Gluteal Region

Question 1

Superior Cluneal Nerves

Answer 1

Dorsal Rami of L1-L3

can be seen coming out over the iliac crest

Question 2

Middle (medial) cluneal nerves

Answer 2

Dorsal Rami of S1-S3

closer to the medial side of the glute

Question 3

Inferior Cluneal Nerves

Answer 3

Ventral Rami of S1-S3

also consits of the posterior femoral cutaneous N

Question 4

Nerve impingement in the lumbar spine

Answer 4

usually has to do with impingement of the superior and medial cutaneous nerves

Question 5

Superficial Lymphatic drainage of gluteal region

Answer 5

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

Question 6

Deep Lymphatic drainage of the gluteal region

Answer 6

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

Question 7

Greater sciatic foramina contents, 7 nerves, 3 vessels, and 1 muscle

Answer 7

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

Question 8

Lesser Sciatic Foramina 4 items go through here

Answer 8

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

Question 9

Sacrotuberous ligament

Answer 9

Posterior sacrum to the ischial tuberosity

Question 10

Sacrospinous Ligament

Answer 10

Posterior sacrum to spine of the ischium

Question 11

Gluteus Maximus M

Answer 11

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

Question 12

GLuteus Medius M

Answer 12

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

Question 13

Gluteus Minimus M

Answer 13

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

Question 14

Tensor Fascia Latae M

Answer 14

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

Question 15

Abductor and medially rotate thigh muscles

Answer 15

Gluteus Medius M
Gluteus Minimus M
Tensor fascia Latae M

Question 16

Lateral Rotators and thigh extension/abduction muscles

Answer 16

Piriformis M
Obturator Internus M
Superior Gemelli M
Inferior Gemeli M
Quadratus Femoris M

Question 17

Piriformis M

Answer 17

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

Question 18

Obturator Internus M

Answer 18

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

Question 19

Superior Gemelli M

Answer 19

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

Question 20

Inferior Gemelli M

Answer 20

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

Question 21

Quadratus Femoris M

Answer 21

Lateral border of ischial tuberosity to the quadrate tubercle on femur

Nerve to quadratus femoris M

Medial circumflex Femoral A

Laterally rotates the thigh

Question 22

Piriformis Syndrome

Answer 22

Piriformis tightness and spasms can impinge the sciatic N

this is because the piriformis muscle runs directly over the nerve

Question 23

PIN mnemonic

Answer 23

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

Question 24

Crucuate Anastomosis

Answer 24

Inferior Gluteal A
Medial circumflex femoral A
Lateral Circumflex femoral A
First perforating branch of profunda femoris A

Question 25

Trendelenburg sign

Answer 25

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

Question 26

Intragluteal Injections

Answer 26

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?

Question 27

Anesthetic block of sciatic nerve

Answer 27

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

Question 28

Injury to sciatic N in gluteal region

Answer 28

Compression by the piriformis muscle

spasm of the piriform muscle

complete and incomplete sections of sciatic nerve