Gluteal Region Flashcards
What are the three functions of the lower limb?
support body weight, locomotion, maintain balance
What are the six regions of the lower limb?
Gluteal, femoral, knee, leg, ankle and foot
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.
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
Where are the superficial muscles of the gluteal region found?
Deep to the skin, superficial fascia and deep fascia
What are the superficial muscles of the gluteal region?
Three gluteal muscles: gluteus maximus, gluteus medius and gluteus minimus as well as tensor fascia lata.
What is the most superficial and largest of the gluteal muscles?
Gluteus maximus
What are the proximal and distal attachments of the gluteus maximus?
It attaches to the iliac crest, sacrum, sacrotuberous ligament and coccyx proximally and distally onto the iliotibial tract.
What is the most powerful extensor of the hip?
Gluteus maximus- this helps you when climbing stairs
What are the proximal and distal attachments of the gluteus medius and minimus?
Both attach to the external/posterior/gluteal aspect of the ilium and the anterolateral aspect of the greater trochanter of the femur
Actions of gluteus medius and minimus?
They act to abduct and medially (internally) rotate the thigh at the hip joint.
Function of the group of muscles in the gluteal region?
extensors (on contraction they straighten the leg), abductors (moves thigh away from the body’s midline) and medial and lateral rotators of thigh
What is gluteus maximus innervated by?
Inferior gluteal nerve (L5, S1, S2). GLUTEUS MAXIMUS= INFERIOR ALL OTHERS = SUPERIOR
What is gluteus medius and minimus innervated by?
superior gluteal nerve (spinal nerve root values L4, L5, & S1
Damage to the superior gluteal nerve can cause?
Trendelenburg’s Gait ( abnormal gait (as with walking) caused by weakness of the abductor muscles of the lower limb, gluteus medius and gluteus minimus)
What neurovascular bundle is located deep to the gluteus maximus? What does it contain and what is the function?
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.
What neurovascular bundle is located deep to gluteus medius? What does it contain and what is the function?
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.
What is the action of the deep muscle layer of the gluteal region?
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.
Name the four deep muscles of the gluteal region?
piriformis, obturator internus, gemelli and quadratus femoris
Proximal and distal attachments of the piriformis muscle?
Proximal attachment: anterior surface of sacrum; sacrotuberous ligament.
Distal attachment: superior border of greater trochanter of the femur
Proximal and distal attachments of the obturator internus muscle?
Proximal attachment: pelvic surface of obturator membrane and surrounding bones
Distal attachment: medial surface of greater trochanter of femur
Proximal and distal attachments of superior and inferior gemelli muscle?
PROXIMAL
Superior: ischial spine
Inferior: ischial tuberosity
DISTAL
medial surface of greater trochanter of femur
Proximal and distal attachments of quadrates femoris muscle?
Proximal: lateral border of ischial tuberosity
Distal: Quadrate tubercle on intertrochanteric crest of femur and area inferior to it
The iliotibial tract is a ________1____________. It runs from the ________2_________. It supports _____3____.
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
The tensor fascia is the ____1______ and is enclosed within the _____2_______.
1) muscular part of the fascia lata
2) proximal portion of the tract
What is the largest nerve the body?
The sciatic nerve
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___________
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.
What spinal nerve roots is the sciatic nerve formed from?
spinal nerve roots L4-S3
What does sciatic nerve do?
Supplies sensation to most of the lower leg and foot
The pudendal nerve forms in the______1_______, emerges into the ____2______ and supplies _________3______________
1) sacral plexus within the pelvis
2) middle of the gluteal region
3) the muscles, skin & fascia of much of the perineum
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_______
1) sacral plexus
2) middle of the gluteal region
3) the skin over the posterior aspect of the thigh
4) sensory and sympathetic fibres.
Posterior cutaneous nerve is formed from which nerve roots?
S1-3
Which nerve receives its own named artery? What is it called?
Sciatic nerve
Artery to sciatic nerve
Does the sciatic nerve supply anything in the gluteal region?
No
Where does the sciatic nerve separate and what does it separate into?
- separates in distal thigh
tibial nerve
- larger, medial
common fibular
- smaller, lateral always heading laterally
Actions of the superficial vs deep gluteal muscles?
Superficial- medial/ internal rotation
Deep- lateral/ external rotation
Extension of the hip
How can you possibly identify piriformis in dissection? What is clinical importance?
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
