Gluteal Region Flashcards
What roots start the lumbar plexus and in which muscle does it form?
Lumbar plexus = L1,2,3,4 Formed in the posts muscle
What are the attachments of the psoas major muscle?
attaches at the lumbar plexus and to the lesser trochanter - this muscle is to blame for the lateral rotation characteristic of a broken femur.
Where does the sciatic nerve stem from?
It comes from L4,5, S1,2,3
What three muscles compose the glutes and what are their attachments?
Gluteus Maximus- ilium/sacrum- to gluteal tuberosity and iliotibial tract Gluteus Minimus - gluteal line to the greater trochanter Gluteus Medius - gluteal line to the greater trochanter
What movements are the gluteus minimus and medius capable of?
lateral rotation of the hip and hip abduction
What movements is the gluteus maximus capable of?
Hip extension against gravity and lateral rotation
What nerve supplies the gluteus maximus?
the inferior gluteal nerve
What nerve supplies gluteus minimus and medius?
The Superior Gluteal nerve
Describe the path of the superior gluteal nerve
Originates from L4,5,S1 passes through the greater sciatic foramen above the piriformis
Describe the path of the inferior gluteal nerve
originates from L5,S1,2 passes through the grater sciatic foramen BELOW the piriformis
What is Trendelenburg’s Sign?
When a patient walks and their left hip drops, it is an indication that they have weakness/damage in their RIGHT superior gluteal nerve- which supplies gluteus medius and minimus (responsible for hip abduction)
What is Trendelenburg’s Test?
not related to the gluteal region whatsoever- this is a test of the venous valves in the lower limb.
Describe the attachments of the piriformis muscle
piriformis attaches from the anterior of sacrum to the upper border of the greater trochanter through the greater sciatic foramen
What muscle passes through the lesser sciatic foramen?
The obturator internus - which attaches at the medial side of the greater trochanter
What structures pass through the greater sciatic foramen above the piriformis?
The superior gluteal nerve and vessels
What structures pass through the greater sciatic foramen below the piriformis?
(lateral to medial) Sciatic nerve, inferior gluteal nerve and vessels, pudendal nerve and vessels
Where do you inject anesthetic into the buttocks?
place your hand so it is touching the anterior superior iliac spine and inject between fingers into the gluteus maximus - avoid the sciatic nerve
What are the three compartments of the thigh?
Anterior = quadriceps (rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis) - supplied by femoral nerve
Medial= adductors (gracilis, adductor longus, adductor brevis, adductor magnus) - supplied by obturator nerve
Posterior = hamstrings (semimembranosus, semitendinosus, biceps femoris long head and short head) - supplied by sciatic nerve
What are the attachments of the muscles in the medial compartment of the thigh?
Adductors (obturator nerve L2,3,4)
Gracilis = inferior ramus of pubis to medial side of tibia
Adductor Longus = body of pubic bone to medial side of femur
Adductor brevis - inferior ramus of pubic bone to medial side of femur
Adductor Magnus = from ischio ramus and ischial tuberosity to the medial side of femur
What are the attachments of the muscles on the posterior part of the thigh?
Hamstrings (sciatic nerve L4,5, S1,2,3)
All but biceps femoris short head attach at the ischial tuberosity
Semimembranosus = ischial tuberosity to medial tibia
Semitendinosus = from ischial tuberosity to medial tibia
Biceps femoris long head = from ischial tuberosity to head of fibula
Biceps femoris short head = from posterior femur to head of fibula
Describe the blood supply of the glutes
Supplied by the inferior gluteal vessels and superior gluteal vessels
