Pelvis Flashcards
What is the nerve supply and nerve roots of gluteus maximus?
Inferior gluteal nerve (L5, S1 and S2)
What are the actions of gluteus maximus?
External rotation and extension of the hip
What nerve supplies the tensor fasciae lata?
The superior gluteal neve
Where does the gluteus medius muscle insert?
Onto the lateral surface of the greater trochanter
What is the action of gluteus medius?
During standing it is a hip abductor
During gait, gluteus medius, together with gluteus minimus it supports the body whilst one leg is in the air preventing the pelvis from dropping to the opposite side
What clinical sign is evident with weakness of gluteus medius and minimus
A trendelenburg gait or a positive trendelenburg test
What are the causes of a Trendelenburg gait?
Weak abductor muscles
Avulsion of the abductor muscle tendon
L5 radiculopathy
Superior gluteal nerve injury
Myopathy
Neurological conditions such as stroke or MS
Trauma or #s of the pelvis or hip
DDH, congenital coxa vara or valga
Painful hip
Unequal leg length
Wide walking baseWHi
Which bones make up the hip?
Ischium
Ilium
Pubis
What bones make up the pelvis?
The two hip bones, the sacrum, coccyx
Which muscles make up the external rotators of the hip?
Gluteus maximus
Piriformis
Obturator externus
Obturator internus
Superior gemellus
Inferior gemellus
Quadratus femoris
What are the origins, insertion, actions and innervation of gluteus maximus
Origin - ilium, posterior gluteal line
Insertion - iliotibial band, gluteal sling (femur)
Innervation - inferior gluteal nerve (L5-S2)
What are the origins, insertion, actions and innervation of Piriformis?
Origin - Anterior sacrum/sciatic notch
Insertion - proximal greater trochanter
Nerve supply - piriformis (S2)
What are the origins, insertion, actions and innervation of obturator externus
Origin - ischipubic rami/obturator
Insertion - trochanteric fossa
Nerve supply - obturator (L2-L4)
What are the origins, insertion, actions and innervation of obturator internus
Origin - ischopubic rami/ obturator membrane
Insertion - Medial greater trochanter
Action - Obturator internus (L5-S2)
What are the origins, insertion, actions and innervation of superior gemellus?
Origin - outer ischial spine
Insertion - Medial greater trochanter
Nerve supply - obturator internus (L5-S2)
What are the origins, insertion, actions and innervation of Inferior gemellus
Origin - ischial tuberosity
Insertion - medial greater trochanter
Nerve supply - quadratus femoris (L5-S1)
What are the origins, insertion, actions and innervation of Quadratus femoris
Origin - lateral border of the upper part of the ischial tuberosity
Insertion - quadrate line of the femur
Nerve supply - quadratus femoris (L5-S1)
Which muscles make up the abductors of the hip?
Gluteus medius
GLuteus minimus
Tensor fascia latae
What are the origins, insertion, actions and innervation of gluteus medius
origin - ilium between posterior and anterior gluteal line
insertion - greater trochanter
Nerve supply - superior gluteal (l4-s1)
What are the origins, insertion, actions and innervation of gluteus minimus
origin - ilium between anterior and inferior gluteal line
Insertion - anterior border of the greater trochanter
Nerve supply - superior gluteal (L4-S1)
What are the origins, insertion, actions and innervation of tensor fascia latae?
Origin - anterior iliac crest
Insertion - Iliotibial band
Nerve supply - superior gluteal nerve (L4-S1)
Which muscles attach to the greater trochanter?
P-GOGO
Piriformis
Gluteal medius and minimus
Obturator internus
Gemeli
Obsturator externus
Where does the iliotibial tract attach?
Anterolateral iliac tubercle of the iliac crest proximally and the lateral condyle of the tibia distally
What muscle insert into the iliotibial tract?
Gluteus maximus
Tensor fascia lata
What is the clinical significance of the iliotibial tract?
Stabilises the knee in extension and in partial flexion and is important for walking and running
What are the surface markings for the sciatic nerve?
a curved line drawn from 2 points - halfway between the posterior superior iliac spine to the ischial tuberosity to halfway between the ischial tuberosity and the greater trochanter
Which vessels exit the greater sciatic foramen from above?
the superior gluteal vessels and nerve exist above piriformis
What variation is there with regard to the sciatic nerve exiting the pelvis?
In the majority of cases the sciatic nerve exists beneath the piriformis
Alternatively, either the whole nerve may pass through piriformis, or it may divided high with one division passing through or around the piriformis
