Gluteal Region, Posterior Thigh, & Popliteal Fossa | B2, WK5 Flashcards
What’s the action of the gluteal region
extension, abduction, and lateral rotation at hip
What are the muscles of the gluteal region [9]
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- TFL
- Piriformis
- Obturator internus
- Superior gemelli
- Inferior gemelli
- Quadratus femoris
What is the innervation to the gluteal region?
- Superior gluteal nerve (L4-S1)
- Inferior gluteal nerve (L5-S2)
- Branches of sacral plexus
Gluteus Maximus O, I, & A
O: Posterior ilium, sacrum, & sarcotuberous ligament
I:
Superficial: Anterolateral tubercle of tibia (via IT Tract)
Deep: Gluteal tuberosity
A: Extend thigh and assist in lateral rotation
Gluteus Medius & Minimus O, I, & A
O:
Medius - gluteal surface of ilium between anterior & posterior gluteal lines
Minimus - gluteal surface of ilium between anterior & inferior gluteal lines
I: Greater trochanter
A: Abduct & medially rotate thigh, keep pelvis level when opposite foot is lifted
Gluteus Maximus - innervation
Inferior gluteal N (L5-S2)
Gluteus medius & minimus innervation
Superior gluteal N (L4-S1)
TFL O, I, & A
O: ASIS
I: anterolateral tubercle of tibia (Gerdy’s tubercle) via IT tract
A: Assist in flexion and medial rotation of the thigh, tenses IT tract to stabilize knee extension
TFL innervation
Superior gluteal N
What muscles laterally rotate the hip/thigh?
- Piriformis
- Obturator internus
- Sup & Inf Gemelli
- Quadratus femoris
Where do a majority of the lateral rotators of the thigh insert?
Greater trochanter
Exception: Quadratus femoris - inserts on intertrochanteric crest
What structures exit superior to the piriformis?
-Superior gluteal N
-Superior gluteal vessels
What structures exit inferior to the piriformis?
-Inf. gluteal N
-Inf. gluteal vessels
-Pudendal N & internal pudenal vessels
-Post. cutaneous n of the thigh
-Sciatic nerve
Describe blood supply of the gluteal region
- internal illiac artery
-s. gluteal a.
-inf. gluteal a. - Deep a. of thigh (& 1st perforating branch)
- Cruciate anastomosis
- Anastomosis between branches of femoral a. and internal iliac a.
Innervation of the gluteal region is supplied by what plexus (branches)?
Sacral
What does the superior gluteal N. innervate?
-Gluteus medius
-Gluteus minimus
-TFL
What N supplies the gluteus maximus
Inferior gluteal N
N. to obturator internus innervates/supplies what structure?
Superior gemellus
N. to quadratus femoris also supplies what structure?
Inferior gemellus
What is the piriformis innervated by?
Branches of S1 & S2
Where would you give an intragluteal injection (safely)
-Superior lateral injection
-avoid Nerves & arteries
What would happen when a patient has a superior gluteal nerve injury?
-Pelvis drops
-Opposite side of pelvis drops when the opposite foot is lifted
EX: injury of R. Superior Gluteal N = left hip drop
Someone with a superior gluteal nerve injury typically leans the upper body in which direction?
-Toward the injured side to lift opposite hip
What type of gait is seen in a superior gluteal nerve injury
Tredelenburg Gait
What actions occur in the posterior thigh?
- Extension of thigh
- Flexion of knee
What muscles make up the posterior thigh?
- Biceps Femoris
- Semitendinosus
- Semimembranosus
- “hamstring part” of adductor magnus
What nerves innervate the posterior thigh?
- Tibial division of sciatic N
Note: Short head of biceps innervated by common fibular division
Biceps Femoris LONG and SHORT head - O, I, & A
O:
SH - lateral lip of linea aspera
LH - Ischial tuberosity
I: Both on Head of fibula
A: Flexion of leg at knee joint (laterally rotates leg when knee is flexed, long head extends the thigh)
Bicep femoris long head innervation
tibial division of sciatic N
Bicep femoris short head innervation
common fibular division of sciatic N
What is the origin of the semitendinosus & semimembranosus?
Ischial tuberosity
The semitendinosus and semimembranosus complete what actions?
-extend thigh
-flex knee
The semitendinosus and semimembranosus are innervated by?
Tibial division of sciatic N
Action of adductor magnus
Extend thigh
Adductor magnus innervation
Tibial division of Sciatic N
What is the pes anserinus?
“Goose’s Foot”
1. Sartorius
2. Gracilis
3. Semitendinosus
What is the function of the pes aserinus?
Stabilizes medial aspect of knee joint in extension
What posterior thigh muscles are innervated by the tibial division of the sciatic N? What about common fibular division of sciatic N.
Tibial Division:
-Long head of biceps femoris
-Semitendinosus
-Semimembranosus
-Adductor Magnus Hamstring part
Common fibular division of sciatic N:
-Short head of biceps femoris
What is the main blood supply of the posterior thigh?
Perforating branches of deep femoral a.
What are the boundaries of the popliteal fossa?
-Biceps Femoris
-Semimembranosus
-Lateral & medial heads of gastrocnemius
What are the contents of the popliteal fossa from superficial to deep?
- Termination of small saphenous vein and cutaneous nerves
- Tibial & Common fibular nerves
- Popliteal vein
- Popliteal artery
- Popliteal lymph nodes (surrounding vessels)
In the popliteal fossa, the sciatic nerve divides. What does it divide into?
- Tibial N (L4-S3)
- Common fibulr nerve (L4-S2)
What are the cutaneous nerves in the popliteal fossa?
-Posterior cutaneous n. of the thigh
-Medial sural cutaneous nn. (from tibial n)
The _________________ artery is a continuation of the femoral artery
Popliteal
What does the popliteal artery divide into?
anterior + posterior tibial aa.
