Week 5 Anatomy

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Questions and Answers

Which bone is NOT a part of the innominate (pelvic bone)?

Sacrum (correct)

Ilium

Ischium

Pubis

What passes through the greater sciatic notch?

Femoral artery

Tibial nerve

Sciatic nerve (correct)

Obturator nerve

Which landmark is found on the ilium?

Iliac Crest (correct)

Obturator Foramen

Ischial Tuberosity

Pubic Tubercle

What is the role of the tri-radiate cartilage?

Forms a joint between the three pelvic bones Signup and view all the answers

Which structure is located on the sacrum?

Auricular Surface Signup and view all the answers

Which bony landmark represents the outlet of the pelvic cavity?

Pelvic outlet Signup and view all the answers

Which of the following structures is NOT associated with the pubis?

Sacral Hiatus Signup and view all the answers

Which landmark is located at the anterior aspect of the innominate bone?

Anterior Superior Iliac Spine Signup and view all the answers

Which artery is a branch of the obturator artery and contributes to the supply of the hip joint?

Ligamentum fovea capitis Signup and view all the answers

Which nerve is responsible for innervating the hip joint?

Femoral Nerve Signup and view all the answers

What role does the gluteus maximus muscle play in hip movement?

Extension of the hip Signup and view all the answers

What is the iliotibial (IT) tract a thickening of?

Deep fascia (Fascia Lata) Signup and view all the answers

Which of the following structures helps provide lateral stability for the pelvis?

Gluteus medius Signup and view all the answers

What does a weakness in the gluteus medius and minimus muscles potentially cause?

Trendelenburg gait Signup and view all the answers

Which of the following nerves is NOT involved in innervating the hip joint?

Ulnar Nerve Signup and view all the answers

What is the primary function of deep gluteal muscles?

Lateral rotation of the hip Signup and view all the answers

What structures compose the anterior boundary of the true pelvis?

Body, rami, and symphysis of pubis Signup and view all the answers

Which of the following distinguishes the false pelvis from the true pelvis?

Location superior to the inlet/brim Signup and view all the answers

What is the shape of the lunate surface of the acetabulum?

Horseshoe Signup and view all the answers

Which structure increases contact of the femoral head within the acetabulum by deepening the acetabular socket?

Acetabular labrum Signup and view all the answers

What does the transverse acetabular ligament do?

Bridges the acetabular notch Signup and view all the answers

How does the female pelvis differ from the male pelvis?

Wider superior aperature Signup and view all the answers

Which of the following describes the head of the femur?

Spherical and covered in hyaline cartilage Signup and view all the answers

What is a true statement about the pelvic diaphragm?

It contains the pelvic organs. Signup and view all the answers

What is often the main cause of avascular necrosis of the femoral head?

Torn retinacula Signup and view all the answers

Which condition is characterized by a dislocated femoral head resulting from trauma, often leading to sciatic nerve damage?

Fracture dislocation of the hip Signup and view all the answers

What can commonly result from femoroacetabular impingement?

Osteoarthritis and labral tears Signup and view all the answers

What is a common presentation of congenital dislocation of the hip?

Shorter limb and limited abduction Signup and view all the answers

What gait deviation may occur due to weakness of the gluteus medius?

Trendelenburg gait Signup and view all the answers

Which of the following is a common site of bursa inflammation in the hip region?

Trochanteric bursa Signup and view all the answers

Which vessels and nerves enter the gluteal region above the piriformis muscle?

Superior gluteal vessels and nerve Signup and view all the answers

What condition causes pain radiating down the posterior thigh from the inferior gluteal area?

Sciatica Signup and view all the answers

Which of the following muscles is responsible for stabilizing the pelvis during single leg standing?

Tensor fascia lata Signup and view all the answers

Which muscle group is implicated in causing 'hip drop' during gait?

Gluteus medius/minimus Signup and view all the answers

What is the primary action of the gluteus maximus muscle?

Extension of the thigh Signup and view all the answers

The tensor fascia lata muscle inserts into which anatomical structure?

IT band Signup and view all the answers

Which muscle is located deep to other gluteal muscles and inserts at the trochanteric fossa?

Obturator internus Signup and view all the answers

Which nerve innervates the gluteus minimus muscle?

Superior gluteal nerve Signup and view all the answers

What is the origin of the piriformis muscle?

Anterior surface of sacrum Signup and view all the answers

The external rotators of the hip joint generally originate from which region?

Obturator foramen Signup and view all the answers

The gluteus medius muscle primarily performs which action?

Abduction of the thigh Signup and view all the answers

Which of the following muscles inserts at the greater trochanter of the femur?

Piriformis Signup and view all the answers

What is the primary action of the quadratus femoris muscle?

Laterally rotates the thigh Signup and view all the answers

The nerve to obturator internus provides innervation to which muscles?

Obturator internus and superior gemellus Signup and view all the answers

Which muscle assists in rising from a sitting position?

Gluteus maximus Signup and view all the answers

Study Notes

Pelvis

Pelvic bone (Inominate) comprised of ilium, ischium, and pubis
Tri-radiate cartilage is the area where the 3 bones meet, forming the acetabulum
Acetabulum is the socket where the femoral hip head sits
Pelvic cavity boundaries include the superior and inferior aperature
- Superior aperture (pelvic inlet/pelvic brim) formed by the ala and promontory of the sacrum, arcuate line, and pectin pubis
- Inferior aperture (pelvic outlet) formed by the pubic arch, ischial tuberosities, inferior margin of the sacrotuberous ligament, and tip of the coccyx
The false pelvis is superior to the pelvic brim, while the true pelvis is inferior to the brim
Pelvic sexual dimorphism -- female pelvis is wider, with more rounded superior aperature (pelvic brim), wider inferior aperture, and a shallower false pelvis

Hip Joint

Synovial ball-and-socket joint
Joint surfaces
- Acetabulum
  - Concave surface formed by ilium, ischium, and pubis.
  - Lunate surface is the horseshoe-shaped articular surface, covered in hyaline cartilage.
  - Acetabular labrum is fibrocartilage that deepens the socket, increasing contact by 10%.
  - Acetabular notch is a gap in the lunate surface bridged by the transverse acetabular ligament
- Head of femur is spherical with hyaline cartilage
Ligaments
- Ligamentum fovea capitis originates from the obturator artery off the internal iliac
- Transverse acetabular ligament
Blood Supply
- Medial and lateral circumflex femoral arteries
  - Originate from the profunda femoral artery
  - Deep to the synovium, provide retinacular arteries which are branches of the deep femoral
- Ligamentum fovea capitis blood supply is from the obturator artery off the internal iliac
- Inferior gluteal artery and a deep branch of the superior gluteal artery -- originate from the internal iliac
Innervation
- Any nerve that crosses a joint innervates that joint
- Femoral nerve
- Anterior division of the obturator nerve
- Superior gluteal nerve
- Nerve to quadratus femoris/obturator internus

Fascia of the Gluteal Region

Superficial fascia
- Fat storage in the hypodermis
Deep fascia (fascia lata)
- Attached to the iliac crest, dorsal sacrum, sacrotuberous ligament, inferior ramus, body, and superior ramus of the pubic bone
- Thickening of the fascia lata along the lateral thigh is the iliotibial tract (IT band)
- Gluteus maximus and tensor fascia lata insert into the IT band for stability.
- The fascia lata blends with the crural fascia of the leg inferiorly.

Gluteal Muscles

Superficial Muscles

Gluteus maximus, medius, and minimus, and tensor fascia lata
Action
- Gluteus maximus extends the hip.
- Gluteus medius and minimus stabilize the pelvis during single limb stance.
- Trendelenburg gait results from weakness of the gluteus medius and minimus.
- Weakness in hip abductors affects the frontal plane forces at the knee.

Deep Muscles

Role: Stabilize the hip joint and laterally rotate the hip.
Piriformis -- midpoint of the PSIS to the coccyx extending to the greater trochanter.
Blood supply
- Superior gluteal vessels and nerve pass through superior to piriformis.
- Other vessels and nerves pass through inferior to piriformis
Muscles: (Order from medial to lateral)
- Piriformis - Superior gemellus - Obturator internus - Inferior gemellus - Quadratus femoris
Remember PGOGOQ to remember order from superior to inferior.
Obturator externus tendon inserts deep to other muscles in the trochanteric fossa.

Clinical Considerations

Hip joint range of motion is limited due to capsular tightness.
Hip replacement due to osteoarthritis.
Femoral head avascular necrosis
- Retinacula tears can compromise the blood supply to the head of the femur, leaving it reliant on the obturator artery through the ligamentum capitis.
- Since this is inadequate, the femoral head undergoes avascular necrosis
Congenital dislocation of the hip.
- The articular joint capsule is loose and the hip head is hypoplastic.
- Recognition includes shorter limb and limited ability to abduct.
Fracture dislocation of the hip.
- Often caused by car accidents.
- The femoral head is dislocated posteriorly, fracturing the posterior acetabular rim.
- Results in sciatic nerve damage.
Femoroacetabular impingement
- Abnormally shaped acetabulum or femoral neck.
- Causes pinching within the hip joint.
- Leads to bone spurs in joint, and can cause osteoarthritis or labral tears.
- Presents with groin pain aggravated by squatting and rotation at the hip.
Bursitis.
- Inflammation of the bursa, most common in trochanteric and gluteal femoral
Gluteus medius/minimus weakness or paralysis.
- Caused by nerve injury or disuse.
- Hip drop and Trendelenburg gait, depending on severity.
Sciatica.
- Pain in the distribution of the sciatic nerve, radiating from the inferior gluteal area to the posterior thigh.
- Caused by muscle compression of the sciatic nerve.
- Piriformis syndrome may be the culprit.
Positive "adverse mechanical tension" -- may indicate a problem with lumbar spine, hip, or pelvis.

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Description

This quiz covers the anatomy of the pelvis and hip joint, including the structure of the pelvic bones such as ilium, ischium, and pubis. It also explores the acetabulum and the distinctions between the false and true pelvis, as well as pelvic sexual dimorphism. Test your understanding of these crucial components of human skeletal anatomy.