Blue boxes Gluteal and Posterior Thigh regions

Question 1

Describe trochjnteric bursitis

Answer 1

Inflammation of the trochanteric bursa, which are located on the lateral sides of the hips

This occurs due to the gluteus maximus fibers repeatedly moving back and forth over the bursa

Question 2

How does trochanteric bursitis present?

Answer 2

Point tenderness over the greater trochanter and radiates down the IT band to the tibia

Question 3

Describe ischial bursitis

Answer 3

Recurrent micro trauma that is due to repeated hip extension

excessive friction between the ischial bursa and the ischial tuberosities

calcification can occur when the condition is chronic

can lead to pressure sores in debilitated people

Question 4

Describe hamstring injuries

Answer 4

Occur more commonly than quad strains and are common in athletes who run or kick hard

Usually accompanied with a hematoma secondary to the contusion and tearing of muscle fibers which results in rupturing of the blood vessels

Question 5

What could happen if there is a forcible flexion at the hip when the knee is extended? Which muscle would this affect?

Answer 5

Avulsion at the ischial tuberosity which would result in a hamstring injury

Question 6

Describe what would happen in the event of an injury to the superior gluteal nerve?

Answer 6

The gluteus medium is limp to compensate for weakened abduction

Trendelenberg gait will result secondary to the inability of the gluteus medius and minimus from preventing the pelvic tilt; resulting in the Trendelenberg gait

Question 7

What are other causes of the Trendelenberg gait other than an injury to the superior gluteal nerve?

Answer 7

Fracture of the greater trochanter and hip dislocation

Question 8

Describe the presentation of sciatic nerve parasthesia and the correct way in which to administer an anesthetic block?

Answer 8

Paresthesia will radiate all the way to the foot via the sciatic nerve, tibial nerve, and the medial and lateral plantar nerves

Inject the block a few Cms inferior to the midpoint of the line joining the PSIS And the greater trochanter

Question 9

What are the 3 main ways in which a person can obtain an injury to the sciatic nerve?

Answer 9

Compression of the nerve by the piriformis which is more common in people who have excessive gluteus muscle use or women

Trauma that causes spasm of the piriformis

Incomplete section of the sciatic nerve, which involves the gluteal and femoral cutaneous nerves

Question 10

Describe intragluteal injections… why are they done here and what you have to be cautious of?

Answer 10

They are done here because the muscles are thick and large

Have to be careful about the sciatic nerve, so you want to inject in the superior lateral region

Question 11

What is another area that intramuscular injections can be administered if the gluteal region will not work?

Answer 11

Anterolateral part of the thigh