Gluteal Region Flashcards
Superior cluneal nerves
Dorsal rami of L1-3
Middle cluneal nerves
Dorsal rami of S1-3
Inferior cluneal nerves
Ventral rami of S1-3
Posterior femoral cutaneous nerve
Nerve impingement in the lumbar spain
Can result in pain over the distribution of the superior and medial cluneal nerves
Lymphatic drainage of the gluteal system superficial structures- list the order of drainage from top to bottom
Superficial gluteal structures Superficial inguinal nodes External iliac nodes Common iliac nodes Lumbar/caval nodes Cisterna chyli Thoracic duct
Lymphatic drainage of the gluteal system deep structures- list the order of drainage from top to bottom
Superior and inferior gluteal nodes Internal and external iliac nodes Common iliac nodes Lumbar/caval nodes Cisterna chyli Thoracic duct
Greater sciatic foramina
Gateway to the pelvis
Lesser sciatic foramina
Gateway to the perineum
Sacrotuberous ligament
Posterior sacrum to ischial tuberosity
Sacrospinous ligament
Posterior sacrum to spine of the ischium
Which nerves pass through the greater sciatic foramen
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)
Which vessels pass through greater sciatic foramen
Superior gluteal artery and vein
Inferior gluteal artery and vein
Internal pudendal artery and vein (passes through both)
Which muscle passes through greater sciatic foramen
Piriformis
What passes through the lesser sciatic foramen
Tendon of obturator internus Internal pudendal artery and vein (pass through both) Pudendal nerve (passes through both) Nerve to obturator internus (passes through both)
Gluteus maximus OINB(blood supply)A
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
Gluteus medius OINBA
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
Gluteus minimus OINBA
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
Tensor fascia latae muscle OINBA
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
Name the muscles that abduct and medially rotate the thigh
Gluteus medius
Gluteus minimus
Tensor fascia latae
Name the muscles that are lateral rotators, extensors and abductors of the thigh
Piriformis Obturator internus Superior gemelli Inferior gemelli Quadratus femoris
Piriformis OINBA
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
Obturator internus OINBA
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
Quadratus femorus OINBA
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
Piriformis syndrome
Pathology of piriformis can irritate nearby sciatic nerve
PIN
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
Cruciate anastomosis- what arteries involved
Inferior gluteal
Medial circumflex femoral
Lateral circumflex femoral
First perforating branch of profundal femoris artery
Trendelenburg sign
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
Intragluteal injections
Intramuscular injections of drugs
Safe to inject on lateral side, dangerous to inject on medial side
Anesthetic block of sciatic nerve
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
Injury to sciatic nerve in gluteal region can be caused by
Compression by piriformis
Spasm of piriformis
