LL: Gluteal region Flashcards
Pelvis bony anatomy

Femoral triangle borders
Inguinal ligament
Sartorius
Adductor longus

Floor of femoral triangle

Roof of femoral triangle
fascia lata
Structures in femoral triangle
Medial to lateral VAN
Lymphatics
Femoral vein
Femoral artery
Femoral nerve

Femoral canal content
Lymphatics
Cloquet’s lymph node

Femoral sheath
Covers femoral artery vein and femoral canal

What fascia gives rise to femoral canal
Continuation of extraperitoneal fascia
Anteriorly formed by fascia from transversalis fascia
Posteriorly formed by fascia from ilio-psoas fascia
Femoral canal borders
Anterior: inguinal ligament
Lateral: femoral vein
Medial: lacunar ligament
Posterior: Pectineal ligament

Clinical significance of femoral canal
Femoral hernias strangulate in this space
Deep muscles of gluteal region

Origin and insertion of piriformis
Anterior surface of sacrum
Greater trochanter

Origin and insertion of obturator internus
Internal surface of obturator foramen
Greater trochanter

Gemillus superior origin and insertion
External surface of ischial spine
Greater trochanter

Gemillus inferior origin and insertion
Ischial tuborisity
Greater trochanter

Quadratus femoris origin and insertion
Anterior to ischial tuboresity
Intertrochanteric crest

Function of piriformis
Lateral rotation/abduction
Function of obturator internus
Lateral rotation/abduction of hip
Gemillus superior function
Lateral rotation/abduction
Gemillus inferior function
Lateral rotation/abduction
Quadratus femoris function
Laterally rotates hip
Gluteus minimus origin and insertion
Inferior and anterior gluteal lines
Greater trochanter

Gluteus medius origin and insertion
Anterior and posterior gluteal lines
Greater trochanter

Gluteal maximus origin and insertion
Posterior gluteal line/ fascia covering gluteus medius
iliotibial tract of fascia lata and gluteal tuberosity

Tensor fasciae latae origin and insertion
Lateral ilial crest
Iliotibial tract

Gluteus minimus and medius function
abduct femur
Gluteus maximus function
Hip extension
Lateral rotation/abduction
Tensor fasciae latae function
Stabilises knee extension
Innervation of piriformis
L5 S1 S2
Innervation of obturator internus
Nerve to obturator internus
Innervation of gemellus superior
Obturator internus
Innervation of gemellus inferior
Nerve to quadratus femoris
Innervation of tensor fasciae latae
Superior gluteal nerve
Innervation of gluteaus medius and minimus
Superior gluteal nerve
Innervation of gluteus maximus
Inferior gluteal nerve
Structures through the greater sciatic foramen below piriformis
SNIP NIP
Sciatic nerve
Nerve to obturator internus
Internal pudendal artery and vein
Pudendal nerve
Nerve to quadratus femoris
Inferior gluteal artery, vein and nerve
Posterior cutanous nerve
Structures through the greater sciatic foramen above piriformis
Superior gluteal nerve artery and vein
Structures through lesser sciatic foramen
Obturator internus tendon
Pudendal nerve and internal pudendal vessels
Structures through obturator canal
Obturator nerve
Obturator vessels
Structures through gap between inguinal ligament and pelvis
Muscles: psoas major, illiacus, pectineus
Vessels: femoral A+V,
Nerves: femoral nerve, femoral branch of genitofemoral, lateral cutanous nerve of the thigh
Nerves of gluteal region

Origin of arteries supplying hip
External iliac -> profunda femoris -> medial, lateral circumflex femoral arteries, ascending 1st perforator
Internal iliac -> gluteal arteries
Obturator artery → head of femur (ligamentum teres artery)

Trochanteric anastemosis
Inferior and superior gluteal arteries
Medial and lateral circumflex arteries

Cruciate anastemosis

Veins of lower leg

Course of long saphenous vein
Starts at the confluence of dorsal vein of big toe and dorsal venous arch
Goes anterior to medial malleolus and goes posterior to tibia in the popliteal fossa
Goes up the medial aspect of the thigh until it pierces the fascia lata to enter femorasaphenous junction (2cm lateral and inferior to pubic tubercle)

Tributaries to great saphenous vein
Variable position but some say:
1cm below and above medial malleolus
10 cm above medial malleolus
Half way up the calf
Just below knee
Which nerve close to great saphenous vein? what is its significance?
Saphenous nerve (branch of femoral nerve)
Could be damaged in lower leg great saphenous vein stripping
Lymphatics of lower leg
Superficial inguinal
Deep inguinal
Popliteal nodes

What does deep inguinal node drain
femoral vessels
glans of penis/clitoris
What does superficial inguinal node drain
gluteal region
perineum
lower abdo
Lower limb dermatomes

Lower limb myotomes

Pudendal canal location
Within the obturator internus fascia

Pudendal canal aka
Aclocks canal
Pudendal canal content
Pudendal artery, nerve, vein
Structures passing through greater/lesser sciatic foramen
Pudendal nerve
Internal pudendal artery
Nerve to obturator
Sciatic nerve root
L4 - S3
Femoral nerve root
L2-4
Sciatic nerve course

Arterial supply of gluteus maximus vs medius
Max= inferior gluteal artery
Min= superior gluteal artery
Layers that you go through during posterior approach to hip
Skin
Subcut fascia
Gluteal fascia
Gluteus maximus
Short external rotators
Hip capsule
Which nerves in danger in posterior approach to hip
sciatic
Superior gluteal n