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Lower Limb Written > Gluteal Region & Pelvis > Flashcards

Gluteal Region & Pelvis Flashcards

1
Q

Shape of pelvic inlet

A

Females: oval shaped
Males: heart shaped

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2
Q

Shape of pelvic outlet

A

Females; round (facilitate childbirth)

Males: oblong/oval

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3
Q

Subpubic angle

A

Males: very narrow, ~30 degrees (approximate with “peace fingers)
Females: much larger angle (approximate with thumb and forefinger)

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4
Q

General gender differences in pelvis

A

Females have a wider, shorter pelvis

Males have thicker bones, narrower and taller pelvis

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5
Q

What is the Q angle?

A

Angle between vertical bisection of tibial tuberosity and the ASIS to midpoint of patella line.
Q-angle is affected by shape of pelvis, is ~16 degrees in females and ~11 degrees in males.
*Males have a smaller Q angle

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6
Q

Clinical correlation with Q angle

A

Larger Q angles (especially in genu valgum) can be associated with patellar dislocation
Some foot orthotics can decrease the Q angle

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7
Q

Posterior sacroiliac ligament has ___ fibers, Anterior sacroiliac ligament has ___ fibers

A

Long; short

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8
Q

Which ligament separates the greater and lesser sciatic foramen?

A

Sacrospinous ligament

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9
Q

What ligament goes from the sacrum to the ischial tuberosity?

A

Sacrotuberous ligament

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10
Q

What is in between the sacrospinous and sacrotuberous ligament?

A

the lesser sciatic foramen

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11
Q

What nerve lies in the lesser sciatic foramen?

A

Pudendal n

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12
Q

How many vertebrae in sacrum?

A

~ 5 fused together

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13
Q

Auricular surface

A

sacrum and iliac articulation

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14
Q

Median sacral crest

A

formed from spinal processes

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15
Q

Articular crest

A

formed from articular spinous processes

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16
Q

Lateral sacral crest

A

formed from transverse spinous processes

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17
Q

What 3 bones fuse around puberty?

A

Ilium, ishium, and pubis

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18
Q

The acetabulum consists of

A

the body of each of the ilium, ishium, and pubis (1/3 of each)

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19
Q

What is the Ala?

A

(wing) of the ilium

Iliac fossa is medially and dorsum illi is laterally

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20
Q

Between which bones is the greater sciatic notch?

A

the ilium and the ischium

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21
Q

ASIS is origin of what?

A

Sartorius
Iliacus
Tensor Fascia Lata
Inguinal Lig

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22
Q

AIIS is origin of what?

A

Iliofemoral ligament
Straight head of the Rectus Femoris
Part of the Iliacus

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23
Q

PSIS attachments

A

Posterior sacroiliac ligaments

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24
Q

Anything behind posterior gluteal line is going to be origin of?

A

gluteus maximus

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25
Q

Between posterior and anterior gluteal line is

A

gluteus medius origin

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26
Q

between anterior and inferior gluteal line is where

A

gluteus minimus originates

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27
Q

Origins from ischial tuberosity (7)

A 
Semimembranosus
Long head of biceps femoris
Semitendinosus
Adductor magnus
Quadratus femoris
Inferior gemilus
Sacrotuberous ligament
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28
Q

Ischial ramus attachments

A

Adductor magnus

Obturator internus

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29
Q

Body of Pubis attachments

A

Gracilis
Adductor Longus
Adductor Brevis

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30
Q

Superior pubic ramus attachments

A

Pectineus

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31
Q

Inferior pubic ramus attachments

A

Gracilis
Adductor Brevis
Adductor Magnus
Obturator Externus

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32
Q

Where is the obturator groove and what runs in it?

A

Runs inferior to the superior pubic ramus/body of the pubis

Obturator nerve and artery run in the groove

33
Q

Psoas major

A

Actions: flexes hip, flexes lumbar spine (bending over), spinal flexion (left and right)
Origin: vertebrae
inserts: lesser trochanter of femur
Innervated: L2-L3

34
Q

Psoas minor

A

Action: synergistic with major, spinal flexion (left and right tilt)
Origin: upper lumbar vertebrae
insertion: iliopectineal eminence and iliac fossa
innervated: L1

35
Q

Iliacus

A

Action: hip flexion
Origin iliac fossa
insertion: lesser trochanger of femur (along with psoas)
innervated: L2-L4
*note inserts same as psoas major and becomes iliopsoas

36
Q

What are the muscles of the iliac region?

A

Psoas major, psoas minor, iliacus

37
Q

Gluteus maximus

A

Origin: posterior side of the ilium and part of the sacrum/coccyx
Inserts: deep fibers on the gluteal tuberosity of the femur, iliotibial tract
action: extend and laterally rotate the leg (rising from sitting)
innervation: inferior gluteal nerve, L5-S2

38
Q

Tensor fasciae latae

A

origin: iliac crest near ASIS
inserts: broad fascia, iliotibial tract
action: hip flexion, medial rotation of thigh
innervation: superior gluteal n (also supplies glut. med & min.) L4-S1

39
Q

Gluteus medius

A

origin: between posterior and anterior gluteal lines, ilium
insertion: great trochanter of the femur
action: abductor of thigh and medially rotate extended thigh, stabilizes hip in locomotion and balance
innervation: superior branch of superior gluteal n

40
Q

what is piriformis syndrome?

A

when piriformis and gluteus medius fuse… makes it difficult to walk

41
Q

gluteus minimus

A

origin: ilium between anterior and inferior gluteal lines
inserts: on greater trochanter of femur (near medius)
action: synergist of medius. Abductor of thigh, medially rotates extended thigh, important in hip balance and locomotion
innervation: superior gluteal nerve, L4-S1

42
Q

Piriformis

A

Attached to gluteus medius or receives fibers from superior gemilus. May be pierced by sciatic n.
origin: anterior portion of sacrum
inserts: greater trochanter of femur
Action: laterally rotates thigh or abducts a flexed hip, hip extension
innervation: S2, some fibers from S1

43
Q

Obturator internus

A

Inside of obturator foramen, inside of pelvic bowl, wraps around ischium to insert on greater trochanter femur. Looks like a white tendon.
Action: synergist to piriformis; lateral hip rotation, abduction of flexed thigh, hip extension
innervation Nerve to obturator internus, L5-S1 (NOT the obturator n)

44
Q

Superior gemellus

A

often small, sometimes absent.

origin: ischial spine
insert: greater trochanter of femur
action: lateral rotation of thigh
innervation: nerve to obturator internus, L5-S1

45
Q

inferior gemellus

A

same action and insertion as superior gemellus

origin: ischial tuberosity
innervated: nerve to quadratus femoris, L5-S1

46
Q

Quadratus femoris

A

origin: ischial tuberosity
inserts: linea quadrata of femur
action: adduct and laterally rotate hip
innervation: nerve to quadratus femoris, L4-S1

47
Q

Obturator externus

A

Found directly opposite of obturator internus. It is on outside ofpelvis. Complete synergist with quadratus femoris - adduct and laterally rotate hip.
Origin: ischium and pubis (external part of obturator foramen)
insertion: trochanteric fossa
innervation: posterior division of the obturator nerve (this one IS innervated by the obturator nerve) L2-L4

48
Q

What are the muscles of the gluteal region?

A 
Gluteus maximus
Tensor fasciae latae
Gluteus medius
Gluteus minimus
Piriformis
Obturator internus
Superior gemellus
Inferior gemellus
Quadratus femoris
Obturator externus
49
Q

Sacral plexus

A

Part of L4
L5, S1, S2, S3
Part of S4

50
Q

Coxygeal plexus

A

Part of S4

S5

51
Q

What is the Nervus Furcalis?

A

“forked nerve”
L4
**know this

52
Q

Lumbar plexus

A

Part of T12
L1, L2, L3
Part of L4

53
Q

Lateral femoral cutaneous innervates?

A

lateral compartment

54
Q

Femoral n innervates?

A

anterior compartment

55
Q

Obturator n innervates?

A

obturator externus and medial compartment

56
Q

Posterior division of the sacral plexus

A

Superior gluteal L4-S1
Inferior gluteal L5-S2
Nerve to Piriformis S2 (occasionally S1

57
Q

Superior gluteal n

A

L4-S1
Branches: splits after greater sciatic foramen
Superior branch: goes deep to gluteus medius
Inferior branch: goes to gluteus minimus, medius, and tensor fasciae latae

58
Q

Inferior gluteal n

A

L5-S2

Gluteus maximus

59
Q

Nerve to Piriformis

A

S2 (occasionally S1)

Piriformis

60
Q

What nerve is the posterior division of the sciatic?

A

Common peroneal

61
Q

What nerve is the anterior division of the sciatic?

A

Tibial n

62
Q

Anterior division of the sacral plexus

A

Nerve to Quadratus femoris L4-S1
Nerve to Obturator internus L5-S2
Pudendal

63
Q

Which nerve runs parallel to sciatic?

A

Posterior femoral cutaneous (mix of anterior/posterior divisions) S1-S3

64
Q

The superior gluteal n is superior to what m?

A

Piriformis

Superior gluteal n always comes out above the piriformis, the inferior gluteal n always comes out below it

65
Q

Branches of External Iliac artery?

A

Aberrant obturator

Deep circumflex iliac

66
Q

Branches of internal iliac artery?

A 
Iliolumbar
Lateral sacral
Obturator
Superior gluteal
Inferior gluteal
Internal pudendal
67
Q

What muscles does the iliolumbar artery supply?

A

Iliacus and psoas major

68
Q

What muscle does the lateral sacral artery supply?

A

Piriformis

69
Q

Which artery goes to all the (superficial) gluteal muscles?

A

Superior gluteal a

goes to gluteus minimus, medius, with some branches to maximus and tensor fasciae latae

70
Q

What artery goes to the femoral head?

A

Obturator a. It travels with obturator n. It is important in children during ossification.

71
Q

Inferior gluteal artery goes where?

A

to gluteus maxiums and sometimes branches to piriformis

72
Q

Important sensory sacral plexus spinal cord levels

A 
Medial thigh, proximal to distal: L1-L3
Medial leg: L3, L4
*Big Toe: L4
*Digits 2,3,4: L5
*Little Toe: S1
Lateral leg: L5, S1
Lateral thigh, proximal to distal: L1-L5
Posterior thigh: S1,S2
73
Q

Patellar Ligament reflex

A

L4

four quadriceps muscles

74
Q

Extensor digitorum and Hallucis longus

A

L5

five toes

75
Q

Calcaneal tendon reflex

A

S1

Achille’s 1 weak spot

76
Q

Plantar reflex

A

Babinski sign
- normal in babies (up to ~4 years old)
if positive in adult problem with corticospinal tract

77
Q

What are the variations in the sciatic nerve orientation?

A

Can emerge under piriformis
Can pierce piriformis
Can emerge above piriformis

78
Q

Where should injections be done on the gluts?

A

Laterally and superiorly to avoid the sciatic

79
Q

Trendelenburg sign

A

unaffected side drops down

Lower Limb Written (3 decks)

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