Pelvis

Question 1

What is the nerve supply and nerve roots of gluteus maximus?

Answer 1

Inferior gluteal nerve (L5, S1 and S2)

Question 2

What are the actions of gluteus maximus?

Answer 2

External rotation and extension of the hip

Question 3

What nerve supplies the tensor fasciae lata?

Answer 3

The superior gluteal neve

Question 4

Where does the gluteus medius muscle insert?

Answer 4

Onto the lateral surface of the greater trochanter

Question 5

What is the action of gluteus medius?

Answer 5

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

Question 6

What clinical sign is evident with weakness of gluteus medius and minimus

Answer 6

A trendelenburg gait or a positive trendelenburg test

Question 7

What are the causes of a Trendelenburg gait?

Answer 7

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

Question 8

Which bones make up the hip?

Answer 8

Ischium
Ilium
Pubis

Question 9

What bones make up the pelvis?

Answer 9

The two hip bones, the sacrum, coccyx

Question 10

Which muscles make up the external rotators of the hip?

Answer 10

Gluteus maximus
Piriformis
Obturator externus
Obturator internus
Superior gemellus
Inferior gemellus
Quadratus femoris

Question 11

What are the origins, insertion, actions and innervation of gluteus maximus

Answer 11

Origin - ilium, posterior gluteal line

Insertion - iliotibial band, gluteal sling (femur)

Innervation - inferior gluteal nerve (L5-S2)

Question 12

What are the origins, insertion, actions and innervation of Piriformis?

Answer 12

Origin - Anterior sacrum/sciatic notch

Insertion - proximal greater trochanter

Nerve supply - piriformis (S2)

Question 13

What are the origins, insertion, actions and innervation of obturator externus

Answer 13

Origin - ischipubic rami/obturator

Insertion - trochanteric fossa

Nerve supply - obturator (L2-L4)

Question 14

What are the origins, insertion, actions and innervation of obturator internus

Answer 14

Origin - ischopubic rami/ obturator membrane

Insertion - Medial greater trochanter

Action - Obturator internus (L5-S2)

Question 15

What are the origins, insertion, actions and innervation of superior gemellus?

Answer 15

Origin - outer ischial spine

Insertion - Medial greater trochanter

Nerve supply - obturator internus (L5-S2)

Question 16

What are the origins, insertion, actions and innervation of Inferior gemellus

Answer 16

Origin - ischial tuberosity

Insertion - medial greater trochanter

Nerve supply - quadratus femoris (L5-S1)

Question 17

What are the origins, insertion, actions and innervation of Quadratus femoris

Answer 17

Origin - lateral border of the upper part of the ischial tuberosity

Insertion - quadrate line of the femur

Nerve supply - quadratus femoris (L5-S1)

Question 18

Which muscles make up the abductors of the hip?

Answer 18

Gluteus medius
GLuteus minimus
Tensor fascia latae

Question 19

What are the origins, insertion, actions and innervation of gluteus medius

Answer 19

origin - ilium between posterior and anterior gluteal line

insertion - greater trochanter

Nerve supply - superior gluteal (l4-s1)

Question 20

What are the origins, insertion, actions and innervation of gluteus minimus

Answer 20

origin - ilium between anterior and inferior gluteal line

Insertion - anterior border of the greater trochanter

Nerve supply - superior gluteal (L4-S1)

Question 21

What are the origins, insertion, actions and innervation of tensor fascia latae?

Answer 21

Origin - anterior iliac crest

Insertion - Iliotibial band

Nerve supply - superior gluteal nerve (L4-S1)

Question 22

Which muscles attach to the greater trochanter?

Answer 22

P-GOGO

Piriformis
Gluteal medius and minimus
Obturator internus
Gemeli
Obsturator externus

Question 23

Where does the iliotibial tract attach?

Answer 23

Anterolateral iliac tubercle of the iliac crest proximally and the lateral condyle of the tibia distally

Question 24

What muscle insert into the iliotibial tract?

Answer 24

Gluteus maximus
Tensor fascia lata

Question 25

What is the clinical significance of the iliotibial tract?

Answer 25

Stabilises the knee in extension and in partial flexion and is important for walking and running

Question 26

What are the surface markings for the sciatic nerve?

Answer 26

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

Question 27

Which vessels exit the greater sciatic foramen from above?

Answer 27

the superior gluteal vessels and nerve exist above piriformis

Question 28

What variation is there with regard to the sciatic nerve exiting the pelvis?

Answer 28

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