Gluteal Region

Question 1

Where can the gluteal region be found?

Answer 1

Lies between the back and posterior thigh, and is posterior to the pelvis

Question 2

What are the boundaries of the gluteal region?

Answer 2

Superior = iliac crest
Inferior = gluteal fold/sulcus

Question 3

Where is the intergluteal cleft located?

Answer 3

Between the buttocks

Question 4

What marks the lateral extent of the gluteal region?

Answer 4

Greater trochanter of femur

Question 5

What muscles make up the superficial muscle layer of the gluteal region?

Answer 5

Gluteus maximus, medius and minimus

Question 6

Where is the superficial muscle layer of the gluteal region located?

Answer 6

Deep to the skin, superficial and deep fascia

Question 7

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

Answer 7

The gluteus maximus

Question 8

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

Answer 8

Proximal = iliac crest, sacrum, sacrotuberous ligament, coccyx
Distal = iliotibial tract (some fibres also attach to the gluteal tuberosity of the femur)

Question 9

What are some functions of the gluteus maximus?

Answer 9

Most powerful extensor of the hip, helps to define the gluteal fold along with the overlying superficial fascia

Question 10

Where do the gluteus medius and minimus attach?

Answer 10

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

Question 11

What function do the gluteus medius and minimus have?

Answer 11

Act to abduct and medially (internally) rotate the thigh at the hip joint

Question 12

What innervates the gluteus medius and minimus?

Answer 12

Superior gluteal nerve (L4,L5,S1)

Question 13

What can damage to the gluteus medius and minimus or their supply cause?

Answer 13

Trendelenburg’s gait

Question 14

What are the neurovascular bundles present in the gluteal region?

Answer 14

Inferior and Superior gluteal neurovascular bundles

Question 15

What are some features of the inferior gluteal neurovascular bundle?

Answer 15

Contains inferior gluteal artery, vein and nerve (L5, Si, S2), supplies gluteus maximus, located deep to gluteus maximus

Question 16

What are some features of the superior gluteal neurovascular bundle?

Answer 16

Contains superior gluteal artery, vein and nerve (L4, L5, S1), supplies gluteus medius and minimus, located deep to gluteus medius

Question 17

Where is the deep muscle layer of the gluteal region located?

Answer 17

Deep to the gluteal muscles

Question 18

What muscles make up the deep muscle layer of the gluteal region?

Answer 18

The lateral rotators of the hip (including piriformis)

Question 19

How are the lateral rotators of the hips organised?

Answer 19

Arranged in strips running transversely from medial to lateral between the sacrum, ilium and ischial spine and tuberosity, and mainly the greater trochanter of the femur laterally

Question 20

What action do the deep muscles of the gluteal region perform?

Answer 20

External (lateral) rotation of the lower limb at the hip joint (also stabilise head of femur in the acetabulum)

Question 21

What is the iliotibial tract?

Answer 21

Thickening of the fascia lata that runs from the ASIS to the lateral aspect of the lateral tibial condyle at the Gerdy’s tubercle

Question 22

What does the iliotibial tract do?

Answer 22

Supports the knee joint

Question 23

What is the tensor fasciae latae?

Answer 23

Muscular part of the fascia lata and is enclosed within the proximal portion of the iliotibial tract

Question 24

What nerves are present in the gluteal region?

Answer 24

Sciatic nerve (spinal nerve roots L4-S3), pudendal nerve (spinal nerve roots S2-4), posterior cutaneous nerve of the thigh (S1-3)

Question 25

Where does the sciatic nerve form?

Answer 25

In the (lumbo-) sacral plexus of the pelvis and emerges into the middle of the gluteal region

Question 26

Where does the sciatic nerve flow to?

Answer 26

Descends and leaves gluteal region to enter the posterior compartment of the thigh, branches to descend into the popliteal fossa and posterior and lateral compartments of the leg into the foot

Question 27

What are some features of the sciatic nerve?

Answer 27

Largest nerve in body, nerve roots are commonly affected by lumbar slipped discs giving symptoms in the foot (sciatica)

Question 28

Where does the pudendal nerve form?

Answer 28

In sacral plexus within the pelvis and emerges into middle of gluteal region

Question 29

What does the pudendal nerve supply?

Answer 29

Muscles, skin and fascia of much of the perineum

Question 30

What kind of procedure is a pudendal nerve block?

Answer 30

Obstetric procedure

Question 31

What is the other name for the posterior cutaneous nerve of the thigh?

Answer 31

Posterior femoral cutaneous nerve

Question 32

Where does the posterior cutaneous nerve of the thigh form?

Answer 32

In the sacral plexus and emerges in middle of gluteal region

Question 33

What does the posterior cutaneous nerve of the thigh supply, and what kind of nerve is it?

Answer 33

Supplies skin over posterior aspect of thigh; somatic nerve that contains sensory and sympathetic fibres

Question 34

Why may a lumbar puncture be performed?

Answer 34

To look for evidence of conditions that affect the brain, spinal cord or other parts of the nervous system

Question 35

What must be taken during a lumbar puncture?

Answer 35

Pressure measurements must be recorded and samples of cerebrospinal fluid (CSF) are taken form the subarachnoid space surrounding the spinal cord

Question 36

What position should a patient be in when getting a lumbar puncture?

Answer 36

On their left side and fully flexed (i.e knees to chin)

Question 37

What anatomical landmark is used in a lumbar puncture?

Answer 37

The iliac crests = plane between them visualised (plane is at level of L3/4)

Question 38

What is used to withdraw cerebrospinal fluid form the level of L3/4 in a lumbar puncture?

Answer 38

A spinal pack

Question 39

Where does the spinal cord end in adults?

Answer 39

Around the L1/2 intervertebral disc

Question 40

Why is a lumbar puncture taken from the level of L3/4?

Answer 40

It avoids injury to the terminal end of the spinal cord (conus medullaris)