Dissection 2 - Gluteal Region Flashcards
where is the gluteal region?
between the back and the posterior thigh
posterior to the pelvis
what are the boundaries of the gluteal region?
superior = iliac crests inferior = gluteal folds/sulcus lateral = greater trochanter of the femur medial = intergluteal cleft
what are the superficial gluteal muscles?
gluteus maximus
gluteus medius
gluteus minimus
tensor fascia latae
what is the most powerful extensor of the hip?
gluteus maximus
where does the gluteus maximus attach and insert?
attachments - iliac crest, sacrum, sacrotuberous ligament and coccyx
Inserts - iliotibial tract
where do gluteus medius and minimus attach?
attach - external/posterior/gluteal aspect of the ileum and anterolateral aspect of the greater trochanter of the femur
what nerve supplies the gluteal muscles?
maximus = inferior gluteal
medius and minimus = superior gluteal (L5, S1, S2)
what do the medial and minimus gluteal muscles do?
extend the thigh
medially rotate the thigh
what results from damage to the superior gluteal nerve?
Trendelenburg gait
what 2 neurovascular bundles exist in the gluteal region?
inferior gluteal neurovascular bundle
superior gluteal neurovascular bundle
what is contained within the inferior gluteal neurovascular bundle and what does it do?
inferior gluteal artery, vein and nerve (L5, S1, S2)
supplies the gluteus maximus muscle (deep to gluteus maximus)
what is contained within the superior gluteal neurovascular bundle and what does it do?
superior gluteal artery, vein and nerve (L5, S1, S2)
supplies gluteus medius and minimus (deep to gluteus medius)
what are the deep gluteal muscles and what do they do?
piriformis gimelli obturator interna quadrator femoris lateral rotators and stabilisers of the hip
where are the deep gluteal muscles?
run transversely from medial to lateral between sacrum, ileum and ischial spine and tuberosity medially and the greater trochanter of the femur laterally
what is the iliotibial tract?
thickening of deep fascia of the thigh (fascia lata)
runs from ASIS to lateral aspect of lateral tibial condyle at the gerdy tubercle
supports knee
what is the tensor fascia latae?
muscular part of fascia lata (iliotibial tract)
enclosed within proximal portion of the tract
what is the course of the sciatic nerve?
forms in lumbo-sacral plexus (L4-S3)
emerges into the middle of the gluteal region
then descends and leaves the region to enter the posterior compartment of the thigh
its branches then descend through the popliteal fossa and posterior and lateral compartments of the leg and foot
what is sciatica?
nerve roots of the sciatic nerve are affected by lumbar slipped discs giving symptoms in the foot
what is the course of the pudenal nerve?
forms in sacral plexus (S2-S4)
emerges into middle of gluteal region and supplies muscles, skin and fascia of most of perineum
how can the pudenal nerve be used clinically?
pudenal nerve block is an obstetric procedure
what is the course of the posterior cutaneous nerve of the thigh?
forms in sacral plexus S1-S3
emerges into middle of gluteal region and supplies skin over posterior thigh
somatic nerve
what is a lumbar puncture and when is it used?
pressure measurements are recorded and samples of CSF are taken from the subarachnoid space surrounding the spinal cord
looks for evidence of conditions affecting the brain
how is a lumbar puncture performed?
patient lying on left side with knees held to chin
iliac crests are identified and the plane between them visualised (level of L3/L4)
Spinal pack is used to withdraw CSF at this level
at what level does the spinal cord end?
L1-L2 IV disc
why is lumbar puncture performed at L3-4 level?
avoids injury to the terminal part of the spinal cord (conus medullaris)
