gluteal region

Question 1

where does the gluteal region lie?

Answer 1

between the back and posterior thigh and is posterior to the pelvis
bounded superiorly by the iliac crests and inferiorly by the gluteal fold/sulcus

Question 2

what marks the lateral extend of gluteal region

Answer 2

greater trochanter or femur

Question 3

3 gluteal muscles

Answer 3

gluteus maximus, medius, minimus

Question 4

most superficial gluteal muscle

Answer 4

gluteus maximus

Question 5

gluteus maximus and attachments

Answer 5

largest, attaches to iliac crest, sacrum, sacrotuberous ligament and coccyx proximally and distally onto iliotibial tract (some fibres attach distally to gluteal tuberosity of femur)

Question 6

what helps define the gluteal fold

Answer 6

gluteus maximus and supercial fascia overlying it

Question 7

most powerful extensor of the hip

Answer 7

gluteus maximus

Question 8

gluteus medius and minimus both attach to

Answer 8

external/posterior/gluteal aspect of plum and the anterolateral aspect of the greater trochanter of the femur

Question 9

gluteus medius and minimus do what?

Answer 9

abduct and medially rotate the thigh and hip joint

Question 10

nerve supply to gluteus medius and minimus

Answer 10

superior gluteal nerve (spinal nerve root values L5, S1 and 2); damage to these can resent in the sign “Trendelenburg”

Question 11

what is the inferior neuromuscular bundle?

Answer 11

contains inferior gluteal artery, vein, and nerve (spinal nerve root L5, S1 and 2) and supplies gluteus maximus, located deep to this muscle

Question 12

superior gluteal neuromuscular bundle?

Answer 12

contains superior artery, vein, and nerve and supplies the gluteus medius and minimus muscles
located deep to gluteus medius

Question 13

what lies deep to the gluteal muscles?

Answer 13

the lateral rotators of the hip (including piriformis)
these small muscles are arranged in strips running approximately transversely from medial to lateral between the sacrum, ilium, and ischial spine and tuberosity medially and mainly greater trochanter of femur laterally

Question 14

lateral rotators of the hip action?

Answer 14

external rotation of the lower limb at the hip joint, although they also play a role in stabilizing the head of the femur in acetabulum

Question 15

what is the iliotibial tract?

Answer 15

thickening of the deep fascia of the thigh (fascia lata)

runs from ASIS to lateral aspect of lateral tibial condyle at Gerdy tubercle

Question 16

iliotibial tract supports…

Answer 16

the knee joint

Question 17

what is the tensor fascia lata

Answer 17

muscular part of fascia lata, enclosed within the proximal portion of the tract

Question 18

sciatic nerve?

Answer 18

L4-S3, forms the sacral plexus of the pelvis and emerges into the middle of the gluteal region then descends and leaves the region to enter the posterior compartment of the thigh

Question 19

sciatic nerve branches path…

Answer 19

descend though popliteal fossa and posterior and lateral compartments of the leg into the foot

Question 20

largest nerve in the body? how is it usually affected?

Answer 20

sciatic nerve, lumbar slipped discs (sciatica)

Question 21

how does piriformis cause sciatica?

Answer 21

hypertrophy or tightness of the muscle which may compress the sciatic nerve

Question 22

pudenal nerve?

Answer 22

S2-4, forms sacral plexus within the pelvis, emerges into the middle of the gluteal region and supplies the muscles, skin + fascia of much of the perineum

Question 23

posterior cutaneous nerve of thigh

Answer 23

(PCNT- posteriorr femoral cutaneous nerve: S1-3) forms in sacral plexus, emerges into middle of gluteal region and supplies the skin over the posterior aspect of the thigh
somatic nerve - sensory and sympathetic

Question 24

reason for a lumbar puncture

Answer 24

conditions affecting brain, spinal cord, or other parts of the nervous system
pressure measurements are recorded and CSF is taken from subarachnoid space

Question 25

how does lumbar puncture work

Answer 25

patient on left side and knees to chin. iliac crests identified, L3/4, spinal fluid between

Question 26

what does insertion at this point for lumbar puncture avoid?

Answer 26

injury to the terminal part of the spinal cord (L1/2) - conus medullaris

Question 27

gluteus medius attachments, nerve supply, action

Answer 27

prox: external ilium between anterior and posterior gluteal lines distal: lateral surface of greater trochanter of femur nerve: superior gluteal action: abduct and medially rotate thigh

Question 28

gluteus minimus attachments, nerve, action

Answer 28

prox: external ilium between anterior and inferior gluteal lines distal: superior surface of greater trochanter nerve: superior gluteal action: abduct and medially rotate thigh

Question 29

piriformis attach, nerve, action

Answer 29

prox: anterior surface of sacrum distal: superior surface of greater trochanter nerve: anterior rams of S1/2 action: laterally rotate and extend thigh and abducts flexed thigh

Question 30

superior and inferior gemelli attach, nerve, action

Answer 30

prox: sup-ischial spine inf- ischial tuberosity distal: trochanteric fossa nerve: sup- nerve to obturator internus, inf- quad femoris action: same as piriformis

Question 31

obturator internus attach, nerve, action

Answer 31

prox: internal surface of obturator membrane distal: trochanteric fossa nerve: nerve to obturator internus action: same as piriformis

Question 32

quadrates femoris attach, nerve, action

Answer 32

prox: ischial tuberosity distal: intertrochanteric crest (quad tubercle) nerve: nerve to quad femoris action: lateral rotate thigh

Question 33

sciatic nerve course and action

Answer 33

enters gluteal region through infra-piriform foramen and deep to gluteus maximus, supplies nothing in gluteal region but supplies posterior compartment of thigh and all of leg

Question 34

posterior cutaneous nerve of the thigh

Answer 34

enters gluteal region through infra-piriform foramen, medial to sciatic nerve, supplies skin of inferior half of butt and skin of posterior thigh and popliteal fossa

Question 35

inferior gluteal nerve

Answer 35

enters gluteal region through infra-piriform foramen, divides into many branches before piercing the gluteus maximus, supplies gluteus maximus

Question 36

nerve to quadrates femoris

Answer 36

enters gluteal region through the infra-piriform foramen, deep to sciatic nerve, supplies hip joint, inferior femellus and quad femoris

Question 37

nerve to obturator internus

Answer 37

enters gluteal region through infra-piriform foramen, posterior to sacrospinous ligament to enter pelvis through lesser sciatic foramen, supplies superior gemellus and obturator internus

Question 38

pudenal nerve

Answer 38

enters gluteal region through infra-piriform foramen, posterior to sacrospinous ligament to enter pelvis through lesser sciatic forament, supplies perineum