Anatomy II Lecture 9 Gluteal Region and Hip Joint Flashcards
What is the cutaneous innervation of the upper medial quadrant of the buttock?
Posterior rami of L1-3, S1-3
What is the cutaneous innervation of the upper lateral quadrant of the buttock?
Iliohypogastric nerve (L1) Anterior rami T12
What is the cutaneous innervation of the Lower medial quadrant of the buttock?
Branches from posterior femoral nerves (S1-3)
What is the cutaneous innervation of the lower lateral quadrant of the buttock?
Branches from lateral femoral cutaneous nerve S2-3
The deep fascia of the gluteal region is continuous with
The deep fascia of the thigh (Fascia Lata)
- Single layer attached to iliac crest covering outer surface of Gluteus MEDIUS
- Splits and encloses the gluteus maximus
What continues as an iliotibial tract on the lateral surface of the thigh:
- Attached to tubercle of iliac crest superiorly
- Attached to lateral condyle inferiorly
- Forms sheath for tensor fascia latae muscle
- Receives greater part of an insertion of gluteus maximus
Deep fascia of the gluteal region
What is tied down to the bottom of the buttock and forms gluteal (natal) fold?
Superficial fascia of the gluteal region
Where do the structures that pass through the greater sciatic foramen go or come from?
Passageway for structures entering or leaving the pelvis
Where do the structures that pass through the lesser sciatic foramen go or come from?
Passageway for structures entering or leaving Perineum
What structures move through the greater sciatic foramen?
Piriformis Muscle
Sciatic Nerve
Superior/Inferior gluteal vessels and nerves
Pudendal Nerve (lesser sciatic foramen too)
**Internal Pudendal artery/Vein (lesser sciatic foramen too)
Posterior femoral cutaneous nerve
Nerves to quadratus femoris and obturator internus* (He said know this last one because obturator also passes through the lesser sciatic foramen)
What structures move through the lesser sciatic foramen?
Tendon of obturator internus Nerve to obturator internus Pudendal nerve Internal pudendal vessels (All but the tendon also passes through the greater)
What divides the sciatic notch into a greater foramen and a lesser foramen?
Sacrospinous
What do all of these have in common? Obturator membrane Sacrotuberous Sacrospinous Sacroiliac Iliolumbar
Ligaments of articulated pelvis
What are the posterior ligaments of the pelvis
Posterior sacrospinous ligament
Sacrotuberous ligaments
Sacrospinous ligaments
Refer to fig 6.6
Which of the following are part of the lateral compartment of the gluteal abductors? A. Gluteus Medius B. Gluteus Maximus C. Gluteus Minimus D. Tensor Fascia Latae
B. Gluteus Maximus: Posterior compartment
Lateral compartment:
A. Gluteus Medius
C. Gluteus Minimus
D. Tensor Fascia Latae
What is the function of the gluteal group abductors?
Prevent pelvis and body from falling to the unsupported side when one foot is off the ground (I.e. walking)
What is the function of the six deep external rotators of the gluteus?
Rotate unsupported side of the pelvis forward to increase stride
What is the origin and insertion of the gluteus maximus?
Origin: Posterior gluteal line of ilium; Surfaces of sacrum, coccyx, sacrotuberous ligament
Insertion: Gluteal tuberosity and Iliotibial tract
What is the function, vascular supply, and innervation of the gluteus maximus?
Function: Necessary for rising from seated position, climbing, running, and jumping (NOT walking)
Extends and rotates thighs
Vascular supply: Inferior gluteal artery (Branch of the internal iliac)
Innervation: Inferior gluteal nerve
What are the three bursae of the posterior gluteal compartment?
Trochanteric bursa
Gluteofemoral bursa
Ischial (sciatic) bursa
T/F Gluteus Medius and Gluteus minimus are the same muscle separated by the inferior gluteal nerve
False
Gluteus Medius and Gluteus minimus are the SAME muscle separated by the SUPERIOR gluteal nerve
Where does the tensor of fascia lata insert into?
Iliotibial tract
Function: Tense the fascia lata
What innervates the lateral gluteal compartment?
Superior gluteal nerve (This also splits one muscle to form the gluteus minimus and medius)
What is the vascular supply of the lateral gluteal compartment?
Superior gluteal artery (branch of the internal iliac)
What muscles functions to:
- Hip ABduction with a free swinging limb
- Tensor of fascia lata and anterior deep gluteal fibers act as medial rotators of the thigh
Lateral gluteal compartment
What is the Trendelenburg test?
Evaluates the strength of contralateral gluteus medius
Patients stands upright and raises one foot off the ground
Contralateral gluteus should lower contralateral hip and raise ipsilateral hip
Needed to clear foot from the ground during swing phase of walking
If a patient fails this, an indicator is dragging feet when walking
What do these muscles have in common? Piriformis Superior gemellus Obturator internus Inferior gemellus Obturator externus Quadratus femoris
They are the six deep external rotators of the gluteus
What is the function of the piriformis and obturator internus?
externally rotate the thigh and abduct flexed thigh
What is the internal iliac artery a branch of?
Common iliac artery
What branches off the internal iliac artery?
Superior gluteal and inferior gluteal artery
What branches off the femoral artery?
medial femoral circumflex artery and the lateral femoral circumflex artery
What artery does the medial femoral circumflex artery anastomoses with?
Inferior gluteal artery
What artery does the lateral femoral circumflex artery anastomoses with?
Superior gluteal artery
What is made by the fusing of all three pelvic bones?
Acetbular fossa
Where does the femoral head insert into?
Acetabular labrum
How many degrees of freedom does the synovial ball and socket joint have?
3
What separates the sciatic notches?
Ischial spine
What are the ligaments of the ischial spine?
Sacrospinous and sacrotuberous
What converts the acetabular notch into a foramen for the transmission of the artery to the head of the femur?
Transverse acetabular ligament
What is the strongest and most important ligament of the hip joint?
Iliofemoral ligament
What is the Y ligament of Bigelow?
Iliofemoral ligament
What ligaments resists hyperextension of the hip?
Pubofemoral ligament, Ischiofemoral ligament, and the iliofemoral ligament
What ligament supports artery to the head of the femur?
Ligamentum teres
What is a collar-like ligament around the distal neck of the femur?
Zona orbicularis
What is the angle of inclination in an infant, 3-year old, Adult, and elderly respectively?
Infant: 150º
3-year old: 135º
Adult: 125º
Elderly: 120º
Pathology: Increase in angulation
Anteversion
The anterior surface of femur faces more medially
Pathology: Decrease in angulation
Retroversion
The anterior surface of femur faces more laterally