Anatomy: Gluteal and Posterior Thigh

Question 1

Hip Bone major parts

Answer 1

Ilium (top)
Ischium (back)
Pubis

Acetabulum - socket for femoral head

Question 2

Extends from sacrum/coccyx to ischial tuberosity

Answer 2

sacrotuberous ligament

Question 3

extends from sacrum/coccyx to ischial spine

Answer 3

sacrospinous ligament

Question 4

Two ligaments convert greater and lesser sciatic notches into greater and lesser sciatic foramina
Other purpose?

Answer 4

Sacrotuberous and Sacrospinous ligaments

• also prevent outward thrust of sacrum

Question 5

Greater sciatic foramen

Answer 5

passageway for structures entering or leaving pelvis

Question 6

Lesser sciatic foramen

Answer 6

passageway for structures entering or leaving the perineum

Question 7

Gluteus Maximus

Answer 7

N: Inferior Gluteal Nerve

Forcefully extends and laterally rotates thigh at hip joint, extends leg at knee joint through IT band

Question 8

Superficial Gluteal Muscles

Answer 8

Gluteus Maximus, Medius, Minimus

Tensor Fasciae Latae

Question 9

Gluteus Medius and Minimus

Answer 9

N: Superior Gluteal Nerve

Abduct thigh at hip joint and steady pelvis, medial rotators

Question 10

Tensor Fasciae Latae

Answer 10

N: Superior Gluteal Nerve
Action: Assists gluteus maximus in extending knee joint
Embedded in tensor fascia - inserts into IT band

Question 11

Lateral Rotators of thigh at hip joint

Answer 11

Piriformis
Obturator internus
Gemellus Superior and Inferior
Quadratus femoris

Question 12

Intragluteal injections

Answer 12

Upper outer quadrant - avoid sciatic nerve and gluteal nerves

Question 13

The inferior gluteal artery is a branch of the __________

Answer 13

The inferior gluteal artery is a branch of the internal iliac artery in the pelvis.

Question 14

Gluteal gait or lurch

Answer 14

Paralysis of G. Maximus due to damage/lesion to inferior gluteal nerve (L5-S2)

Limited hip extension on affected side during mid-stance, compensated for by
hyperextension of trunk.

Question 15

The deep fascia of the thigh, the ______, is a tough fascia which forms a sleeve around the muscles of the thigh. Laterally, it splits to enclose the belly of the muscle, __________. This muscle pulls on the thickened portion of the fascia lata overlying the vastus lateralis called the ________

Answer 15

The deep fascia of the thigh, the fascia lata, is a tough fascia which forms a sleeve around the muscles of the thigh. Laterally, it splits to enclose the belly of the muscle, tensor fasciae latae. This muscle pulls on the thickened portion of the fascia lata overlying the vastus lateralis called the ILIOTIBIAL TRACT (IT Band)

Question 16

Iliotibial band syndrome (ITBS) is the result of ________ This is an overuse injury with symptoms that include inflammation and irritation of the iliotibial band. The pain is typically felt on the ___________ , and is often more intense when descending stairs, or getting up from a seated position.

Answer 16

Iliotibial band syndrome (ITBS) is the result of irritation of the distal portion of the iliotibial tendon as it rubs against the lateral femoral condyle, or less commonly, proximally, the greater trochanter. This is an overuse injury with symptoms that include inflammation and irritation of the iliotibial band. The pain is typically felt on the lateral aspect of the knee or lower thigh, and is often more intense when descending stairs, or getting up from a seated position.

Question 17

Weaver’s Bottom (Ischial bursitis)

Answer 17

cycling, rowing and other activities that require repetitive hip extension while seated may overwhelm the bursa’s ability to dissipate applied stress.

Question 18

Trochanteric bursitis

Answer 18

deep gluteal pain felt over the trochanteric bursa, usually due to repetitive action like climbing stairs or running on a steeply elevated treadmill or hills. The gluteus maximus rubs over the greater trochanter causing this friction bursitis.

Question 19

Superior gluteal nerve innervates _________ (3)
The superior gluteal artery is a branch of the ____________
This neurovascular bundle runs between the ________

Answer 19

Superior gluteal nerve innervates G. medius and G. minimus and Tensor Fasciae Latae
The superior gluteal artery is a branch of the internal iIliac artery in the pelvis.
This neurovascular bundle runs between the medius and minimus.

Question 20

Gluteus gait or limp (Trendelenburg’s sign)

Answer 20

is due to paralyzed gluteus medius and minimus muscles as a result of injury to the superior gluteal nerve; the normal steadying effect of these muscles is lost so when the foot is raised on the normal side, the pelvis falls on that side. A congenital dislocation of the hip or nonunion of a fracture of the femoral neck can also produce this limp. The supporting mechanism fails and the pelvis sinks when an attempt is made to stand on the affected limb

Question 21

A lateral rotator, originates on the pelvic surface of the sacrum, the sacrotuberous ligament and the ilium below the PIIS. It leaves the pelvis through the greater sciatic foramen and inserts on the upper border of the greater trochanter.

Answer 21

piriformis muscle

Question 22

Sciatica

Answer 22

a neuritis (inflammation of the nerve) of the sciatic nerve characterized by intense pain at the back of the leg and/or thigh; can also be caused by pressure on a root of the nerve, e.g., from a herniated disc

Question 23

Piriformis syndrome

Answer 23

individuals involved in sports (ice skaters, cyclists, rock climbers) and women are more likely to develop this syndrome. In 50% of cases, trauma in the buttock is associated with hypertrophy and spasm of the piriformis which compresses the sciatic nerve.

Question 24

Pudendal nerve

Answer 24

The pudendal nerve (S2,3,4) innervates the structures in the perineum. It is the most medial structure crossing the sacrospinous ligament, possibly under cover of the sacrotuberous ligament.

Question 25

Posterior dislocation of hip can injure ___

Answer 25

sciatic nerve

Question 26

Anterior compartment thigh

Answer 26

Hip flexors
Knee extensors

Femoral nerve

Question 27

Medial compartment thigh

Answer 27

Thigh adductors, medial rotators

Obturator nerve

Question 28

Posterior compartment thigh

Answer 28

Hip extensors, knee flexors

Tibial and fibular nerves

Question 29

Posterior thigh muscles

Answer 29

Hamstrings –>
biceps femoris
semitendinosus
semimembranosis

Question 30

biceps femoris

Answer 30

Long head - tibial portion of sciatic nerve

Short head - common fibular portion of sciatic nerve

Question 31

Semitendonosus

Answer 31

tibial portion of sciatic nerve

Question 32

Semimembranosus

Answer 32

tibial portion of sciatic nerve

Question 33

Hamstring injuries

Answer 33

are common in individuals who run and kick hard (baseball, basketball, football and soccer). Parts of the proximal attachment to the ischial tuberosity may tear (avulsion). Hamstring injuries are twice as common as quadriceps strains.

Question 34

Charley horse

Answer 34

contusion and tearing of muscle fibers enough to result in a thigh hematoma (collection of blood); pain and stiffness

Question 35

Blood supply to posterior thigh

Answer 35

perforating branches of deep femoral artery

Question 36

Sciatic nerve

Answer 36

L4,5
S1,2,3
Largest nerve in body, no branches in gluteal region

Question 37

Pudendal nerve

Answer 37

S2,3,4

Supplies structures in perineum

Question 38

Posterior Femoral cutaneous Nerve

Answer 38

S1,2,3

Cutaneous to skin of lower buttock and skin of posterior compartment of thigh

Question 39

Superior Gluteal nerve

Answer 39

L4,5 S1

To gluteus medius, minimus and Tensor Fasciae latae

Question 40

Inferior Gluteal nerve

Answer 40

L5, S1,2

To gluteus Maximus

Question 41

Other muscular nerve branches

Answer 41

To quadratus femoris, obturator internus and piriformis