Gluteal Region Flashcards
What are the superior and inferior boundaries of the gluteal region?
iliac crest and gluteal sulcus.
What ligaments form important foramina for the passage of structures into and out of the gluteal region?
Greater sciatic foramen
Lesser sciatic foramen
What exits the greater sciatic foramen?
Gluteal neurovascular bundles
Piriformis muscle
Sciatic nerve
Posterior femoral cutaneous nerve
pudenal and internal pudenal nerves
obturator internus/superior gemellus nerve
What enters and exits the lesser sciatic foramen?
pudenal nerve, internal pudenal nerve, obturator internus/superior gemellus nerve (enter)
obturator internus (exits)
What are the two major classifications of nerves in the gluteal region?
cluneal nerves and deep nerves (from the sacral plexus)
The superior and middle clunearl nerves arise from what regions of the dorsal rami?
lateral branches
The superior and middle cluneal nerves supply what areas?
superior 2/3, sacrum and adjacent area
The inferior cluneal nerves supply what area?
inferior 1/3 of gluteal region.
What comprises the inferior cluneal nerves?
Gluteal branchs of posterior femoral cutaneous nerve (S1 - S3 ventral rami branches)
Where does the superior glutreal nerve run between?
gluteus medius and gluteus minimus
The superior gluteal nerve leaves the pelvis with what artery?
superior gluteal artery.
What does the superior gluteal nerve supply?
gluteus medius, gluteus minimus, tensor fasciae latae
What does the inferior gluteal nerve supply?
gluteus maximus
What artery does the inferior gluteal nerve leave the pelvis with?
inferior gluteal artery
The sciatic nerve arises from what roots?
L4 - S3 ventral rami
What is the largest nerve in the body?
sciatic nerve
True or false: the sciatic nerve supplies gluteal structures.
False
The sciatic nerve leaves the pelvis inferior to what muscle?
piriformis
Where does the sciatic nerve run inferiorly to?
gluteus maximus
You encounter a patient who has dislocated their hip during a car accident. The hip dislocation caused paralysis of hamstrings and muscles distal to the knee. What nerve has most likely been affected?
sciatic nerve
What roots doe the posterior femoral cutaneous nerve arise from?
S1 - S3.
What nerve supplies more skin than any other cutaneous nerve?
posterior femoral cutaneous nerve
What roots does the quadraturs/inferior gemellus nerve arise from?
L4 - S1
What roots does the obturator internus/superior gemellus nerve arise from?
L5 - S2
The obturator internus/superior gemellus leaves the pelvis via what foramen?
greater sciatic foramen
Where does the obturator internus/superior gemellus nerve reenter the pelvis?
lesser sciatic foramen
What roots comprise the pudenal nerve?
S2 - S4
Which nerve is the most medial structure exiting the greater sciatic foramen?
pudenal nerve
Where does the pudenal nerve reenter the pelvis?
via lesser sicatic foramen to supply perineal structures.
Arteries of the gluteal region have branches that arise from what major artery?
internal iliac artery
What braches of the internal iliac artery are found in the gluteal region?
superior gluteal artery
inferior gluteal artery
internal pudenal artery
What is the largest internal iliac artery branch?
superior gluteal artery
The superficial branch of the superior gluteal artery supplies what muscle?
gluteus maximus
The deep branch of the superior gluteal artery supplies what muscles
gluteus medius
gluteus minimus
tensor fascia lata
What muscles do the inferior gluteal artery supply?
gluteus maximus
small lateral rotators
superior hamstrings
The inferior gluteal artery participates in ____ of the thigh.
criciate anastomosis
What makes up the criciate anastomosis of the thigh?
transverse branch of medial circumflex femoral artery
terminal part of the transverse branch of the lateral circumflex femoral artery
First perforating artery
Inferior gluteal artery
Where does the internal pudenal artery reenter the pelvis?
via the lesser sciatic foramen with pudenal nerve
What does the internal pudenal artery supply?
perineal muscles and external genitalia
True or false: the internal pudenal artery supplies gluteal structures
false
Where should injections to the gluteal region be administered?
the supero-lateral part of the gluteal region in order to avoid the sciatic nerve and other gluteal nerves and vessels.
What muscles make up the gluteal thigh extensors and abductors?
gluteal aponeurosis
gluteus maximus
tensor fascia lata
What is the largest gluteal muscle?
gluteus maximus
What is the action of the gluteus maximus?
extensor of the thigh and lateral rotation.
What nerve innervates the gluteus maximus?
inferior gluteal nerve (L5 - S1)
Where does the gluteus maximus attach?
Posterior gluteal line
The gluteus medius and minimus are partially covered by what muscle?
gluteus maximus
What are the actions of the gluteus medius and minimus?
Thigh abduction and medial rotation.
What are the gluteus medius and minimus innervated by?
Superior gluteal nerve
What nerve innervates the gluteus medius and minimus?
superior gluteal nerve
What is the tensor fascia lata enclosed by?
fascia lata
What nerve innervates the tensor fascia lata?
superior gluteal nerve
What are the actions of the tensor fascia lata?
Abducts, medially rotates and flexes thigh.
Slight extension of knee along with the gluteus maximus.
What are some of the functions of the iliotibial tract?
Decelerates adduction of thigh
Laterally stabilizes knee
Extends leg, compensate for quadirceps paralysis via gluteus maximum flexion.
Pulls patella laterally, antagonist of vastus medialis and synergist with flexing vastus laterials for this action.
In order to treat chondromalacia patella, what must be stretched?
Illiotibial tract
You encounter a patient with gluteal gait or limp. What nerve is most likely affected?
superior gluteal nerve
What is the effect of a gluteal gait or limp?
patient loses steadying action of gluteus medius and minimus.
The piriformis lies deep to_____.
gluteus maximus
The piriformis muscle attaches to what region?
The sacral region and the greater trochanter of the femur.
Where does the obturator internus leave the pelvis?
Through lesser sciatic foramen
What two muscles, along with the obturator internus, form the triceps coxae?
superior and inferior gemelli
Where does the obturator externus attach?
External margins of obturator foramen
trochanteric fossa
What nerve innervates the obturator externus?
obturator nerve (L3, L4).
The gluteal region is located posterior to what bone?
The pelvis
What muscles medially rotate the gluteal region?
Tensor fascae latae
Glutus minimus
Gluteus medius
What muscles laterally rotate the gluteal region?
quadratus femoris
gluteus maximus
Which of the small lateral rotators is least effective when the thigh is flexed?
Quadratus femorus