gluteal and posterior femoral regions Flashcards
piriformis
attached to the sacrum
greater and lesser sciatic notches form what?
foramen because there are ligaments-sacrotubrerous ligament-becomes greater and lesser sciatic foramina
gluteal region?
superficial and deep layers
attachments of gluteus maximus
origin: between posterior crest of ilium and posterior gluteal line and sacrotuberous ligament
insertion: gluteal tuberosity of femur and IT tract**has distal tendon on IT tract
action of gluteus maximus
extension
, lateral rotation of thigh
action at ITT with tensor fascia latae stabilizes the knee
important in going up stairs or getting up from a sitting position
superficial gluteal muscles?
gluteus maximusgluteus mediusgluteus minimustensor fascia latae
attachments of gluteus medius
origin: between posterior crest of ilium and posterior gluteal line and sacrotuberous ligament
insertion: gluteal tuberosirt of femur and IT tract
deltoid of the lower limb
gluteal medius
action of gluteus medius?
abduction of thigh
posterior fibers - laterally rotate thigh (w/ gluteus maximus)
anterior fibers - medially rotate thigh (w/ gluteus minimus)
levels sacral base when opposite limb is unsupported
innervation of gluteus maximus
inferior gluteal nerve
attachments of gluteus minimus?
origin: ilium between anterior and inferior gluteal lines
insertion: greater trochanter of femur - anterior surface
action of gluteus minimus?
abduction and medial rotation of thigh
acts with gluteus medius in leveling sacral base
paralyze the L5 (which is what nerve?)
nerve is the superior gluteal nerve
sacral base drops
usually the gluteus medius and minimus are leveling the sacral base when the opposite foot is off the ground
attachment of tensor fascia latae?
origin: anterior outer portion of iliac crest next to ASIS
insertion: via IT tract to lateral tibial condyle
action of tensor fascia latae?
abducts, flexes and medially rotates thigh
by tensing IT tract maintains knee extended
crosses two joints
brace and buttress the knee
action of tensor fascia latae?
abducts, flexes and medially rotates thigh
by tensing IT tract maintains knee extended
brace and buttress the knee
muscles of deep gluteal region?
piriformis gemellus superior obturator internus gemellus inferior quadratus femoris **lateral rotation
innervation of tensor fascia latae?
superior gluteal nerve
attachment of piriformis
origin: anterior surface of sacrum, lateral to anterior sacral foramina
insertion: greater trochanter of femur
action of piriformis
abduction of thigh, lateral rotation of thigh
tensor fascia latae with straight leg?
flex and medially rotate
attachments of gemellus superior?
origin: ischial spine
insertion: tendon of obturator internus (greater trochanter)
innervation to piriformis?
nerve to piriformis
action of gemellus superior?
lateral rotation of thigh
what attaches to greater trochanter?
gemellus superior and inferior
obturator internus
attachments of obturator internus
origin: internal surface of obturator membrane and margins of oburator foramen
insertion: greater trochanter
innervation of gemellus superior?
nerve to obturator internus
action of obturator internus?
lateral rotation and some abduction of thigh
attachments of gemellus inferior
origin: ischial tuberosity near margin of lesser sciatic notch
insertion: tendon of obturator internus (greater trochanter)
innervation of obturator internus?
nerve to obturator internus
action of gemellus inferior?
lateral rotation of thigh
innervation of gemellus inferior?
nerve to quadratus femoris
attachments of quadratus femoris
origin:ischial tuberosityinsertion:area midway between trochanter on posterior surface of femur
action of quadratus femoris
lateral rotation of thigh
muscles of posterior femoral compartment?
biceps femoris
semimembranosus
semitendinosus
attachment of biceps femoris?
origin:long head - ischial tuberosity
short head - middle third lateral lip linea aspera of femur
insertion:lateral condyle of tibia, head of fibula
innervation of quadratus femoris
nerve to quadratus femoris
innervation of biceps femoris?
long head - tibial component of sciatic nerve
short head - common fibular nerve
action of biceps femoris?
long head - extends thigh, flexes legshort head - flexes leg
attachments of semimembranosus
origin:ischial tuberosityinsertion:posterior surface, medal condyle of tibia
attachments of semitendinosus
origin: ischial tuberosity
insertion: medial anterior surface of tibia below condyle
action of semitendinosus
extends thigh
flexes and medially rotates leg when knee is flexed
action of semimembranosus
extends thigh, flexes leg and medially rotates leg when knee flexed
what forms the pes anserinus?
sartorius, gracilis, semitendinosus
same actions on knee-flexion and medial rotation of tibia when tibia flexed
superior gluteal artery
branch of internal iliac artery
passes from pelvic cavity to gluteal area through the greater sciatic foramen SUPERIOR to piriformis
innervation of semitendinosus
tibial component of sciatic nerve
vessels around piriformis?
superior gluteal and inferior gluteal
deep branch of superior gluteal artery?
divides into superior and inferior branches-both travel between gluteus medius and minimus
superior branch - tensor fascia lata fossa
inferior branch - trochanteric fossa
superficial branch of superior gluteal artery?
to gluteus maximus
inferior gluteal artery?
branch of internal iliac arterypasses to gluteal area from pelvic cavity via greater sciatic foramen INFERIOR to piriformis
muscular branch of inferior gluteal artery?
to gluteus maximus and muscles in area of ischial tuberosity
inferior gluteal artery anastomosis?
branches to cruciate anastomosis
so near the neck of the femur
largest peripheral nerve in body?
sciatic nerve
branches of inferiour gluteal artery?
muscular, anastomosis branch, branch to sciatic nerve, coccygeal, cutaneous
coccygeal branch of inferior gluteal artery?
pierce sacrotuberous ligament to gain gluteus maximus and subcutaneous region over coccyx
cutaneous branch of inferior gluteal artery?
accompanies posterior femoral cutaneous nerve
sacral plexus
ventral rami spinal nerves L 4,5 S 1,2,3
motor and cutaneous innervation to lower limb, muscles of pelvus and perineum, and skin of perineum
vasculature of posterior femoral compartment?
perforating vessels of profunda femoral artery and vein
nerves to gluteal area
pass from sacral plexus as neurovasacular bundles to deep side of muscles
superior gluteal nerve
L4,5 S1
originates in sacral plexus
exits pelvis via greater sciatic foramen ABOVE piriformis muscle in company with superior gluteal artery and vein
courses between gluteus medius and minimus
innervates gluteus medius, minimus and tensor fascia latae
inferior gluteal nerve?
L5 S1,2
originates from sacral plexus, exits pelvis through greater sciatic foramen ANTERIOR to piriformis in company with sciatic, pudenal, and posterior femoral cutaneous nerves, inferior gluteal and internal pudenal vessels
passes directly into gluteus maximus which it innervates
sciatic nerve
L 4,5 S 1,2,3
largest peripheral nerve of body and principal nerve of sacral plexus
exits pelvis through greater sciatic foramen, passing anteriorly and sometimes through substance of piriformis
two components of sciatic nerve?
tibial
common fibular
tibial nerve?
component of sciatic nerve-composed of anterior divisions of ventral rami,
spinal nerves L4-S3
semimembranosus, semitendinosus, long head of biceps femoris
as well as ischiocondylar portion of the adductor magnus
sciatic nerve course in the butt and thigh. what muscles is it laying under or on top of?
passes deep to piriformus
superifical to the deep lateral rotators of thigh (gamellus superior and inferior, quadratus femurs, obturator internus) and deep to the gluteus maxinus
in thigh, lies on the posterior surface of the adductor magnus (deep to hamstrings)
common fibular nerve?
component of sciatic nerve-composed of posterior divisions of ventral rami,
spinal nerves L4-S2
short head of biceps femurs
what is the relationship of the piriformis to the sciatic nerve.
the sciatic nerve emerges underneath the piriformis
need to know courses of what?
superior and inferior gluteal and sciatic nerves***
cord levels of the posterior femoral cutaneous n.
S1 2 3
what does cluneal nerve refer to?
the buttocks
why is the hamstring hurt more often?
because it is one muscle layer and can’t distribute strain as easily as the quadriceps
what is the consequence of injury to the superior gluteal n?
sacral base will not be level when opposite limb is unsupported because of weak or paralyzed medius and minimus muscles
TRENDELENBERG SIGN