Gluteal Region

Question 1

What roots start the lumbar plexus and in which muscle does it form?

Answer 1

Lumbar plexus = L1,2,3,4 Formed in the posts muscle

Question 2

What are the attachments of the psoas major muscle?

Answer 2

attaches at the lumbar plexus and to the lesser trochanter - this muscle is to blame for the lateral rotation characteristic of a broken femur.

Question 3

Where does the sciatic nerve stem from?

Answer 3

It comes from L4,5, S1,2,3

Question 4

What three muscles compose the glutes and what are their attachments?

Answer 4

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

Question 5

What movements are the gluteus minimus and medius capable of?

Answer 5

lateral rotation of the hip and hip abduction

Question 6

What movements is the gluteus maximus capable of?

Answer 6

Hip extension against gravity and lateral rotation

Question 7

What nerve supplies the gluteus maximus?

Answer 7

the inferior gluteal nerve

Question 8

What nerve supplies gluteus minimus and medius?

Answer 8

The Superior Gluteal nerve

Question 9

Describe the path of the superior gluteal nerve

Answer 9

Originates from L4,5,S1 passes through the greater sciatic foramen above the piriformis

Question 10

Describe the path of the inferior gluteal nerve

Answer 10

originates from L5,S1,2 passes through the grater sciatic foramen BELOW the piriformis

Question 11

What is Trendelenburg’s Sign?

Answer 11

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)

Question 12

What is Trendelenburg’s Test?

Answer 12

not related to the gluteal region whatsoever- this is a test of the venous valves in the lower limb.

Question 13

Describe the attachments of the piriformis muscle

Answer 13

piriformis attaches from the anterior of sacrum to the upper border of the greater trochanter through the greater sciatic foramen

Question 14

What muscle passes through the lesser sciatic foramen?

Answer 14

The obturator internus - which attaches at the medial side of the greater trochanter

Question 15

What structures pass through the greater sciatic foramen above the piriformis?

Answer 15

The superior gluteal nerve and vessels

Question 16

What structures pass through the greater sciatic foramen below the piriformis?

Answer 16

(lateral to medial) Sciatic nerve, inferior gluteal nerve and vessels, pudendal nerve and vessels

Question 17

Where do you inject anesthetic into the buttocks?

Answer 17

place your hand so it is touching the anterior superior iliac spine and inject between fingers into the gluteus maximus - avoid the sciatic nerve

Question 18

What are the three compartments of the thigh?

Answer 18

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

Question 19

What are the attachments of the muscles in the medial compartment of the thigh?

Answer 19

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

Question 20

What are the attachments of the muscles on the posterior part of the thigh?

Answer 20

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

Question 21

Describe the blood supply of the glutes

Answer 21

Supplied by the inferior gluteal vessels and superior gluteal vessels