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Anatomy > Gluteal Region Posterior Thigh and Popliteal Fossa > Flashcards

Gluteal Region Posterior Thigh and Popliteal Fossa Flashcards

1
Q

This is a very strong ligament that attaches superiorly to the PSIS, PIIS, and dorsal surface and lateral borders of the lower part of the sacrum and the coccyx. It attaches inferiorly to the ischial tuberosity.

A

sacrotuberous ligament

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2
Q

This ligament is smaller than the sacrotuberous ligament. It is triangular and attaches to the lateral border of the sacrum and coccyx. It inserts on the ischial spine

A

sacrospinous

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3
Q

The ____ ____ foramina is the irregular oval space bound by the greater sciatic notch of the coxa, the sacrotuberous ligament, and the sacrospinous ligament. This is the passageway for some of the structures entering or exiting the pelvis.

A

greater sciatic

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4
Q

What are the structures passing through the greater sciatic foramen?

A

pirifiormis muscle
superior to piriformis - superior gluteal vessels and nerves
inferior to piriformis - inferior gluteal vessels and nerves, pudendal nerve, the sciatic nerve, the posterior femoral cutaneous nerve

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5
Q

This is the space created by the crossing of the sacrospinous ligament and the sacrotuberous ligament with the lesser sciatic notch forming the anterior border. This forms a passageway for structures entering or leaving the perineum

A

lesser sciatic foramen

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6
Q

What are the structure passing through the lesser sciatic foramen?

A

tendon of obturator internus muscle (with nerve to the obturator innerness) and pudendal nerve (with the internal pudendal vessels)

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7
Q

What gluteal muscles are in the superficial group?

A

gluteus maximus, gluteus medius, and gluteus minimus

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8
Q

What is the deep group of gluteal muscles?

A

piriformis through quadratus femoris, the lateral rotators, and important stabilizers of hip joint

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9
Q

There is an additional origin for gluteus maximus from the ____ fascia

A

throacolumbar

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10
Q

Give the attachments, innervation, and main action of gluteus maximus

A

proximal attachment: ilium; dorsal surface of sacrum and coccyx; sacrotuburous ligament

distal attachment: most fibers end in iliotibial tract which inserts not lateral condyle of tibia

innervation: inferior gluteal nerve

main action: extends thigh and assists in lateral rotation, steadies thigh and assist in rising from siting position

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11
Q

Give the attachments, innervation, and main action of gluteus medius

A

proximal attachment: ilium between ant and post gluteal lines

distal attachment: lateral surface of greater trochanter of femur

innervation: superior gluteal nerve

main action: abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight bearing

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12
Q

Give the attachments, innervation, and main action of gluteus minimus

A

proximal attachment: ilium between ant and post gluteal lines

distal attachment: anteriorl surface of greater trochanter of femur

innervation: superior gluteal nerve

main action: abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight-bearing

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13
Q

Give the attachments, innervation, and main action of tensor fascia lata

A

proximal attachment: anterior superior iliac spine; anterior part of iliac crest

distal attachment: iliotibial tract

innervation: superior gluteal nerve

main action: abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight-bearing

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14
Q

Give the attachments, innervation, and main action of pirifiormis

A

proximal attachment: ASIS, anterior part of iliac crest

distal attachment: superior border of greater trochanter of femur

innervation: branches of anterior rami S1-S2

main action: laterally rotate extended thigh and abduct flexed thigh; steady femoral head in acetabulum

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15
Q

Give the attachments, innervation, and main action of obturator internus

A

proximal attachment: pelvic surface of obturator membrane and surrounding bones

distal attachment: medial surface of greater trochanter of femur

innervation: nerve to obturator internus

main action: laterally rotate extended thigh and abduct flexed thigh; steady femoral head in acetabulum

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16
Q

this bursa is between the gluteus maximus and greater trochanter: Friction Bursitis manifests as point tenderness over the greater trochanter radiating along iliotibial tract to tibia

A

trachanteric bursa

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17
Q

this bursa is located between the gluteus maximus and the ischial tuberosity

A

ischial bursa

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18
Q

this bursa separates the iliotibial tract from the superior part of the proximal attachment of vastus laterals on the femur

A

gluteofemoral

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19
Q

The contraction of these two gluteal muscles prevents sagging of the unsupported limb (trendelenburg’s sign)

A

gluteus medius, gluteus minimus

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20
Q

This muscle is pear-shaped

A

piriformis

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21
Q

Give the complaint, diagnosis, pathogenesis, and treatment of piriformis syndrome

A

complaint: localized buttock pain and localized tenderness over the greater sciatic notch region
diagnosis: patient sleeps on his back and the examiner flexes the hip and extends the knee at right angle to reproduce pain
pathogenesis: compression of the sciatic nerve by piriformis, by fibrous tissue or by vascular anomalies
treatment: physiotherapy, OMM, NSAID injections
surgery: decompress nerve by releasing piriformis

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22
Q

Most of this muscle is within the pelvis while its tendon passes through the lesser sciatic foramen into the gluteal region

A

obturator internis

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23
Q

Give the attachments, innervation, and main action of semitendinosus

A

proximal attachment: ischial tuberosity

distal attachment: medial surface of superior part of tibia

innervation: tibial division of sciatic nerve

main action: extend thigh, flex leg and rotate it medially

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24
Q

Give the attachments, innervation, and main action of semimembranosus

A

proximal attachment: ischial tuberosity

distal attachment: posterior part of medial condyle of tibia

innervation: tibial division of sciatic nerve

main action: extend thigh; flex leg and rotate it medially

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25
Q

Give the attachments, innervation, and main action of biceps femoris

A

proximal attachment: long head - ischial tuberosity, short head - linea aspera and lateral supracondylar line of femur

distal attachment: lateral side of head of fibula; tendon is split at this site by fibular collateral ligament of knee

innervation: long head - tibial division of sciatic nerve, short head - common fibular vision of sciatic nerve

main action: external rotator of flexed leg

26
Q

Superior part of medial surface of tibia represents SGS: insertion points of what 3 muscles

A

sartorius, gracilis, semitendinosus

27
Q

Forced hip flexion with extended knee can result in avulsion of fracture of the ischial tuberosity. True or false?

A

true

28
Q

Give the course and distribution of the sciatic nerve

A

course: enters gluteal region via greater sciatic foramen, descends in posterior thigh, bifurcates into tibial and common fibular nerves at popliteal fossa
distribution: supplies no muscles in gluteal region, but supplies all muscles of posterior compartment of thigh

29
Q

Give the course and distribution of the posterior cutaneous nerve of thigh

A

course: enters gluteal region via greater sciatic foramen, emerges from inferior border of gluteus maximus, descends in posterior thigh deep to facia lata
distribution: supplies skin of inferior half of buttock, skin over posterior thigh and popliteal fossa, and skin of lateral perineum and upper medial thigh

30
Q

Give the course and distribution of the superior gluteal nerve

A

course: enters gluteal region via greater sciatic foramen, courses laterally between gluteus medius and minimum as far as tensor fasciae latae
distribution: innervates gluteus medius, gluteus minimus, and tensor fascie latae muscles

31
Q

Give the course and distribution of the inferior gluteal nerve

A

course: enters gluteal region via greater sciatic foramen inferior to piriformis and deep to gluteus maximus
distribution: supplie gluteus maximus

32
Q

Give the course and distribution of the nerve to quadratus femoris

A

course: enters gluteal region via greater sciatic foramen inferior to piriformis, and deep to sciatic nerve
distribution: innervates hip joint, inferior gemellus, and quadratus femoris

33
Q

Give the course and distribution of the pudendal nerve

A

course: exits pelvis via greater sciatic foramen inferior to piriformis; descends posteriorly; enters perineum through lesser sciatic foramen
distribution: supplies no structure in gluteal region or posterior thigh

34
Q

Give the course and distribution of the nerve to obturator internus

A

course: exits pelvis via greater sciatic foramen inferior to piriformis; descends posteriorly; enters perineum through lesser sciatic foramen
distribution: supplies superior gemellus and obturator internus

35
Q

Give the origin, course, and distribution of the superior clunial nerve

A

origin: lateral cutaneous branches of posterior rami of L1-L3
course: pass inferolaterally across iliac crest
distribution: supply skin of superior buttock as far as tubercle of iliac crest

36
Q

Give the origin, course, and distribution of the middle clunial nerve

A

origin: as lateral cutaneous branches of posterior rami S1-S3
course: exit through posterior sacral foramina and pass laterally to gluteal region
distribution: supply skin over sacrum and adjacent area of buttock

37
Q

Give the origin, course, and distribution of the inferior clunial nerve

A

origin: posterior cutaneous nerve of thigh
courses: emerges rom inferior border of gluteus maximus and ascends superficial to it
distribution: supplies skin of inferior half of buttock as far as greater trochanter

38
Q

The sacral plexus contains ventral rami from which vertebrae?

A

L4-S4

39
Q

injuries to the superior gluteal nerve result in what?

A

gait abnormalities; the gluteus medium gait (positive trendelenburg test) where the pelvis sags toward the opposite side of the injury during walking

40
Q

In regards to the sciatic nerve, intragluteal intramuscular injections are preferred here. Why?

A

thick large muscles with substantial volume of absorption of the injected substance

41
Q

Intragluteal intramuscular injections are safe only in the ____ quadrant of the region

A

superolateral

42
Q

In regards to the sciatic nerve, where would an anesthetic block need to be administered?

A

a few cm inferior to the line drawn from PSIS to the greater trochanter

43
Q

Compression of the sciatic nerve by the piriformis muscle can cause ____ syndrome

A

piriformis

44
Q

Complete section injury to the sciatic nerve results in what?

A

loss of extension of hip and flexion of knee

45
Q

Incomplete section injury to the sciatic nerve is usually caused by what?

A

stab wound

note: recovery is slow and incomplete

46
Q

The hip joint receives fibers from the femoral, sciatic, and obturator nerves which also supply the knee joint. It is not uncommon that a patient complains of knee pain while the cause is the diseased hip. What law is demonstrated here?

A

Hilton’s law

47
Q

Give the origin, course, and distribution of the superior gluteal artery

A

origin: largest branch of the internal iliac artery
course: usually passes between the lumbosacral trunk and S1 nerve, then passes out of the pelvis though the greater sciatic foramen
distribution: supplies gluteus maximus (superficial branch); supplies tensor fascia latae (deep branch)

48
Q

Give the origin, course, and distribution of the inferior gluteal artery

A

origin: one of the two terminal branches of the anterior division of the internal iliac artery
course: usually passes between S2 and S3 nerves, then exits the pelvis through the lower part of the greater sciatic foramen to the gluteal region
distribution: supplies gluteus maximus, obturator internus, quadratus femoris, and superior parts of hamstrings

49
Q

Give the course and distribution of the internal pudendal artery

A

course: enters gluteal region through greater sciatic foramen; descends posterior to ischial spine; enters perineum through lesser sciatic foramen
distribution: supplies external genitalia and muscles in perineal region

50
Q

Give the course and distribution of the perforating artery

A

course: enters posterior compartment by perforating aponeurotic portion of adductor magnus attachment and medial inter muscular septum; after providing muscular branches to hamstring, continues to anterior compartment by piercing lateral inter muscular septum
distribution: supplies majority of hamstring muscles, then continues to supply vastus lateralis in anterior compartment

51
Q

Superior gluteal veins, inferior gluteal veins, internal pudendal veins, and obturator veins are venae comitantes to their respective arteries and terminate within the pelvis by draining not the ___ ___ vein

A

internal iliac

52
Q 
Give the borders of the popliteal fossa
superolateral
superomedial
inferolateral
inferomedial
posteriorly
anteriorly
A

superolateral: biceps femoris
superomedial: semitendinosus and semimembranosus
inferolateral: lateral head of gastrocnemius
inferomedial: medial head of gastrocnemius
posteriorly: popliteal fascia and skin
anteriorly: popliteal surface of femur, knee joint capsule, and popliteal surface of tibia

53
Q

Give the origin and course of the popliteal artery

A

origin: continuation of femoral artery as it passes through the adductor hiatus
course: descends close to the posterior aspect of the femur and ends at the lower border of the popliteus by dividing into the anterior and posterior tibial arteries

54
Q

this vein is a continuation of the posterior tibial vein, it courses superficial to the popliteal artery, and receives the small saphenous vein within this space

A

popliteal vein

55
Q

this nerve descends most superficially, beneath the deep fascia through the middle of the fossa

A

tibial nerve

56
Q

this nerve descends laterally along the upper part of the fossa, close to the tendon of biceps femoris

A

common fibular

57
Q

popliteal aneurysm is only common in horse riding with high riding boots or when direct trauma is applied to posterior knee results in what?

A

pressure on adjacent vein causing venous thrombosis and peripheral edema or pressure on tibial nerve causing leg pain

58
Q

A popliteal cyst (baker cyst) is a ____ cyst. If it becomes infected, the infection spreads superiorly or inferiorly

A

synovial

59
Q

this is a network of small arteries from different sources that form both superficial and deep plexus around the patella and distal end of femur and proximal portion of the leg bones

A

genicular anastomosis

60
Q

There are ten vessels involved in the genicular anastomosis. ___ descend from above, ___ are branches of popliteal artery at level of knee, and ___ ascend from below

A

2; 5; 3

Anatomy (44 decks)

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