gluteal region and hip Flashcards
gluteus maximus
- actions - origin - insertion - innervation
- posterior to posterior line of os coxa, sacrotuberous ligament
- iliotibial band on lateral thigh
gluteus medius
- actions - origin - insertion - innervation
- abductor of thigh. rotation of thigh
- ilium
- ## greater trochanter
gluteus minimus
- actions - origin - insertion - innervation
-
- between anterior and inferior gluteal lines on os coxa
structures between gluteus maximus and gluteus minimus
superior gluteal nerve and artery branches
muscles that externally rotate the hip
obturator internus and externus
quadratus femoris
piriformis
gluteus maximus
muscles that internally rotate the hip
gluteus medius and minimus
TFL
muscles involved in balance
gluteal
TFL (by tensing iliotibial tract)
adductor
trendelenburg test
for femoral head dislocation, gluteus medius rupture or weakness, and superior gluteal nerve damage
ask patient to stand on one leg - positive test if there’s a significant drop of the unsupported hip - suggests that the gluteus medius on the supported side isn’t working
greater sciatic foramen
most nerves and vessels to the gluteal region pass though here
filled by piriformis
pass superior to piriformis:
- superior gluteal artery and vein and nerve
pass inferior to piriformis:
- inferior gluteal nerve, artery, and vein
- pudendal nerve
- internal pudendal artery and vein
- sciatic nerve
- posterior femoral cutaneous nerve
posterior femoral cutaneous nerve
passes through greater sciatic foramen inferior to piriformis
supplies skin on back of the thigh
branch of sacral plexus - arises from upper sacral nerve roots
sciatic nerve
tibial and fibular nerves
usually enter gluteal region inferior to piriformis but varies
ligaments of hip joint
prevent hyperextension of femur on pelvis
useful while standing cause don’t have ot use hip flexor muscles to prevent yourself from falling over backwards - rest in slight extension on hip joins
ligaments tighten with extension
iliofemoral = anterior = strongest
posterior weakest - dislocations occur here if not also accompanied by a fracture (rare)
acetabular labrum
fibrocartilage that deepens acetabulum
inside of synovial capsule of joint and ligamentous capsule that covers joint
ligamentum teres
in head of femur
carries artery of the head of the femur
blood flow to femoral head
from artery of head of femur and from blood vessels that enter femur near trochanter and extend along the neck to the head
implications: before closure of epiphyseal plate, blood can’t get from neck into head - get avascular necrosis if artery to head damaged
artery of head can be insufficient in older people, fracture of neck of femur can also lead to necrosis of head of femur
what would a patient’s leg look like if he/she fractured the neck of his/her femur?
stronger muscles displace femur => externally rotated and superiorly displaced lower extremity
innervation to skin over gluteal area
upper routes to this skin from lumbar area
lower routes to this skin from sacral area
innervation of hamstring muscles
all innervated by tibial nerve except short head of biceps = fibular nerve
iliotibial band
inserts on lateral tibial plateau at Gerty’s tubercle (where biceps femoris inserts on fibular head)
distal end passes over lateral femoral condyle - can be irritated here by repetitive flexion of knee (iliotibial band syndrome - common in runners)
pes anserine
where tendons from semitendinosus, gracilis, and sartorius insert (semitendiousus closest to bone)
blood supply to posterior thigh
from perforating branches of deep femoral artery
penetrate insertion of adductor magnus muscle (so not one large blood vessel)
cruciate anastomosis
around posterior aspect of hip joint
anastomosis between perforating branches of deep femoral artery and branches of medial and lateral femoral circumflex vessels and inferior gluteal vessels
