Gluteal and Posterior Regions of Thigh

Question 1

trochanteric bursitis

Answer 1

inflammation of the trochanteric bursa (a friction bursitis)
-deep diffuse pain in the lateral thigh region w/ point tenderness over greater trochanter

Question 2

ischial bursitis

Answer 2

inflammation of the ischial bursa due to repeated trauma that overwhelms the ability of the bursa to dissipate applied stress (a friction bursitis)

• localized pain over the bursa
• can lead to pressure sores in debilitated people

Question 3

what type of strains are twice as common as quad strains?

Answer 3

hamstring strains

Question 4

what often accompanies thigh strains?

Answer 4

contusion and tearing of muscle fibers and vessels-> hematoma contained by fascia lata

Question 5

what can cause avulsion of the ischial tuberosity?

Answer 5

forcible flexion of hip with knee extended (kicking a football)

Question 6

injury to the superior gluteal nerve

Answer 6

causes disabling gluteus medius limp and/or gluteal gait (leans away from unsupported side to get leg high enough off ground to step forward - waddling)

Question 7

what is indicative of a superior gluteal nerve lesion?

Answer 7

positive Trendelenburg test -pelvis on unsupported side descends when standing on one leg

Question 8

what besides superior gluteal nerve lesion can cause a positive Trendelenburg test?

Answer 8

• fracture of the greater trochanter

- dislocation of the hip joint

Question 9

steppage gait

Answer 9

lift the foot higher as it is brought forward

Question 10

swing-out gait

Answer 10

swing the foot laterally

Question 11

characteristic sign of common fibular nerve lesion and gaits to compensate?

Answer 11

steppage gait and swing-out gait - to compensate for footdrop

Question 12

where is anesthetic injected for sciatic nerve block?

Answer 12

a few cm inferior to the midpoint of the line joining the PSIS and superior border of the greater trochanter

Question 13

how far does paresthesia extend with a sciatic nerve block?

Answer 13

to the foot b/c sciatic n -> tibial n -> plantar nerve branches

Question 14

piriformis syndrome

Answer 14

compression of sciatic nerve by piriformis - causes pain in butt
-associated w/ spasm of piriformis and hypertrophy

Question 15

functional deficit w/ complete section of sciatic nerve

Answer 15

• no extension of hip
• no flexion of leg
• no ankle or foot movements

Question 16

in respect to sciatic nerve: side of safety and side of danger of the butt?

Answer 16

safety: lateral side
danger: medial side

Question 17

why is the gluteal region a common site for IM injections?

Answer 17

thick, large muscles can absorb substantial volume of injected substances

Question 18

where are IM injections made in the leg/butt?

Answer 18

• superolateral quadrant of butt
• superior to a line extending from PSIS to the superior border of the greater trochanter
• anterolateral part of thigh into tensor fasciae latae