Quiz 2 Flashcards
Where is the femoral Pulse located?
The midpoint between the Anterior Superior Iliac Spine and the pubic tubercle.
What muscle can flex and extend the hip, But not simultaneously?
Adductor magnus
Insertion at medial lip of the linea aspera ( Hip extension)
Insertion at adductor tubercle of the femur (Hip Flexion)
If the leg moves anteriorly due to an injury in an “Anterior drawer” fasion, what is likely injured ?
The Anterior Cruciate ligament (ACL)
When do Primary and Secondary Ossification centers appear in Vertebrae?
Primary Ossification centers Develop around 9-10 Weeks gestation
Secondary Ossifcation happens during puberty
Ossification centers fuse by mid 20s
The lateral intermuscular septum connects to what landmark?
The IT Band
What angle is produced by the long axis of diaphysis that runs through knee verticallly with orientation of the femor ?
Angle of Obliquity
~10 to 15 degrees-Vertical line usually runs throuh head of femur but shaft is tilted 10- 15 degrees
What muscles cross 2 joints?
Rectus femoris and Sartorius
What Landmark is located on the intertrochanteric crest?
The Quadratic tubercle
What is immediately superior to the intercondylar fossa?
Popliteal surface
What two structures combine to make the linea aspera ?
The gluteal tuberosity and the spiral line
If the patella difts laterally, what anterior thigh muscle is likely damaged?
The Vastus Medialis
What is the strongest connection between the sacrum and the illiac?
Interosseous ligament (Part of syndesmosis)
What is the order of Secondary Ossifcation apperance of the femur?
Condyles(9th months of fetal life)
Head(1st 6 months)
Greater Trochanger (4th Year)
Lesser Trochanter (11-14 years)
A Diarthroses is an example of what kind of Synovial Joint ?
interphalnageal, knee (is composite synovial Joint)
What pass through the adductor canal ?
Saphenous Nerve *(leaves the adductor canal between sartorius and gracilis just above the knee (medial side). )
Femoral Artery and Vein
What muscle abducts and flexes the hip?
Sartorius
What Angle is formed between long axis of head/neck of femur and long axis of shaft ?
Angle of Inclination
~126 degrees , smaller in females due wider distance of acetabulum from a wider pelvis
Newborn ~180 degrees
3 years ~ 135 degrees
Decreases gradually with age
What are the two parts of the Femoral Nerve and what do they innervate?
Anterior Part(Primarily cutaneous)-Intermediate and medial femoral cutaneous nerves to the anterior thigh. Muscular branch to sartorius(often arices with intermediate femoral cutaneous)
Posterior Part(Primarily muscular)-muscular branches to anterior thigh muscles (rectus femoris, vastus medialis, vastus lateralis , vastus intermedius and articularis genu)
What are abnormal angles of inclination and what can they cause?
Coxa Vara - <120 degrees (produces stress on femoral neck)
Coxa Valga - >135 degrees( increase joint pressure)
What angle is used to diagnose Genu Varum or Genu Valgum?
Q angle (quadraciep angle)
~10 to 14 degrees (Males) ~15-17 degrees (females)
Runs from patella to ASIS and from middle of patella to tibial tuberosity.
Similar to angle of inclination. Helps determine proper alignment between thigh and leg.
What are the nerves of the lumar plexus ?
Iliohypogastric nerve: T12-L1
Ilioinguinal nerve: L1
Genitofemoral nerve: L1-L2
Lateral femoral Cutaneous nerve: L2-L3 (contains dorsal division fibers)
Femoral nerve: L2-L4 (dorsal division fibers )
Obturator Nerve: L2 -L4 (ventral division fibers)
Accessory Obturator: L3-L4 (Ventral division fibers)
What muscles attach to the pubis?
Pectinus, Graceillis , Adductor longus,Adductor brevis, Adductor Longus (Not hamstring portion of adductor magnus)
What are the 4 gateways to the lower extremity from the abdominopelvic cavity and what do they transmit?
Subinguinal Space- (femoral vessels & Nerve, lympatics,iliopsoas & pectinus)
Obturator Canal -( obturator vessels & nerve)
Greater Sciatic Foramen -( superior and inferior gluteal vessels & Nerves, sciatic nerve, pudendal nerve, internal pudenal vessesls , posterior cutaneous nerve of the thigh,nerves to the small lateral rotators of the thigh, tendon of piriformis)
Lesser sciatic foramen- ( pudenal nerve and internal pudenal vessels, tendon of obturator internus, nerve to obturator internus)
What is the order of fusion of the secondary ossification centers of the femur?
Lesser Trochanter(18 years)
Greater Trochanter (18-19 years)
Head(18-20 years)
Condyles (20-22 years)
At what point does maximum contact of the tibia and femur occur?
Extension
At what point does the inferior epiphysis of the femur ossify ?
9 Months Gestation
A midshaft femoral fracture would least likely damage what adductor muscle ?
Pectineus ,( muscles such as adductor brevis, longus and adductor magnus would be at risk)
What is the weak point called which is vulnerable for fracture in elderly persons ?
Ward’s Triangle (internal femoral triangle)
What are the 3 intracapsular structures of the hip joint?
Transverse acetabular ligament
ligament of the head of the femur
acetabular labrum(rim) (TAL is really part of labrum but with cartilage cells)
What part of the femoral head is not covered by Hyaline cartilage?
Fovea Capitis (where ligament of the head of femur is found)
What is the angle of torsion/declination?
Angle of neck and shaft to coronal plane is ~15 degrees
Clincial relevant Neck is usually a bit anterior to shaft.
Abnormal Anteversion ( medially rotate leg to compensate)
Abnormal Retroversion( angle becomes small and compensatory mechanism is to externally Rotate leg and have toes pointing outward)
What collateral ligament has an attachment with a meniscus ?
Medial Collateral ligament(Tibial Collateral ligament) attaches to the medial meniscus. The Lateral Collateral Ligament(Fibular Collateral ligament) does not attach to the lateral meniscus.
MCL prevents and is tensed in attempted abduction
LCL prevents and is tensed in attempted adduction
