Gluteal Region Flashcards
Superior Cluneal Nerves
Dorsal Rami of L1-L3
can be seen coming out over the iliac crest
Middle (medial) cluneal nerves
Dorsal Rami of S1-S3
closer to the medial side of the glute
Inferior Cluneal Nerves
Ventral Rami of S1-S3
also consits of the posterior femoral cutaneous N
Nerve impingement in the lumbar spine
usually has to do with impingement of the superior and medial cutaneous nerves
Superficial Lymphatic drainage of gluteal region
Superficial tissues of gluteal region superficial inguinal nodes external iliac nodes common iliac nodes (now joined with deep) Lumbar (caval) lymph nodes cisterna chyli thoracic duct
Deep Lymphatic drainage of the gluteal region
superior and inferior gluteal nodes internal and external iliac nodes common iliac nodes (superficial dumps in here) Lumbar (caval) lymph nodes cisterna chyli thoracic duct
Greater sciatic foramina contents, 7 nerves, 3 vessels, and 1 muscle
gateway to pelvis
formed by the sacrotuberus ligament and the sacrospinous ligament
7 nerves: sciatic N superior gluteal N inferior gluteal N Pudendal N Posterior Femoral Cutaneous N N to Quadratus femoris N to Obturator Internus
3 vessels:
Superior Gluteal A and V
inferior gluteal A and V
internal Pudendal A and V
1 muscle: Piriformis M
Lesser Sciatic Foramina 4 items go through here
Gateway to the perineum
formed via the sacrotuberous ligament and the sacrospinous ligament
Tendon of Obturator internus
Internal Pudendal A and V
Pudendal N
N to obturator internus
Sacrotuberous ligament
Posterior sacrum to the ischial tuberosity
Sacrospinous Ligament
Posterior sacrum to spine of the ischium
Gluteus Maximus M
mdeial ilium, gluteal line and sacrum to the IT band and gluteal tuberosity
Inferior Gluteal N (L5-S2)
Superior and Inferior gluteal A
Extension, lateral rotation, rising from a seated position
GLuteus Medius M
External ilium between ant and post gluteal lines to the lateral surface of greater trochanter
superior gluteal N
Superior gluteal A
Abduct and medially rotate the thigh
Gluteus Minimus M
External ilieum between anterior and inferior gluteal lines to the anterior surface of greater trochanter
Superior Gluteal N
Superior Gluteal A
Abduct and medially rotate the thigh
Tensor Fascia Latae M
ASIS to the IT tract and the lateral condyle of the tibia
Superior gluteal N
Lateral Circumflex femoral A
Abduct and medially rotate the thigh
Abductor and medially rotate thigh muscles
Gluteus Medius M
Gluteus Minimus M
Tensor fascia Latae M
Lateral Rotators and thigh extension/abduction muscles
Piriformis M Obturator Internus M Superior Gemelli M Inferior Gemeli M Quadratus Femoris M
Piriformis M
Anterior surface of sacrum and sacrotuberus ligament to the superior border of the greater trochanter of femur
Nerve to Piriformis
Inferior Gluteal A
Laterally rotate extended thigh and abduct flexed thigh
Obturator Internus M
Pelvic surface of Obturator membrane to medial surface of greater trochanter of femur
Nerve to Obturator Internus
Inferior Gluteal A
Laterally rotate extended thigh and abduct flexed thigh
Superior Gemelli M
Ischial spine to the medial surface of greater trochanter of femur
Nerve to obturator Internus
inferior gluteal artery
Laterally rotate extended thigh and abduct flexed thigh
Inferior Gemelli M
Ischial tuberosity to Medial surface of grater trochanter of femur
Nerve to quadratus Femoris
inferior gluteal A
Laterally rotate extended thigh and abduct flexed thigh
Quadratus Femoris M
Lateral border of ischial tuberosity to the quadrate tubercle on femur
Nerve to quadratus femoris M
Medial circumflex Femoral A
Laterally rotates the thigh
Piriformis Syndrome
Piriformis tightness and spasms can impinge the sciatic N
this is because the piriformis muscle runs directly over the nerve
PIN mnemonic
Pudendal Nerve
Internal Pudendal A
Nerve to obturator Internus
these exit the pelvic space through the greater sciatic foramen and pass through the lesser sciatic foraman to enter the perineum
Crucuate Anastomosis
Inferior Gluteal A
Medial circumflex femoral A
Lateral Circumflex femoral A
First perforating branch of profunda femoris A
Trendelenburg sign
Duchennes limp
lesion to superior gluteal nerve
weakness to gluteus medius and minimus mm
leads to gluteal gait: foot wont clear ground in swing phase
Pelvis drops on side opposite of injury
Intragluteal Injections
safe side: lateral side in between the tubercle of the iliac crest and the anterior superior iliac spine halfway up the hip
Side of danger is the medial side: lots of nerves and arteries?
Anesthetic block of sciatic nerve
a few centimeters inferior to the midpoint of the junction of the PSIS and superior part of the greater trochanter
used for distal LE fractures or trauma and LE pain due to sciatic pathology
Injury to sciatic N in gluteal region
Compression by the piriformis muscle
spasm of the piriform muscle
complete and incomplete sections of sciatic nerve
