Lower ExtremityOSTEOLOGY, LIGAMENTS, GLUTEAL MUSCULATURE

Which of the following is most likely pertaining to the two pelves depicted?

A. The left is male and the right is female

B. The right is male and the left is female

C. The left is from a younger person than the right

D. The right is from a younger person than the left

The l

eft is m

ale and the rig

ht is...

The r

ight is m

ale and th

e left is

...

The l

eft is fr

om a yo

unger p

erso...

The r

ight is fr

om a

younge

r pers.

.

95%

0%5%0%

LE Unit Overview

Superficial fascia, veins, lymph

Skeletal structures / joint surfaces

Ligamentous support

Musculature / vasculature

Nerves

Forces and injuries

Objectives

Describe the gross anatomy for each system (circulatory, muscular, nervous, and skeletal) in the lower extremity.

Integrate the systems to discuss the lower extremity stability and mobility functions.

Analyze common injuries in the lower extremities.

For each muscle, describe how the attachment sites result in an action around a joint.

For each muscle, identify the innervation (peripheral nerve and nerve roots).

LE Overview

Coxae (Pelvis)

Obturator Membrane

Anatomical Position

Sacroiliac Joint - Ligaments

Primary:

Anterior Sacroiliac

Interosseus

Short and long posterior sacroiliac

Secondary:

Sacrotuberous

Sacrospinous

Sacroiliac Joint - Motions

Anterior Tilt and Posterior Tilt

Nutation (sacral flexion) and Counternutation (sacral extension)

Stability vs. Mobility

http://www.youtube.com/watch?v=elo2_sWBXaM

Your patient has significant posterior tilt in his pelvis but when palpating, you notice his sacrum is nutated. What ligament would be most stretched?

A. Posterior Sacroiliac

B. Anterior Sacroiliac

C. Sacrospinous

D. None of these would be stretched

Posterio

r Sacro

iliac

Anterio

r Sacro

iliac

Sacro

spinous

None of these

would be s.

..

18%

8%

51%

23%

Your female patient has anterior pelvic tilt due to excessive lumbar lordosis. Which of the following is TRUE?

A. She must be in nutationB. She must be in

counternutationC. She is at risk for posterior

disc herniationD. None of these

She m

ust be in

nutation

She m

ust be in

counte

rnutati

on

She is

at risk

for p

osterio

r disc

h...

None of these

15%

69%

0%

15%

Femur:Torsion Angle

Averages:7 degrees in males12 degrees in females

Discussion question: What effect does this difference have?

Femur:Angle of Inclination

The part of the femur that is most susceptible to fracture in conjunction with osteoporosis is:

A. mid-shaft.B. medial condyle.C. along the

intertrochanteric line.D. neck.E. intercondylar area. mid-sh

aft.

medial co

ndyle.

along t

he inter

troch

ante

ric lin

e.neck

.

interco

ndylar a

rea.

0% 0% 0%

100%

0%

In the following radiograph of the hip, the arrow points to the:

A. greater trochanter.

B. lesser trochanter.

C. ischial spine.

D. femoral neck.gre

ater

troch

ante

r.

lesse

r tro

chante

r.

ischial

spine.

femoral

neck.

5% 0%0%

95%

Coxa vara refers to:

A. an abnormal decrease in the angle between the shaft of the femur and the tibia.

B. an abnormal decrease in the angle between the head and neck of the femur and its shaft (angle of inclination).

C. an abnormally short distance between the anterior superior iliac spine and the center of the acetabulum.

D. an abnormally short distance between the iliac crest and the greater trochanter.

E. an abnormally short femur. an ab

normal

decreas

e in th

e an...

an ab

normal

decreas

e in th

e ang..

an ab

normall

y short

distan

ce ...

an ab

normall

y short

distan

ce ...

an ab

normall

y short

femur.

18%

79%

0%3%0%

Hip musculature Gluteal region

Gluteus maximus

Gluteus medius

Gluteus minimus

TFL

Piriformis

Obturator internus

Gemelli

Obturator externus

Quadratus femoris

Anterior hip Iliopsoas

Pectineus

Sartorius

Rectus femoris

Bursa

Ischial

Obturator internus

Trochanteric

Gluteofemoral

The iliotibial tract is the conjoint distal aponeurotic attachment of which of the following pairs of muscles?

A. gluteus medius and minimus

B. gluteus medius and maximus

C. gluteus maximus and the tensor of the fascia lata

D. the tensor of the fascia lata and rectus femoris

E. rectus and biceps femorisglu

teus m

edius and m

inimus

glute

us medius a

nd max

imus

glute

us maxim

us and th

e tenso

r ..

the te

nsor o

f the fa

scia la

ta an

d ...

rectu

s and bice

ps femoris

0% 0% 0%0%

100%

Which of the following is incorrect pertaining to the great saphenous vein?

A. It passes posterior to the medial malleolus.

B. It passes posterior to the medial condyle of the femur.

C. It drains into the femoral vein.D. It has a nearly uniform

diameter because blood is shunted to deeper veins.

E. It traverses the saphenous opening in the fascia lata.

It pas

ses p

osterio

r to th

e med

ia...

It pas

ses p

osterio

r to th

e med

ial...

It drai

ns into

the fe

moral

vein.

It has

a nearly u

niform

diamete

r...

It tra

verses t

he sap

henous open...

92%

0% 0%3%5%

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