Gluteal Region Flashcards
superior boundary of the gluteal region
iliac crest
inferior boundary of gluteal region
groove beneath gluteal fold
what exits from the greater sciatic foramen? (7)
gluteal neurovascular bundles piriformis m. sciatic nerve posterior femoral cutaneous n. pudendal n. internal pudendal n. obturator interns/sperior gemellus nerve
enters in lesser sciatic foramen (4)
pudendal n.
internal pudendal artery
obturator internus
superior gemellus nerve
exits lesser sciatic foramen
obturator internus
two main ligaments of the gluteal region
sacrospinous ligament
sacrotuberous ligament
superior and middle cluneal nerves
via lateral branches of dorsal rami
supply superior 2/3 (sacrum and adjacent area)
inferior cluneal nerves
gluteal branches of posterior femoral cutaneous nerve
supply inferior 1/3
superior gluteal nerve
leaves pelvis superior to piriformis with superior gluteal artery
runs between gluteus medius and gluteus minimus
supplies gluteus medius, gluteus minimus, sensor fasciae latae
inferior gluteal nerve
supplies gluteus maximus
leaves pelvis inferior to piriformis (with inferior gluteal artery)
what is the largest nerve in the body?
sciatic
L4-S3 ventral rami
where does the sciatic nerve leave the pelvis? How?
Greater sciatic foramen
inferior to piriformis
runs inferiorly deep to gluteus maximus
where does the sciatic nerve divide?
halfway down the thigh into tibial and common fibular nerves
true or false
sciatic nerve doesn’t supply ANY gluteal structures
true
posterior hip dislocation
causes damage to sciatic nerve
may result in paralysis of hamstrings and muscles distal to knee
sensory change may occur in skin
posterior femoral cutaneous
S1- S3
supplies skin of the region
more than any other cutaneous nerve
ventral rami of quadratus femurs/inferior gemellus nerve
L4-S1
ventral rami of obturator internus/superior gemellus nerve
L5-S2
obturator internus/superior gemellus leaves and reenters where?
leaves pelvis via greater sciatic foramen
reenters via lesser sciatic foramen
pudendal nerve
anterior division of S2-S4
most medial structure exiting greater sciatic
renters via lesser sciatic foramen to supply perineal structures
arteries of the gluteal region (3)
arise from internal iliac
superior gluteal artery
inferior gluteal artery
internal pudendal artery
superior gluteal artery
largest internal iliac artery branch
superficial branch: gluteus maximus
deep branch: gluteus medium, minimum, tensor fascia lata
inferior gluteal artery supplies
gluteus maximus
small lateral rotators
superior hamstrings
cruciate anastomosis
transverse branch of medial circumflex femoral
terminal part of lateral circumflex femoral artery
first perforating artery
inferior gluteal
allows blood to enter knee, leg if femoral artery is occluded or severed (war)
internal pudendal artery
reenters pelvis via lesser with pudendal nerve
supplies perineal muscles and external genitalia
doesn’t supply gluteal structures
where should intragluteal injections be made?
supero-ateral part of gluteal region
avoids sciatic nerve and other gluteal nerves and vessels
gluteus maximus
largest gluteal muscle
chief extensor of the thigh and lateral rotation
slight extension of leg when working with tensor fascia late
inferior gluteal nerve (L5-S1)
gluteus medius and minimus
partially covered by gluteus maximus
medius is over minimus
thigh abduction and medial rotation
superior gluteal nerve (L5-S1)
tensor fascia lata is enclosed by
fascia lata
tensor fascia lata innervation
superior gluteal nerve (L4-S1)
function of tensor fascia lata
abducts, medially rotates and flexes thigh
slight extension of knee along with gluteus maximus (30 degrees)
distinct feature of fascia lata
Iliotibial Tract
Iliotibial Tract (IT Band) runs from
iliac tubercle to gerry’s tubercle on lateral tibial condyle
function of IT band
assists in decelerating adduction of thigh
laterally stabilizes knee
extends leg (compensates for quadriceps paralysis via gluteus max flexion)
pulls patella laterally, antagonist of vastus medals, and synergist with flexing vastus lateralis
stretch to treat chondromalacia patella
stores energy to bring leg forward
superior gluteal nerve injury causes what conditions
gluteal gait/limp
positive trendelenburg’s sign
pt loses steadying action of gluteus medius and minimus
gluteal placement the bipedal gait
chimps don’t have a curve to the spine
to walk upright, they bend knees more
when they step, don’t have muscles to stabilize pelvis so they lean to opposite side (moving center of mass side to side)
piriformis
lies deep to gluteus maximus
medial to gluteus medius
demarcates gluteal blood vessels and nerves
attachments of the gluteus muscle
posterior gluteal line to the femur
duchenne’s limp
seen also in apes
occurs when the pelvis is elevated during walk, results in waddling
lacking of muscles to stabilize pelvis, so leaning to opposite side
tensor fascia lata location
found on the anterior right from the side of the thigh running town to the knee
obturator internus
inserts on the bottom of hip and attaches to superior femur
aids in rotation of hip
triceps coxae is composed of
superior and inferior gemelli and obturator internus
attachments of gemelli
head of the femur to the base of the hip
obturator externes
deep to pectinous
attaches to trochanter fossa and margins of obturator foramen
innervated by obturators nerve
most inferior of hip rotator muscles
quadrates femoris
function of glutei
medial rotation of hip advances opposite side of pelvis and free limb (walking)
lateral rotation of hip advancing limp keeps the foot parallel to line of advancement
bursa of the gluteal region
ischial bursa
trochanteric bursa
gluetofemoral bursa
