Gluteal Region

Question 1

What are the three functions of the lower limb?

Answer 1

support body weight, locomotion, maintain balance

Question 2

What are the six regions of the lower limb?

Answer 2

Gluteal, femoral, knee, leg, ankle and foot

Question 3

The gluteal region lies between the ______1_________ and posterior to the ___2____. It is bounded superiorly by the ____3___ and inferiorly by the ___4____. The ______5______ lies between the buttocks. The _______6_______ marks its lateral extent.

Answer 3

1) back and the posterior thigh
2) pelvis
3) iliac crests
4) gluteal fold/sulcus (skin fold underlying the buttocks)
5) intergluteal cleft
6) greater trochanter of the femur

Question 4

Where are the superficial muscles of the gluteal region found?

Answer 4

Deep to the skin, superficial fascia and deep fascia

Question 5

What are the superficial muscles of the gluteal region?

Answer 5

Three gluteal muscles: gluteus maximus, gluteus medius and gluteus minimus as well as tensor fascia lata.

Question 6

What is the most superficial and largest of the gluteal muscles?

Answer 6

Gluteus maximus

Question 7

What are the proximal and distal attachments of the gluteus maximus?

Answer 7

It attaches to the iliac crest, sacrum, sacrotuberous ligament and coccyx proximally and distally onto the iliotibial tract.

Question 8

What is the most powerful extensor of the hip?

Answer 8

Gluteus maximus- this helps you when climbing stairs

Question 9

What are the proximal and distal attachments of the gluteus medius and minimus?

Answer 9

Both attach to the external/posterior/gluteal aspect of the ilium and the anterolateral aspect of the greater trochanter of the femur

Question 10

Actions of gluteus medius and minimus?

Answer 10

They act to abduct and medially (internally) rotate the thigh at the hip joint.

Question 11

Function of the group of muscles in the gluteal region?

Answer 11

extensors (on contraction they straighten the leg), abductors (moves thigh away from the body’s midline) and medial and lateral rotators of thigh

Question 12

What is gluteus maximus innervated by?

Answer 12

Inferior gluteal nerve (L5, S1, S2). GLUTEUS MAXIMUS= INFERIOR ALL OTHERS = SUPERIOR

Question 13

What is gluteus medius and minimus innervated by?

Answer 13

superior gluteal nerve (spinal nerve root values L4, L5, & S1

Question 14

Damage to the superior gluteal nerve can cause?

Answer 14

Trendelenburg’s Gait ( abnormal gait (as with walking) caused by weakness of the abductor muscles of the lower limb, gluteus medius and gluteus minimus)

Question 15

What neurovascular bundle is located deep to the gluteus maximus? What does it contain and what is the function?

Answer 15

Inferior Gluteal Neurovascular Bundle
This bundle contains the inferior gluteal artery, vein and nerve (spinal nerve root values L5, S1 & S2) and supplies the gluteus maximus muscle.

Question 16

What neurovascular bundle is located deep to gluteus medius? What does it contain and what is the function?

Answer 16

Superior Gluteal Neurovascular Bundle
This bundle contains the superior gluteal artery, vein and nerve (spinal nerve root values L4, L5, & S1) and supplies the gluteus medius and minimus muscles.

Question 17

What is the action of the deep muscle layer of the gluteal region?

Answer 17

Their action is external (lateral) rotation of the lower limb at the hip joint, although they also play a role in stabilising (holding) the head of the femur in the acetabulum.

Question 18

Name the four deep muscles of the gluteal region?

Answer 18

piriformis, obturator internus, gemelli and quadratus femoris

Question 19

Proximal and distal attachments of the piriformis muscle?

Answer 19

Proximal attachment: anterior surface of sacrum; sacrotuberous ligament.
Distal attachment: superior border of greater trochanter of the femur

Question 20

Proximal and distal attachments of the obturator internus muscle?

Answer 20

Proximal attachment: pelvic surface of obturator membrane and surrounding bones
Distal attachment: medial surface of greater trochanter of femur

Question 21

Proximal and distal attachments of superior and inferior gemelli muscle?

Answer 21

PROXIMAL
Superior: ischial spine
Inferior: ischial tuberosity

DISTAL
medial surface of greater trochanter of femur

Question 22

Proximal and distal attachments of quadrates femoris muscle?

Answer 22

Proximal: lateral border of ischial tuberosity
Distal: Quadrate tubercle on intertrochanteric crest of femur and area inferior to it

Question 23

The iliotibial tract is a ________1____________. It runs from the ________2_________. It supports _____3____.

Answer 23

1) thickening of the deep fascia of the thigh, which is known as the fascia lata
2) ASIS to the lateral aspect of the lateral tibial condyle at the Gerdy’s tubercle
3) knee joint

Question 24

The tensor fascia is the ____1______ and is enclosed within the _____2_______.

Answer 24

1) muscular part of the fascia lata

2) proximal portion of the tract

Question 25

What is the largest nerve the body?

Answer 25

The sciatic nerve

Question 26

The sciatic nerve forms in the ______1______ and emerges into the middle of the ___2_____ then descends and leaves the region to enter ______3_______. Its branches descend through the _______4___________

Answer 26

1) lumbo-sacral plexus of the pelvis
2) gluteal region
3) the posterior compartment of the thigh
4) popliteal fossa and posterior and lateral compartments of the leg into the foot.

Question 27

What spinal nerve roots is the sciatic nerve formed from?

Answer 27

spinal nerve roots L4-S3

Question 28

What does sciatic nerve do?

Answer 28

Supplies sensation to most of the lower leg and foot

Question 29

The pudendal nerve forms in the______1_______, emerges into the ____2______ and supplies _________3______________

Answer 29

1) sacral plexus within the pelvis
2) middle of the gluteal region
3) the muscles, skin & fascia of much of the perineum

Question 30

The posterior cutaneous nerve of thigh forms in the _____1______, emerges into the ________2____ and supplies ________3________. This is a somatic nerve that contains ________4_______

Answer 30

1) sacral plexus
2) middle of the gluteal region
3) the skin over the posterior aspect of the thigh
4) sensory and sympathetic fibres.

Question 31

Posterior cutaneous nerve is formed from which nerve roots?

Answer 31

S1-3

Question 32

Which nerve receives its own named artery? What is it called?

Answer 32

Sciatic nerve

Artery to sciatic nerve

Question 33

Does the sciatic nerve supply anything in the gluteal region?

Answer 33

No

Question 34

Where does the sciatic nerve separate and what does it separate into?

Answer 34

• separates in distal thigh

tibial nerve
- larger, medial

common fibular
- smaller, lateral always heading laterally

Question 35

Actions of the superficial vs deep gluteal muscles?

Answer 35

Superficial- medial/ internal rotation
Deep- lateral/ external rotation
Extension of the hip

Question 36

How can you possibly identify piriformis in dissection? What is clinical importance?

Answer 36

Piriformis divides the greater sciatic foramen so many nerves go through it. If you see nerves going into it that’s likely piriformis which helps orientate you. Clinical importance if you have hypertrophy of piriformis or tightness then you could get sciatica