Exam #5: Gluteal Region

Question 1

When do the lower limb buds first appear, and where?

Answer 1

• 5th week of development

- L2-S2

Question 2

How are the toes & soles of the feet initially oriented in the limb bud?

Answer 2

• Great toes are superior

- Soles are directed medially

Question 3

When do the lower limb buds rotate?

Answer 3

7th week of development

Question 4

What direction do the lower limb buds rotate? How does this compare to the upper limb buds?

Answer 4

• Lower limb buds rotate medially

- Upper limb buds rotate laterally

Question 5

What are the three parts of the hip bone?

Answer 5

Ilium
Ischium
Pubis

*Note that the three parts fuse at the end of the teenage years & each contains its own ossification center.

Question 6

What does the hip bone articulate with?

Answer 6

Sacrum & the femur

*This is where the axial & appendicular skeleton join

Question 7

What is the pelvic girdle?

Answer 7

2 hip bones together

Question 8

What is the bony pelvis?

Answer 8

Pelvic girdle
Sacrum
Coccyx

All bound together by ligaments

Question 9

Where do the gluteal muscles & iliacus attach?

Answer 9

Both attach to the “ala” or wing of the ilium

• Gluteal muscles attach laterally
• Iliacus attaches medially

Question 10

What is the iliac fossa?

Answer 10

Concavity of the ala

Question 11

What part of the acetabulum does the ilium form?

Answer 11

Superior 2/5

Question 12

What vertebral structure is the iliac crest directly in line with?

Answer 12

L4-5 disc

Question 13

What is the posterior inferior iliac spine the attachment site for?

Answer 13

Posterior sacroiliac ligament

Question 14

How much of the acetabulum does the ischium contribute?

Answer 14

2/5

Question 15

What four structures are part of the body of the ischium?

Answer 15

Ischial tuberosity
Ischial spine
Lesser sciatic notch
Greater sciatic notch

Question 16

What forms the ischiopubic ramus?

Answer 16

Ischial ramus joins with the inferior ramus of the pubis to form the ischiopubic ramus

Question 17

How much of the acetabulum does the pubis contribute?

Answer 17

1/5

Question 18

What three structures are part of the body of the pubis?

Answer 18

Symphysis pubis
Pubic crest
Pubic tubercle

Question 19

What part of the pubis joins with the ilium & ischium?

Answer 19

The superior ramus of the pubis fuses with the ilium & ischium within the acetabulum

Question 20

What structure is part of the inferior ramus of the pubis?

Answer 20

Obturator foramen

Question 21

What is the greater sciatic foramen?

Answer 21

Passageway for all lower limb nerves & arteries to leave the pelvis

Question 22

What forms the greater sciatic foramen?

Answer 22

Greater sciatic notch
Sacrospinous ligament
Sacrotuberous ligament

Question 23

List the structures that pass through the greater sciatic foramen (7).

Answer 23

1) Piriformis muscle
2) Superior & inferior gluteal vessels/ nerves
3) Internal pudendal vessels & pudendal nerve
4) Sciatic nerve
5) Posterior femoral cutaneous nerve
6) Nerve to guadratus femoris & inferior gemellus
7) Nerve to obtruator internus & superior gemellus

Question 24

What forms the lesser sciatic foramen?

Answer 24

Less sciatic notch
Sacrospinous ligament
Sacrotuberous ligament

Question 25

What structures pass through the lesser sciatic foramen?

Answer 25

1) Tendon of obturator internus 2) Internal pudenal vessels & pudendal nerve 3) Nerve to the obturator internus

Question 26

What muscles form the superficial layer of gluteal muscles?

Answer 26

Gluteus maximus Gluteus medius Gluteus minimus

Question 27

What muscles form the deep layer of gluteal muscles?

Answer 27

``` Piriformis Obtruator Internus Superior Gemellus Inferior Gemellus Quadratus Femoris ```

Question 28

What is the origin of the gluteus maximus?

Answer 28

1) Sacrotuberous ligament 2) Ilium 3) Sacrum 4) Coccyx

Question 29

What is the insertion of the gluteus maximus?

Answer 29

1) Gluteal tuberosity | 2) Iliotibial tract

Question 30

What is the function of the gluteus maximus?

Answer 30

Extension & lateral rotation of the thigh *Note that this most is used in rising from a sitting position & running

Question 31

What nerve innervates the gluteus maximus?

Answer 31

Inferior gluteal

Question 32

What arteries supply the gluteus maximus?

Answer 32

Superior & inferior gluteal arteries

Question 33

What is the origin of the gluteus medius?

Answer 33

Ilium between the anterior & posterior gluteal line

Question 34

What is the insertion of the gluteus medius?

Answer 34

Greater trochanter of the femur

Question 35

What is the action of the gluteus medius?

Answer 35

1) ABduction & medial rotation of the thigh | 2) With the gluteus minimus, stops hip from sagging on unsupported side

Question 36

What nerve innervates the gluteus medius?

Answer 36

Superior gluteal

Question 37

What artery supplies the gluteus medius?

Answer 37

Superior gluteal artery

Question 38

What is the origin of the gluteus minimus?

Answer 38

Ilium between the anterior & inferior gluteal lines

Question 39

What is the insertion of the gluteus minimus?

Answer 39

Greater trochanter of the femur

Question 40

What is the action of the gluteus minimus?

Answer 40

ABduction & medial rotation of the thigh

Question 41

What nerve innervates the gluteus minimus?

Answer 41

Superior gluteal nerve

Question 42

What artery supplies the gluteus minimus?

Answer 42

Superior gluteal artery

Question 43

What does a positive Trendelenburg Sign indicate?

Answer 43

Damage to the superior gluteal nerve

Question 44

What is the origin of the piriformis?

Answer 44

Anterior surface of the sacrum

Question 45

What is the insertion of the piriformis?

Answer 45

Greater trochanter of the femur

Question 46

What nerves innervate the piriformis?

Answer 46

S1 & S2

Question 47

What is the function of the piriformis?

Answer 47

Lateral rotation of the thigh

Question 48

What is the origin of the Obturator Internus?

Answer 48

Obtruator membrane & surrounding bone

Question 49

What is the insertion of the Obturator Internus?

Answer 49

Greater trochanter of the femur

Question 50

What nerves innervate the Obtruator Internus?

Answer 50

L5, S1, & S2

Question 51

What is the function of the Obtruator Internus?

Answer 51

1) Lateral rotation 2) Extension 3) Abduction of flexed thigh

Question 52

What is the origin of the superior gemellus?

Answer 52

Ischial spine

Question 53

What is the insertion of the superior gemellus?

Answer 53

Tendon of the obtruator internus

Question 54

What nerve innervates the superior gemellus?

Answer 54

Nerve to the obtruator internus, L5, S1, & S2

Question 55

What is the action of the superior gemellus?

Answer 55

Same as the obtruator internus 1) Lateral rotation 2) Extension 3) Abduction of flexed thigh

Question 56

What is the origin of the inferior gemellus?

Answer 56

Ischial tuberosity

Question 57

Where does the inferior gemellus insert?

Answer 57

Tendon of the obturator internus

Question 58

What nerve innervates the inferior gemellus?

Answer 58

Same as the quadratus femoris L5 & S1

Question 59

What is the action of the inferior gemellus?

Answer 59

Same as the obtruator internus 1) Lateral rotation 2) Extension 3) Abduction of flexed thigh

Question 60

Where is the origin of the quadratus femoris?

Answer 60

Ischial tuberosity

Question 61

Where does the quadratus femoris insert?

Answer 61

Intertrochanteric crest

Question 62

What nerve innervates the quadratus femoris?

Answer 62

Nerve to the quadratus femoris (L5 & S1)

Question 63

What is the function of the quadratus femoris?

Answer 63

Lateral rotation of the thigh

Question 64

What does the term "hip fracture" most commonly refer to?

Answer 64

Fractures of the femoral head, neck, or trochanter