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MSK Exam I > L7 -Gluteal Region > Flashcards

L7 -Gluteal Region Flashcards

1
Q

Describe the surface anatomy of the gluteal region

A

Located posterior to the pelvis
Superior border: iliac crest
Inferior border: gluteal sulcus (groove beneath gluteal fold)

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2
Q

What exits the greater sciatic foramen?

A

Gluteal neurovascular bundle, piriformis muscle, sciatic nerve, posterior femoral cutaneous nerve, pudendal and internal pudendal artery, obturator internus/superior gemellus nerve

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3
Q

What structures enter the lesser sciatic foramen?

A

Pudendal nerve and internal pudendal artery

Obturator internus/superior gemellus nerve

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4
Q

What structure exits the lesser sciatic foramen?

A

Obturator internus

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5
Q

Which two ligaments form the greater and lesser sciatic foramen?

A

Sacrotuberous and sacrospinous ligament

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6
Q

Describe the cluneal nerves

A

Cutaneous innervation to the buttock region

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7
Q

Describe the course of the superior gluteal nerve

A

Leaves pelvis via greater sciatic foramen superior to the piriformis with the superior gluteal artery
Runs b/w gluteus medius and gluteus minimus
Supplies gluteus medius, minimus and tensor fascia latae

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8
Q

Describe the inferior gluteal nerve

A

Leaves pelvis inferior to the piriformis with inferior gluteal artery
Supplies gluteus Maximus

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9
Q

Describe the sciatic nerve

A 
L4-S2 
Leaves pelvis inferior to piriformis 
Runs inferiorly deep to gluteus Maximus 
Divides half way down the thigh into tibial and common fibular nerves 
Does not supply any gluteal structures
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10
Q

Which nerve supplies more skin than any other cutaneous nerve?

A

Posterior femoral cutaneous nerve

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11
Q

Describe the nerves of small rotators

A

Obturator internus/superior gemellus: leaves pelvis via greater sciatic foramen and re-enters pelvis via lesser sciatic foramen
Quadratus femoris/inferior gemellus nerve

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12
Q

Describe the pudendal nerve

A

Most medial structure exiting greater sciatic foramen
Re-enters pelvis via lesser sciatic foramen to supply perineal structures
Anterior division of S2-4 ventral rami

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13
Q

What are the arteries of the gluteal region that arise from the internal iliac artery?

A

Superior and inferior gluteal artery

Internal pudendal artery

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14
Q

Describe the superior gluteal artery

A

Largest internal iliac artery branch
Superficial branch supplies gluteus maximus
Deep branch supplies gluteus medius + minimus and tensor fascia latae

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15
Q

What does the inferior gluteal artery supply?

A

Gluteus maximus, small lateral rotators and superior hamstrings

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16
Q

Describe the cruciate anastomosis of the thigh

A

Arteries involved: transverse branch of the medial circumflex femoral artery, terminal part of the transverse branch of the lateral circumflex femoral artery and the inferior gluteal artery
May provide blood to the leg if the femoral artery is occluded or severed

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17
Q

Describe the internal pudendal artery

A

Re-enters the pelvis via lesser sciatic foramen with pudendal nerve
Supplies perineal muscles and external genitalia
Does not supply any gluteal structures

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18
Q

What are the origin and insertion of the gluteus maximus?

A

O: external aspect of ilium, sacrotuberous ligament and dorsal surface of sacrum and coccyx
I: IT band, gluteal tuberosity on femur

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19
Q

What innervates the gluteus maximus?

A

Inferior gluteal nerve

20
Q

What is the arterial supply for the gluteus maximus?

A

Superior and inferior gluteal arteries

21
Q

What is the action of the gluteus maximus?

A

Extend and laterally rotate the thigh

22
Q

What are the attachments of gluteus medius and minimus?

A

O: ilium between anterior and posterior gluteal lines
I: greater trochanter of femur
Minimus is deep to medius

23
Q

What innervates and provides blood supply to gluteus medius and minimus?

A

Superior gluteal nerve and artery

24
Q

What is the action of gluteus minimus and medius?

A

Abduct and medially rotate the thigh

25
Q

What innervates the tensor fascia latae?

A

Superior gluteal nerve

26
Q

What is the function of the tensor fascia latae?

A

Abducts, medially rotates and flexes thigh

Maintains extended leg

27
Q

What are the attachments of the tensor fascia latae muscle?

A

O: outer lip of ASIS
I: IT band

28
Q

What are the actions of the IT band?

A

Abduct, medially rotate and flex the thigh
Extend and flexes the knee
Extends leg, compensates for quadriceps paralysis via gluteus maximus flexion
Pulls patella laterally, antagonist of vastus medialis and synergist with flexing vastus lateralis for this action

29
Q

If the center of rotation is within the boundaries of the IT band, then the band acts as what?

A

An extensor of the knee when the gluteus maximus contracts

30
Q

If the center of rotation of anterior to the boundaries of the IT band, then the band acts as what?

A

As a flexor at the knee when the gluteus maximus contracts

31
Q

What are the attachments of the piriformis muscle?

A

O: anterior sacrum and sacrotuberous ligament
I: greater trochanter of femur

32
Q

What innervates the piriformis?

A

Nerve to piriformis

33
Q

What is the arterial supply for the piriformis muscle?

A

Superior and inferior gluteal arteries

34
Q

What is the collective action of the piriformis, obturator internus, superior and inferior gemellus?

A

Lateral rotation of the thigh when thigh is extended and abduction when thigh is flexed
Stabilize femoral head in acetabulum

35
Q

What are the attachments for obturator internus?

A

O: internal surface of obturator foramen
I: greater trochanter of femur

36
Q

Which muscles are innervated by the nerve to obturator internus?

A

Obturator internus + superior gemellus

37
Q

Which muscles does the inferior gluteal artery provide blood supply to?

A

Obturator internus, superior gemellus and inferior gemellus

38
Q

What are the attachments for superior and inferior gemellus?

A

O: ischial spine and ischial tuberosity
I: tendon of obturator internus muscle to greater trochanter

39
Q

Which muscles are innervated by nerve to quadratus femoris?

A

Inferior gemellus and quadratus femoris

40
Q

What are the attachments for the quadratus femoris muscle?

A

O: ischial tuberosity
I: intertrochanteric crest of femur

41
Q

Which artery provides blood supply to the quadratus femoris muscle?

A

Medial femoral circumflex artery

42
Q

What is the action of the quadratus femoris muscle?

A

Laterally rotate the hip

43
Q

What are the attachments for obturator externus?

A

O: external margins of obturator foramen
I: trochanteric fossa

44
Q

Which muscles of the gluteal region are considered to be in the vertically orientated group?

A

Gluteus maximus, medius and minimus , piriformis, and tensor fascia latae

45
Q

Which gluteal region muscles are considered to be in the horizontally orientated group

A

Both gemelli, obturator internus and quadratus femoris

46
Q

What are the bursa of the gluteal region?

A

Ischial bursa, trochanteric bursa and gluteofemoral bursa

47
Q

Which muscles are innervated by the obturator nerve?

A

Quadratus femoris and obturator externus

MSK Exam I (34 decks)

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