Gluteal Region

Question 1

Nelatons line

Answer 1

Line drawn from ASIS to most prominent part of ischial tuberosity.
It crosses over or just near the greater trochanter.
The top of trochanter is superior to this line in :
* Factured neck of femur
* Dislocated hip

Question 2

Sacrotuberous ligament

Answer 2

Broad band of fibrous tissue extending from sacrum and coccyx to medial part of ischial tuberosity.

Question 3

Sacrospinous ligament

Answer 3

Triangular sheet of fibrous tissue extending from ischial spine to sacrum and coccyx.

Question 4

Structures passing through greater sciatic foramen

Answer 4

Pyriformis: arise from pelvis and almost completely cover the foremen.
Key muscle of the region.

Structure above pyrifomis : superior gluteal nerve and superior gluteal vessels.

Below pyriformis:
Inferior gluteal nerves and vessels
Sciatic nerve
Nerve to quadratus femoris
Posterior cutaneous nerve of thigh
Pudendal nerve
Internal pudendal vessels
Nerve to obturator internus

Question 5

What are PIN structure

Answer 5

Pudendal nerve
Internal pudendal vessels
Nerve to obturator internus

These structures cross dorsal aspect of ischial spine and adjoining sacrospinous ligament.

Question 6

Structure passing through lesser sciatic Foramen

Answer 6

Tendon of obturator internus
Pudendal nerve
Internal pudendal vessels
Nerve to obturator internus

Question 7

Trendelenbergs sign

Answer 7

Both gluteus medius and gluteus minimus prevent the pelvis from unsupported side from sagging during walking.

When there is injury to superior gluteal nerve this causes paralysis of gluteas medius and minimus.

Pelvis sags on healthy side if that foot is off ground. The person walks in lurching gait.

Question 8

Superior gluteal artery is a branch of

Answer 8

Posterior division of internal illiac artery

Question 9

Course of superior gluteal nerve

Answer 9

Enters gluteal region through greater sciatic foramen above pyriformis.
Here it divides to superficial and deep branches.
Superficial branch passes between gluteus medius and gluteus minimus and supplies it.
Deep branch passes laterally between medius and minimus and divides to upper and lower branch.
Upper branch formation of spinous anastomoses near ASIS.
Lower branch trochanteric anastomoses

Question 10

Inferior gluteal artery is a branch of

Answer 10

Anterior division of internal iliac artery.

Question 11

Course of inferior gluteal nerve

Answer 11

Enters the gluteal region below the pyriformis along with inferior gluteal nerve and continues along with posterior cutaneous nerve of thigh.
Gives:
Muscular branch to adjacent muscles
Trochanteric and cruciate anastomoses
Artery to sciatic nerve.