Unit 3- Gluteal Muscles Flashcards
Thigh anterior compartment movement
Flex the thigh (femur)- also involved in extending the leg- innervated by femoral nerve
Movement of medial compartment of the thigh
Adduct the thigh
Innervated by the obturator nerve
Movement of the post compartment of the thigh
Extend the thigh and flex the left
Innervated by the tibial portion of sciatic nerve
Movement of the lateral compartment of the thigh
Abduct the thigh
This groups has migrated slightly posteriorly and superiorly to form the gluteal muscles
Location allows them to be major thigh extensors
Hip, sacrum and coccyx are bound together by
Dense ligaments
Sacrotuberous ligament
Converts the lesser sciatic notch into the lesser sciatic foramen
Sacrospinous ligament
Converts the greater sciatic notch into the greater sciatic foramen
Foramen in/out of the pelvis
Greater sciatic foreamen
Foramen in/out of the perineum
Lesser sciatic foramen
Superficial later of gluteal muscles attach to the:
Posterolateral surface and margins of the ala of the iliac bone
Superficial layer of glut muscles (4)
Gluteus Maximus
Gluteus mediums
Gluteus minimus
Tensor of the fascia lata
Actions of the superficial lateral of the gluteal muscles
Extensors, abductors, and rotators
Deep layer of the glu tmuscles attach to
To or adjacent to the intertrochanteric crest of the femur
Deep layer glut muscles
Piriformis
Obturator internus and externus
Gemelli sup and inf
Quadratus femoris
Action of the deep layers of the glut muscles
Stabilize the hip joint and laterally rotate
Largest muscle of the body
Gluteus Maximus
OINA for Gluteus Maximus
OR: Ilium posterior to the post gluteal line
Dorsal surface of the sacrum
Coccyx
Sacrotuberous ligament
INS: Upper 3/4ths - iliotibial tract (into the lateral condyle of the tibia)
Lower 1/4- on the gluteal tubercle of the femur
NS: Inf gluteal nerve
AC: Extends the thigh (especially when thigh is flexed) Assists lateral rotation Extends the trunk when LE is fixed Stabilized the extended knee Abducts thigh
Blood supply for glut Maximus
Extremely good blood supply from
Sup and inf gluteal artery
Glut max is little involvement when:
But major role in:
Walking on a flat surface
Climbing
Glut max fibers run:
Inferolaterally at 45 degree to the iliotibial tract
Gluteal bursa (3)
Trochanteric bursa
Ischial bursa
Gluten-femoral bursa
Trochanteric bursa
Over the:
Present at:
Over the greater trochanter
Present at birth
Usually the largest bursa in body
Ischial bursa
Located:
Between the inferior gluteus max and ischial tuberosity
Gluten-femoral bursa location
Between the ilitibial tract and proximal attachment of the vastus lateralis
OINA for glut mediums
OR: External surface of the ilium between the ant and post gluteal lines
INS: Lateral surface of the greater trochanter
NS: Superior gluteal nerve
AC: Chief abductor of the thigh
Weak medial rotation
OINA for Glut minimus
OR: External surface of the ilium between ant and post gluteal lines
Ins: Anterior surface of the greater trochanter
NS: Superior gluteal nerve
AC: abducts the thigh
Weak medial rotation
Glut medius and minimus are separated by:
The deep branches of the superior gluteal neurovascular bundle
OINA for tensor fascia lata
OR: ASIS, Iliac crest
INS: Ilitibial tract (attached to lateral condyle of the tibia)
NS: Superior gluteal nerve
AC: Chief action is flexion of the thigh (with iliopsoas and rectus femoris )
Also stabilized the extended knee
OINA for piriformis
OR: Ant sacrum (S1-S4)
INS: Sup border of greater trochanter
NS: Nerve to piriformis (ant rami of S2 & S2)
AC: Laterally rotate thigh
Abduct thigh
Landmark of the gluteal region
Piriformis
Where do superior gluteal vessels and nerves emerge
Superior to the piriformis
Where do the inf gluteal vessels and nerves emerge
Inf to the piriformis
Sciatic nerve emerges where?
Inf to the piriformis
Occasionally it will go through the piriformis
Triceps Coxae includes (3)
Superior gemellus
Obturator internus
Inferior gemellus
Triceps coxae form:
A tricipital muscle located between the piriformis and quadratus femoris
Common tendon of the triceps runs:
Horizontally to the greater trochanter of the femur
OINA for sup and inf gemellus
OR: Sup- Ischial spine
Inf- Ischial tuberosity
INS: greater trochanter (common tendon)
NS: Sup- nerve to obturator internus
Inf- nerve to quadratus femoris
AC: Laterally rotates extended thigh
Abduct the flexed thigh
Stabilize femoral head in acetabulum
OINA for obturator internus
OR: Pelvis surface of the obturator membrane Obturator foramen (bony ring)
INS: Greater trochanter
NS: nerve to obturator internus
AC: Lateral rotates extended thigh
Abduct flexed thigh
Stabilize femoral head in acetabulum
Obturator internus exists the pelvis through the:
Lesser sciatic foramen
OINA for quadratus femoris
OR: Ischial tuberosity
INS: Quadrate tubercle on intertrochanteric crest
NS: Nerve to quadratus femoris
AC: Laterally rotates thigh
Stabilize femoral head in acetabulum
Smallest muscle block and strongest lateral rotator of the thigh
Quadratus femoris
Piriformis syndrome caused by:
An entrapment of the sciatic nerve as it exits the greater sciatic notch in the gluteal region
2 normal variations for exit of the sciatic nerve
1- sciatic nerve emerges inf to the piriformis muscle and sup to the gemellus muscle
2- sciatic nerve pierces the piriformis itself (in about 1-10% of humans)
Piriformis syndrom when entrapped in the first variation for exit of the sciatic nerve
Entrapment is likely due to a myospasm or contracture (tightening and shortening respectively) of either of the 2 muscles
Second sciatic nerve pathway- piriformis syndrome
Myospasm and/or contraction of the piriformis muscle itself can lead to pain along the back of the thigh to the knee
Loss of sensation
Numbness and tingling in sole of the foot
This mimics sciatica
Difference between sciatica and piriformis syndrome
The cause
Sciatica is due to a lumbar disc pressing on a nerve root as it exits the IVF in the lumbar spine
Piriformis syndrome and sciatica both complain about:
Pain, numbness, and tingling below the knee and into the foot
Piriformis syndrome symptoms
Deep aching in buttock and thigh, usually not beyond the knee
Affected led often externally rotates (toes point out) when relaxed
Often causes low back pain
Can be reproduces by a deep palpating of the sciatic nerve as it exits below the piriformis
Piriformis pain often aggravated by
Siting, squatting, or walking
Right leg often affected by piriformis syndrome after
Driving a long distance if the foot has been in external rotation while depressing the gas pedal
Prirformis syndrom femal to male ratio
6:1
