Gluteal Region Flashcards
what are the bones of the gluteal region (4)
- lumbar spine
- sacrum
- pelvis: ilium, ischium, pubis
- femur
what are the powerful ligaments of the sacroiliac joint (3)
- anterior sacroiliac (weakest)
- posterior sacroiliac - divided into long and short
- interosseous (strongest)
what ligaments stabilise the sacroiliac joint
- sacrospinous ligament
- sacrotuberous ligament
what is the pubic symphyisis
a fibrocartilagenous joint that joins R and L pubic bones, assisted by ligaments
what are the 3 foramen of the gluteal region
- obturator
- greater sciatic
- lesser sciatic
what are 3 consequences of hip fracture/ dislocation
- osteoarthritis
- DDH- developmental displasia of the hip
- bursitis
what are the 2 muscle groups of the gluteal region
gluteals
external rotators
gluteus maximus:
origin
insertion
action
antagonist
innervation
- origin: posterior surface of the ilium and sarum; sacrotuberous ligament
- insertion: gluteal tuberosity, IT tract
- action: hip extension and external rotation; stabilises knee and pelvis
- antagonist: hip flexors
- innervation: Inferior gluteal nerve - L5, S1, S2
gluteus medius:
origin
insertion
action
antagonist
innervation
- origin: ilium between anterior and posterior gluteal lines
- insertion: lateral surface of greater trochanter
- action: ABduction and internal rotation of thigh at hip
- antagonist: ADductors and external rotators
- innervation: superior gluteal nerve L4, L5, S1
gluteus minimus:
origin
insertion
action
antagonist
innervation
- origin: ilium between anterior and inferior gluteal lines
- insertion: anterior surface of the greater trochanter
- action: ABduction and internal rotation of thigh at hip
- antagonist: ADductors, external rotators
- innervation: superior gluteal nerve L4, L5, S1(confirmed in Grays)
what are the external rotators of the hip (6)
- piriformis
- quadratus femoris
- superior gemelli
- obturator internus
- inferior gemelli
- obturator externus
piriformis:
origin
insertion
action
antagonist
innervation
- origin: middle 3 parts of sacrum
- insertion: upper border of greater trochanter
- action: ABduction and external rotation of thigh at hip
- antagonist: ADductors, internal rotators
- innervation: branches from S1, S2
quadratus femoris
origin
insertion
action
antagonist
innervation
- origin: upper, outer ischial tuberosity
- insertion: quadrate tubercle of intertrochanteric crest
- action: external rotation of hip and stabilisation
- antagonist: internal rotators
- innervation: nerve from: L4, L5, S1
obturator internus:
origin
insertion
action
antagonist
innervation
- origin: obturator membrane and surrounding bones
- insertion: greater trochanter, above in front of trochanteric fossa
- action: external rotation and stabilisation of hip
- antagonist: internal rotators
- innervation: nerve from L5, S1, S2
the gemelli:
origin
insertion
action
antagonist
innervation
- origin: superior ischial spine and inferior ischial tuberosity
- insertion: with obturator internus
- action: assists obturator internus
- antagonist: internal rotators
- innervation: Superior- obturator internus L5, S1, S2; Inferior L4, L5, S1- quadratus femoris
obturator externus:
origin
insertion
action
antagonist
innervation
- origin: external surface of obturator membrane and ischiopubic ramus
- insertion: trochanteric fossa
- action: external rotation of thigh
- antagonist: internal rotators
- innervation: obturator L3, L4
what are the 7 sensory nerves of the gluteal region
(Some Panty Liners SLIP)
- subcostal
- perforating cutaneous
- lateral femoral cutaneous
- sacral posterior rami
- lumbar 1-3
- iliohypogastric
- posterior femoral cutaneous
what are the 5 nerves that supply the hip joint
- femoral nerve
- obturator nerve (and/or accessory obturator)
- nerve to quadratus femoris
- superior gluteal
- sciatic
what are the vascular structures of the gluteal region, including the 2 anastomoses (4)
- superior gluteal artery
- inferior gluteal artery
- trochanteric anastomosis
- cruciate anastomosis
what artery supplies the head of the femur and remainder of hip joint
posterior branch of obturator artery (intracapsular) and maybe some medial circumflex femoral artery
and
medial and lateral circumflex femoral arteries (extracapsular)
what are the AB and ADduction angles of the hip
ABduction: 40°
ADduction: 25°
what are the flexion and extension angles of the hip
flexion: 120° (30° required for gait)
extension: 30° (10° required for gait)
what are the angles for internal and external hip rotation
int and ext: 45° ( 15°-20° required for gait)
what are the ligaments that support the hip joint
- pubo-femoral (relatively weak)
- ilio-femoral (anterior)
- ischiofemoral (posterior)
what is the arterial supply to the hip joint
- medial and lateral circumflex artery
- artery of ligamentum teres, derived from obturator or medial circumflex
inadequate to supply femoral head with displaced fractures
