Hip Joint, Gluteal Region and Posterior Thigh Flashcards
Gluteus Maximus.
Gluteus Medius
Gluteus Minimus
Tensor Fascia Latae
The gluteus maximus is located in the gluteal region, behind the sacrum. Action: Primarily extend the hip, also laterally rotate and abduct hip Function: stabilizer of hip joint and knee joint Origin: sacrotuberous ligament, ilium, sacrum, coccyx, Insertion: iliotibial tract of fascia lata & gluteal tuberosity of femur This muscle is innervated by the Inferior Gluteal Nerve from the anterior rami of L5-S2
Gluteus Minimus sits right below the Gluteus Medius. Origin: ilium Insertion: anterolateral aspect of greater trochanter. Nerve supply: superior gluteal nerve (L4,L5, S1) Action: abduct femur, medially rotate, stabilize the pelvis..same as glute med.
Tensor Fascia Latae
The most anterior of the superficial group of muscle in the gluteal region and anterior to gluteus medius.
Origin: lateral aspect of iliac crest Insert: iliotibial tract of fascia lata Nerve: superior gluteal nerve
Function: stabilizes the knee in extension
Origin and Insertion of gluteus medius
The Gluteus Medius is a fan-shaped muscle. Function: stabilizes the pelvis during a one-legged stance; Also prevents pelvic drop on the opposite side during walking Action: abduct the hip joint; anterior fibers medially rotate the hip Origin: outer surface of the ilium Insertion: lateral surface of Greater Trochanter of the femur (posteomedial aspect) Receives nerve supply from the Superior Gluteal Nerve from L4-S1 nerve root Vascular supply: Superior Gluteal Artery
Piriformis muscle.
The piriformis muscle is one of the two muscles that forms the lateral wall of the pelvic cavity. It passes laterally and inferiorly through the greater sciatic foramen. Origin: Sacrum (anterior surface) between anterior sacral foramina. Insertion: Greater trochanter of femur (medial side of superior border) The piriformis is innervated in the pelvic cavity by the nerve to the piriformis, which originates as branches from S1 & S2 of the sacral plexus. The piriformis divides the greater sciatic foramen into two regions, one above or one below where vessels and nerves pass between the pelvis and gluteal region by passing through the greater sciatic foramen either above or below the piriformis. Function: laterally rotate the femur at the hip joint; abducts flexed femur at hip joint
Superior Gemmelus - location & function - origin & insertion - nerve supply & nerve roots
One of 5 deep lateral rotators of the hip. This muscle sits above Obturator internus. Origin: ischial spine Insertion: the medial side of greater trochanter of femur with obturator internus tendon -Receives innervation from branch L5, S1 -Function: laterally rotates the hip and abduct flexed femur
Obturator Internus muscle - location & function - origin, insertion - nerve supply & nerve roots
Course - Location - Gluteal region, forms the anterolateral wall of the pelvic cavity - laterally hip rotator - Origin: obturator membrane & surrounding bones - Inserts: medial side of greater trochanter of femur just inferior to the attachment of the piriformis - Nerve to obturator internus L5, S1 The nerve to the obturator internus enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and between the posterior cutaneous nerve of the thigh and the pudendal nerve (Fig. 6.47). It supplies a small branch to the gemellus superior and then passes over the ischial spine and through the lesser sciatic foramen to innervate the obturator internus muscle from the medial surface of the muscle in the perineum. Drake, Richard; Vogl, A. Wayne; Mitchell, Adam W. M.. Gray’s Anatomy for Students E-Book (Page 580). Elsevier Health Sciences. Kindle Edition. Function: laterally rotate hip, abduct flexed femur
Inferior Gemmelus Describe - location & function - origin, insertion - nerve supply & nerve roots
- sits above the quadrates femurs in the gluteal region Origin: upper aspect of ischial tuberosity Insert: obturator internus tendon and greater trochanter of femur - Nerve to quadratus femoris, L5, S1
Quadratus Femoris Describe - location & function - origin, insertion - nerve supply & nerve roots
- Is the most inferior of the deep hip rotators in the gluteal region. - laterally rotate the hip Origin: -lateral aspect of ischium Inserts: -Quadrate tubercle on the intertrochanteric crest of the proximal femur - Nerve to quadratus femoris L5, S1 - It supplies a small branch to the gemellus inferior
Identify & Describe the course, branches, muscle and cutaneous (if any) supply of Superior & Inferior Gluteal Nerve
Superior Gluteal nerve passes above the piriformis muscle and loops toward the gluteus medius and min. and terminates at the tensor fascia lata muscle supplying all three muscles of the gluteal region. The nerve have no cutaneous branches The Inferior Gluteal nerve passes below the piriformis muscle as it exits the greater sciatic foramen and innervates the Obturator Internus and Superior gemellus
Identify & Describe the course, branches, muscle and cutaneous (if any) supply of the Sciatic Nerve in the Gluteal Region and the Posterior Thigh Region
The sciatic nerve enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle (Fig. 6.47). It descends in the plane between the superficial and deep group of gluteal region muscles, crossing the posterior surfaces of first the obturator internus and associated gemellus muscles and then the quadratus femoris muscle. It lies just deep to the gluteus maximus at the midpoint between the ischial tuberosity and the greater trochanter. At the lower margin of the quadratus femoris muscle, the sciatic nerve enters the posterior thigh. The sciatic nerve is the largest nerve in the body and innervates all muscles in the posterior compartment of the thigh that flex the knee and all muscles that work the ankle and foot. It also innervates a large area of skin in the lower limb.
Identify & Describe the course, branches, muscle and cutaneous (if any) supply of Posterior Cutaneous Nerve of Thigh
The posterior cutaneous nerve of the thigh enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and immediately medial to the sciatic nerve It descends through the gluteal region just deep to the gluteus maximus and enters the posterior thigh. The posterior cutaneous nerve of the thigh has a number of gluteal branches, which loop around the lower margin of the gluteus maximus muscle to innervate skin over the gluteal fold. A small perineal branch passes medially to contribute to the innervation of the skin of the scrotum or labia majora in the perineum. The main trunk of the posterior cutaneous nerve of the thigh passes inferiorly, giving rise to branches that innervate the skin on the posterior thigh and leg.
Identify & Describe the course, branches, muscle and cutaneous (if any) supply of The Pudental Nerve
The pudendal nerve enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and medial to the sciatic nerve. It passes over the sacrospinous ligament and immediately passes through the lesser sciatic foramen to enter the perineum. The course of the pudendal nerve in the gluteal region is short and the nerve is often hidden by the overlying upper margin of the sacrotuberous ligament. The pudendal nerve is the major somatic nerve of the perineum and has no branches in the gluteal region. Innervates the perineum, area around the anus Motor supply to the Levator Ani muscles and external anal and urethral sphincters Nerve root, S2, S3, S4
Posterior cutaneous nerve of the thigh
The posterior cutaneous nerve of the thigh
enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and immediately medial to the sciatic nerve (Fig. 6.47). It descends through the glutealregion just deep to the gluteus maximus and enters the posterior thigh. The posterior cutaneous nerve of the thigh has a number of gluteal branches, which loop around the lower margin of the gluteus maximus muscle to innervate skin over the gluteal fold.
A small perineal branch passes medially to contribute to the innervation of the skin of the scrotum or labia majora in the perineum. The main trunk of the posterior cutaneous nerve of the thigh passes inferiorly, giving rise to branches that innervate the skin on the posterior thigh and leg.
The posterior thigh is supplied by which artery?
Describe the course, branches, and supply of this artery.
The posterior thigh receives arterial supply from the perforating artery of the profundus artery of the anterior thigh.
The Profundus Femoris Artery
is a deep artery of the thigh .. that is located on the anterior thigh
- emerge on the lateral side of the Femoral Artery
It sends out 4 branches which wraps around the posterior femur, supplying the hamstrings.
These branches passes between the adductor muscles (either above the the adductor brevis, anterior, or inferior) ….
then penetrate the adductor magnus muscle
Descends to connect with the popliteal artery behind the knee.
Describe the course, branches, and supply of the Popliteal Artery and Veins
A continuation of the femoral artery The popliteal artery and vein travels down the popliteal fossa above the knee joint and ends behind the tibia below the knee joint…. and divides into the anterior and posterior tibial artery / vein
Inferior Gluteal Artery
The inferior gluteal artery originates from the anterior trunk of the internal iliac artery in the pelvic cavity. It leaves the pelvic cavity with the inferior gluteal nerve through the greater sciatic foramen inferior to the piriformis muscle (Fig. 6.49). The inferior gluteal artery supplies adjacent muscles and descends through the gluteal region and into the posterior thigh where it supplies adjacent structures and anastomoses with perforating branches of the femoral artery. It also supplies a branch to the sciatic nerve.
