Gluteal Region Flashcards
What are the major functions of the lower limb?
Support our body weight, maintain equilibrium, allow locomotion
What are the four major parts of the lower limb?
Hip/gluteal region (from iliac crest to thigh), Thigh (from hip to knee), leg (knee to ankle), foot (from ankle and on)
Describe the major function of deep fascia
Separates muscles from one another, especially strong in lower limb and invests limb like an elastic stocking.
Prevents buldging of muscles during contraction (allows contraction to be more efficient pumping blood toward the heart)
What type of tissue does deep fascia consist of?
dense connective tissue
Superficial fascia consist of what type of tissue?
loose connective tissue
What is the deep fascia of the thigh called?
fascia lata
Describe the iliotibial tract
deep fascia lata thickened laterally and strengthened by additional longitudinal fibers
The fascia lata is continuous with the deep fascia of the leg which is called?
crural fascia
Identify the structure
iliotibial tract of fascia lata
Identify the structure
Saphenous opening, a defect in the deep fascia that allows passage of the great saphenous vein
Identify the vein
Great saphenous vein
describe the function of valves
cuplike flaps of endothelium that fill from above
when full they occlude lumen of vein and prevent reflux of blood distally
Identify the vein
great saphenous vein
identify the vein
small saphenous vein
describe characteristics of the superficial veins of the lower limb
consists of greater and small saphenous veins
lie within subcutaneous fascia, less numerous valves
list the drainage of blood through the great saphenous vein from the foot to the femoral vein
union of dorsal vein of great toe and dorsal venous arch of foot -> ascends medially -> passes posterior to the medial condyle of femur -> eneter saphenous opening (defect in fascia lata) -> empties into femoral vein
describe characteristics of the great saphenous vein
anastamoses freely with small saphenous vein
consists of 10-12 valves (more numerous in leg than thigh)
valves allow blood to move towards heart (against gravity)
state the drainage of the small saphenous vein from the foot to the knee
union of dorsal vein of little toe and dorsal venous arch of foot -> ascends posteriorly -> penetrates deep fascia -> empties into popliteal vein
blood is continuously shunted to deep veins via
perforating veins
describe characteristics of perforating veins
contain valves and arranged in oblique angle within muscle so only allows blood to flow from superficial to deep veins
whay is the venous blood flow important?
enables contractions to propel blood to heart against gravity
Where are deep veins?
deep to deep fascia
contained in vascular sheath with artery
What is the significance of having deep veins in vascular sheath with artery?
arterial pulsationshelp to compress and move blood in veins
Characteristics of deep veins of the lower limb?
have more valves, accompany all major arteries
superficial lymphatics of the lower limb accompany what
great saphenous and small saphenous veins
The superficial lymphatics that accompany the great saphenous vein drain into
superficial inguinal lymph nodes (most drain into external iliac and some drain into deep inguinal nodes)
The superficial lymphatics that accompany the small saphenous vein drain into
popliteal nodes
Deep lymphatics accompany?
deep veins
Where are deep lymphatics located and where do they drain?
lie under deep fascia; medial to femoral vein, eventually drains into deep inguinal lymph nodes followed by external iliac lymph nodes
Identify the lymph nodes
superficial inguinal nodes
Identify the lymph nodes
popliteal nodes
Identify the lymph nodes
external iliac nodes
Identify the lymph nodes
deep inguinal lymph nodes
Name the location, origin, and innervation of cutaneous nerves
Lie in suprficial fascia
mainly from lumbar and sacral plexuses
supply skin
Describe peripheral nerves
contain cutaneous branches from more than 1 spinal segment (more than 1 spinal nerve)
Describe dermatomes
an area of skin that is supplied by all cutaneous branches of 1 spinal nerve ( 1 spinal segment)
Buttocks are separated by what deep grove?
intergluteal (natal) cleft
What muscle forms the bulk of the buttock?
gluteus muscles
what demarcates the inferior boundary of buttock and start of thigh?
gluteal fold
Buttocks are located between what (borders)
between iliac crests and inferior border of gluteus maximus
At birth your hip bone is compsed of what?
3 separate bones joined by cartilage
When does you hip bnes begin to fuse?
15-17 years
what are the 3 bones in the hip separated by at puberty?
triadiate cartilage (Y-shaped cartilage)
What three bones of the hip fuse as an adult?
fusion of ileum, ischium, and pubis
When is fusin of the hip bones completed?
20-25 years
Are there fushion lines of the 3 hip bones visible in older adults?
no, but still refer to the 3 bones
Identify the yellow area/structure
Ileum
Identify the blue area/structure
Ischium
Identify the red area/structure
pubis
Identify the structure
acetabulum
Characteristics of acetabulum
“shallow vinegar cup”
Large cup-shaped cavity of lateral side of hipbone
formed by ileum, ischium, pubis
Identify the stucture
acetabular notch
Identify the surface
Ala (wing) of ileum
Identify the structure
Iliac crest
Identify the structure
ischial spine
Identify the structure
greater sciatic notch
Identify the structure
lesser sciatic notch
Identify the structure
obturator foramen
Identify the structure
anterior superior iliac spine
Identify the structure
inferior iliac spine
Identify the structure
pubic tubercle
Identify the structure
obturator foramen
Identify the structure
posterior superior iliac spine
Identify the structure
ischial tuberosity
Characteristics of obturator foramen
small passageway for obturator nerve and vessels otherwise completely closed by obturator membrane
Identify the structure
greater sciatic foramen
Identify the structure
lesser sciatic foramen
Identify the structure
sacrospinous ligament
Identify the structure
sacrotuberous ligaments
What sturcutres convert the sciatic notches into foramina?
sacrospinous and sacrotuberous ligaments
Greater sciatic foramen provides passageway for
structures enetering or leaving pelvis
“Doorway” for all lower limb arteries and nerves (leaves pelvis to enter gluteal region)
Lesser sciatic formen provides passageway for
structures entering or leaving perineum
Identify the muscle
gluteus maximus
Action of the gluteus maximus
extension and lateral rotation of thigh
Innervation of gluteus maximus
inferior gluteal nerve
Identify the muscle
glutues medius
Action of the gluteus medius muscle
abduct and medially rotate the thigh
innervation of gluteus medius
superior gluteal nerve
Identify the muscle
gluteus minimus
action of gluteus minimus
abduct and medially rotate the thigh
innervation of gluteus minimus
superior gluteal nerve
Identify the muscle
piriformis
action of the piriformis
laterall rotates extended thigh; abducts flexed thigh; stabilize hip joint
innervation of the piriformis
S1 and S2 spinal nerves
Identify the muscle
superior gemellus
action of superior gemellus
laterally rotates extended thigh; abducts flexed thigh; stabilizes hip joint
innervation of superior gemellus
nerve to obturator internus
identify the muscle
obturator internus
Action of obturator internus
laterally rotates extended thigh; abducts flexed thigh; stabilizes hip joint
innevration of obturaotr internus
nerve to obturator internus
identify the muscle
inferior gemellus
action of inferior gemellus
laterally rotates extended thigh; abducts flexed thigh; stabilizes hip joint
innervation of inferior gemellus
nerve to quadratus femoris
identify the muscle
quadratus femoris
action of quadratus femoris
laterally rotates extended thigh (strong rotator); stabilizes hip
Innervation of quadratus femoris
nerve to quadratus femoris
Shape of the gluteus medius and minimus muscles?
fan shaped
Gluteus minimus and medius largely responsible for
preventing sagging of the unsupported pelvis during walking, therefore keeps pelvis level
Allows nonweightbearing foot to clear the ground as it is brought forward during walking
What happens if you injure your superior gluteal nerve?
gluteus medius doesn’t contract when standing on one foot and pelvis on unsupported side
when walking pelvis descends on unsupported side and lower limb becomes too long and foot doesn’t clear the ground
How does someone compensate for injury to superior gluteal nerve?
leans away from unsupported side therefore raising pelvis “wadding gait”
lifting foot higher “stepping gait”
Piriformis can be used as a landmark for locating what nerve and where does the nerve run?
sciatic nerve, runs below piriformis
What is piriformis syndrome?
excessive use of gluteal muscles causes hypertrophy and spasm of piriformis can cause compression of sciatic nerve
skin of the gluteus is innervated by
superior, middle, and inferior clunial nerves
Deep gluteal nerves arise from the
sacral plexus
sciatic nerve arises from
ventral rami of L4-S3
Sciatic nerve composed of how many nerves and what are they?
2, tibial nerve and common fibular (peroneal) nerve
Superior gluteal nerve arises from what and located where?
arises from ventral rami of L4-S1, leaves greater sciatic foramen, superior to piriformis, runs between gluteus medius and minimus, runs with superficial gluteal artery
Superificial gluteal nerve supplies
gluteus medius and minimus and tensor of fascia lata
inferior gluteal nerve arises from and located where?
arises from ventral rami of L5-S2, leaves greater sciatic foramen, inferior to piriformis, runs with inferior gluteal artery
Inferior gluteal nerve innervates
gluteus maximus
