Muscles and Innervation of the Hip Joint

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Questions and Answers

What is the primary function of the iliofemoral ligament at the hip joint?

Supports the acetabulum

Limits abduction of the thigh

Prevents posterior dislocation of femur

Limits hyperextension at hip joint (correct)

How does the labrum contribute to the stability of the hip joint?

By increasing flexibility of the joint

By enhancing the mobility of the femur

By deepening the socket of the acetabulum (correct)

By restricting blood flow to the femur

Which ligament is responsible for preventing anterior dislocation of the femur from the acetabulum?

Ischiofemoral ligament

Ligament of the head of the femur

Pubofemoral ligament

Iliofemoral ligament (correct)

What does the ischiofemoral ligament limit at the hip joint?

Hyperextension of the femur Signup and view all the answers

What is the role of the ligament of the head of the femur?

To supply blood to the head of the femur Signup and view all the answers

Which muscle does the inferior gluteal artery primarily supply?

Gluteus maximus Signup and view all the answers

Which nerve crosses over the sacrospinous ligament before entering the ischio-anal fossa?

Pudendal nerve Signup and view all the answers

Which artery exits the pelvis superior to the piriformis muscle?

Superior gluteal artery Signup and view all the answers

What area does the posterior femoral cutaneous nerve innervate?

Skin of the posterior thigh Signup and view all the answers

Which of the following correctly describes the pathway of the superior gluteal artery?

It travels between the gluteus medius and minimus. Signup and view all the answers

What is the main action of the piriformis muscle?

Lateral rotation of the thigh Signup and view all the answers

What is a common function of the superior gluteal nerve?

Innervates gluteus medius and minimus Signup and view all the answers

What is the function of the superior gluteal nerve?

Innervates the gluteus medius muscle Signup and view all the answers

Which of these motor nerves reach the gluteal region?

Nerve to the obturator internus Signup and view all the answers

Which muscles are considered rotator muscles of the hip joint?

Superior and inferior gemelli Signup and view all the answers

Where does the common fibular portion of the sciatic nerve typically pass in relation to the piriformis muscle?

Over the piriformis muscle Signup and view all the answers

Which nerve exits the pelvis above the piriformis muscle?

Superior gluteal nerve Signup and view all the answers

What contributes to the formation of the lumbosacral plexus?

The anterior ramus of L4 and L5 Signup and view all the answers

Which muscle is innervated by the inferior gluteal nerve?

Gluteus maximus Signup and view all the answers

Which of the following spinal segments predominantly contribute to the sciatic nerve?

L4, L5, S1, S2, S3 Signup and view all the answers

What is the primary role of the obturator externus muscle?

Lateral rotation of the hip Signup and view all the answers

What is the primary function of the sacroiliac joints?

To transmit body weight from the spine to the lower limbs Signup and view all the answers

Which structure forms the concave surface of the hip joint?

Acetabulum Signup and view all the answers

What composite structure is referred to as the 'bony pelvis'?

Os coxae and sacrum Signup and view all the answers

What is transmitted through the hip joints?

Body weight above the hip joints Signup and view all the answers

Which part of the pelvic bone is not mentioned as forming the junction of the three parts of the pelvic bone?

Sacrum Signup and view all the answers

Where does the largest area of bone for muscle attachment occur within the pelvic girdle?

At the os coxae Signup and view all the answers

What anatomical term refers to the combination of the head, arms, and trunk in relation to weight transmission?

HAT Signup and view all the answers

What is the significance of the anterior inferior iliac spine?

It offers an attachment for ligaments and muscles Signup and view all the answers

Which muscle groups are primarily associated with the lower limb?

Intrinsic foot muscles and Triceps surae Signup and view all the answers

The popliteal region primarily refers to which part of the body?

Back of the knee Signup and view all the answers

What is the primary function of the gluteus maximus muscle?

Extension and lateral rotation of the thigh at the hip joint Signup and view all the answers

Which structure is a thickening of the fascia lata on the lateral aspect of the thigh?

Iliotibial tract Signup and view all the answers

What is the main role of the superior gluteal nerve?

Innervates the gluteus minimus and medius muscles Signup and view all the answers

Where does the iliotibial tract attach?

To the lateral tibia Signup and view all the answers

What are the clunial nerves collectively named?

Superior, middle, and inferior clunial nerves Signup and view all the answers

What nerve primarily innervates the gluteus maximus muscle?

Inferior gluteal nerve Signup and view all the answers

Which muscles are the primary abductors of the thigh?

Gluteus medius and gluteus minimus Signup and view all the answers

Which bursa lies over the greater trochanter?

Trochanteric bursa Signup and view all the answers

Which muscle is primarily responsible for flexing the hip joint?

Iliopsoas Signup and view all the answers

What action is associated with the gluteus maximus under normal circumstances?

Hip extension Signup and view all the answers

Which nerve innervates the gluteus maximus muscle?

Inferior gluteal nerve Signup and view all the answers

Which bony landmark is located in the gluteal region and serves as an attachment point for muscles?

Greater trochanter Signup and view all the answers

Which of the following actions is primarily limited by the ischiofemoral ligament?

Hip extension Signup and view all the answers

What type of joint is the hip joint classified as?

Ball-and-socket joint Signup and view all the answers

Which artery primarily supplies the gluteus maximus muscle?

Inferior gluteal artery Signup and view all the answers

Which structure is essential in providing stability to the hip joint?

Acetabular labrum Signup and view all the answers

Which nerve is responsible for providing sensory innervation to the skin over the gluteal region?

Posterior femoral cutaneous nerve Signup and view all the answers

What is the function of the posterior femoral cutaneous nerve?

Innervation of the skin over the posterior thigh Signup and view all the answers

Which nerve exits the pelvis through the greater sciatic foramen and crosses over the sacrospinous ligament?

Pudendal nerve Signup and view all the answers

The superior gluteal artery exits the pelvis superior to which muscle?

Piriformis Signup and view all the answers

Which spinal segments contribute to the pudendal nerve?

S2-S4 Signup and view all the answers

Which of the following properly describes the pathway of the inferior gluteal artery?

Exits pelvis below the piriformis muscle Signup and view all the answers

Which muscles are primarily supplied by the superior gluteal artery?

Gluteus medius and minimus Signup and view all the answers

What area is innervated by the anterior rami of S1 and S2?

Gluteal region muscles Signup and view all the answers

What is the primary action of the gluteus medius and minimus when the foot is off the ground?

Hip abduction Signup and view all the answers

What happens to the pelvic girdle if the hip abductors of the stance limb are weak?

Pelvis drops to the opposite side Signup and view all the answers

What is the primary artery supplying blood to the head of the femur in adults?

Medial circumflex femoral artery Signup and view all the answers

In a traumatic scenario, what is the primary purpose of using an A-P pelvis view?

To identify potential pelvic injuries Signup and view all the answers

What is the secondary action of the gluteus medius and minimus at the hip joint?

Medial rotation of the femur Signup and view all the answers

Which muscle originates at the anterior iliac crest and inserts into the iliotibial tract?

Tensor fasciae latae Signup and view all the answers

Which of the following best describes the movement of the hip joint in an open-chain scenario?

Leg is moving while the foot is off the ground Signup and view all the answers

Which type of femoral fracture involves the neck of the femur without displacement?

Non-displaced femoral neck fracture Signup and view all the answers

What is the functional significance of the Trendelenberg gait?

It suggests weakness in the hip abductors Signup and view all the answers

The penetration of arteries into the hip joint capsule occurs at which specific part of the femur?

Lower neck of femur Signup and view all the answers

Which of the following movements at the hip joint is NOT a type of rotation?

Circumduction Signup and view all the answers

What type of surgery is performed for severe hip joint arthritis to replace the joint?

Total Hip Arthroplasty (THA) Signup and view all the answers

Which structure is considered a palpable bony landmark in the gluteal region?

Greater trochanter Signup and view all the answers

What structure primarily transfers weight from the spine to the lower limbs?

Os coxae Signup and view all the answers

Which part of the pelvic bone does not contribute to the acetabulum?

Coccyx Signup and view all the answers

Which structure is specifically referred to as the 'bony pelvis'?

Os coxae and sacrum Signup and view all the answers

What is the role of the sacroiliac joints in relation to body weight?

Transmit weight from the spine to the pelvis Signup and view all the answers

Which of the following structures does NOT form the junction of the three parts of the pelvic bone?

Sacrum Signup and view all the answers

Which term describes the area of bone that allows for large muscle attachments in the pelvic region?

Large area of bone for attachments Signup and view all the answers

Which anatomical term refers to the combination of head, arms, and trunk as related to weight transmission?

HAT Signup and view all the answers

What anatomical feature forms the concave surface of the hip joint?

Acetabulum Signup and view all the answers

Which structure or region does NOT belong to the proximal femur anatomy?

Patella Signup and view all the answers

What is indicated by the term 'trokhos' in Greek as it relates to the hip joint?

Wheel or spherical shape Signup and view all the answers

Study Notes

Obturator Externus

Positioned around the obturator foramen; connected to greater trochanter.
Involved in hip joint rotation.

Rotator Muscles of the Hip Joint

Include superior and inferior gemelli alongside the obturator internus.
Functionally assist in the lateral rotation of the hip.

Lumbosacral Plexus

Comprises L4, L5, S1, S2, and S3, formed by anterior ramus contributions from L4 and L5.
Connects lumbosacral trunk to sacral plexus to provide sensory and motor functions.

Nerve Innervation

Superior Gluteal Nerve: Exits pelvis above the piriformis muscle; innervates gluteus medius, gluteus minimus, and tensor fasciae latae.
Inferior Gluteal Nerve: Exits pelvis inferior to the piriformis; innervates gluteus maximus.
Sciatic Nerve: Contains tibial and common fibular nerves; exits pelvis below piriformis muscle—variations in pathway exist.

Safe Zone for IM Injections

The gluteal region has designated safe zones for intramuscular injection to avoid nerve damage.

Other Motor Nerves in the Gluteal Region

Include branches like the nerve to obturator internus and nerve to quadratus femoris, innervating their respective muscles.

Posterior Femoral Cutaneous Nerve

Supplies sensory innervation to the inferior buttock and posterior thigh.

Pudendal Nerve

Originates from S2 to S4, exits pelvis via the greater sciatic foramen, and enters the ischio-anal fossa.

Gluteal Region Dermatomes

Differentiated maps help locate sensory innervation areas corresponding to gluteal muscle anatomy.

Blood Supply of the Lower Limb

Arises from the abdominal aorta, branching into common iliac, external iliac, and femoral arteries, including specific gluteal arteries for muscle supply.

Superior and Inferior Gluteal Arteries

Superior gluteal artery exits above piriformis; supplies gluteus medius and minimus.
Inferior gluteal artery exits below piriformis; supplies gluteus maximus.

Pelvic Bone and Girdle

Os coxae transfers body weight from the spine to the lower limbs, aiding large muscle attachments.

Hip Joint Structure

Comprises a deep socket formed by acetabulum and is supported by a capsule with ligaments preventing dislocation and hyperextension.

Acetabulum and Joint Stability

The labrum increases hip joint stability, while various ligaments provide joint strength and inhibit excessive movement.

Fascia Lata and Iliotibial Tract

The fascia lata encloses gluteal muscles; the iliotibial band, a thickening of this fascia, connects to the lateral tibia.

Gluteus Maximus

Attaches to ilium, sacrum, coccyx, and sacrotuberous ligament; primarily functions in thigh extension and lateral rotation.

Bursae in the Gluteal Region

The trochanteric bursa lies over the greater trochanter; bursitis in this area can lead to pain.

Gluteus Medius and Minimus

Gluteus medius extends from the lateral ilium to the greater trochanter, while the gluteus minimus lies deeper and has similar attachment points.

Intramuscular Injection in the Gluteal Region

Recommended safe zone for intramuscular (IM) injections in the gluteal area to avoid nerve damage.

Motor Nerves of the Gluteal Region

Innervation from anterior rami of S1 and S2 through the piriformis muscle.
Obturator internus muscle innervated by the nerve to obturator internus (L5, S1).
Quadratus femoris muscle supplied by the nerve to quadratus femoris (L5, S1).

Posterior Femoral Cutaneous Nerve

Arises from S1-3 roots, providing sensory innervation to the skin over the inferior buttock and posterior thigh.

Pudendal Nerve Anatomy

Exits the pelvis via the greater sciatic foramen, crossing the sacrospinous ligament.
Enters the ischio-anal fossa through the lesser sciatic foramen, accompanying internal pudendal artery and vein.

Gluteal Region Dermatomes

Clinical maps highlight specific dermatomes related to gluteal region sensitivity.

Blood Supply to the Lower Limb

Major vessels include:
- Abdominal aorta
- Common iliac artery
- External iliac artery
- Femoral artery with branches like profunda femoris, and internal iliac artery.

Gluteal Muscles Blood Supply

Superior gluteal artery exits pelvis above the piriformis, supplying gluteus medius and minimus.
Inferior gluteal artery supplies gluteus maximus and exits below the piriformis.

Learning Objectives

Identify bony landmarks in the gluteal region.
Describe muscles of the gluteal region, along with their nerves, attachments, and functions.
Understand the course of named nerves and blood vessels in the gluteal region.
Analyze hip joint anatomy, including soft tissue structures.
Assess impact of hip injuries on lower limb function.
Recognize anatomical structures in hip radiographs.

Gait Cycle Dynamics

Key contributors to lower limb function during the gait cycle include iliopsoas, gluteus maximus, quadriceps, and hamstrings.

Structure of the Pelvic Girdle

Comprises the os coxae, facilitating weight transfer from the spine to the lower limbs.
The bony pelvis provides a large area for muscle attachments, enhancing mobility.

Hip Joint Anatomy

Acetabulum forms the concave hip joint surface, with the femoral head fitting snugly for stability.
The medial circumflex femoral artery primarily supplies blood to the femoral head in adults.

Proximal Femur Fractures

Types include displaced femoral neck and intertrochanteric fractures.
Advances in fixation techniques for both types of fractures reveal a shift in clinical approaches.

Hip Joint Motion

Involves various movements including medial/lateral rotation and circumduction.
Crucial for assessing functional mobility in clinical settings.

Gluteus Medius and Minimus

Provide primary hip abduction and stabilize the pelvis during unilateral weight-bearing.

Trendelenburg Sign and Gait

Weak hip abductors contribute to a Trendelenburg gait pattern, characterized by pelvis dropping on the opposite side while walking, demonstrating functional deficits.

Tensor Fasciae Latae

Originates from the anterior iliac crest and inserts into the iliotibial tract.
Innervated by the superior gluteal nerve, it plays a role in stabilizing the hip during movement.

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Description

This quiz covers the anatomy and function of the hip joint, focusing on the obturator externus, rotator muscles, and their nerve innervations. Additionally, it highlights safe zones for intramuscular injections in the gluteal region. Test your knowledge on the lumbosacral plexus and its components.