Anatomy- Gluteal region

Question 1

where is the gluteal region

Answer 1

between the back and the posterior thigh. is posterior to the pelvis

Question 2

what is the pelvis superiorly bounded by

Answer 2

the iliac crests

Question 3

what is the gluteal region bounded inferiorly by

Answer 3

gluteal fold/ sulcus

Question 4

where is the intergluteal cleft

Answer 4

between the buttocks

Question 5

what marks the lateral extent of the gluteal region

Answer 5

the greater trochantor of the femor

Question 6

what muscles are in the superficial muscle layer (deep to the skin, superficial and deep fascia)

Answer 6

gluteus:
maximus, medius and minimus

tensor fascia latae

Question 7

what do muscles in the superficial gluteal region do

Answer 7

extend, adduct and medially rotate the femor

Question 8

where does the tensor fascia latea orginate and attach

Answer 8

iliac crest behind ASIS

inserts into iliotibial tract (band of fascia running down lateral leg)

Question 9

what muscles are innervated by the superior gluteal nerv

Answer 9

tensor fascia latae

gluteus medius and minimus

Question 10

what nerve innervates gluteus maximus

Answer 10

inferior gluteal nerve

Question 11

where does the gluteus maximus attach to proximally

Answer 11

iliac crest, sacrum, sacrotuberous ligament and coccyx

Question 12

where does the gluteus maximus attach to distally

Answer 12

iliotibial tract and gluteal tuberosity of the femur

Question 13

what is the most powerful extensor of the hip

Answer 13

gluteus maximus (also stabilies knee and hip joint)

Question 14

where do the gluteus medius and minimus attach to proximally

Answer 14

the external/ posterior/ gluteal aspect of the ilium

Question 15

where do the gluteus medius and minimus attach to proximally

Answer 15

the anterolateral aspect of the greater trochanter of the femor

Question 16

what is the role of gluteus medius and minimus

Answer 16

abduct and medially rotate the thigh at the hip joint

Question 17

what nerve supplies the gluteus medius and minimus

Answer 17

the superior gluteal nerve

Question 18

what is trendenlenburg gait

Answer 18

walk caused by damage to the superior gluteal nerve (L5, S1 and S2)

downward tilt of pelvis on contralateral side upon weight bearing on the injured side due to weak hip abduction by the gluteus medius

Question 19

what is contained in the inferior gluteal neurovascular bundle

Answer 19

the inferior gluteal artery, vein and nerve

Question 20

what are the spinal chord roots of the superior and inferior gluteal nerves

Answer 20

L5, S1 and S2

Question 21

where is the inferior gluteal neurovascular region located

Answer 21

deep to the gluteus maximus

Question 22

what does the superior gluteal neurovascular bundle contain

Answer 22

superior gluteal artery, vein and nerve

Question 23

where is the superior gluteal neurovascular bundle located

Answer 23

deep to the gluteus medius

Question 24

what muscles are in the deep muscle group

Answer 24

piriformis
obturator internus
gemelli
quadratus femoris

Question 25

what is the role of the deep muscle group

Answer 25

lateral rotators of the thigh and hip stabilisers (hold its head in the acetabulum)

Question 26

what two lines define the quadrants of the gluteal region

Answer 26

from the greater trochanter to PSIS extended from the midpoint of the iliac crest

Question 27

where do muscles in the deep muscle layer originate and insert

Answer 27

``` they run medially to laterally from sacrum (piriformis) ilium ischial spine ischial tuberosity (quadratus femoris) ``` to laterally the greater trochanter of the femur

Question 28

what is the iliotibial tract

Answer 28

thickening of the deep fascia of the thigh (fascia lata)

Question 29

where does the iliotibial tract run from

Answer 29

ASIS to the lateral aspect of the lateral tibial condyle at the gerdy tubercle

Question 30

what does the iliotibila tract do

Answer 30

supports the knee joiny

Question 31

what is the tensor fasciae latae

Answer 31

the musclular part of the fascia lata, is enclosed within the proximal portion of the tract

Question 32

what are the spinal roots of the sciatic nerves

Answer 32

L4-S3

Question 33

where does the sciatic and pudendal nerve form

Answer 33

the sacral plexus of the pelvis

Question 34

where does the sacral nerve emerge and descend to

Answer 34

emerges into the gluteal region then descends and leaves the region to enter the posterior compartment of the thigh

Question 35

describe the path of the branches of the sciatic nerve after the thigh

Answer 35

descends through the popliteal fossa and posterior and lateral compartments of the leg into the foot

Question 36

what is the largest nerve in the body

Answer 36

the sciatic nerve

Question 37

where are symptoms of slipped discs commonly felt

Answer 37

sciatica in the foot

Question 38

tightness in what muscle can cause sciatic leg pain

Answer 38

piriformis

Question 39

via what do nerves enter/ exit the pelvis and perineum

Answer 39

greater and lesser sciatic foramen greater- pelvis lesser- perineum

Question 40

what forms the greater and lesser sciatic foramens

Answer 40

sacrotuberous and sacrospinous ligaments

Question 41

what in lower limb does the sciatic nerve supply

Answer 41

posterior thigh, all lef and foot muscle and most of skin via tibial and common fibular branches

Question 42

what is the principle nerve of the perineum

Answer 42

the pudendal S2-4 (2,3,4 guts of floor)

Question 43

what does the posterior cutaneous nerve of the thigh (s1-3) supply

Answer 43

skin over posterior thigh, popilteal fossa, lateral perineum and upper medial thigh

Question 44

where does the sciatic nerve usually exit

Answer 44

inferior to piriformis

Question 45

what is usually the most lateral structure exiting the greater sciatic foramen

Answer 45

the sciatic nerve

Question 46

what does the sciatic nerve innervate in the gluteal region

Answer 46

nothing

Question 47

what does the sciatic nerve separate into in the distal thigh

Answer 47

tibial nerve and common fibular

Question 48

what is the spinal roots of the pudendal nerve

Answer 48

S2,3,4

Question 49

where does the pudendal emerge

Answer 49

into the middle of the gluteal region

Question 50

what does the pudendal innervate

Answer 50

muscles, skin and fascia of much of the perineum

Question 51

what is pudendal nerve block

Answer 51

an obstetric procedure

Question 52

when should a lumbar puncture be done

Answer 52

to look for evidence affecting the brain, spinal chord or other parts of the nervous system

Question 53

what is recorded in a lumber puncture

Answer 53

pressures, samples of cerebrospinal fluid taken from subarachnoid space surrounding spinal chord

Question 54

describe the method for a lumbar puncture

Answer 54

patient should be on their left side and fully flexed (knees to chin) the iliac crests should be identified and the plane between them visualised (L3/4) a spinal pack should be used to remove CSF at this level

Question 55

in adults when does the spinal chord end

Answer 55

around L1/2 intervertebral disc

Question 56

why are spinal punctures done at level L3/4

Answer 56

to avoid injury to the terminal part of the spinal chord (conus medullaris)

Question 57

what nerves innervate the deep muscles

Answer 57

branches from the sacral plexus

Question 58

where does the posterior cutaneous nerve of the thigh form

Answer 58

in the sacral plexus

Question 59

where does the PCNT emerge

Answer 59

into middle of gluteal region

Question 60

what is the posterior cutaneous nerve of the thigh

Answer 60

somatic nerve that contains sensory and sympathetic fibres

Question 61

what does the PCNT innnervate

Answer 61

the skin over the posterior aspect of the thigh

Question 62

where should intergluteal injections be done

Answer 62

upper outer (superlateral) quadrant- to avoid sciatic nerve

Question 63

where does the sacrotuberous ligament run between

Answer 63

the sacrium and ischial tuberosity

Question 64

what does the sarcospinous ligament run between

Answer 64

sacrium and ischial spine