L6: Gluteal Region & Hip Joint

Question 1

cutaneous innervation upper medial buttock

Answer 1

posterior rami L1-3, S1-3

Question 2

cutaneous innervation upper lateral buttock

Answer 2

Iliohypogastric L1

ant. rami T12

Question 3

cutaneous innervation lower medial buttock

Answer 3

branches from post. femoral nerves

S1-3 ant. rami

Question 4

cutaneous innervation lower lateral buttock

Answer 4

branches of ant. rami from lat. femoral cutaneous nerve S2-3

Question 5

deep gluteal fascia is continuous w/ ?

Answer 5

deep fascia of the thigh, also called fascia lata

Question 6

gluteal deep fascia

Answer 6

single later
iliac crest covering outer glute max
splits to enclose glute max

Question 7

deep gluteal fascia continues as ______ tract on ?

Answer 7

iliotibial tract on lateral surface of thigh

or IT band

Question 8

iliotibial tract attachments

Answer 8

tubercle of iliac crest
lateral condyle of tibia

forms sheath for tensor fascia latae muscle

Question 9

greater site of insertion for the gluteus maximus

Answer 9

iliotibial tract

Question 10

superficial gluteal fascia

Answer 10

tied down to bottom of buttock

forms gluteal fold or natal fold

Question 11

structures passing thru greater sciatic foramen

Answer 11

1. piriformis
2. sciatic nerve
3. pudendal nerve
4. post. femoral cutaneous n
5. nerves to quad fem and obturator internus
6. sup/inf gluteal vessels/n.
7. internal pudendal art/v

Question 12

structures passing thru lesser sciatic foramen

Answer 12

1. tendon for obturator internus
2. nerve to obturator internus
3. pudendal nerve
4. internal pudendal vessels

Question 13

ligaments of articulated pelvis

Answer 13

obturator memb.
Sacrotuberous
sacrospinous
sacroiliac
iliolumbar

Question 14

greater vs lesser sciatic foramen allow passage for ?

Answer 14

greater = enter/exit pelvis

lesser = enter/exit perineum

Question 15

posterior pelvis ligaments

Answer 15

post. sacrospinous lig

Sacrotuberous lig

sacrospinous lig

Question 16

the ___ muscles of gluteal group are all _____. list the muscles

Answer 16

4 muscles
all abductors

glute max, med, min
tensor fascia latae

Question 17

muscles of glute posterior vs lateral

Answer 17

post = glute max, med

lat = glute min, tensor

Question 18

function of the gluteal muscles

Answer 18

prevent pelvis and body from falling to the unsupported side when one foot is off the ground

Question 19

function of the deep external rotators

Answer 19

rotate unsupported side of pelvis forward to increase stride

Question 20

gluteus maximus - origin/insertion

Answer 20

post. gluteal line of ilium
surfaces of sacrum
coccyx
Sacrotuberous lig

gluteal tuberosity
IT band

Question 21

gluteus maximus - action

Answer 21

extends thigh
ext. rotate thigh

ext. pelvis

necessary for: standing from sitting, climbing, running, jumping

not needed for walking

Question 22

gluteus maximus - innervation and blood supply

Answer 22

inferior gluteal n

inf. gluteal art. — from internal iliac

Question 23

posterior gluteal bursae

Answer 23

trochanteric bursa
gluteofemoral b
ischial or sciatic b

Question 24

gluteus minimus and medius are the same _____ but ?

Answer 24

same muscle

separated by the superior gluteal nerve

Question 25

tensor fascia latae inserts on ?

Answer 25

it band

Question 26

lateral glute compartment muscles -- innervation and vascular supply

Answer 26

superior gluteal n superior gluteal art --- from internal iliac

Question 27

lateral gluteal compartment muscles -- action

Answer 27

hip abduction w/ free swinging limb tensor and ant. gluteal fibers -- med rotators of thigh

Question 28

gluteus medius - origin and insertion

Answer 28

ilium gluteal aponeurosis anterior border of greater trochanter

Question 29

gluteus minimus - origin and insertion

Answer 29

ilium anterior border of greater trochanter

Question 30

tensor fascia latae - origin and insertion

Answer 30

outer lip of iliac crest ASIS it band

Question 31

what does a Trendelenburg test evaluate?

Answer 31

the strength of contralateral gluteus medius patient standing - raises one foot gluteus med is needed to clear foot from ground during sweeping phase of walking

Question 32

list the deep external rotators of the hip

Answer 32

``` 6 piriformis sup. gemellus obturator internus inferior gemellus obturator externus quadratus femoris ```

Question 33

piriformis innervation

Answer 33

ventral rami S1-2

Question 34

obturator externus innervation

Answer 34

obturator nerve

Question 35

nerve to quadratus femoris

Answer 35

innervates gemellus inf. and quadratus femoris

Question 36

nerve to obturator internus

Answer 36

obturator internus | sup. gemellus

Question 37

functions of piriformis and obturator internus

Answer 37

ext. rotate thigh | abduct flexed thigh

Question 38

the internal iliac artery arises from ?

Answer 38

common iliac artery

Question 39

branches from internal iliac artery

Answer 39

superior gluteal art | inferior gluteal art

Question 40

branches from femoral artery

Answer 40

medial femoral circumflex a lateral femoral circumflex a

Question 41

medial femoral circumflex artery ______ branch anastomoses w/ ?

Answer 41

ascending inf. gluteal art

Question 42

lateral femoral circumflex artery ________ branch anastomoses w/ ?

Answer 42

ascending sup. gluteal art

Question 43

acetabular fossa is formed by the fusion of ?

Answer 43

all 3 pelvic bones

Question 44

acetabular fossa -- what portion participates in articulation?

Answer 44

only the outer - horse shoe shaped portion cover by hyaline cartilage

Question 45

acetabular fossa -- where is a fat pad located?

Answer 45

deeper central part

Question 46

acetabular labrum

Answer 46

deepens socket grasps head of femur holds it in socket

Question 47

fibrocartilage pad of acetabular labrum

Answer 47

covers acetabular notch converts it into a foramen neurovascular bundle containing main blood supply to head of femur passes thru the foramen

Question 48

the hip joint is arranged to favor _____ or _____ and has ____ degrees of freedom

Answer 48

stability over mobility 3 degrees

Question 49

sciatic notches are separated from each other by ?

Answer 49

ischial spine

Question 50

transverse acetabular ligament

Answer 50

continuation of acetabular labrum across acetabular notch converts notch to foramen for transmission of artery to head of femur

Question 51

iliofemoral ligament characteristics

Answer 51

strongest, most important ligament of the hip called Y ligament of bigelow resists hyperextension of hip

Question 52

iliofemoral ligament -- proximal/distal attachments

Answer 52

ant. inf. iliac spine intertrochanteric line

Question 53

pubofemoral ligament -- prox/distal attachment and function

Answer 53

pubis near inf. rim of acetabulum neck of femur above lesser trochanter resists hyperextension of hip

Question 54

ischiofemoral ligament -- prox/distal attachments and function

Answer 54

ischium near post. rim of acetabulum neck of femur medial to greater trochanter resists hyperextension of hip

Question 55

ligamentum teres -- prox/distal attachments and function

Answer 55

fovea of femoral head transverse acetabular lig supports artery to head of femur

Question 56

zona orbicularis

Answer 56

a collar like ligament around the distal neck of the femur

Question 57

nerve supply to hip ligaments

Answer 57

mostly supplied by branches of the femoral and obturator nerves

Question 58

blood supply to hip ligaments

Answer 58

sup/inf gluteal arteries med/lat femoral circumflex arteries obturator arteries

Question 59

obturator arteries supplying the hip ligaments

Answer 59

via a branch that is part of the neurovascular bundle supported by the lig. teres

Question 60

angle of inclination

Answer 60

axis of femoral neck and femoral shaft

Question 61

angle of inclination values -- infant, toddler, adult, elder

Answer 61

150 135 125 120

Question 62

functions of angle of inclination

Answer 62

adducts distal ends of femora so that tibiae are parallel to each other during standing

Question 63

pathologies of angle of inclination

Answer 63

increase = coxa valga decrease = coxa vara

Question 64

Q-angle

Answer 64

created by intersection of the long axes of the tibia and the femur

Question 65

angle of torsion

Answer 65

transverse axis of femoral condyles axis of femoral neck value = 12 degrees (range 8 - 25)

Question 66

function of angle of torsion

Answer 66

produces torque that allows femoral condyles to face anteriorly

Question 67

pathologies of angle of torsion

Answer 67

increase = anteversion ant. surface of femur faces more medially decrease = retroversion ant. surface of femur faces more laterally