Human Anatomy: Pelvis and Perineum

Questions and Answers

Which of the following lymph nodes are situated medial to the femoral vein?

Superficial inguinal lymph nodes

Deep inguinal lymph nodes (correct)

Popliteal nodes

Cloquet's node

Which of the following structures forms the roof of the obturator canal?

Inguinal ligament

Sacrotuberous ligament

Obturator membrane (correct)

Sacrospinous ligament

Which of the following vessels and nerves pass under the inguinal ligament?

Femoral neurovascular bundle (correct)

Sciatic nerve

Obturator neurovascular bundle

Tibial nerve

What is the shape of the arrangement of the superficial inguinal lymph nodes?

T-shaped Signup and view all the answers

Which of the following lymph nodes receives lymph from the lower back and gluteal region?

Lateral part of the horizontal limb of the T Signup and view all the answers

Which of the following foraminae is formed by the presence of the sacrospinous and sacrotuberous ligaments?

Greater sciatic foramen Signup and view all the answers

Which of the following structures anchors the sacrum?

Sacrotuberous ligament Signup and view all the answers

Where do the lymphatics from the superficial inguinal lymph nodes pass to?

Deep inguinal lymph nodes Signup and view all the answers

Which of the following bony landmarks is located at the superior end of the ilium?

Iliac crest Signup and view all the answers

What is the name of the joint formed by the articulation of the ilium and the sacrum?

Sacroiliac joint Signup and view all the answers

Which of the following iliac spines is located at the most anterior point of the ilium?

Anterior superior iliac spine Signup and view all the answers

What is the name of the ridge that forms the inferior border of the ilium?

Arcuate line Signup and view all the answers

Which of the following bones fuses with the pubis to form the ischiopubic ramus?

Ischium Signup and view all the answers

What is the approximate angle of deviation from the vertical axis of the femur?

3 degrees Signup and view all the answers

What is the name of the bony landmark located on the pubis?

Pubic tubercle Signup and view all the answers

What is the primary function of the angle of anteversion?

To keep the shaft of the femur aligned with the centre of gravity Signup and view all the answers

Which of the following statements is true about the iliac tuberosity?

It is a roughened area for ligament attachment Signup and view all the answers

What is the consequence of an excessive angle of anteversion?

Shift of the centre of gravity anterior to the joint Signup and view all the answers

What is the name of the surface on the ilium that articulates with the sacrum?

Auricular surface Signup and view all the answers

What is the resulting gait pattern in individuals with an excessive angle of anteversion?

Toe-in gait Signup and view all the answers

Around which axis does the rotation of the femur occur?

Mechanical axis Signup and view all the answers

What is the name of the Latin term that means 'a bending aside' or 'an avoiding'?

Declination Signup and view all the answers

How can an excessive angle of anteversion be easily identified?

By observing the patient's gait pattern Signup and view all the answers

What is the consequence of lateral rotation compromise in individuals with an excessive angle of anteversion?

Decreased room behind the hip Signup and view all the answers

What is the primary reason why the medial rotators cannot provide a counter-pull in hip fractures?

Shortening of the limb Signup and view all the answers

Which type of hip fracture has a poorer healing outcome?

Transcervical fracture Signup and view all the answers

In which age group is osteoporosis twice as likely to occur in females compared to males?

Females over 75 Signup and view all the answers

What is the primary reason why the angle of inclination is a factor in hip fractures?

It increases the stress on the femoral neck Signup and view all the answers

What is the most common cause of hip fractures in the elderly?

Falls Signup and view all the answers

What is the term for the interruption of the blood supply to the head of the femur?

Avascular necrosis Signup and view all the answers

Why is avascular necrosis a clinical emergency?

The head of the femur will die within 6 hours Signup and view all the answers

What increases the rate of bone loss in post-menopausal women?

Loss of oestrogen Signup and view all the answers

What is the typical age range for the condition that tends to have a progressive onset and gradually becomes more pronounced over time?

Between 10 and 16 years old Signup and view all the answers

What is the primary goal of treatment for the condition that occurs in young children?

To relieve the stress on the femoral head by applying traction to the joint Signup and view all the answers

What is the approximate number of hip replacement operations performed every year worldwide?

800,000 Signup and view all the answers

What is the typical age range for osteoarthritis of the hip?

Above 60 years old Signup and view all the answers

What is the primary consequence of osteoarthritis of the hip?

Destruction of the articular cartilage with resultant loss of the joint-space Signup and view all the answers

What is the term for the bony spurs that develop around the margins of the joint in osteoarthritis of the hip?

Osteophytes Signup and view all the answers

What is a significant risk factor for osteoarthritis of the hip?

Obesity Signup and view all the answers

What is the final condition that is likely to cause pain around the hip?

Hip bursitis Signup and view all the answers

Study Notes

Ilium

The ilium has a crest superiorly, known as the iliac crest, which has a bump called the iliac tubercle.
The iliac crest and tubercle are readily palpable.
The ilium has a ridge at the bottom called the arcuate line, which is part of the pelvic inlet.
The ilium articulates with the sacrum behind, forming the sacroiliac joint.
The articular surface is known as the auricular surface, resembling the external ear or auricle.
Above the auricular surface is a roughened area for ligaments to attach, supporting the sacroiliac joint.

Pubis

The pubis has two rami, superior and inferior, which run from the body of the pubis.
The inferior ramus fuses with a ramus from the ischium to form an ischiopubic ramus.
The pubis has a pubic tubercle and a pubic crest.

Lymph Nodes

There are few deep lymph nodes in the lower limb, with a small cluster behind the knee joint (popliteal nodes).
There are also deep inguinal lymph nodes at the top of the thigh, medial to the femoral vein.
One of these nodes is commonly found in the femoral canal, known as Cloquet's node.
Superficial nodes are restricted to the superficial inguinal lymph nodes around the saphenous opening.
These nodes are arranged in a "T" shape, with the horizontal limb receiving lymph from the lower back and gluteal region, and the medial part receiving lymph from the superficial fascia of the anterior abdominal wall and external genitalia.

Pelvic Foraminae

The vessels and nerves of the lower limb originate inside the abdomino-pelvic cavity and need to pass out of this space to reach their destination.
There are three routes out of the pelvis: under the inguinal ligament, through the obturator canal, and through the greater and lesser sciatic foramina.
The femoral neurovascular bundle passes under the inguinal ligament to gain access to the anterior thigh.
The obturator neurovascular bundle escapes through the obturator canal to reach the medial compartment of the thigh.
The posterior route is through the greater sciatic foramen, leading to the gluteal region and posterior compartments of the thigh and leg.

Femur

The femur rotates about the mechanical axis, whose center runs through the head of the femur.
The normal angle of anteversion is around 12-15 degrees, which helps to keep the shaft of the femur in alignment with the center of gravity.
Excessive angulation of the femur can put strain on the hip muscles and lead to a toe-in gait.
The axes of the femur are important for understanding hip fractures and osteoarthritis.

Hip Fracture

The location of the hip fracture has a bearing on its chances of a successful outcome.
Intertrochanteric or subtrochanteric fractures are extracapsular and have a better healing outcome.
Fractures on the neck (transcervical) or just below the head (subcapital) are likely to cause interruption of the joint and have a poorer prognosis.

Blood Supply of the Hip Joint

One major complication of any displacement of the femoral head is "avascular necrosis," where the blood supply to the head of the femur is interrupted.
A hip dislocation is a clinical emergency, and the head of the femur will die within 6 hours if denied a blood supply.

Osteoarthritis of the Hip

Osteoarthritis of the hip occurs in epidemic proportions worldwide, with approximately 800,000 hip replacement operations performed every year.
Most operations are done in patients over the age of 60, and females outnumber males by a ratio of 3:1.
It is a relatively rare condition in individuals below the age of 40, but can affect young joints if there has been previous trauma to the joint.
Risk factors include obesity and previous trauma to the joint.

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Description

Revision quiz on the bones of the pelvis and perineum, covering the ilium, psis, asis, aiis, and iliac tuberosity.