Glutes and hip joint Flashcards
What is the intergluteal crest?
Buttcrack
What 2 ligaments form the greater sciatic foramen and lesser sciatic foramen
Sacrotuberous L. and sacrospinous L.
What is the origin and insertion for the sacrotuberous L.?
O: Anterior sacrum
I: Ischial tuberosity
What is the origin and insertion for the sacrospinous L.?
O: Anterior sacrum
I: Ischial spine
What exits the greater sciatic foramen?
Gluteal neurovascular bundle, piriformis m., sciatic nerve, posterior femoral cutaneous nerve, pudendal nerve and internal pudendal A., obturator internus/superior gemellus nerve
What enters the lesser sciatic foramen?
pudendal nerve and internal pudendal A., obturator internus/superior gemellus nerve
What exits the lesser sciatic foramen?
Obturator internus
What are the cutaneous nerves of the gluteal region?
Cluneal nerves - superior (L1-L3), middle (S1-S3)
Gluteal branches of posterior femoral cutaneous nerve (anterior rami)
What are the deep nerves of the gluteal region?
Sacral plexus branches (leave via greater sciatic foramen)
What does the superior gluteal nerve supply?
Gluteus medius, Gluteus minimus, Tenor fascia lata m.
Where does the superior gluteal nerve exit?
Superior to the piriformis m.
What does the inferior gluteal nerve supply?
Gluteus maximus
Where does the inferior gluteal nerve exit?
Inferior to the piriformis m.
Describe the largest nerve in the body
Sciatic nerve (L4-S3), eventually splits into tibial and common fibular nerve Does NOT innervate any gluteal region structures Exits inferior to piriformis m.
What are the main arteries in the gluteal region?
Superior and inferior gluteal arteries, pudendal artery (most medial, supplies genitalia)
Where does the superior gluteal artery exit?
Superior to the piriformis m. with the superior gluteal nerve
Where does the inferior gluteal artery exit?
Inferior to the piriformis m. with the inferior gluteal nerve
What does the superior gluteal artery supply?
Largest!
Gluteus maximus, medius, minimus, tenor fascia lata m.
What does the inferior gluteal artery supply?
Gluteus maximus, small lateral rotators, and superior hamstrings
What participates in the cruciate anastomosis?
Inferior gluteal artery, medial circumflex femoral artery, transverse branch of the lateral circumflex femoral artery, and the perforating arteries
Where should intragluteal injections be given?
Supero-lateral to avoid sciatic and other nerves
Gluteus maximus origin, insertion, action and innervation
O: Ilium, posterior sacrum and coccyx, sacrotuberous L.
I: Gluteal tuberosity, lateral tibial condyle via iliotibial band
A: Extend and laterally rotate thigh
Innervation: Inferior gluteal nerve
Gluteus medius origin, insertion, action and innervation
O: Ilium between anterior and posterior gluteal lines
I: Lateral side of greater trochanter
A: Abduct and medially rotate thigh
Innervation: Superior gluteal nerve
Gluteus minimus origin, insertion, action and innervation
O: Ilium between anterior and inferior gluteal lines
I: Anterior side of greater trochanter
A: Abduct and medially rotate thigh
Innervation: Superior gluteal nerve
What is injured in pts with gluteal gait/duchennes limp?
Superior gluteal nerve – impaired gluteus medius and minimus
Symptoms of gluteal gait?
Pelvis leans towards swing side; body leans toward affected side
Tensor fascia lata origin, insertion, action and innervation
O: ASIS, Iliac crest
I: IT band
Action: Abduct and medially rotate thigh, extend leg
Innervation: superior gluteal nerve
Iliotibial tract
IT band;
O: Iliac tubercle
I: Gerdy’s tubercle on lateral tibial condyle
- Tensor fascia lata and gluteus maximus fibers strengthen
Functions of IT band
Laterally support knee, slow down thigh adduction, extend leg and laterally pull patella
- stretch to treat chondromalacia patella
Piriformis origin, insertion, action and innervation
O: Anterior sacrum and sacrotuberous L.
I: Superior trochanter
A: Laterally rotate extended thigh, abduct flexed thigh and stabilize femoral head
Innervation: nerve to piriformis
Obturator internus origin, insertion, action and innervation
O: Obturator membrane
I: Greater trochanter
A: Laterally rotate extended thigh, abduct flexed thigh, stabilize femoral head
Innervation: obturator nerve
Superior gemmelus origin and innervation
O: Ischial spine
Innervation: Obturator nerve
Inferior gemmelus origin and innervation
O: Ischial tuberosity
Innervation: Nerve to quadratus femoris
Insertion and action of gemmeli
I: Medial aspect of greater trochanter
Action: laterally rotate extended thigh, abduct flexed thigh, stabilize femoral head
Obturator externus origin, insertion, action and innervation
O: Margin of obturator membrane
I: Trochanteric fossa
A: laterally rotate extended thigh and stabilize femoral head
Innervation: obturator nerve
Quadratus femoris origin, insertion, action and innervation
O: lateral ischial tuberosity
I: Quadrate tubercle on intertrochanteric crest
A: Laterally rotate extended thigh and stabilize femoral head
Innervation: obturator nerve
What type of joint is the hip joint?
Diarthrotic ball and socket synovial – all ranges of motion pretty much
The rim of acetabulum is incomplete inferiorly, what covers it?
Transverse acetabular L.
What is the non-articular surface inside the acetabulum?
Acetabular fossa
What does the acetabular labrum do?
Increases the depth of the acetabulum for the femoral head
A pt feels a pinching sensation when they bring their knee to chest. No inflammation can be seen and their pain seems to radiate. What is torn?
Acetabular labrum
Name the 3 ligaments of the hip joint
Ischiofemoral, pubofemoral, iliofemoral
What is the main job of the hip joint ligaments?
Prevent overextension and over abduction
What will a person’s leg look like if they have a hip fracture
Leg will be shortened and laterally rotated
What will a person’s leg look like if they have a hip dislocation
Leg will be of normal length and medially rotated
