Gluteal region and Posterior Thigh (Lect) Flashcards
What muscles act to stabilize the head of the femur in the acetabulum?
Superior and inferior gemellus, quadratus femoris, obturator internis
Where is the weak area for anterior dislocation?
between iliofemoral and pubofemoral ligaments
Where is the weak spot for posterior dislocation?
between iliofemoral and ischiofemoral ligaments
What is the position of the leg if it has been posteriorly dislocated?
medially rotated
What is the orientation of the leg if it has undergone anterior dislocation?
laterally rotated
What is the primary opposing muscle to illiopsoas?
Gluteus maximus
T or F: the gluteus maximus helps keep tension in the iliotibial tract?
False, this is a major job of tensor fascia lata
What is illiotibial band syndrome?
Occurs when IT band is inflamed
Causes pain in lateral knee and hip
common in long-distance runners, bicyclists, and other athletes
Whose fibers can be seen deep to the gluteal aponeurosis?
gluteus medius
What is the job of the anterior fibers of gluteaus medius and minimus?
Medial rotation of femur
What is the name of the gait that accompanies the tendelenburg sign?
Duchenne Limp
Where do most of the lateral rotators insert?
on the medial aspect of the greater trochanter
except for quadratus femoris = quadrate tubercle
What muscle passes through the greater sciatic foramen?
Piriformis
What muscles passes through the lesser sciatic foramen?
Obturator internus
What passes through the greater sciatic notch?
Superior Gluteal n. a. v. Pudendal n. and Internal pudendal a. v. Inferior gluteal n. a. v. Nerve to obturator internus, quatratus femoris, piriformis Sciatic nerve
and Posterior Femoral Cutaneous N.
What goes through the lesser sciatic foramen?
Pudendal Nerve (medial)
Internal Pudendal Vessels
Nerve to Obturator Internus (lateral)
What is the job of the structures that emerge superiorly from piriformis?
gluteus minimus and medius
Abduct
Weak Ext
Stabilization of Hip
Tensor fascia Lata
Abduct
Knee stabilization in ext.
Where do all the nerves in the gluteal region originate?
The sacral plexus and lumbosacral trunk
What cutaneous nerve emerges medially to the sciatic?
posterior femoral cutaneous n.
What nerve is directly deep to the sciatic?
N. to quadratus femoris
What nerves are at risk in gluteal injections?
sciatic nerve, inferior gluteal, inferior gluteal
What deficits would result from damage to the sciatic N in a gluteal injection?
deficits in hip extension, leg flexion, and movements of the ankle and toes
What deficits might result from damage to the inferior gluteal N?
deficits in hip extension, lateral rotation, loss of tension in iliotibial tract (reducing knee stability)
What deficits might result from damage to the superior gluteal n.?
deficits in abduction, medial rotation of the hip, loss of stability of the pelvis when walking
Where is the safe zone for gluteal injections?
upper lateral quadrant
What is piriformis syndrome?
Presses the sciatic n. when it becomes inflammed as a result of a fall or be overworked through activity
Where would pain be felt in piriformis syndrome?
in the butt at piriformis, and around the sciatic N.
What is isthmic spondylolisthesis?
lamina (usually of L5) breaks and the vertebra slides forward pinching the L5 nerve
What is a symptom of compression of the cauda equina via a ruptured disk?
pain emanating from parts of the bottock, thigh, leg, and foot served by the individual nerves involved
What are the primary and secondary actions of the muscles in the posterior compartment of the leg?
- Knee Flexion
2. Hip Extension and rotation at the knee joint
What are the muscles of the posterior compartment of the leg?
biceps femoris
Semitendonosus
Semembranosus
Where do the muscles of the posterior compartment originate?
ischial tuberosity except short head of biceps femoris
What is the path of the blood supply to the posterior compartment?
Perforating arteries:
Femoral a. –> Deep Femoral a. —adductor_magnus–> Hamstrings
What muscle acts in conjuction with semitendenosus and semimembranosus to medially rotate the tibia relative to femur?
popliteus
What muscles rotate the leg laterally relative to the femur?
biceps femoris
What motion indicates the locked extended position of the leg?
medial rotation of the femur on a fixed tibia
What motion indicates the unlocked position of the knee?
lateral rotation of the femur relative to the tibia via the popliteus muscle
What forms the superior border of the popliteal fossa?
Biceps femoris (laterally) Semimembranosus and semitendinosus (medially)
What forms the inferior border of the popliteal fossa?
Lateral head of gastrocnemius (laterally)
Medial head of gastrocnemius (medially)
What forms the roof of the popliteal fossa?
Skin and dense popliteal fascia
What forms the floor of the popliteal fossa?
Mostly knee joint capsule and inferiorly the popliteus muscle
What vein drains into the popliteal vein in the popliteal fossa?
Small saphenous
Where does the sciatic nerve divide?
at the superior angle of the popliteal fossa
What nerve does the common fibular nerve give rise to?
The lateral sural cutaneous n.
What gives rise to the medial sural cutaneous n?
Tibial n.
What is the orientation of the popliteal a. and v. in the popliteal fossa?
a. dorsal to v.
What is used to bypass blockage in the femoral artery?
cruciate anastomosis
What is peripheral artery disease (PAD)?
Blockages in arteries serving upper and lower extemities
How do you test for PAD?
test BP in dorsalis pedis or posterior tibial a.
It should be the same or slightly higher than brachial BP
If you test positive for PAD, where is the occlusion most likely occurring?
iliac, femoral, or popliteal arteries
What are the typical symptoms of PAD?
cramping and pain in legs after walking
