LM 6.2: Gluteal Region Flashcards
What is the function of the cluneal nerves?
The sensory nerves of the gluteal region
They carry sensory afferent fibers from the skin of the gluteal region
What are the borders of the gluteal region?
Iliac crest to gluteal fold (bottom of your butt)
Laterally it extends from the mid axillary line
If there is left hip drop every time a patient lifts his left foot off the floor but on the right side his pelvis remains level when he lifts up his right foot. Which nerve has been effected? What happens when this nerve is injured?
The superior gluteal nerve
The right side remains level because the muscles on the left side are intact! These muscles include the abductors of the left lower limb which keep the pelvis level
His left hip drops because the muscles on the gluteal region on the right side are weak and can’t abduct — injury has occurred at gluteus medius muscle due to injury of the superior gluteal nerve that innervates it so the gluteus medius muscle can’t support the hip and it drops
The patient can’t lift left lower limb due to weakened abduction of the contralateral gluteals medius, gluteus minimus and tensor fascia lata so the pelvis can’t stay horizontal
Which muscles are innervated by the superior gluteal nerve? What is their action?
- Gluteus medius
- Gluteus minimus
- Tensor of the fascia lata
They all abduct and medially rotate the hip
What is the fascia lata?
The deep fascia of the thigh between the knee and the hip
What is the cru fascia?
The deep fascia of the leg between the knee and the ankle
What is a positive Trendelemburg sign?
Dropping of the pelvis when the patient is asked to stand on one foot/lifts their foot while walking
What are the nerves of the gluteal region?
- Superior gluteal nerve
- Inferior gluteal nerve
- Pudendal nerve
- Sciatic nerve
- Posterior cutaneous nerve of the thigh
Which nerve innervates the gluteus maximus?
Inferior gluteal nerve
Which muscles does the pudendal nerve innervate?
Peritoneum and external genitalia
Which muscles are involved in lateral rotation of the hip?
- Piriformis
- Superior gemellus
- Inferior gemellus
- Obturator internus
- Quadratus femoris
what is the piriformis used as a landmark for?
the superior gluteal nerve runs superior to it while the inferior gluteal nerve runs inferior to it
actually all the other nerves except the superior gluteal nerve
what is the attachment, action and innervation of the gluteus maximus?
distal attachment to the most lateral condyle of the tibia via the iliotibial tract
action = hip extension
innervation = inferior gluteal nerve
what is the attachment, action and innervation of the gluteus medius?
proximal attachment = external surface of allium superior to gluteus minimus
distal attachment = greater trochanter of femur
action = abduction and medial rotation of hip
innervation = superior gluteal nerve
what is the attachment, action and innervation of the gluteus minimus?
proximal attachment = external surface of ilium inferior to gluteus medius
distal attachment = greater trochanter of femur
action = abduction and medial rotation of the thigh
innervation = superior gluteal nerve
what is the attachment, action and innervation of the tensor fascia lata?
proximal attachment = anterior superior iliac crest (ASIS)
distal attachment = lateral condyle of tibia via IT tract
action = abduction and medial rotation of rhigh
innervation = superior gluteal nerve
what is the attachment, action and innervation of the piriformis?
proximal attachment: anterior surface of sacrum
distal attachment: greater trochanter of femur
action: laterally rotates thigh
where does the piriformis travel through?
the greater sciatic foramen
what is the attachment and action of the superior and inferior gemelli muscles?
they’re located superior and inferior to the tendon of the obturator internus muscle
distal attachment = near greater trochanter of femur
action = laterally rotate thigh
what is the attachment and action of the operator internus?
proximal attachment = Internal surface of obturator membrane
distal attachment = near greater trochanter of femur
makes a 90˚ turn on the lesser sciatic notch
action = laterally rotates thigh
what is the action of the quadratus femoris?
lateral rotate hip
where are the superior and inferior gluteal arteries located?
the superior gluteal artery exits the pelvis through the greater sciatic foramen superior to the piriformis muscle
the inferior gluteal artery exits the pelvis through the greater sciatic foramen inferior to the piriformis muscle
