Gluteal Region

Question 1

boundaries

Answer 1

superior = iliac crest
inferior = gluteal fold
anterolateral = buttocks/greater trochanter + hip/ASIS

L and R buttocks sep by intergluteal cleft

Question 2

sacro-iliac joint

Answer 2

highly reinforced bc holds vert column to pelvis + critical for supporting body mass

anterior and posterior sacroiliac ligs + sacrospinous and tuberous ligs

Question 3

greater sciatic foramen

Answer 3

pelvis > gluteal region

has a ton of stuff aka everything except tendon of obturator internus

Question 4

lesser sciatic foramen

Answer 4

pelvis > perineum

only has tendon of obturator internus

Question 5

long route to perineum structures

Answer 5

internal pudendal A and V
pudendal N
N to obturator internus

pelvis>greater sciatic foramen>gluteal>lesser sciatic foramen>perineum

Question 6

obturator canal

Answer 6

small hole in obturator membrane in obturator foramen

pelvis>medial thigh w/ obturator A,V,N

Question 7

greater trochanter inserts

Answer 7

gluteus medius + minimus + most of lateral hip rotators

Question 8

superficial layer muscles

Answer 8

gluteus maximus + medius + minimus
TFL

hip extension OR hip abduction + medial rotation

vascular supply = superior gluteal A

Question 9

deep layer muscles

Answer 9

piriformis + superior gemellus + obturator internus + inferior gemellus + quadratus femoris

lateral hip rotators

vascular: inferior gluteal

Question 10

gluteus maximus

function

Answer 10

main hip extensor + assist in lateral hip rotation and knee stabilization
-if knee fully flexed then only extensor bc hamstrings can’t assist (rising from chair, climbing stairs, running)

Question 11

gluteus maximus

O/I/N/V

Answer 11

og @ post ilium + sacrum + coccyx + sacrotuberous lig

in @ gluteal tuberosity on femur + IT band

N = inferior gluteal N
V = superior and inferior gluteal A

Question 12

gluteus medius

function

Answer 12

main hip abductor and medial rotator of hip/thigh
-assists in stabilizing pelvis when walking

Question 13

gluteus medius

O/I/N/V

Answer 13

og @ post ilium + b/t post and ant gluteal lines

in @ lateral surface greater troch on femur (anterior to center of greater troch so medial rotate)

N: superior gluteal N
V: superior gluteal A

Question 14

gluteus minimus

function

Answer 14

co-main hip abductor and medial rotator hip/thigh
-assist in stabilize pelvis walking

Question 15

gluteus minimus

O/I/N/V

Answer 15

og @ post ilium + b/t ant and inferior gluteal lines

in @ lateral surface greater troch of femur (anterior to center of greater troch so medial rotate)

N = superior gluteal N
V = superior gluteal A

Question 16

tensor fascia latae

function

Answer 16

assist in hip abduction + medial rotation hip/thigh + stabilize hip when walking + stabilize knee w/ IT band

Question 17

TFL

O/I/N/V

Answer 17

og @ ASIS + ant iliac crest

in @ IT band directly + gerdy tubercle (indirect)

N= superior gluteal N
V= superial gluteal A (main) + ascending branch lateral circumflex femoral A

Question 18

hip stabilization walking

Answer 18

by gluteus medius + minimus + TFL

normally muscles on weight bearing side contract

when abductors on weight bearing side contract = hip bones on lifted side pulled up

Question 19

trendelenburg sign/gait

Answer 19

damage to superior gluteal N weakens or paralyzes all 3 (med, min, TFL) so no abduct or keep weight bearing extended

Question 20

piriformis

Answer 20

lateral rotate hip/thigh when hip extended OR
abduct thigh when hip flexed

exit greater sciatic foramen

above = superior gluteal N
below = inferior gluteal N and sciatic

Question 21

piriformis

O/I/N/V

Answer 21

og @ anterior surface sacrum inside pelvis
in @ superior border/apex of greater troch

N= N to piriformis
V= inferior gluteal main + superior gluteal A sometimes

Question 22

piriformis syndrome

Answer 22

N compression from piriformis muscle

if sheath around sciatic never forms then common fib run thru piriformis

Question 23

triceps coxae

Answer 23

SG + OI + IG as unit

laterally rotate hip/thigh when hip extended OR
abduct thigh when hip flexed
+ hold femoral head steady in acetabulum

Question 24

triceps coxae

O/I/N/V

Answer 24

SG og @ ischial spine
OI og @ obturator membrane + surrounding bone
IG og @ ischial tuberosity

in @ all on medial surface greater troch

V= all inferior gluteal A

N = SG + OI N to obturator internus, IG N to quadratus femoris

Question 25

quadratus femoris

function

Answer 25

laterally rotate hip/thigh
hold femoral head in actetabulum

Question 26

quadratus femoris

O/I/N/V

Answer 26

og @ lateral surface of ischial tuberosity

in @ quadrate tubercle on intertrochanteric rest of femur
-only lateral rotator that not insert on greater troch so does not abduct hip

N= to quadratus femoris
V= inferior gluteal A

Question 27

intragluteal injections

Answer 27

only safe to inject superolateral/anterolateral quadrant to avoid major motor Ns

if too medial can injure superior gluteal N

Question 28

cutaneous innervation

Answer 28

dorsal rami = superior (L1-3, anterolateral quadrant) + middle (S1-3, superior and medial quadrant) cluneals

ventral rami = inferior cluneal (S1-3 both divs, inferior half of buttocks) fro gluteal branch of posterior femoral cutaneous

Question 29

vascular supply

Answer 29

internal iliac A
1. superior gluteal A
-superficial branch = glute max
-deep branch = glute med + min + TFL
2. inferior gluteal A
-glute max + all lateral rotators

Question 30

lymphatics

Answer 30

1. deep vessels @ below deep fascia, run w/ gluteal vessels > superior and inferior lymph nodes > internal iliac > common iliac
2. superficial lymph vessels @superficial fascia > superficial inguinal nodes @ anterior thigh