Gluteal Region

Question 1

Where does the Superior Cluneal N branch from?

Answer 1

Dorsal Rami of L1-L3

Question 2

Where does the middle cluneal N branch from?

Answer 2

Dorsal Rami of S1-S3

Question 3

Where does the Inferior Cluneal Nerves branch from?

Answer 3

From the Posterior Femoral Cutaneous N. which comes from Ventral Rami of S1-S3

Question 4

Nerve impingment of the lumbar spine (~L3) can result in?

Answer 4

Pain over the distribution of the superior and medial cluneal nerves.

Question 5

Map out lymphatic drainage of the superficial gluteal structures.

Answer 5

Superficial tissues of gluteal region

to

Superficial Inguinal nodes

to

External Iliac Nodes

to

Common iliac Nodes

to

Lumbar lymph nodes

to

Cisterna Chyli

to

Thoracic Duct

Question 6

Map out the drainage of the deeper gluteal structures

Answer 6

Superior and Inferior gluteal nodes

to

Internal and External Iliac Nodes

to

Common Iliac Nodes

to

Lumbar lymph nodes

to

Cisterna Chyli

to

Thoracic Duct

Question 7

The Greater Sciatic Foramina is a gateway to what structure?

Answer 7

The Pelvis

Question 8

The Lesser Sciatic Foramina is a gateway to what structure?

Answer 8

The Perineum

Question 9

What does the Sacrotuberous Ligament connect?

Answer 9

Posterior Sacrum to Ischial Tuberosity

Question 10

What Structures run through the Greater Sciatic Foramen? (11)

Answer 10

Nerves

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

Vessels

• Superior Gluteal A & V
• Inferior Gluteal A & V
• Internal Pudendal A & V

Muscles

• Piriformis

Question 11

What structures run through the Lesser Sciatic Foramen?

Answer 11

• Tendon of Obturator Internus
• Internal Pudendal A & V
• Pudenal N
• N. to Obturator Internus

Question 12

What structures run through both the Greater Sciatic Foramen and Lesser Sciatic Foramen?

Answer 12

• Pudendal N
• Internal Pudendal A & V
• N to obturator Internus

Question 13

What is the function, innervation, and blood supply of the gluteus maximus M?

Answer 13

Action

Extension, Lateral rotation, rising from seating position

Innervation

Inferior Gluteal N (L5-S2)

Vascular

Superior + Inferior Gluteal Artery

Question 14

What is the Action, Innervation, and Vascularization of the Gluteus Medius M. ?

Answer 14

Action

Abduct and medially rotate thigh

Nerve

Superior Gluteal Nerve

Vascular

Superior Gluteal Artery

Question 15

What is the action, innervation, and blood supply to gluteus minimus m.?

Answer 15

Action

• Abduct and medially rotate thigh

Innervation

• Superior Gluteal N

Vascular

• Superior Gluteal Artery

Question 16

What is the action, innervation, and blood supply of the Tensor Fascia Latae M.?

Answer 16

Action

• Abduct and Medially Rotate Thigh

Innervation

• Superior Gluteal N.

Vascular

• Lateral Circumflex A.

Question 17

What are the Gluteal Muscles?

Answer 17

Gluteus Maximus

Gluteus Medius

Gluteus Minimus

Tensor Fascia Latae M.

Question 18

What muscles Abduct and Medially Rotate Thigh?

Answer 18

Gluteus Medius M

Gluteus Minimus M

Tensor Fascia Latae M

Question 19

What muscles are Lateral Rotators and Thigh extension/abductors?

Answer 19

• Piriformis M.
• Obturator Internus M.
• Superior Gamelli M.
• Inferior Gamelli M.
• Quadratus Femoris

Question 20

What is the action, innervation, and blood supply of the piriformis muscle?

Answer 20

Action

• Laterally rotate extended thigh and abduct flexed thigh

Innervation

• N to Piriformis (branches of anterior rami S1 and S2)

Vascular

• Inferior Gluteal Artery

Question 21

What is the action, innervation, and blood supply to the Obturator Internus M.

Answer 21

Action

• Laterally Rotate Extended thigh and abduct flexed thigh

Innervation

• N to Obturator Internus (L5, S1)

Vascular

• Inferior Gluteal A.

Question 22

What are the same between the superior gamelli and inferior gamelli muscles?

Answer 22

Insertion onto medial surface of greater trochanter of femur

Inferior Gluteal Artery

Laterally Rotate extended thigh and abduct flexed thigh

Question 23

What are different between the superior gamelli and inferior gamelli?

Answer 23

Origin

Superior - Ischial Spine

Inferior - Ischial Tuberosity

Innervation

Superior - N. to obturator internus

Inferior - N. to quadratus femoris (L5, S1)

Question 24

What is the action, innervation, and blood supply to quadratus femoris?

Answer 24

Action

• Laterally rotates thigh

Innervation

• N to quadratus femoris (L5,S1)

Vascular

• Medial circumflex femoral A.

Question 25

What is Piriformis Syndrome?

Answer 25

Tightness of the piriformis muscle causing irriation of Sciatic N.

Question 26

What does the PIN structure consist of medial to lateral?

Answer 26

Pudendal N.

Internal Pudendal A.

N. to Obturator Internus

Question 27

What are the Cruciate Anastomosis?

Answer 27

Inferior Gluteal A.

Medial circumflex femoral A

Lateral circumflex femoral A.

First perforating branch of deep femoral.

Question 28

A trendelenbrug sign is positive for a lesion in what nerve? What muscles would be weak in it?

Answer 28

• Superior Gluteal Nerve
• Gluteus medius and gluteus minimus

**pelvis drops on side opposite of injury**

Question 29

Where do you give intragluteal injections?

Answer 29

First finger on asis, spread fingers and give shot in between first two fingers.

Question 30

Where do you inject to give an Anesthetic Block of Sciatic Nerve?

Answer 30

a few centimeters inferior to the midpoint of the junction of the PSIS and superior part of greater trochanter.

Question 31

Injury of the Sciatic Nerve in the gluteal region can be due to what? (3)

Answer 31

compression of piriformis

spasm of piriformis

Complete or incomplete sections of sciatic nerve.