Intro to Gluteal Region Misc.

Question 1

Where is the center of gravity, how does it fall wrt to the, hip, knee, and ankle joints

Answer 1

half way between two ASIS in front of S2 vertebrae, lies posterior to hip and anterior to knee and ankle

Question 2

Where does the lateral femoral cutaneous nerve originate and what does it innervate

Answer 2

L2, L3 and conveys sensory from lateral aspect of the thigh

Question 3

Where does the femoral nerve originate and what thigh compartment does it innervate

Answer 3

L2-L4 and innervates muscles in the anterior thigh compartment.

Question 4

Where does the obturator nerve originate and what thigh compartment does it innervate

Answer 4

L2-L4 and innervates muscle sin the medial thigh compartment

Question 5

What is the longest cutaneous branch of the femoral nerve

Answer 5

Saphenous branch (medial aspect of lower leg)

Question 6

Describe the path of the obturator and femoral nerves as they travel into the the thigh compartment.

Answer 6

Femoral travels lateral to the psoas muscle and dives under the inguinal ligament. Obturator travels medial to psoas muscle and travels through the obturator foramen.

Question 7

Where does the sciatic nerve originate? What are the two terminal branches of the sciatic?

Answer 7

L4-S3 The tibial and the common fibular/peroneal nerve

Question 8

Name the branches of the femoral artery

Answer 8

Femoral branches into the deep and superficial femoral. Behind the knee, the femoral becomes the popliteal artery. The popliteal artery branches into the Anterior and posterior tibial arteries and the fibular artery

Question 9

Name the ligaments that reinforce the pelvic girdle

Answer 9

Iliolumbar, Posterior Sacroiliac, anterior sacroiliac

Question 10

What muscle devides the greater sciatic foramen in half? what is the only nerve or vessel that travels superiorly to this muscle through the sciatic foramen?

Answer 10

Piriformis muscle. The Superior gluteal neurovascular bundle.

Question 11

Name the muscles of posterior lateral hip rotators superiorly to inferiorly

Answer 11

piriformis, superior Gemellus, Obturator Internus, Inferior Gemellus, Quadratus femoris

Question 12

Where do the superior and inferior gluteal arteries originate?

Answer 12

Posterior and anterior branches of the internal iliac respectively

Question 13

What is an important source of blood supply for the hip joint that becomes obliterated in the adult

Answer 13

The blood supply contained with in the ligament of the head of the femur.

Question 14

Where is the hip joint strongest and weakest?

Answer 14

Strongest anteriorly and superiorly, weakeast inferiorly and posteriorly

Question 15

Name the three ligaments of the hip joint

Answer 15

Iliofemoral, pubofemoral, ischiofemoral, iliofemoral is the most important and is the strongest ligament of the bone. It helps limit hyperextension of the hip

Question 16

People with a waddling gate have issue with what hip movement, and is caused by lesions to what nerve

Answer 16

Trouble with hip ADduction (medial thigh compartment) most commonly lesions to the obturator nerve (L2-L4)

Question 17

A positive trendelenburg sign is indicative of what?

Answer 17

Poor hip ABductions by the gluteus medius and minimus. on the WEIGHT BEARING leg. The non weight bearing hip will sag. This tests the integrity of the superior gluteal nerve (most commonly the L5 root which is the most significant contributor)

Question 18

What signs would one notice of a dislocated hip?

Answer 18

Medially rotated (due to unopposed adductors) shorter (Due to unopposed iliopsoas) Portions of the sciatic nerve may be compromised

Question 19

What blood supply is in danger during a femoral neck fracture?

Answer 19

Lateral and Medial circumflex arteries branching form the femoral artery.

Question 20

What is the normal angle of the hip, what are the associated deformities

Answer 20

Normal (125-130) Cox Valga Deformity affected limb deviates away from midline (>130 appears short) Cox Vara Deformity affected limb deviates away from the midline (<100 appears long)

Question 21

What spinal roots does the superior gluteal nerve come from?

Answer 21

L4,L5,S1

Question 22

What spinal roots does the inferior gluteal nerve come form?

Answer 22

L5,S1,S2

Question 23

Where does the nerve to the obturator internus and superior gemellus originate?

Answer 23

L5-S1

Question 24

Where does the nerve to the quadratus femoris and inferior gemellus originate?

Answer 24

L5-S1

Question 25

Where does the posterior femoral cutaneous nerve originate from?

Answer 25

S1-S3

Question 26

Where does the nerve to the piriformis originate from?

Answer 26

S1-S2

Question 27

What is the most stable position for the joints of the lower limb?

Answer 27

Hip and knee extended and foot dorsiflexed

Question 28

Name the branches of the lumbosacral plexus that pass into the gluteal region through the greater sciatic foramen

Answer 28

Superior and Inferior gluteal, nerve to quadratus femoris, nerve to piriformis, nerve to obturator internus, posterior femoral cutaneous

Question 29

Describe the share of hip extension activity between the hamstrings and the Gluteus Maximus

Answer 29

The hamstrings are more engaged during normal walking but exaggerated movements like climbing and getting up from a squat require more powerful extension and the use of the gluteus maximus

Question 30

What signs would one observe in a fractured hip?

Answer 30

Affected limb appears laterally rotated and shorter. Avascular necrosis may occur if the lateral and medial circumflex arteries are damaged

Question 31

Iliohypogastric

Answer 31

L1 innervates skin on lateral hip and area just medial and inferior to ASIS

Question 32

Ilioinguinal

Answer 32

L1 innervates skin on anterior scrotum and medial thigh area just lateral to scrotum

Question 33

Genitofemoral

Answer 33

L1-2 innervates skin just lateral to the counderies that ilioinguinal cover

Question 34

What does iliofemoral ligament do?

Answer 34

Resists hyperextension, helps limit AB and AD duction

Question 35

What does pubofemoral ligament do?

Answer 35

weak, helps limit ABduction

Question 36

What does Ischiofemoral ligament do?

Answer 36

Resists excessive extension and medial rotation (On posterior aspect but doesn’t fully cover it)

Question 37

What does a pavlik harness do?

Answer 37

Prevents Extension and adduction but allows flexion and abduction to help head of femur back into socket

Question 38

Describe a Slipped Capital Femoral Epiphysis Fracture (SCFE)

Answer 38

Instability of the proximal femoral growth plate causes fracture. Femoral neck displace anteriorly and externally rotated. Internal rotation is very painful.