosacral trunk

104
Q

which nerve is found just lateral to the psoas major muscle?

A

iliohypogastric

105
Q

segmental innervation of iliohypogastric nerve?

A

L1 (sometimes T12)

106
Q

division of the iliohypogastric nerve?

A

anterior

107
Q

motor supply from the iliohypogastric nerve?

A

internal oblique and transverse abdominis

108
Q

iliohypogastric is the cutaneous supply for what?

A

proximal lateral aspect of buttock

109
Q

the cutaneous only nerve branch off of L1 that is found just lateral to the psoas major muscle?

A

ilioinguinal

110
Q

segment innervation of ilioinguinal nerve?

A

L1

111
Q

division of ilioinguinal nerve?

A

anterior

112
Q

the ilioinguinal nerve is the cutaneous supply for what?

A

proximal medial aspect of thigh

113
Q

which nerve enters the thigh by passing beneath the inguinal ligaments, just medial to the anterior superior iliac spine?

A

lateral (femoral) cutaneous nerve of the thigh

114
Q

seg innervation of lateral cutaneous nerve of the thigh?

A

L2,L3

115
Q

division of the lateral cutaneous nerve of the thigh?

A

posterior

116
Q

the lateral cutaneous nerve of the thigh is the cutaneous supply for what?

A

lateral aspect of the anterior and posterior thigh

117
Q

meralgia means what?

A

thigh pain

118
Q

what is a compression neuropathy of the lateral femoral cutaneous nerve as it leaves the pelvic cavity beneath the inguinal ligament?

A

meralgia paresthesia

lateral femoral cutaneous nerve entrapment

119
Q

what would cause symptoms of pain, burning and tingling sensation along the lateral aspect of the thigh?

A

meralgia paresthesia

120
Q

what are the common causes of meralgia paresthesia?

A

obesity, wearing tight fitting clothing, or an activity which puts the femur in a flexed position for long periods of time?

121
Q

meralgia paresthesia is sometimes confused with certain hip disorders, such as?

A

trochanteric bursitis

122
Q

which nerve pierces the psoas major and runs inferiorly on its anterior aspect?

A

genitofemoral

123
Q

as the genitofemoral nerve descends it divides into a ________ and a _________ branch.

A

femoral and genital

124
Q

segmental innervation of genitofemoral?

A

L1,L2

125
Q

divison of genitofemoral?

A

anterior

126
Q

the genitofemoral is the motor supply for males of what?

A

cremaster muscle (found within the spermatic cord

127
Q

the genitofemoral is the cutaneous supply for what?

A

skin of the genitalia and a small area of skin below the inguinal ligament.

128
Q

what is the largest branch of the lumbar plexus?

A

femoral nerve

129
Q

what is the nerve that passes from the pelvic cavity to the thigh by going deep to the inguinal ligament?

A

Femoral nerve

130
Q

what is the nerve that gives off some muscular branches and then terminates in the thigh into several cutaneous and muscular branches before it leaves the pelvic cavity?

A

femoral nerve

131
Q

segmental innervation of the femoral nerve?

A

L2,L3,L4

132
Q

what is the division of the femoral nerve?

A

posterior

133
Q

what muscles are motor supplied by the femoral nerve?

A
iliacus
psoas major
sartorius
quadriceps
pectineus
134
Q

what is cutaneously supplied by the femoral nerve?

A

medial and intermediate aspect of anterior thigh;

medial aspect of the thigh and foot

135
Q

what is the specific cutaneous branch of the femoral nerve that supplies the medial aspect of the thigh and foot?

A

saphenous

which accompanies the femoral artery in the adductor canal

136
Q

what joint does the femoral nerve articular supply?

A

hip and knee

137
Q

what nerve is damaged when the leg cannot be extended and flexion at the hip is diminished?

A

femoral nerve

138
Q

when the femoral nerve is damaged, what will be the motor symptoms?

A
  • Quadriceps are involved and the leg cannot be extended.

- flexion at the hip is diminished (iliopsoas)

139
Q

what will be the sensory symptoms when the femoral nerve is damaged?

A

medial and intermediate anterior aspect of the thigh and medial aspect of the leg and foot will be numb

140
Q

how does one test for damage of the femoral nerve?

A

assesing both flexion at hip and extension of the leg>

141
Q

in athletes what nerve may become compressed within the adductor canal or where it exits the fascia to supply the medial leg?

A

saphenous nerve

142
Q

enttrapment of the saphenous nerve will cause______ pain and paresthesia along the distribution of the nerve.

A

Knee pain

143
Q

what nerve is the smaller and more medial of the two terminal branches of the lumbar plexus?

A

obturator nerve

144
Q

what nerve passes from the pelvic cavity to the medial aspect of the thigh by passing through an opening in the membrane that covers the obturator foramen?

A

obturator nerve

145
Q

what is the segmental innervation of the obturator nerve?

A

L2,L3,L4`

146
Q

what is the division of the obturator nerve?

A

anterior

147
Q

what muscles are motor supplied by the obturator nerve?

A

pectineus, adductor magnus, adductor longus and brevis, gracilis, obturator externus

148
Q

what does the obturator nerve cutaneous supply?

A

distal medial aspect of the thigh

149
Q

what joint has its articular supply from the obturator nerve?

A

hip and knee

150
Q

accessory obturator nerve is found in what percentage of the population?

A

20%

151
Q

when the accessory obturator nerve is present, where is it found?

A
  • found just lateral to the obturator
152
Q

what is the segmenatl innervation of the accessory obturator nerve?

A

L3 and L4

153
Q

what muscle doe sthe accessory obturator nerve supply?

A

pectineus

154
Q

what joint does the accessory obturator nerve articular supply?

A

hip joint

155
Q

damage to what nerve may occur during a difficult birth or by an anterior dislocation of the hip joint?

A

obturator nerve

156
Q

what are the primary functions of the lower extremity?

A
  1. to support the weight of the body
  2. to provide a stable foundation while standing
  3. to allow locomotion IE. running/walking
157
Q

in comparison to the upper extremity the bones of the lower extremity are _________ and ________ with very well marked areas for muscular and ligamentous attachments.

A

heavier and stronger

158
Q

in comparison to the upper extremity the ________ of the lower extremity are stronger and more stable with good bony configurations.

A

joints

159
Q

muscles of the lower extremity are more powerful and less capable of delicate movements than those of?

A

the upper extremity

160
Q

the lower extremity has fewer ________ nerve fibers, accounting for less defined application of tactile sensations

A

sensory nerve fibers

161
Q

what is larger in the lower extremity due to the greater bulk and workload?

A

blood vessels

162
Q

what is well adapted so it can take the impact of the whole body with every step?

A

the “foot” clan

163
Q

what is responsible for sustaining the body’s weight during prolonged standing and must be adaptable to standing and walking on uneven ground?

A

the foot

164
Q

what are the three parts that make up each innominate?

A

ilium
ischium
pubis

165
Q

the three bones of the innominate are separate until they fuse at the age of?

A

18-20

166
Q

what two bones does the innominate articulate with?

A

femur and sacrum

167
Q

what is the large depression on the lateral aspect of each innominate?

A

acetabulum

168
Q

the acetabulum receives the head of the femur to form what joint?

A

hip joint

169
Q

what is the horseshoe shaped articular surface in the acetabulum?

A

lunar surface

170
Q

what is the rough non-articular center portion of the acetabulum?

A

acetabular fossa

171
Q

what is the outside edge of the acetabulum?

A

acetabular rim

172
Q

what is the inferiorly deficient section of the acetabular rim called?

A

acetabular notch

173
Q

the acetabular notch is bridged by a piece of connective tissue called the?

A

transverse acetabular ligament

174
Q

what is the largest and uppermost portion of the pelvic bone?

A

ilium

175
Q

what are the three oblique lines found on the external or lateral surface of the bone?

A

anterior gluteal line
posterior gluteal line
inferior gluteal line

176
Q

the anterior, posterior, and inferior gluteal lines indicate the bony origins of what muscles?

A

the gluteal muscles

177
Q

the internal or medial surface of the ilium is known as?

A

iliac fossa

178
Q

posterior to the iliac fossa are two distinct areas. The more superior is known as?
and the more inferior is?

A

superior- iliac tuberosity

inferior- auricular surface

179
Q

what is important about the iliac tuberosity?

A

attachment site for ligaments

180
Q

what is important about the auricular surface?

A

where the innominate articulates with the sacrum

181
Q

what is the curved line just inferior to the iliac fossa?

A

arcuate line

182
Q

what marks the boundary between the major or false pelvis from the minor or true pelvis?

A

arcuate line

183
Q

what is the superior border of the ilium known as?

A

iliac crest

184
Q

the iliac crest terminates anteriorly as what two things?

A

anterior superior iliac spine

anterior inferior iliac spine

185
Q

the iliac crest terminates posteriorly as what two structures?

A

posterior superior iliac spine
posterior inferior iliac spine
if you missed this, you are fucking retarded…

186
Q

what is the distinct bump that is found on the lateral most aspect of the iliac crest?

A

iliac tubercle

187
Q

what is the deep notch found just inferior to the posterior inferior iliac spine?

A

greater sciatic notch

188
Q

what is the “L” shaped bone consisting of a body and ramus?

A

ischium

189
Q

what is the portion the ischium that enters into formation of the acetabulum?

A

Body

190
Q

what is the small projection of the ischial body?

A

ischial spine

191
Q

what is the small notch just below the below the ischial spine?

A

lesser sciatic notch

192
Q

what is the large roughened area inferior to the lesser sciatic notch?

A

ischial tuberosity

193
Q

what is the most inferior portion the ischium?

A

Ramus

194
Q

the portion of the innominate that consists of a body and two rami?

A

Pubis

195
Q

The medial body of the pubis consists of the?

A

symphyseal surface

pubis symphysis

196
Q

what does the symphyseal surface articulate with?

A

the pubis of the opposite innominate?

197
Q

what is the on the superior aspect of the pubis body?

A

pubic tubercle

198
Q

what is the line going from the pubic crest to the symphyseal surface?

A

pubic crest

199
Q

the superior ramus is above the body and terminates as the?

A

iliopubic eminence

200
Q

what is the prominent ridge on the superior ramus?

A

pubic pecten (pectineal line)

201
Q

what part of the pubis extends posterior and inferior from the body to join the ramus of the ischium?

A

inferior ramus

202
Q

the obturator foramen is closed by a piece of coonective tissue known?

A

obturator membrane

203
Q

the arcuate line form each innominate forms the?

A

pelvic brim

204
Q

what does the pelvic brim separate?

A

minor/ true pelvis

major/ false pelvis

205
Q

what is bounded ppsteriorly by the lumbar vertebrae, laterally by the ilium and anteriorly by the abdominal wall. it helps support and protect much of the andominal viscera?

A

false pelvis (major)

206
Q

what is bounded posteriorly by the sacrum and coccyx, laterally and anteriorly by the ilium, ischium, and pubis? this portion of the pelvis surround the birth canal in females.

A

true pelvis (minor)

207
Q

what are the four functions of the pelvic bone?

A
  1. protect the viscera
  2. transmit body weight to the limbs and absorb the stresses of muscular activity
  3. allow locomotion by causing pelvic bone to swing from side to side
  4. in the female, provides bony support for the birth canal
208
Q

the most obvious sexual dimorphism between male and female is what?

A

adaptation of the female pelvis for child bearing

209
Q

male general pelvic structure?

A

thicker; prominent processes; longer

210
Q

female general structure of pelvic?

A

thinner; processes less prominent; shorter

211
Q

male pelvic inlet shape?

A

heart shaped

212
Q

female pelvic inlet shape?

A

round or oval

213
Q

male pelvic outlet shape?

A

narrower

214
Q

female pelvic outlet shape?

A

wider

215
Q

male anterior iliac spine difference?

A

close together

216
Q

female anterior iliac spine difference?

A

farther apart

217
Q

male greater sciatic notch?

A

narrower

218
Q

female greater sciatic notch?

A

wider

219
Q

male obturator foramen?

A

round

220
Q

female obturator foramen?

A

triangular

221
Q

male acetabulum?

A

face laterally

222
Q

female acetabulum?

A

face more anteriorly

223
Q

male symphysis pubis?

A

longer

224
Q

female symphysis pubis?

A

shorter

225
Q

male pelvic arch?

A

acute angle

226
Q

female pelvic arch?

A

obtuse angle

227
Q

the typical male pelvis?

A

android pelvis

228
Q

the typical female pelvis?

A

Gynecoid pelvis

229
Q

an exaggerated male pelvis?

A

anthropoid pelvis

230
Q

an exaggerated female pelvis?

A

platyplelloid pelvis

231
Q

pelvic fractures can occur from?

A
  • direct trauma

- force transmitted to the bone during a fall on the feet or knees

232
Q

what are the areas of the pelvis most prone to fractures?

A
  • pubic rami
  • acetabulum (or surrounding area)
  • region of sacroiliac joint
  • most lateral aspect of the ilium
233
Q

there is a high morbidity and mortality rate associated with fractures of what bone?

A

pelvis bone

234
Q

what is the common painful contusion injury of the soft tissue associated with the iliac crest?

A

hip pointers

may result in a painful hematoma in the area of injury

235
Q

what are the three primary ossification centers of the pelvic bone?

A

pubis, ischium, ilium

236
Q

what are the five secondary centers of ossification of the pelvis?

A
iliac crest
anterior inferior iliac spine
ischial tuberosity
pubis symphysis
center of acetabulum
237
Q

what age does the pelvis bone complete its ossification?

A

age 20-22

iliac crest

238
Q

how many ossifications centers does the femur have?

A

1 primary

4 secondary

239
Q

what is the primary ossification of the femur?

A

the shaft

240
Q

what are the secondary ossification centers of the femur?

A
head
greater trochanter
lesser trochanter
distal end (condyles and epicondyles)
241
Q

what are the male and female ages that the femur completes its ossification?

A

15 yrs in female

17 and a half in male

242
Q

when the neck of the femur meets the shaft of the bone, an angle is formed. what is this angle called?

A

angle of inclination

243
Q

when is the angle of inclination greatest? and what is the angle?

A

birth

145 degrees

244
Q

the angle of inclination gradually diminishes, until the adult angle is reached when the bone is?
what is the angle?

A

completely ossified

125 degrees

245
Q

what allows greater mobility at the hip joint by increasing the leverage of the muscles that attach to the proximal part of the femur?

A

angle of inclination

246
Q

the angle of inclination is a great advantage for what?

A

bipedal locomotion

247
Q

though the angle of inclination is great for bipedal locomotion, it puts considerable stress on the neck of the femur, which can lead to what as we age?

A

increased fractures

248
Q

an increase of the angle of inclination, which can occur with developmental dysplasia of the hip (congenital dislocation). this is called?

A

Coxa Valga

249
Q

a decrease in the angle of inclination, which occurs in fractures of the proximal part of the femur and in the condition known as rickets. Causes a mild shortening of the affected limbs. this is called?

A

Coxa Vara

250
Q

even though the femur is the strongest and largest bone in the body, it is commonly fractured. the type of fracture that occurs is frequently _____ and _______ related

A

age and sex

251
Q

what are fractures through the neck of the femur called?

A

subcapital fractures

AKA broken hip

252
Q

what type of femur fracture is fairly common, especially in older individuals who suffer from osteoporosis?

A

subcapital fractures

253
Q

what disease is common in post-menopausal women due to estrogen deficiency?

A

osteoporosis

254
Q

subcapital fractures often interrupt the blood supply to the femoral head, leading to a degeneration of the head. this is called?

A

avascular necrosis

255
Q

the femur head is supplied by a small branch of what artery?

A

obturator artery

256
Q

the artery that supplies the head of the femur passes to the head how?

A

within the ligament of the femoral head

257
Q

the neck of the femur receives a rich blood supply from what branches of the femoral artery?

A

medial and lateral circumflex arteries

258
Q

the patella develops within what tendon?

A

common tendon of insertion of the quadriceps

259
Q

the superior border of the patella is called what?

A

base

260
Q

the inferior border of the patella is called what?

A

apex

261
Q

the posterior surface of the patella is marked by what?

A

two articular surfaces

lateral and medial

262
Q

the lateral and medial articular surfaces of the posterior patella articulate with what features?

A

patellar facet

condyles of the femur

263
Q

what is the main function of the patella?

A

gives additional leverage to the quadriceps during the last part of leg extension

264
Q

ossification of the patella comes from a single center that appears early in what year?

A

3rd year

265
Q

the patella is completely ossified at what age?

A

10 years in female

13 years in male

266
Q

what kind of trauma to the patella will cause it to break into a small number of small pieces?

A

direct trauma

usually non-displaced

267
Q

what kind of trauma to the patella is due to the quadriceps contracting suddenly and causing a transverse fracture through the body of the bone?

A

indirect trauma

might be displaced of non-displaced

268
Q

the condition when the superior lateral portion of the patella remains unossified?

A

patella Emarginata

269
Q

what is the name given to a patella that the superior lateral portion ossified independently?

A

Bipartite or Tripartite patella

occurs in 3% of population

270
Q

what is the condition in which there is softening and fissuring of the articular cartilage on the posterior aspect of the patella

A

chondromalacia

271
Q

what patella condition is common in young adults, and caused by trauma, overuse or muslce weakness which will cause a misaligment to the patella?`

A

chondromalacia

272
Q

what is the deep fascia of the thigh that encloses it like a pant leg?

A

fascia lata

273
Q

what provides a dense envelope for the thigh and prevents bulging outward of thigh muscles during contraction?

A

fascia lata

274
Q

what functions to enhance the effectiveness of the contraction of the thigh muscles, and attaches proximally to the pelvic bone and distally to the tibia?

A

fascia lata

275
Q

what is the thickened lateral aspect of the fascia lata, which receives insertions from the tensor fascia lata and gluteus maximus muscles?

A

iliotibial tract

276
Q

what is the opening found in the proximal anterior aspect of the fascia lata. It allows the great saphenous vein to reach its termination at the femoral vein?

A

saphenous opening

277
Q

where does the great saphenous vein terminate?

A

femoral vein

278
Q

what is the name of the overuse syndrome which occurs when the distal end of the iliotibial band repetively rubs over the lateral condyle of the femur?

A

iliotibial band syndrome

279
Q

three muscles of the anterior hip region?

A

iliacus
psoas major
psoas minor

280
Q

what is the muscle that occupies the iliac fossa within the abdominal cavity.

A

iliacus

281
Q

what muscle’s tendon of insertion fuses with the tendon of insertion of the psoas major as it leaves the abdominal cavity to become the iliopsoas?`

A

iliacus

282
Q

what is the large situated along the lateral aspect of the lumbar vertebrae, within the abdominal cavity?

A

psoas major

283
Q

weakness of the psoas major will result in marked disability in carrying out such activities as?

A
  • stair climbing
  • walking up inclines
  • getting up from a reclining position
  • bringing up the trunk forward in the sitting position before rising from a chair
284
Q

what is it called when an infection such as from tuberculosis may spread from the vertebral column into the space between the muscle and its fascial covering?

A

psoas abscess

285
Q

what muscle is missing in about half the population (unilaterally and bilaterally)?

A

psoas minor

286
Q

what is the collective name for the rectus femoris and the three vastus muscles?

A

quadriceps

287
Q

what is the narrow, superficial muscle, which is the longest muscle in the body. it passes obliquely downward and medial across the anterior aspect of the thigh?

A

sartorius

288
Q

what are the group of 4 muscles that occupy the anterior aspect of the femur and are divided into separate parts?

A

quadriceps

289
Q

the quadriceps femoris muscles all have a common tendon of insertion on the?

A

base of the patella

290
Q

the portion of the quadriceps tendon of insertion which runs to the apex of the patella is known as?

A

patellar ligament

291
Q

what is the most superficial of the quadriceps and is situated in the middle of the thigh between the vastus lateralis and vastus medialis and superficial vastus intermedius?

A

rectus femoris

292
Q

what is the largest of the quadriceps muscles, it forms a broad, fleshy mass on the thigh?

A

vastus lateralis

293
Q

the quadricep muscle that is situated on the anterior medial aspect of the thigh?

A

vastus medialis

294
Q

what is the muscle deep to the other quadriceps and covers most of the anterior aspect of the femur?

A

vastus intermedialis

295
Q

occasionally a distinct bundle of muscle fibers separates from the deepest layers of the vastus intermedius and become a separate muscle attached to the synovial membrane of the knee joint. what is this separate muscle called?

A

Articularis Genu

296
Q

an individual with atrophy of what muscles will have difficulty extending the leg against resistance and will usually press on the distal end of the femur during walking to prevent flexion at the knee joint?

A

paralysis of the quadriceps

297
Q

what is the term to indicate a cramping or spasm of the quadriceps muscles. also used to indicate trauma to the muscles which can cause tearing of the muscle fibers and lead to a painful hematoma?

A

charley horse

298
Q

what is the painful overuse injury of the common tendon of insertion of the quadriceps and/or the patellar ligament?

A

Jumper’s knee

299
Q

what is carried out by tapping the patellar ligament and is used to test for the segmental innervation of L2,L3, and L4?

A

patellar reflex

300
Q

patellar reflex test is used to test the segemental innervation of what nerves?

A

L2,L3 and L4

301
Q

what is the long narrow muscle which passes vertically downward on the medial aspect of the thigh and is superficial through out its course. it is the only muscle of the medial thigh which crosses both the hip and knee joint?

A

gracilis

302
Q

surgeons often use what muscle to replace a damaged muscle?

A

gracilis as its a relatively weak adductor muscle

303
Q

what is the small muscle that is teh most superior of the medial thigh muscles and is found just medial to the iliopsoas?

A

pectineus

304
Q

what is the muscle found just medial and slightly inferior to the pectineus?

A

adductor longus

305
Q

what is the small muscle found deep to the pectineus and adductor longus?

A

adductor brevis

306
Q

what is the large, composite muscle (part medial thigh and part posterior thigh). this muscle is found deep to the adductor longus (anteriorly) and the hamstrings (posteriorly)?

A

adductor magnus

307
Q

what muscle has a tendon of insertion that has a slit like opening, the hiatus tendinosus (adductor hiatus) which leads to the popliteal fossa?

A

adductor magnus

308
Q

the slit in the adductor magnus tendon of insertion is the point at which what happens?

A

the femoral vessels become the popliteal vessels

309
Q

what is the condition when there is stretching of the origin of an adductor muscle beyond their tensile strength?

A

pulled groin

adductor strain

310
Q

how is pulled groin severity classified?

A

grade 1- micro tears
grade 2- partial tears
garde 3- complete tears

311
Q

if one suspects damage to the accessory obturator nerve one should do what to test?

A

adduction of the femur against resistance

312
Q

the sacral plexus is formed from what nerves?

A

L4,L5,S1,S2,S3,S4

313
Q

the sacral plexus lies largely on what muscle?

A

piriformis

314
Q

the sacral nerves enter the pelvis via the?

A

anterior sacral foramina

315
Q

which nerve supplies a large area of skin on the buttock and posterior thigh region?

A

posterior femoral cutaneous nerve

316
Q

seg. innervation of posterior femoral cutaneous nerve?

A

S1,S2,S3

317
Q

what division is the posterior femoral cutaneous nerve?

A

anterior and posterior

318
Q

what is the cutaneous supply of the posterior femoral cutaneous nerve?

A

loweer part of buttocks, posterior thigh and popliteal fossa

319
Q

what nerve leaves the pelvis through the greater sciatic notch, superior to the piriformis muscle?

A

superior Gluteal nerve

320
Q

Seg. innervation of superior gluteal nerve?

A

L4,L5,S1

321
Q

what is the division of the superior gluteal nerve?

A

posterior

322
Q

what is the motor supply of the superior gluteal nerve?

A

gluteus medius
gluteus minimus
tensor fascia lata

323
Q

what is the nerve that leaves the pelvis through the greater sciatic notch, inferior to the piriformis muscle and superior to the sciatic nerve?

A

L5,S1,S2

324
Q

what is the division of the inferior gluteal nerve?

A

posterior

325
Q

what is motor supplied by the inferior gluteal nerve?

A

gluteus maximus

326
Q

what is the main nerve of the perineum and chief sensory nerve of the external genitalia. it leaves the pelvic cavity via the greater sciatic notch?

A

pudendal nerve

327
Q

Seg innervation of the pudendal nerve?

A

S2,S3,S4

328
Q

what is the division classification of the pudendal?

A

anterior

329
Q

what is the largest nerve in the body and is the continuation of the sacral plexus into the leg and foot?

A

sciatic nerve

330
Q

where does the sciatic nerve leave the pelvic cavity?

A

through the greater sciatic notch, deep to the piriformis muscle

331
Q

what are the two main branches of the sciatic nerve?

A

tibial

common fibular nerve

332
Q

what nerve supplies the muscles and most of the skin of the posterior leg and plantar surface of the foot?

A

tibial nerve

333
Q

what nerve wraps around the neck of the fibula and has two branches?

A

common fibular nerve

334
Q

what are the two branches of the common fibular nerve?

A

deep fibular

superficial fibular

335
Q

what two nerves supply the muscles and skin of the anterior leg, lateral leg and dorsum of the foot?

A

deep fibular

superficial fibular

336
Q

what is the Seg. innervation of the sciatic nerve?

A

L4,L5,S1,S2,S3

337
Q

what is the division classification of the sciatic nerve?

A

anterior and posterior

338
Q

motor supply of the sciatic?

A

adductor magnus
semitendinosus
semimembranosus
biceps femoris

339
Q

the sciatic nerve may be injured in what three common ways?

A
  1. fracture of the pelvis
  2. posterior dislocation of the hip joint
  3. penetrating wounds
340
Q

motor clinical sign of sciatic nerve damage?

A
  • hamstring muscles are atrophied but weak flexion of leg is possible due to actions of the sartorius and gracilis
  • all muscles distal to the knee may be involved
  • the foot due to gravity falls into the plantar flexed position
341
Q

sensory clinical signs of sciatic nerve damage?

A

loss of sensation below the knee except for an area along the medial side of the leg and foot

342
Q

what is the term used to describe a condition in which patients complain of pain along the sensory distribution of the sciatic nerve?

A

sciatica

343
Q

where is pain usually experienced with sciatica?

A

in the gluteal region of posterior thigh and leg

344
Q

3 possible causes of sciatica?

A
  1. compression, inflammation and/or subluxation of L4-S3 ( prolapse of an intervertebral disc/herniated disc)
  2. compression neuropathy of the sciatic nerve in the gluteal region
  3. intrapelvic tumor
345
Q

what could cause a compression neuropathy of the sciatic nerve in the gluteal region?

A

piriformis syndrome

wallet in the back pocket

346
Q

what does L1 cutaneous supply?

A

proximal anterior thigh

347
Q

what does L2 cutaneous supply

A

middle anterior thigh

348
Q

what does L3 cutaneous supply?

A

distal anterior thigh; posterior medial leg

349
Q

what does L4 cutaneous supply?

A

distal lateral thigh; medial leg and foot; digit one

350
Q

what does L5 cutaneous supply?

A

lateral leg; digits two, three and four

351
Q

what does S1 cutaneous supply?

A

posterior lateral thigh and leg; lateral aspect of foot, digit five

352
Q

what does S2 cutaneous supply?

A

medial posterior thigh and leg

353
Q

what does S3 cutaneous supply?

A

perineum