32 - Gluteal Reegion + Posterior Thigh Flashcards

1
Q

What are the 3 bony ridges on the posterior aspect of ilium ?

A

superior, middle, inferior gluteal lines

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2
Q

What forms the greater and lesser sciatic foramen?

A

greater :
- greater sciatic notch
- sacrospinous ligament (inferiorly)

lesser:
- sacrospinous ligament (superiorly)
- lesser sciatic notch
- sacrotuberous ligament (inferiorly)

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3
Q

Sacrospinoud ligament
- description
- attachment
- deep/superficial?

A

Ligament formed from attachment between sacrum and ischial spine (superior to ischial tuberosity)

deep to sacrotuberous ligament

between greater and lesser sciatic foramen

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4
Q

Sacrotuberous ligament
- description
- attachment
- deep/superficial?

A

attachment between sacrum and ischial tuberosity

inferior to lesser sciatic foramen

superficial to sacrospinous ligament

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5
Q

What attaches onto the ischial spineL

A

sacropinous ligament

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6
Q

What attaches onto the ischial tuberosity?

A

sacrotuberous ligament
muscles of posterior thigh (origin) except for short head of biceps femoris (linea aspera)

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7
Q

Gluteal tuberosity
- description
- location
- muscles

A

extension of the linea aspera superiorly and laterally

just inferior trochanters - posterior femur

gluteus maximus attaches here

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8
Q

How many groups of gluteal muscles are there?
What are they?

A

2:
- superficial
- deep

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9
Q

Superficial gluteal muscles
- number
- names
- innervation

A

4:
- gluteus maximus
- gluteus medius
- gluteus minimus
- tensor fascia latae

all innervated by inferior gluteal, apart from gluteus maximus

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10
Q

How many superficial gluteal muscles are there?

A

4

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11
Q

Gluteals maximum
- location
- attachments
- movement of hip
- innervation

A

most superficial of gluteal muscles

origin - multiple sites on pelvis
- posterior aspect of posterior ilium
- sacrum
- sacrotuberous ligament

insert - some fibres onto gluteal tuberosity, some into iliotibial band

movements - extend, laterla rotation

N - inferior gluteal nerve

stabilises knee joint

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12
Q

Where does gluteal muscle originate from?

A
  • posterior aspect of posterior ilium
  • saccrum
  • sacrotuberous ligament
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13
Q

Where does gluteal muscle insert onto?

A
  • iliotibial band
  • gluteal tuberosity
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14
Q

Gluteus medius
- location
- attachment
- movement
- innervation

A
  • deep to gluteus maximus
  • origin - anterior aspect of posterior ilium
  • insert - greater trochanter

M - medially rotates and abducts hip
N - superior gluteal nerve

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15
Q

Gluteus minimus
- description
- location
- attachment
- movement of hip
- innervation

A
  • deep to gluteus medius
  • origin - anterior aspect of posterior ilium
  • insert - greater trochanter

M - medially rotates and abducts hip
N - superior gluteal nerve

(same as gluteus medius)

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16
Q

What role to gluteus medius and minimus play in normal gait?

A

contract when standing on one leg - ensures pelvis doesnt tilt towards contralateral leg
prevents limp

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17
Q

How is gait affected if gluteus medius / minimus are weak / paralysed?

A

if muscles weakened on stnading leg, pelvis will tilt towards elevated leg (contralateral leg) when walking -> limp

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18
Q

Tensor fascia latae
- description
- location
- attachments
- movement
- innervation

A

anterior + lateral to gluteus maximus
tenses the fascia lata

O - ASIS
I - iliotibial band

M - flexes hip, stabilises extended knee (not prime mover)
N - superior gluteal

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19
Q

How are the superficial gluteal muscles innervated?

A

superior gluteal nerve
- gluteus medius / minimus
- TFL

inferior gluteal
- gluteus maximus

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20
Q

Where do gluteal nerves originate from?

A

sacral plexus

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21
Q

Who’s foramina do the gluteal nerves pass in the pelvis?

A

greater sciatic

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22
Q

Iliotibial band
- description
- muscles
- insertion
- layers

A

located on lateral thigh

  • stabilises knee
  • fibres from gluteus maximus and TFL

I - lateral proximal tibia (Gerdy’s tubercle)

3 layers :
- superficial
- intermediate
- deep

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23
Q

What does the linea aspera give rise to proximally and distally?

A

proximally
- pectineal line (medial)
- gluteal tuberosity (lateral)

distally
- medial supracondylar line
- lateral supracondylar line

24
Q

What does the gluteal line arise from?

A

linea aspera

25
Deep gluteal muscles - number - names - innervation - origin - inserts - movements
5: - piriformis - gemellis superior - obturator internus - gemellis inferior - quadratus femoris O: - all - ischium - piriformis - anterior sacrum - obturator internus - obturator membrane I - onto / near greater tochanter M - laterally rotate + stabilise hip N -
26
Where do the deep gluteal muscles originate from?
piriformis - anterior sacrum obturator internus - obturator membrane rest - ischium
27
Where do the deep gluteal muscles insert onto?
onto / near greater trochanter
28
Why is piriformis a key landmark?
passes though greater sciatic foramen - sacral plaxus lies on its internal surface - sciatic nerve emerges inferior to it - gluteal arteries originate superior / inferior to it
29
Which deep gluteal muscles pass through the greater and lesser sciatic foramen?.
greater - piriformis lesser - tendon of obturator internus
30
Piriformis - attachments - pathway
O - anterior sacrum I - greater trochanter passes through greater sciatic foramen
31
Which nerve emerges from the inferior border of piriformis?
sciatic nerve
32
What does the sciatic nerve divide into?
tibial (medial) common peroneal (lateral)
33
Posterior compartment of thigh - number - names
4: - semimembranosus - semitendonosus - biceps femoris (short and long head) - adductor magnus (hamstring part)
34
Which muscles make up the hamstring group? Which joints do they span? - attachment - innervation - movement of hip, knee
- semimebranosus - semitendonosus - biceps femoris (long) span hip and knee O - ischial tuberosity I - medial tibia (long head onto fibula head) N - tibial nerve M: - flex knee - extend hip
35
Biceps femoris (long head) - attachments - innervation - movements
O - ischial tuberosity I - fibula head N - tibial nerve M - extend hip, flex knee
36
Biceps femoris (short head) - description - attachments - innervation - movements
O - linea aspera I - fibula head (forms common tendon with long head) N - common peroneal M - flex knee
37
Which muscles of the hamstring group insert onto medial tibia?
semimembranosus semitendonosus
38
Which muscles of hamstring groups insert onto head of fibula?
biceps femoris (long)
39
Adductor Magnus (hamstring) - attachments - innervation - movement - thigh compartment
O - ischial tuberosity I - adducotr tuberosity (femur) N - tibial M - extension of hip C - posterior thigh
40
Adductor Magnus (adductor) - attachments - innervation - movement - thigh compartment
O - inferior pubic ramus I - linea aspera N - obturator M - adduction of hip C - medial
41
Which artery supplies gluteal muscles? Branch of?
superior and inferior gluteal internal iliac
42
Which artery supplies posterior thigh? Branch of?
perofrating branches of profunda femoris femoral artery
43
How do perforating arteries of profunda femoris reach posterior compartment?
penetrate through gaps in adductor magnus (adducotr part)
44
Which artery supplies lower posterior thigh?
popliteal artery
45
Sciatic nerve roots?
L4 - S3
46
Sciatic nerve - roots - pathways
L4 - S3 branches off sacral plexus passes thorugh greter sciatic foramen along inferior border of piriformis
47
What does tibial nerve innervate?
posterior thigh (apart from short head of biceps femoris) posteiror leg
48
What does common peroneal need innervate?
anterior + lateral leg
49
Popliteal fossa - description - boundaries - contents
diamond shaped fossa on posterior aspect of knee Superior - medial - semimebranosus + semitendonosus - lateral - biceps femoris Inferior - gastrocnemius heads Contains: - popliteal artery - popliteal vein - tibial nerve - common peroneal nerve
50
Where and how can the popliteal artery be palpated?
in the popliteal fossa easiest when the knee is completely flexed
51
Branching from eternal iliac artery to fibular artery
external iliac -> femoral -> popliteal artery -> posterior tibial -> fibular artery
52
how does the popliteal artery divide?
popliteal artery -> anterior + posterior tibial posterior tibial -> fibular / peroneal artery
53
common peroneal nerve - pathway - brnaches - innervation
54
gluteal IM injection - muscle - where - why?
55
sciatica - description - common cause
56
popliteal anuerysm - what happens - consequences