The Gluteal Region

Question 1

What is Gait?

Answer 1

Walking and abnormalities in walking or ambulation

Question 2

What are the phases of gait?
What is the walking cycle?
What is stride length?

Answer 2

1. Heel-strike.
2. Stance phase
3. Push-off (or tor-off)
4. Swing Phase
5. Heel-strike
   1-5 is Walking cycle
   3-5 is stride length.

Question 3

How much of the gait cycle involves single-limb support?

Answer 3

75%…Need massive amount of stabilization.

Question 4

What are the four basic regions of the leg.

Answer 4

Gluteal (Pelvic girdle)
Thigh
Leg (Foot)

Question 5

What are the three functions of the limb structure?

Answer 5

Weight bearing
Locomotion
Maintenance of equilibrium
(Strong structurally and Muscularly)

Question 6

What are the two foramen of the pelvis?
What ligament separates them?
What is in the sacrotuberous ligament?

Answer 6

Greater sciatic foramen
Lesser sciatic foramen
Sacrospinous Ligament
Inferior gluteal artery.

Question 7

What is the relationship of the acetabulum and the head of the femur?

Answer 7

The acetabelum grows around the head of the femur to help hold it in place.

Question 8

What are the two attachment sites of the proximal femur?

What two muscles attach to the top part?

Answer 8

Greater Trochanter–Gluteus medius, Gluteus minimus.

Lesser Trochanter

Question 9

What are the two functions of the pelvis?

Answer 9

1. Transfer body weight from pelvis to femur.

2. Mobility (multiaxial ball-&-socket joint)–flex/ext, abd/add, rotation.

Question 10

Name the 4 muscles of the superficial group.

Name the 5 muscles of the deep group.

Answer 10

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia lata

Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris

Question 11

What are the 4 attachments, 3 functions, innervation of Tensor fascia lata?

A lot of fascia. Holds muscle tight.

Answer 11

A: Anterior superior iliac spine.
Anterior part of iliac crest.
Iliotibial tract.
Lateral condyle of the tibia.

F: Flexion, Medial rotation, Stabilization of hip and knee joints.

N: Superior gluteal n. (the reason it is in this group)

Question 12

Gluteus maximus
6 Attachments
4 Functions
Innervation

Answer 12

A: Ilium, Sacrum, Erector spinae tendon, Sacrotuberous lig., Gluteal tuberosity (1/4), Iliotibial tract (3/4).

F: Extension standing from sitting, lateral rotation against IT, Upper:abduction, Lower:adduction. Increases ability to go faster, stronger due to torque.

N: Inferior gluteal n.

Question 13

Gluteus medius
Attachments 4
Function 4
Nerve

Answer 13

A: Anterior gluteal line, Posterior gluteal line (post greater trochanter), Deep fascia, Greater trochanter.

F: Hold hip level, Abduction, rotation, ant fibers–medial rotation, post fiber–lateral rotation.

N:Superior gluteal n.

Question 14

Gluteus minimus
3 attachments
1 function
nerve

Answer 14

A: Anterior gluteal line, Inferior gluteal line, Greater trochanter

F: Abduction (ant trochanter overlapping allows abduction in multiple planes.

Innervation: Superior gluteal n.

Question 15

Name the three muscls innervated by the superior gluteal nerve

Answer 15

Gluteus medius
Gluteus minimus
Fascia lata

Question 16

Piriformis
A: 3
F: 3 specialized
N:
Exits pelvis where?

Answer 16

A: Sacrum, Sacrotuberous ligament, Greater trochanter (Medial inside).

F: Lateral rotation when extended,
Abduction when flexed.
Holds the head in acetablulm (preserves function)

N: Posterior division of S1-2

Exits pelvis through the greater sciatic foramen.

Question 17

Obturator internus
A;2 and route
F:2
N;1

Answer 17

A: Obturator membrane and bone, greater trochanter, exits lesser sciatic foramen, lateral rotation.

F: Lateral rotation–when extended, Holds head in acetabulum.

N: Nerve to the obturator internus m.

Question 18

Superior Gamellus
A: 2
I:1
Inferior Gamellus
A:2
I:1

F:

Answer 18

SG
A; Superior margin of lesser sciatic notch, becomes continuous with Tendon of obturator internus.

F: Nerve to the obturator internus m.

IG
A: Inferior margin o lesser sciatic notch, becomes continuous with Tendon of obturator internus m.

N: Nerve to the quadratus femoris m. (L4-5, S1)

Lateral rotators

Question 19

Quadratus femoris M
A:2
N:1
F:

Answer 19

A: Ischial tuberosity, intertrochanteric crest.

N:Nerve to quadratus femoris

F:Horrible lateral rotator–just pulls hip together. really just stabilizes hip.

Question 20

Nerve supply of gluteal region comes from.

Answer 20

Sacral plexus (L4–S4) all comes from here.

Question 21

Describe the Superior Gluteal Artery (4)

Answer 21

Continuation of posterior division of internal iliac artery.
Exits pelvis superior to piriformis muscle.
Superficial branch (Gluteous max muscle)
Deep branch (Gluteus med, minimus, tensor fascia lata)

Question 22

Descrive the Inferior gluteal artery (4)

Answer 22

Largest of two branches of ant division of internal iliac artery.
Inferior to piriformis
Supplies (Gluteus max, obturator internus, quadratus femoris, and superior parts of hamstring)
Anastomoses with superior gluteal art.

Question 23

What happens with Cuchenne syndrome?

Answer 23

Gluteal abductors are paralyzed leads to a characteristic limp where the patient throw upper body over support limb during gait to keep from tipping to opposite side.