The Gluteal Region

Question 1

What is the location of the gluteal region?

Answer 1

Behind the pelvis and extending from the iliac crest superiorly to the gluteal fold (fold of the buttock) inferiorly

Question 2

Gluteal fold and gluteal sulcus/crease functions

Answer 2

The gluteal fold indicates the lower border of the gluteus maximus muscle and the gluteal sulcus/crease is a skin crease for the hip join

Question 3

What separates the buttocks from each other?

Answer 3

The natal (intergluteal) cleft

Question 4

Superficial fascia of the gluteal region in women

Answer 4

It is thick, dense, well developed, laden with large quantities of fat (specially in women) that gives the butt convexity and cushions the ischial tuberosity

Question 5

Upper layers quadrant innervation

Answer 5

Lateral branches of iliohypogastric (L1) and T12

Question 6

Upper medial quadrant innervation

Answer 6

Posterior rami of L1,2,3 & S1,2,3

Question 7

Lower lateral quadrant innervation

Answer 7

Branches from lateral cutaneous nerve of thigh (L2,3)

Question 8

Lower medial quadrant innervation

Answer 8

Branches from posterior cutaneous nerve of thigh (S1,2,3)

Question 9

Skin in the floor of the natal cleft innervation

Answer 9

Branches from the lower sacral and coccygeal nerves

Question 10

The skin and the fat of the gluteal region is supplied by…

Answer 10

…perforating branches of the superior and inferior gluteal arteries

Question 11

Bones of the gluteal region

Answer 11

Posterior aspects of the hip joint and part of the pelvic bone

Question 12

Which ligaments convert the greater & lesser sciatic notches into greater & lesser sciatic foramina?

Answer 12

Sacrospinous and Sacrotuberous

Question 13

Which vessels passes superior to the piriformis?

Answer 13

Superior gluteal vessels & nerve

Question 14

Which vessels pass inferior to the piriformis?

Answer 14

Inferior gluteal vessels & nerve
Sciatic nerve
Posterior cutaneous nerve of thigh
Pudendalnerve & Internal pudendal vessels
Nerve to obturator internus
Nerve to quadratus femoris

Question 15

What is the pudendal nerve?

Answer 15

The pudendal nerve is a major somatic nerve of the sacral plexus.

Question 16

Which structures pass through the lesser sciatic foremen?

Answer 16

Pudendal nerve & Internal pudendal vessels enter

Tendon of and nerve to obturator internus

Question 17

There is a gluteal radical aponeurosis over gluteus medialis. True or false?

Answer 17

True

Question 18

Origin and insertion of the iliotibial tract

Answer 18

From the iliac tubercle to the lateral tibial condyle

Question 19

Gluteus maximus originates and inserts

Answer 19

From the outer surface of ilium behind the posterior gluteal line and posterior surfaces of the sacrum and coccyx to the iliotibial tract and gluteal tuberosity of femur

Question 20

Gluteus Maximus is innervated by

Answer 20

Inferior gluteal nerve

Question 21

What is the chief antigravity muscle of the hip?

Answer 21

Gluteus Maximus

Question 22

What is forced extension?

Answer 22

Muscle movement in where extension of the hip moves the trunk upwards. Gluteus maximus does this and is used in standing up from a sitting position, running & climbing up stairs.

Question 23

Origin and insertion of gluteus medius

Answer 23

Between posterior and inferior gluteal lines to lateral surface of greater trochanter

Question 24

Which muscles insert into the lesser trochanter?

Answer 24

Iliopsoas

Question 25

Which muscles insert into the greater trochanter?

Answer 25

Gluteus medius, gluteus minimus and piriformis and other lateral rotators

Question 26

What innervates gluteus medius?

Answer 26

Superior gluteal nerve

Question 27

Origin and insertion of gluteus minimus

Answer 27

From the outer surface of ilium to the I nterior surface of greater trochanter

Question 28

Origin and insertion of tensor fascia lata

Answer 28

From between the anterior superior iliac spine & iliac tubercle into the iliotibial tract

Question 29

Which muscles inserts into the iliotibial tract?

Answer 29

Gluteus maximus, TFL

Question 30

Nerves of the gluteal region

Answer 30

``` ● Sciatic ●Posterior cutaneous nerve of the thigh ●Superior gluteal ●Inferior gluteal ●Nerve to quadratus femoris ●Pudendal nerve ●Nerve to obturator internus ```

Question 31

Arteries of the Gluteal Region

Answer 31

``` ● Superior gluteal ●Inferior gluteal ●Lateral circumflex ●Medial circumflex ●First perforating branch of profunda femoris ```

Question 32

The superior and inferior gluteal arteries are branches of...

Answer 32

The internal iliac artery

Question 33

Which arteries form the trochanter ic anastomoses?

Answer 33

- Descending branches of superior and inferior gluteal arteries - Ascending branches of lateral and medial circumflex arteries

Question 34

Where is the cruciate anastomoses of the lower limb?

Answer 34

At the level of the lesser trochanter

Question 35

The cruciate anastomoses is formed by:

Answer 35

- Descending branch of inferior gluteal artery - Transverse branches of medial and lateral circumflex arteries & - Ascending branch of first perforating artery

Question 36

Bursae Related to Gluteus Maximus

Answer 36

Gluteofemoral Bursa: lies between gluteus maximus tendon and vastus lateralis ●Trochanteric Bursa: lies between gluteus Maximus tendon and greater trochanter ●Ischial Bursa: lies between gluteus maximus & ischial tuberosity

Question 37

The Gluteofemoral Bursa lies between

Answer 37

...gluteus maximus tendon and vastus lateralis

Question 38

The Trochanteric Bursa lies...

Answer 38

Between gluteus Maximus tendon and greater trochanter

Question 39

The Ischial Bursa lies between

Answer 39

Gluteus maximus & ischial tuberosity

Question 40

What is common to all the bursae of the gluteal region?

Answer 40

They lie between gluteus maximus and other structures

Question 41

What part of the gluteal region is safest for intramuscular injection?

Answer 41

Outer upper quadrant of the buttock is the safe area for intramuscular injection to avoid injury to the underlying sciatic nerve

Question 42

The Trendelenburg test is used...

Answer 42

...to assesses whether the hip abductors (particularly gluteus medius) are functioning normally

Question 43

How is the Trendelenburg test done?

Answer 43

The patient is asked to stand on 1 foot and then the other foot while the doctor observes from behind

Question 44

Positive Tredenlenburg test

Answer 44

Pelvis ‘sags’ on contralateral side

Question 45

Negative Trendelenburg test

Answer 45

Pelvis ‘tilts up’ on contralateral side

Question 46

Problems that could lead to a positive Trendelenburg test

Answer 46

●Fracture neck of femur ●Dislocation of hip joint ●Coxa Vara ●Nonfunctioning gluteus medius and minimus

Question 47

Causes of non-functioning gluteus medius and minimus

Answer 47

- Neurological damage (L4 – 5 disc herniation) | - Any disease affecting muscles (myopathy)