Lecture 9: Gluteal Region And Hip Joint Flashcards
Cutaneous innervation of the lower medial quadrant of the buttock is done by the
A. Posterior rami of L1-3, S1-3
B. Iliohypogastric nerve (L1)
C. Branches from posterior femoral nerves (S1-3)
D. Branches from lateral femoral cutaneous nerve (S2-3)
Ans C
Cutaneous Innervation
Upper medial quadrant: • Posterior rami of L1-3, S1-3
Upper lateral quadrant: • Iliohypogastric nerve (L1)
• Anterior rami T12
Lower medial quadrant: • Branches from posterior femoral
nerves (S1-3)
Lower lateral quadrant: • Branches from lateral femoral
cutaneous nerve (S2-3)
Which of the following muscles of the gluteal group is part of the posterior compartment? A. Gluteus maximus B. Gluteus medius C. Gluteus minimus D. Tensor fascia latae
Ans A
Muscles of Gluteal Group
Four muscles of gluteal group are abductors: • Consist of: • Gluteus maximus- PC
• Gluteus medius-LC
• Gluteus minimus- LC
• Tensor fascia latae- LC
• Function: • Prevent pelvis and body from falling to the unsupported side when one foot is off the ground (i.e., walking)
Six deep external rotators: • Function: Rotate unsupported side of pelvis forward to increase stride
Which is true of the superficial facia of the gluteal region?
A. Attached to tubercle of iliac crest superiorly
B. Forms gluteal (natal) fold
C. Attached to lateral condyle of tibia inferiorly
D. Forms sheath for tensor fascia latae muscle
Ans: B Forms gluteal natal fold
Gluteal Region Fascia:
Deep fascia is continuous with deep fascia of thigh (fascia lata): • Single layer attached to iliac crest covering outer surface of gluteus medius • Splits to enclose gluteus maximus muscle • Continues as iliotibial tract on lateral surface of thigh:
• Attached to tubercle of iliac crest superiorly
• Attached to lateral condyle of tibia inferiorly
• Forms sheath for tensor fascia latae muscle
• Receives greater part of insertion of gluteus maximus
Superficial fascia: • Tied down to bottom of buttock • Forms gluteal (natal) fold
Structures passing through greater and lesser sciatic foramen: A. Tendon of obturator internus B. Nerve to obturator internus C. Pudendal nerve D. Internal pudendal vessels
Ans C
Sciatic foraminae:
• Greater sciatic foramen: Passageway for structures entering or leaving pelvis
• Lesser sciatic foramen: Passageway for structures entering or leaving perineum
Structures passing through greater sciatic foramen:
• Piriformis muscle • Sciatic nerve • Superior/inferior gluteal vessels and nerves • Pudendal nerve • Internal pudendal artery/vein • Posterior femoral cutaneous nerve • Nerves to quadratus femoris and obturator internus
Structures passing through lesser sciatic foramen:
• Tendon of obturator internus • Nerve to obturator internus
• Pudendal nerve • Internal pudendal vessels
Sacrospinous ligament run along this bony land mark A. Sacrospinous B. Sacroilliac C. Illiolumbar D. Sacrotuberous
A. Sacrospinous Bony Landmarks Ligaments of articulated pelvis: • Obturator membrane • Sacrotuberous: Posterior iliac spine, lower sacrum, coccyx to ischial tuberosity • Sacrospinous: Sacrum, coccyx to ischial spine, Divides greater sciatic notch into two foraminae: Greater sciatic foramen &Lesser sciatic foramen • Sacroiliac • Iliolumbar
Function of the six deep external rotators are
A. Prevent pelvis and body from falling to the unsupported side when one foot is off the ground (i.e., walking)
B. Rotate unsupported side of pelvis forward to increase stride
C. Extends pelvis by reverse action when lower limbs are flexed
D. Necessary for rising from seated position, climbing, running and jumping
Ans B
Four muscles of gluteal group are abductors:
Function: • Prevent pelvis and body from falling to the unsupported side when one foot is off the ground (i.e., walking)
Six deep external rotators: • Function: • Rotate unsupported side of pelvis forward to increase stride
C and D Gluteus Maximus
Insertion of the gluteus Maximus
A. Iliotibial (IT) tract
B. Anterior border of greater trochanter
C. Ilium between anterior and inferior gluteal lines
D. Gluteal tuberosity and iliotibial tract
Ans D
Posterior gluteal compartment
Insertion:
Gluteus maximus • Gluteal tuberosity and iliotibial tract
Lateral gluteal compartment:
• Insertion:
• Gluteus medius: Anterior border of greater trochanter
• Gluteus minimus: anterior border of greater trochanter
• Tensor of fascia lata: Iliotibial (IT) tract
Orgin of the tensor of fascia lata:
A. Posterior gluteal line of ilium; surfaces of sacrum, coccyx, sacrotuberous ligament
B. Outer lip of iliac crest and ASIS
C. Ilium between anterior and inferior gluteal lines
D. Ilium between anterior and posterior gluteal lines and gluteal aponeurosis
Origin: Gluteus Maximus:
• Posterior gluteal line of ilium; surfaces of sacrum,
coccyx, sacrotuberous ligament
Lateral gluteal compartment:
• Origin:
• Gluteus medius: Ilium between anterior and posterior gluteal lines and gluteal aponeurosis
• Gluteus minimus: Ilium between anterior and inferior gluteal lines
• Tensor of fascia lata: Outer lip of iliac crest and ASIS
This muscle has innervation from the inferior gluteal nerve (L5, S1-2) and vascular supply from inferior gluteal artery and from internal iliac. A. Gluteus maximus B. Gluteus medius C. Gluteus minimus D. Tensor fascia latae
Ans A
Gluteus maximus
• Innervation: Inferior gluteal nerve (L5, S1-2)
• Vascular supply: Inferior gluteal artery: From internal iliac
Lateral gluteal compartment:
• Innervation: Superior gluteal nerve (L5, S1)
• Vascular supply: Superior gluteal artery: From internal iliac.
This muscle does not enable hip abduction with a free-swinging limb. A. Gluteus minimus B. Gluteus medius C. Gluteus Maximus D. Tensor fascia latae
Ans C
Posterior gluteal compartment:
Action:
• Extends and externally rotates thigh
• Extends pelvis by reverse action when lower limbs are flexed
• Necessary for rising from seated position, climbing, running and jumping
• Not required for normal walking
Lateral gluteal compartment
Action:
• Hip abduction with a free-swinging limb
• Tensor of fascia lata and anterior deep gluteal fibers also act as
medial rotators of the thigh.
Which of the following muscle is part of the six deep external rotator: A. Gluteus Maximus B. Superior gemellus C. Gluteus minimus D. Tensor of fascia lata
Ans B Muscles Six deep external rotators: • Piriformis: • Leaves pelvis through greater sciatic foramen • (Main door for passage of structures from pelvis to thigh) • Superior gemellus • Obturator internus • Inferior gemellus • Obturator externus • Quadratus femoris
Nerve to quadratics femoris : A. L1- L2 B. L2- L3 C. L3-L4 D. L5-S1
Ans D L5-S1
Six deep external rotators:
• Innervation:
• Ventral rami of S1-2 (piriformis)
• Obturator nerve (L3-4) (obturator externus )
• Nerve to quadratus femoris (L5-S1) (gemellus inferior and
quadratus femoris)
• Nerve to obturator internus (others)
This muscle can externally rotate thigh and can abduct flexed thigh A. Piriformis B. Inferior gemellus C. Obturator externus D. Quadratus femoris
Ans: A
Six deep external rotator
- Function:
- Piriformis and obturator internus can externally rotate thigh and can abduct flexed thigh
- Rest externally rotate hip.
Lateral femoral circumflex artery is related to the:
A. Ascending branch anastomoses with superior gluteal artery.
B. Medial femoral circumflex artery
C. Ascending branch anastomoses with inferior gluteal artery
D. Obturator artery
Ans A Vascular Supply Internal iliac artery: • Arises from common iliac artery • Branches from internal iliac: • Superior gluteal • Inferior gluteal • Branches from femoral artery: • Medial femoral circumflex artery: • Ascending branch anastomoses with inferior gluteal artery. • Lateral femoral circumflex artery: • Ascending branch anastomoses with superior gluteal artery.
Sacrospinous and sacrotuberous are separated by which bony landmark: A. Greater sciatic foramen B. Lesser sciatic foramen C. Ischial spine D. Illiac crest
Ans C
Sciatic Notches
Separated from each other by ischial spine.
• Ligaments:
• Sacrospinous
• Sacrotuberous
Ligaments convert notches into foramina:
• Greater sciatic foramen for structures entering or leaving pelvis.
• Lesser sciatic foramen for structures entering or leaving the perineum.
