Anatomy- Gluteal region Flashcards
where is the gluteal region
between the back and the posterior thigh. is posterior to the pelvis
what is the pelvis superiorly bounded by
the iliac crests
what is the gluteal region bounded inferiorly by
gluteal fold/ sulcus
where is the intergluteal cleft
between the buttocks
what marks the lateral extent of the gluteal region
the greater trochantor of the femor
what muscles are in the superficial muscle layer (deep to the skin, superficial and deep fascia)
gluteus:
maximus, medius and minimus
tensor fascia latae
what do muscles in the superficial gluteal region do
extend, adduct and medially rotate the femor
where does the tensor fascia latea orginate and attach
iliac crest behind ASIS
inserts into iliotibial tract (band of fascia running down lateral leg)
what muscles are innervated by the superior gluteal nerv
tensor fascia latae
gluteus medius and minimus
what nerve innervates gluteus maximus
inferior gluteal nerve
where does the gluteus maximus attach to proximally
iliac crest, sacrum, sacrotuberous ligament and coccyx
where does the gluteus maximus attach to distally
iliotibial tract and gluteal tuberosity of the femur
what is the most powerful extensor of the hip
gluteus maximus (also stabilies knee and hip joint)
where do the gluteus medius and minimus attach to proximally
the external/ posterior/ gluteal aspect of the ilium
where do the gluteus medius and minimus attach to proximally
the anterolateral aspect of the greater trochanter of the femor
what is the role of gluteus medius and minimus
abduct and medially rotate the thigh at the hip joint
what nerve supplies the gluteus medius and minimus
the superior gluteal nerve
what is trendenlenburg gait
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
what is contained in the inferior gluteal neurovascular bundle
the inferior gluteal artery, vein and nerve
what are the spinal chord roots of the superior and inferior gluteal nerves
L5, S1 and S2
where is the inferior gluteal neurovascular region located
deep to the gluteus maximus
what does the superior gluteal neurovascular bundle contain
superior gluteal artery, vein and nerve
where is the superior gluteal neurovascular bundle located
deep to the gluteus medius
what muscles are in the deep muscle group
piriformis
obturator internus
gemelli
quadratus femoris
what is the role of the deep muscle group
lateral rotators of the thigh and hip stabilisers (hold its head in the acetabulum)
what two lines define the quadrants of the gluteal region
from the greater trochanter to PSIS
extended from the midpoint of the iliac crest
where do muscles in the deep muscle layer originate and insert
they run medially to laterally from sacrum (piriformis) ilium ischial spine ischial tuberosity (quadratus femoris)
to laterally the greater trochanter of the femur
what is the iliotibial tract
thickening of the deep fascia of the thigh (fascia lata)
where does the iliotibial tract run from
ASIS to the lateral aspect of the lateral tibial condyle at the gerdy tubercle
what does the iliotibila tract do
supports the knee joiny
what is the tensor fasciae latae
the musclular part of the fascia lata, is enclosed within the proximal portion of the tract
what are the spinal roots of the sciatic nerves
L4-S3
where does the sciatic and pudendal nerve form
the sacral plexus of the pelvis
where does the sacral nerve emerge and descend to
emerges into the gluteal region then descends and leaves the region to enter the posterior compartment of the thigh
describe the path of the branches of the sciatic nerve after the thigh
descends through the popliteal fossa and posterior and lateral compartments of the leg into the foot
what is the largest nerve in the body
the sciatic nerve
where are symptoms of slipped discs commonly felt
sciatica in the foot
tightness in what muscle can cause sciatic leg pain
piriformis
via what do nerves enter/ exit the pelvis and perineum
greater and lesser sciatic foramen
greater- pelvis
lesser- perineum
what forms the greater and lesser sciatic foramens
sacrotuberous and sacrospinous ligaments
what in lower limb does the sciatic nerve supply
posterior thigh, all lef and foot muscle and most of skin via tibial and common fibular branches
what is the principle nerve of the perineum
the pudendal S2-4 (2,3,4 guts of floor)
what does the posterior cutaneous nerve of the thigh (s1-3) supply
skin over posterior thigh, popilteal fossa, lateral perineum and upper medial thigh
where does the sciatic nerve usually exit
inferior to piriformis
what is usually the most lateral structure exiting the greater sciatic foramen
the sciatic nerve
what does the sciatic nerve innervate in the gluteal region
nothing
what does the sciatic nerve separate into in the distal thigh
tibial nerve and common fibular
what is the spinal roots of the pudendal nerve
S2,3,4
where does the pudendal emerge
into the middle of the gluteal region
what does the pudendal innervate
muscles, skin and fascia of much of the perineum
what is pudendal nerve block
an obstetric procedure
when should a lumbar puncture be done
to look for evidence affecting the brain, spinal chord or other parts of the nervous system
what is recorded in a lumber puncture
pressures, samples of cerebrospinal fluid taken from subarachnoid space surrounding spinal chord
describe the method for a lumbar puncture
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
in adults when does the spinal chord end
around L1/2 intervertebral disc
why are spinal punctures done at level L3/4
to avoid injury to the terminal part of the spinal chord (conus medullaris)
what nerves innervate the deep muscles
branches from the sacral plexus
where does the posterior cutaneous nerve of the thigh form
in the sacral plexus
where does the PCNT emerge
into middle of gluteal region
what is the posterior cutaneous nerve of the thigh
somatic nerve that contains sensory and sympathetic fibres
what does the PCNT innnervate
the skin over the posterior aspect of the thigh
where should intergluteal injections be done
upper outer (superlateral) quadrant- to avoid sciatic nerve
where does the sacrotuberous ligament run between
the sacrium and ischial tuberosity
what does the sarcospinous ligament run between
sacrium and ischial spine
