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MSK Exam 2 > Gluteal Region > Flashcards

Gluteal Region Flashcards

1
Q

What marks the overall superior and inferior boundaries of the Gluteal region?

A 
Superior = Iliac Crests 
Inferior = Gluteal Sulcus (groove beneath gluteal fold)
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2
Q

What provides cutaneous innervation to the booty?

A

Superior Cluneal Ns.
Middle (Medial) Cluneal Ns.
Inferior Cluneal Ns.

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3
Q

What spinal nerves give rise to the Superior Cluneal Ns.?

A

Dorsal Rami of L1-L3

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4
Q

What spinal nerves give rise to the Middle (Medial) Cluneal Ns.?

A

Dorsal Rami of S1-S3

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5
Q

What spinal nerves give rise to the Inferior Cluneal Ns.?

A

Ventral Rami of S1-S3

Posterior Femoral Cutaneous N.

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6
Q

What happens to gluteal cutaneous innervation if there is nerve impingement in the lumbar spine (L3, etc.)?

A

Results in pain over the distribution of the Superior and Medial Cluneal Ns.

***Remember they are derived from L1-3 (superior) and S1-3 (medial)

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7
Q

Why are the Inferior Cluneal Ns. not affected if there is a nerve impingement in the lumbar spine?

A

Because they are derived from Ventral Rami

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8
Q

What is the path of LN travel for the superficial gluteal structures?

A 
Superficial tissues of gluteal region ----> 
Superficial Inguinal Nodes ----> 
External Iliac Nodes ----> 
Common Iliac Nodes ---->
Lumbar (Caval) LNs ----> 
Cisterna chyli ----> 
Thoracic duct
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9
Q

What is the path of LN travel for the deep gluteal structures?

A 
Superior and Inferior Gluteal Nodes ---->
Internal and External Iliac Nodes ---->
Common Iliac Nodes ---->
Lumbar (Caval) LNs ---->
Cisterna chyli ---->
Thoracic duct
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10
Q

What are the pathway steps for LNs that both the superficial and deep gluteal structures share?

A

Common Iliac Nodes —->
Lumbar (Caval) LNs —->
Cisterna chyli —->
Thoracic duct

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11
Q

What do LNs tend to follow?

A

Veins

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12
Q

This is considered the gateway to the pelvis.

A

Greater Sciatic Foramina

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13
Q

This is considered the gateway to the perineum.

A

Lesser Sciatic Foramina

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14
Q

This ligament runs from the posterior Sacrum to the Ischial Tuberosity.

A

Sacrotuberous L.

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15
Q

This ligament runs from the posterior Sacrum to the Spine of the Ischium.

A

Sacrospinous L.

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16
Q

What passes through the Greater Sciatic Foramen?

A

7 Nerves
3 Vessel Sets (Artery and Vein)
1 Muscle

***Think of 7 + 3 = 1(0)

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17
Q

What nerves pass through the Greater Sciatic Foramen?

A 
Sciatic N. 
Superior Gluteal N.
Inferior Gluteal N.
Pudendal N.
Posterior Femoral Cutaneous N.
N. to Quadratus Femoris 
N. to Obturator Internus

***7 Nerves

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18
Q

What vessel sets pass through the Greater Sciatic Foramen?

A

Superior Gluteal A. and V.
Inferior Gluteal A. and V.
Internal Pudendal A. and V.

***3 Vessel Sets

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19
Q

What muscles pass through the Greater Sciatic Foramen?

A

Piriformis M.

***1 Muscle

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20
Q

What passes through the Lesser Sciatic Foramen?

A

Tendon of Obturator Internus M.
Internal Pudendal A. and V.
Pudendal N.
N. to Obturator Internus

21
Q

What structures pass through both the Greater and Lesser Sciatic Foramina?

A

Pudendal N.
N. to Obturator Internus
Internal Pudendal A. and V.

***Remember “PIN”

22
Q

This is the only muscle of the “Gluteus” group that laterally rotates the thigh.

A

Gluteus Maximus M.

23
Q

What are the actions of the Gluteus Maximus M.?

A

Extend thigh

Laterally rotate thigh

24
Q

What are the actions of the Gluteus Medius M. and the Gluteus Minimus M.?

A

Abduct thigh

Medially rotate thigh

25
Q

What innervates the “Gluteus” group of muscles?

A

Gluteus Maximus M. = Inferior Gluteal N.

Gluteus Medius M. and Gluteus Minimus M. = Superior Gluteal N.

26
Q

What is the blood supply to the “Gluteus” group of muscles?

A

Gluteus Maximus = Superior and Inferior Gluteal As.

Gluteal Medius M. and Gluteus Minimus M. = Inferior Gluteal A.

***Remember Medius and Minimus innervation and blood supply are opposite. Innervation is Superior Gluteal N., and blood supply is Inferior Gluteal A.

27
Q

This muscle originates between the Anterior and Inferior Gluteal Lines of the Ilium and inserts on the Greater Trochanter of the Femur.

A

Gluteus Minimus M.

28
Q

This muscle originates between the Posterior and Anterior Gluteal Lines of the Ilium and inserts on the Greater Trochanter of the Femur.

A

Gluteus Medius M.

29
Q

This gluteal muscle also abducts and medially rotates the thigh, but it is not a “Gluteus” muscle.

A

Tensor Fascia Latae M.

30
Q

What are the Gluteal muscles that abduct and medially rotate the thigh?

A

Gluteus Medius M.
Gluteus Minimus M.
Tensor Fascia Latae M.

***Remember GTG

31
Q

What are the group of Gluteal muscles that laterally rotate the extended thigh, and abduct the flexed thigh?

A

Piriformis M.
Obturator Internus M.
Superior Gemelli M.
Inferior Gemelli M.

***Remember POSI Q — The “Q” is Quadratus Femoris M. and it only laterally rotates the thigh but is usually grouped with these muscles.

32
Q

What innervates the Tensor Fascia Latae M.?

A

Superior Gluteal N.

***Same as other muscles in its group (GTG)

33
Q

What are the actions of the Quadratus Femoris M.?

A

Laterally rotate thigh

34
Q

What innervates the Piriformis M.?

A

N. to Piriformis M.

35
Q

What provides blood supply to the Tensor Fascia Latae M.?

A

Lateral Circumflex A.

36
Q

What is the blood supply for “POSI Q”?

A

POSI = Inferior Gluteal A.

Q = Medial Circumflex A.

37
Q

What innervates the Obturator Internus M.?

A

N. to Obturator Internus M.

38
Q

What innervates the Superior and Inferior Gemelli Ms.?

A

Superior Gemelli M. = N. to Obturator Internus M.

Inferior Gemelli M. = N. to Quadratus Femoris M.

39
Q

What innervates the Quadratus Femoris M.?

A

N. to Quadratus Femoris M.

40
Q

Where do all of the muscles of “POSI Q” insert?

A

POSI = Greater Trochanter of Femur

Q = Quadrate Tubercle of Femur

41
Q

When there is pathology in this muscle, the muscle can tense up and pinch down on the Sciatic N. causing a syndrome.

A

Piriformis M.

***Causes Piriformis Syndrome

42
Q

The _________ N. and _________ _________ A. exit the Pelvic space through the Greater Sciatic Foramen and pass through the Lesser Sciatic Foramen to enter the Perineum.

A 
Pudendal (nerve) 
Internal Pudendal (artery)
43
Q

The Cruciate Anastomosis is a circular anastomosis in the upper thigh that provides collateral blood supply to prevent necrosis of the Femoral head. What arteries are included in this?

A

Inferior Gluteal A.
Medial Circumflex Femoral A.
Lateral Circumflex Femoral A.
First perforating branch of Profunda Femoris A.

44
Q

What spinal nerves give rise to the N. to Quadratus Femoris M. and the N. to Obturator Internus M.?

A

L5

S1

45
Q

This is the term for a lesion of the Superior Gluteal N. This causes denervation or weakness of the Gluteus Medius M., Gluteus Minimus M., or Tensor Fascia Latae M. It leads to gluteal gait (foot won’t clear the ground in swing phase) and the pelvis drops on the side opposite of the injury.

A

Trendelenburg Sign (Duchenne’s Limp)

46
Q

Where should IM injection of drugs be done in the gluteal region? Where is it dangerous?

A 
Lateral side (more superior) 
Medial side
47
Q

Where is the proper injection site for an anesthetic block of the Sciatic Nerve?

A

A few centimeters inferior to the midpoint of the junction of the PSIS and superior part of the Greater Trochanter.

48
Q

When is it appropriate to receive an anesthetic block of the Sciatic Nerve?

A

Distal LE fractures or trauma

Distal LE pain due to Sciatic N. pathology

49
Q

What can cause injury to the Sciatic N. in the gluteal region?

A

Compression by Piriformis M.

Spasm of Piriformis M.

Complete and incomplete sections of Sciatic N.

MSK Exam 2 (26 decks)

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