The Gluteal Region Flashcards
What is the location of the gluteal region?
Behind the pelvis and extending from the iliac crest superiorly to the gluteal fold (fold of the buttock) inferiorly
Gluteal fold and gluteal sulcus/crease functions
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
What separates the buttocks from each other?
The natal (intergluteal) cleft
Superficial fascia of the gluteal region in women
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
Upper layers quadrant innervation
Lateral branches of iliohypogastric (L1) and T12
Upper medial quadrant innervation
Posterior rami of L1,2,3 & S1,2,3
Lower lateral quadrant innervation
Branches from lateral cutaneous nerve of thigh (L2,3)
Lower medial quadrant innervation
Branches from posterior cutaneous nerve of thigh (S1,2,3)
Skin in the floor of the natal cleft innervation
Branches from the lower sacral and coccygeal nerves
The skin and the fat of the gluteal region is supplied by…
…perforating branches of the superior and inferior gluteal arteries
Bones of the gluteal region
Posterior aspects of the hip joint and part of the pelvic bone
Which ligaments convert the greater & lesser sciatic notches into greater & lesser sciatic foramina?
Sacrospinous and Sacrotuberous
Which vessels passes superior to the piriformis?
Superior gluteal vessels & nerve
Which vessels pass inferior to the piriformis?
Inferior gluteal vessels & nerve Sciatic nerve Posterior cutaneous nerve of thigh Pudendalnerve & Internal pudendal vessels Nerve to obturator internus Nerve to quadratus femoris
What is the pudendal nerve?
The pudendal nerve is a major somatic nerve of the sacral plexus.
Which structures pass through the lesser sciatic foremen?
Pudendal nerve & Internal pudendal vessels enter
Tendon of and nerve to obturator internus
There is a gluteal radical aponeurosis over gluteus medialis. True or false?
True
Origin and insertion of the iliotibial tract
From the iliac tubercle to the lateral tibial condyle
Gluteus maximus originates and inserts
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
Gluteus Maximus is innervated by
Inferior gluteal nerve
What is the chief antigravity muscle of the hip?
Gluteus Maximus
What is forced extension?
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.
Origin and insertion of gluteus medius
Between posterior and inferior gluteal lines to lateral surface of greater trochanter
Which muscles insert into the lesser trochanter?
Iliopsoas
Which muscles insert into the greater trochanter?
Gluteus medius, gluteus minimus and piriformis and other lateral rotators
What innervates gluteus medius?
Superior gluteal nerve
Origin and insertion of gluteus minimus
From the outer surface of ilium to the I nterior surface of greater trochanter
Origin and insertion of tensor fascia lata
From between the anterior superior iliac spine & iliac tubercle into the iliotibial tract
Which muscles inserts into the iliotibial tract?
Gluteus maximus, TFL
Nerves of the gluteal region
● Sciatic ●Posterior cutaneous nerve of the thigh ●Superior gluteal ●Inferior gluteal ●Nerve to quadratus femoris ●Pudendal nerve ●Nerve to obturator internus
Arteries of the Gluteal Region
● Superior gluteal ●Inferior gluteal ●Lateral circumflex ●Medial circumflex ●First perforating branch of profunda femoris
The superior and inferior gluteal arteries are branches of…
The internal iliac artery
Which arteries form the trochanter ic anastomoses?
- Descending branches of superior and inferior gluteal arteries
- Ascending branches of lateral and medial circumflex arteries
Where is the cruciate anastomoses of the lower limb?
At the level of the lesser trochanter
The cruciate anastomoses is formed by:
- Descending branch of inferior gluteal artery
- Transverse branches of medial and lateral circumflex arteries &
- Ascending branch of first perforating artery
Bursae Related to Gluteus Maximus
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
The Gluteofemoral Bursa lies between
…gluteus maximus tendon and vastus lateralis
The Trochanteric Bursa lies…
Between gluteus Maximus tendon and greater trochanter
The Ischial Bursa lies between
Gluteus maximus & ischial tuberosity
What is common to all the bursae of the gluteal region?
They lie between gluteus maximus and other structures
What part of the gluteal region is safest for intramuscular injection?
Outer upper quadrant of the buttock is the safe area for intramuscular injection to avoid injury to the underlying sciatic nerve
The Trendelenburg test is used…
…to assesses whether the hip abductors (particularly gluteus medius) are functioning normally
How is the Trendelenburg test done?
The patient is asked to stand on 1 foot and then the other foot while the doctor observes from behind
Positive Tredenlenburg test
Pelvis ‘sags’ on contralateral side
Negative Trendelenburg test
Pelvis ‘tilts up’ on contralateral side
Problems that could lead to a positive Trendelenburg test
●Fracture neck of femur
●Dislocation of hip joint
●Coxa Vara
●Nonfunctioning gluteus medius and minimus
Causes of non-functioning gluteus medius and minimus
- Neurological damage (L4 – 5 disc herniation)
- Any disease affecting muscles (myopathy)
