Gluteal Region

Question 1

Superior cluneal nerves

Answer 1

Dorsal rami of L1-3

Question 2

Middle cluneal nerves

Answer 2

Dorsal rami of S1-3

Question 3

Inferior cluneal nerves

Answer 3

Ventral rami of S1-3

Posterior femoral cutaneous nerve

Question 4

Nerve impingement in the lumbar spain

Answer 4

Can result in pain over the distribution of the superior and medial cluneal nerves

Question 5

Lymphatic drainage of the gluteal system superficial structures- list the order of drainage from top to bottom

Answer 5

Superficial gluteal structures
Superficial inguinal nodes
External iliac nodes
Common iliac nodes
Lumbar/caval nodes
Cisterna chyli
Thoracic duct

Question 6

Lymphatic drainage of the gluteal system deep structures- list the order of drainage from top to bottom

Answer 6

Superior and inferior gluteal nodes
Internal and external iliac nodes
Common iliac nodes
Lumbar/caval nodes
Cisterna chyli
Thoracic duct

Question 7

Greater sciatic foramina

Answer 7

Gateway to the pelvis

Question 8

Lesser sciatic foramina

Answer 8

Gateway to the perineum

Question 9

Sacrotuberous ligament

Answer 9

Posterior sacrum to ischial tuberosity

Question 10

Sacrospinous ligament

Answer 10

Posterior sacrum to spine of the ischium

Question 11

Which nerves pass through the greater sciatic foramen

Answer 11

Sciatic nerve
Superior gluteal nerve
Inferior gluteal nerve
Pudendal nerve (passes through both greater/lesser)
Posterior femoral cutaneous nerve
Nerve to quadratus femoris
Nerve to obturator internus (passes through both)

Question 12

Which vessels pass through greater sciatic foramen

Answer 12

Superior gluteal artery and vein
Inferior gluteal artery and vein
Internal pudendal artery and vein (passes through both)

Question 13

Which muscle passes through greater sciatic foramen

Answer 13

Piriformis

Question 14

What passes through the lesser sciatic foramen

Answer 14

Tendon of obturator internus
Internal pudendal artery and vein (pass through both)
Pudendal nerve (passes through both)
Nerve to obturator internus (passes through both)

Question 15

Gluteus maximus OINB(blood supply)A

Answer 15

O-Ilium, dorsal sacrum, sacrotuberous ligament
I- IT band, gluteal tuberosity
N- inferior gluteal nerve
B- superior gluteal artery
A- extension, lateral rotation, rising from seated position

Question 16

Gluteus medius OINBA

Answer 16

O- external ilium b/w ant/post gluteal lines
I- Lateral surface of greater trochanter
N- Superior gluteal nerve
B- inferior gluteal artery
A- abduct and medially rotate thigh

Question 17

Gluteus minimus OINBA

Answer 17

O- external ilium b/w ant/inf gluteal lines
I- ant surface of greater trochanter
N- superior gluteal nerve
B- inferior gluteal artery
A- abduct and medially rotate thigh

Question 18

Tensor fascia latae muscle OINBA

Answer 18

O- ASIS, anterior iliac crest
I- IT tract, lateral condyle of tibia
N- superior gluteal nerve
B- lateral circumflex artery
A- abduct and medially rotate thigh

Question 19

Name the muscles that abduct and medially rotate the thigh

Answer 19

Gluteus medius
Gluteus minimus
Tensor fascia latae

Question 20

Name the muscles that are lateral rotators, extensors and abductors of the thigh

Answer 20

Piriformis
Obturator internus
Superior gemelli
Inferior gemelli
Quadratus femoris

Question 21

Piriformis OINBA

Answer 21

O- ant surface of sacrum, sacrotuberous ligament
I- superior border of greater trochanter
N- nerve to piriformis/ant rami of S1-2
B- inferior gluteal artery
A- laterally rotate extended thigh and abduct flexed thigh

Question 22

Obturator internus OINBA

Answer 22

O- pelvic surface of obturator membrane
I- medial surface of greater trochanter
N- Nerve to obturator internus
B- inferior gluteal artery
A- laterally rotate extended thigh and abduct flexed thigh

Question 23

Quadratus femorus OINBA

Answer 23

O- lateral border of ischial tuberosity
I- quadrate tubercle on femur
N- nerve to quadratus femoris
B- medial circumflex femoral artery
A- laterally rotates thigh

Question 24

Piriformis syndrome

Answer 24

Pathology of piriformis can irritate nearby sciatic nerve

Question 25

PIN

Answer 25

Pudendal nerve
Internal pudendal artery
Nerve to obturator internus
-Structures are listed medial to lateral and are all right next to eachother
Pudendal nerve and artery exit the greater pelvic space through the greater sciatic foramen and pass through the lesser sciatic foramen to enter the perineum

Question 26

Cruciate anastomosis- what arteries involved

Answer 26

Inferior gluteal
Medial circumflex femoral
Lateral circumflex femoral
First perforating branch of profundal femoris artery

Question 27

Trendelenburg sign

Answer 27

Also known as duchennes limp
Lesion of superior gluteal nerve
Denervation or weakness of gluteus medius and minimus
Leads to gluteal gait- foot wont clear ground in swing phase
Pelvis drops on opposite side of injury

Question 28

Intragluteal injections

Answer 28

Intramuscular injections of drugs

Safe to inject on lateral side, dangerous to inject on medial side

Question 29

Anesthetic block of sciatic nerve

Answer 29

Injection site is a few centimeters inferior to the midpoint of the junction of the PSIS and superior part of greater trochanter
Done for distal lower extremity fractures or trauma or distal lower extremity pain due to sciatic nerve pathology

Question 30

Injury to sciatic nerve in gluteal region can be caused by

Answer 30

Compression by piriformis

Spasm of piriformis