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Anatomy > Gluteal Region, Posterior Thigh, and Popliteal Fossa > Flashcards

Gluteal Region, Posterior Thigh, and Popliteal Fossa Flashcards

1
Q
  • What is the prominent area posterior to the pelvis?
  • What is the gluteal region bounded superiorly by?
  • What is it bounded inferiorly by?
  • What demarcate the inferior border of the buttocks and the superior boundary of the thigh?
  • What separates the buttocks from each other?
A
  • gluteal region
  • iliac crest, greater trochanter, and ASIS (superiorly)
  • gluteal fold (inferiorly)
  • gluteal folds
  • intergluteal cleft
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2
Q
  • What provides the gluteal region and posterior compartment of the thigh with support?
  • Enclosing the tissues of the gluteal and posterior thigh region are (…) and (…), which form an enveloping sleeve over the muscles in these regions
  • What converts the sciatic notches in the hip bones into the greater and lesser sciatic foramina?
  • What is the passageway for structures entering to leaving the pelvis?
  • What is a passageway for structures entering or leaving the perineum?
A
  • pelvic girdle and femur
  • gluteal aponeurosis and fascia lata
  • sacrotuberous and sacrospinous ligaments
  • greater sciatic foramen
  • lesser sciatic foramen
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3
Q

What is the common attachment for hamstring muscles?

A

ischial tuberosity

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4
Q

What provides cutaneous innervation to the upper gluteal and posterior iliac crest?

A
  • dorsal rami: L1-L3 + S1-S3
    **superior cluneal n (L1-L3) and middle cluneal n (S1-S3)
  • ventral rami of S1-S3
    **inferior cluneal n. (S1-S3) - posterior cutaneous of thigh)
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5
Q
  • What are the two layers of the gluteal muscles?
  • What muscles are included in the superficial layer?
  • What muscles are included in the deep layer?
A
  • superficial and deep
  • gluteus maximus, medius, and minimus, and tensor fascia latae
  • piriformis, obturator internus, superior and inferior gemelli, and quadratus femoris
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6
Q
  • What muscle is the most superficial of the gluteal mm and gives roundness to posterior thigh region?
  • What are the main actions of this muscle?
  • This muscle functions primarily when (…)
A
  • gluteus maximus
  • thigh extension and lateral rotation
  • rising from sitting position, straightening from bending position, walking uphill and upstairs, and running
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7
Q
  • What are the actions of the superficial gluteal muscles (minus gluteus max)?
  • What are the actions of the deep gluteal muscles?
A
  • medial rotators and abductors
  • lateral rotators and abductors
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8
Q
  • What are the actions of gluteus medius and minimus?
  • What are the actions of the tensor fascia lata?
A
  • abduct and medially rotates the thigh
  • abduct and medially rotates the thigh but does not act independently
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9
Q

What are the neurovascular structures in the gluteal region?

A
  • inferior and superior gluteal aa
  • inferior gluteal n
  • sciatic n
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10
Q

What are the distal attachments of these muscles?
- gluteus maximus
- gluteus medius
- gluteus minimus

A
  • iliotibial tract → lateral condyle of tibia; gluteal tuberosity of femur
  • greater trochanter of femur
  • greater trochanter of femur
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11
Q

What is the innervation of these muscles?
- gluteus maximus
- gluteus medius
- gluteus minimus

A
  • inferior gluteal nerve
  • superior gluteal nerve
  • superior gluteal nerve
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12
Q
  • What are the actions of gluteus maximus?
  • What are the actions of gluteus medius and minimus?
A
  • extends hip b/w flexed and standing positions, lateral rotation, steadies thigh, assists in rising from sitting position
  • abducts and medially rotates hip joint, keeps pelvis level when opposite limb is elevated
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13
Q

Damage to the gluteus medius or minimus can lead to what?

A

a tilted pelvis

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14
Q

What is the proximal and distal attachment of the tensor fascia lata?
- What innervates the TFL?
- What artery supplies the TFL?
- What are the actions of the TFL?

A
  • ASIS, iliotibial tract
  • superior gluteal n
  • superior gluteal a
  • flexes hip, abducts and medially rotates thigh, stabilizes extended knee joint
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15
Q

What is an overuse injury of connective tissues that are located on the lateral or outer part of the thigh and knee?

A

iliotibial band syndrome

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16
Q

What muscles does the TFL act with?

A
  • gluteus medius and minimus
  • gluteus maximus
  • iliopsoas and rectus femoris
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17
Q

What is the proximal attachment of the piriformis muscle?

A
  • greater sciatic notch and sacrotuberous ligament
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18
Q

What are the distal attachments of these muscles?
- piriformis
- obturator internus
- gemelli, superior and inferior
- quadratus femoris

A
  • greater trochanter (superior)
  • greater trochanter - trochanteric fossa (medial)
  • greater trochanter - trochanteric fossa (medial)
  • quadrate tubercle on intertrochanteric crest of femur
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19
Q

What innervates these muscles?
- piriformis
- obturator internus
- gemelli, superior and inferior
- quadratus femoris

A
  • anterior rami of S1-S2
  • nerve to obturator internus
  • superior: nerve to obturator internus; inferior: nerve to quadratus femoris
  • nerve to quadratus femoris
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20
Q
  • What are the actions of the piriformis, obturator internus, and gemelli muscles?
  • What are the actions of quadratus femoris?
A
  • laterally rotate extended hip, abduct flexed him, steadies femoral head in acetabulum
  • laterally rotates hip, pulls femoral head into acetabulum to stabilize hip joint/pelvis
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21
Q

What are the muscles included in the hip extensors?

A
  • gluteus maximus
  • biceps femoris long head
  • semitendinosus
  • semimembranosus
  • adductor magnus (hamstring part)
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22
Q
  • What muscle is a powerful hip extensor and lateral rotator?
  • When thigh is flexed, this muscle (…) such as in sitting
  • When thigh is extended, it (…)
A
  • gluteus maximum
  • abducts
  • adducts
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23
Q
  • What are causes to an inferior gluteal nerve injury?
  • What muscle would be affected?
  • What would someone have difficulty doing if this nerve was injured?
A
  • posterior hip dislocation, surgery, trauma (inappropriately administered IM injection)
  • gluteus maximus
  • difficulty raising from sitting and climbing stairs
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24
Q

What muscles/nerves keep contralateral side of the pelvis from sagging (dropping) to the unsupported side?

A
  • gluteus medius and minimus
  • superior gluteal nerve
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25
Q

What is the blood supply to gluteus maximus? innervation?

A
  • superior and inferior gluteal aa
  • inferior gluteal n
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26
Q
  • What muscles would be affected in a superior gluteal nerve injury?
  • How would the pelvis be affected?
  • What is this called?
  • What actions would be impaired?
A
  • gluteus medius and minimus
  • pelvis would sag on opposite side of lesion when leg is unsupported
  • positive trendelenburg gait
  • weakened abduction of thigh, severely impaired medial thigh rotation
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27
Q

What describes a contralateral hemi-pelvis drop, so the pelvis sags on the opposite side of lesion?

A

positive trendelenburg gait

28
Q
  • What are causes of positive trendelenburg gait?
  • When the pelvis on unsupported side descends, what does this indicate?
A

causes
- paralysis of gluteus medius and minimus
- fracture of greater trochanter
- dislocation of hip joint
indication
- gluteus medius and minimus on supported side are weakened/non-functional

29
Q

What are compensation gaits to the positive trendelenburg gait?

A

too long lower limb
- waddling/gluteal gate: swing forward
- steppage gait: lift foot higher and move forward
- swing-out: swing foot outward (without footdrop)

30
Q

Where is the lateral swing-out gait also seen?

A

in common fibular n injury leading to footdrop

31
Q
  • What muscles medially rotate the thigh (posterior lower extremity)?
  • What muscles laterally rotate thigh?
A
  • superficial gluteal mm except for gluteus max
  • all deep gluteal mm and gluteus max
32
Q

What other muscles are used when rising from sitting/squatting and climbing up stairs?

A
  • main muscles: quadriceps femoris
  • secondary muscles: glutes
  • other muscles: hamstrings and abdominals
33
Q
  • Piriformis and obturator internus act as lateral rotators when thigh is (…) and abduct when thigh is (…)
  • These muscles also act as what?
  • Damage of deep gluteal muscles muscles can increase the risk of what?
A
  • extended; flexed
  • hip join stabilizer
  • hip dislocation
34
Q

What are the actions of the gemelli muscles?

A
  • stabilizes hip joint
  • assists and reinforces obturator internus (laterally rotates extended thigh; abducts flexed thigh)
35
Q

What are the actions of quadratus femoris?

A
  • strong lateral rotator
  • hip joint stabilizer
36
Q
  • What is a condition in which the piriformis muscle spasms and causes buttock pain and can compress the sciatic nerve causing pain, numbness, and tingling along the back of the leg and into the foot? This can cause 50% buttock trauma.
  • What is this caused by?
  • Who is this most prevalent in, males or females?
  • People who are (…) are more prone to this due to overusing their gluteal region?
A
  • piriformis syndrome
  • overusing gluteal mm
  • females
  • ice skaters, cyclists, rock climbers
37
Q
  • What is the safe site in the gluteal region for intramuscular injections?
  • What are complications of improper intramuscular injection technique in the gluteal region?
A
  • upper lateral quadrant, superolateral quadrant
  • nerve injury, hematoma, abscess formation
38
Q
  • What are flattened membranous sacs containing a capillary layer of synovial fluid, separate from the gluteus maximus from adjacent structures?
  • These are located in areas subject to (…), such as between a muscle and bony prominence, reducing friction and promoting free movement
A
  • the gluteal bursae
  • friction
39
Q
  • What are the busae associated with the gluteus maximus?
  • What do they separate?
A
  • trochanteric bursa: separates deep aspect of gluteus maximus from greater trochanter of femur
  • ischial bursa: separates inferior body of gluteus maximus from ischial tuberosity
  • gluteofemoral bursa: separates iliotibial tract from superior part of proximal attachment of vastus lateralis
40
Q
  • How many posterior thigh muscles are considered hamstring muscles?
  • Which muscle is not considered a hamstring muscle?
  • What do the hamstring muscles arise from and insert onto?
  • What are the hamstring muscles innervated by?
A
  • 3 out of the 4 muscles
  • biceps femoris short head
  • ischial tuberosity; leg bones
  • tibial n
41
Q
  • Hamstring muscles span and act on (…) joints
  • What actions does this allow for?
  • Can both of these actions be preformed maximally at the same time?
  • A fully flexed knee shortens the hamstrings so they cannot further contract to (…) the hip joint
  • A fully extended hip shortens the hamstrings so they cannot act on the (…)
  • When the thighs are and legs are fixed, the hamstrings can help (…) at the hip joint; they are active in (…) under all situations except full (…) of the knee, including maintenance of the standing position.
A
  • two joints
  • hip extension, knee flexion
  • no
  • extend
  • knee
  • extend the trunk
  • hip extension
  • flexion
42
Q
  • Why is the short head of the biceps femoris m not considered a hamstring m?
  • What is it innervated by?
A
  • it crosses only at the knee joint, allowing for knee flexion
  • common fibular n
43
Q

What is the proximal attachment of these muscles?
- semitendinosus
- semimembranosus
- biceps femoris long head
- biceps femoris short head

A
  • ischial tuberosity
  • ischial tuberosity
  • ischial tuberosity
  • linea aspera, lateral supracondylar line of femur
44
Q

What are the distal attachments of these muscles?
- semitendinosus
- semimembranosus
- biceps femoris long head
- biceps femoris short head

A
  • medial superior part of tibia
  • posterior medial condyle of tibia
  • lateral side of head of fibula
  • lateral side of head of fibula
45
Q

What innervates these muscles?
- semitendinosus
- semimembranosus
- biceps femoris long head
- biceps femoris short head

A
  • tibial n
  • tibial n
  • tibial n
  • common fibular n
46
Q
  • What are the actions of semitendinosus and semimembranosus?
  • What are the actions of biceps femoris long head and short head?
A
  • extends hip, flex knee, medially rotate knee when knee is flexed, extend trunk when hip and knee are flexed
  • flexes knee, laterally rotates knee when it is flexes, extends hip, such as when starting to walk (long head)
47
Q
  • Hamstring injuries are common in people who do what?
  • The muscular exertion required to excel in these sports may tear what?
A
  • people who run and/or kick hard (quick-start sports such as sprinting, baseball, and soccer)
  • proximal attachment of hamstrings to ischial tuberosity
48
Q
  • What is a type of hamstring injury due to fast “stop/start” such as in sprints, hurdles, and long jump?
  • What active sports lead to hamstring injuries?
A
  • hurdle’s injury
  • football, soccer, basketball, skiers, climbers
49
Q

The classic mechanism of hamstring injuries is flexion of the hip jt with extension of the knee such as?

A
  • strains/pulled/torn
  • hematomas
50
Q

What injuries are more common than quadriceps injuries and is the consequence of inadequate warm-up?

A
  • hamstring injuries
51
Q
  • The gluteal region is richly innervated by superficial gluteal nn: (1), (2) and (3)
  • What are the deep gluteal nerves?
  • What nerve supplies no structures in the gluteal region, exits via the less sciatic foramen, and supplies the structures in the perineum?
A
  • superior, middle, and inferior cluneal nn
  • sciatic, posterior cutaneous nn of the thigh, superior gluteal, inferior gluteal, nerve to quadratus femoris, pudendal n, nerve to obturator internus
  • pudendal n
52
Q
  • What is the largest nerve in the body and is the continuation of the main part of the sacral plexus?
  • What runs inferolaterally under gluteus maximus, midway b/w greater trochanter and ischial tuberosity?
  • This nerve lies posterior to the (…) and deep to the (…)
A
  • sciatic nerve
  • sciatic nerve
  • posterior to adductor magnus, deep to biceps femoris long head
53
Q
  • The sciatic n is really two nerves loosely bound together in the same connective tissue sheath: the (1) and (2)
  • These two nerves separate in the inferior third of thigh, however, in 12% of people, the nerves separate as they leave (…)
  • In these cases, the tibial n passes inferior to the (1) and the common fibular nerve pierces the (2) or passes superior to it
A
  • tibial n and common fibular n
  • pelvis
  • piriformis, piriformis
54
Q

What supplies no structures in the gluteal region, innervates the posterior thigh mm, all leg and foot mm, the skin of most of the leg and foot, and supplies articular branches to lower limb joints inferior to the hip?

A

the sciatic n

55
Q
  • What is a sensory branch of the sacral plexus that supplies the skin of the posterior thigh, buttock, and posterior scrotum/labia?
  • What is the medial, larger terminal branch of the sciatic nerve, is the anterior division of the sacral plexus, and what does it give off?
  • What is the lateral, smaller terminal branch of the sciatic nerve, and is the posterior division of the sacral plexus?
A
  • posterior femoral cutaneous nerve
  • tibial nerve; gives off medial sural cutaneous n
  • common fibular n
56
Q
  • The blood supply to the gluteal region is from branches of the (…)
  • What is the largest branch of this artery that enters the gluteal region from pelvis along superior border of piriformis m?
  • What does this branch divide into and what muscles do they supply?
A
  • internal iliac artery
  • superior gluteal artery
  • superficial branch (gluteus maximus) and deep branch (runs b/w glut med and glut min, supplies gluteus medius, minimus, and TFL)
57
Q
  • What is a branch off the internal iliac a that enters the gluteal region from the pelvis inferior to the piriformis m? What does it supply?
  • What branch of the internal iliac a enters the gluteal region with the pudendal n, turns back, and re-enters the pelvis through lesser sciatic foramen? What does it supply?
A
  • inferior gluteal artery; supplies gluteus maximus, obturator internus, quadratus femoris, and superior parts of posterior thigh muscles
  • internal pudendal artery; supplies external genitalia and pelvis muscles
58
Q
  • What is the largest branch of the femoral artery, originating in upper part of thigh, descending through anterior compartment of thigh, where it branches into three major perforating muscular branches to posterior thigh muscles and ends in the inferior third of thigh as the 4th perforating artery?
  • The fourth perforating artery pierces and supplies what muscles?
A
  • deep branch of the thigh
  • supplies adductor magnus and lower parts of hamstring muscles
59
Q
  • Venous drainage of the gluteal region is by what veins?
  • What do these drain into?
  • What do the internal pudendal veins drain and empty into?
  • Venous drainage from the large veins of the posterior compartment of the thigh follows the course of the (…) and empties into the (…)
A
  • superior and inferior gluteal veins
  • primarily into pelvis but also communicate with femoral veins, providing alternate route of drainage from lower limb
  • drain blood from external genitalia; empty into internal iliac veins
  • deep artery of the thigh; empties into the femoral vein
60
Q
  • What is an arterial network found on the back of the thigh’s proximal femur consisting of 4 different components?
  • What are the 4 components?
A
  • cruciate anastomosis of the posterior thigh
  • inferior gluteal a, medial circumflex femoral a, lateral circumflex femoral a, 1st perforating branch of deep femoral artery
61
Q

What allows blood to reach the popliteal artery indirectly from the internal iliac artery and IGA if there is an interruption of flow between the external iliac and the femoral arteries?

A

cruciate anastomosis of the posterior thigh

62
Q
  • What is a mostly fat-filled diamond-shaped space posterior to the knee joint where all important vessels and nerves from the thigh pass through this fossa?
  • What is a strong sheet of deep fascia forming a protective covering for neurovascular structures passing through popliteal fossa?
  • What is this fascia continuous with?
A
  • popliteal fossa
  • popliteal fascia
  • continuous fascia lata superiorly, and deep (crural) fascia of the leg inferiorly
63
Q
  • What is the continuation of the femoral artery as it passes through the adductor hiatus?
  • The popliteal artery ends at the inferior border of the popliteus by dividing into what arteries?
  • What is the deepest structure in the popliteal fossa that gives off 5 genicular branches?
  • What do these branches supply?
  • What are the names of the genicular branches?
  • What do these branches participate in the formation of?
A
  • popliteal artery
  • anterior and posterior tibial arteries
  • popliteal artery
  • supply the knee joint capsule and ligaments of the knee joint
  • superior lateral, superior medial, middle, inferior lateral, and inferior medial genicular arteries
  • genicular anastomosis
64
Q

What are the boundaries of the popliteal fossa?

A
  • superolaterally: biceps femoris
  • superomedially: semimembranosus
  • inferolaterally and inferomedially: gastrocnemius (lateral and medial)
  • posteriorly (roof): skin and fascia
  • anteriorly (floor): popliteal surface femur, oblique popliteal ligament, popliteal fascia
65
Q

What are the contents of the popliteal fossa?

A
  • small saphenous v
  • popliteal artery and vein
  • tibial and common fibular nn
  • posterior cutaneous n of the thigh
  • popliteal lymph nodes and lymphatic vessels

Anatomy (25 decks)

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