Gluteal Region

Question 1

Deep fascia of the thigh

Answer 1

Fascia lata - encloses thigh muscles

Attachment foor intermuscular septae

Question 2

3 compartments of thigh

Answer 2

Anterior
Medial
Posterior

Question 3

What is the opening in fascia lata called

Answer 3

Saphenous opening - saphenous vein enters drains into femoral vein, lymphatic vessels

Question 4

Thickened aspect of fascia lata

Answer 4

Iliotibial tract (iliotibial band) 
Runs from iliac crest to lateral tibial condyle (knee)

Question 5

Tensor fascia lata

Answer 5

Originates: anterior superior iliac spine

Inserts: between two layers of iliotibial band

Innervation: superior gluteal nerve

Question 6

Function of tensor fascia lata

Answer 6

Pulls on iliotibial tract

Abduct hip joint (with gluteus medius and minimus)

Compresses deep veins - help venous return

Supports gait

Question 7

Iliotibial band problems

Answer 7

Shortened when seated
Easily becomes tight
Lateral knee pain
Patella instability

Treat with physio

Question 8

Superficial gluteal muscles

Answer 8

Large muscles
Abduct and extend lower limb at hip

Gluteus maximus, gluteus medius, gluteus minimus, tensor fascia lata

Question 9

Deep gluteal muscles

Answer 9

Laterally rotate lower limb, stabilise hip joint (pull femoral head into acetabulum)

Piriformis, gemellus superior, obturator internus, gemellus inferior, quadratus femoris

Question 10

Arterial supply to gluteal muscles

Answer 10

Superior and inferior gluteal arteries (branches of internal iliac artery)

Question 11

Gluteus maximus

Answer 11

Largest gluteal muscle
Most superficial - round shape buttocks

Originates: posterior surface of ilium, sacrum, coccyx

Insert: iliotibial tract (superficial) Gluteal tuberosity of femur (deeper)

Actions: main extensor, assists lateral hip rotation, climbing/running, extension of knee

Innervtation: Inferior gluteal nerve (L5, S1, S2)

Question 12

Gluteus medius

Answer 12

Fan shaped
Between gluteus maximus and gluteus minimus

Originates: gluteal surface

Inserts: lateral surface of greater trochanter

Actions: abducts and medially rotates limb, secures pelvis when walking

Innervation: superior gluteal nerve (L4, L5, S1)

Question 13

Gluteus minimus

Answer 13

Deepest and smallest superficial gluteal

Originates: ilium

Inserts: anterior aspect of greater trochanter

Actions: abducts and medially rotates lower limb, secures pelvis in horizontal alignment

Innervation: superior gluteal nerve (L4, L5, S1)

Question 14

Superior gluteal nerve injury

Answer 14

Gluteus medius and minimus affected
Weakness abducting thigh

Complications hip surgery, injections, fractures to trochanter

Malfunctioning side rises (pelvis tilts away)
= TRENDELENBURG SIGN

Question 15

Piriformis

Answer 15

Sciatic nerve emerges from pelvis inferior to it

Originates: anterior surface of sacrum through greater sciatic foramen

Insert: greater trochanter

Actions: lateral rotation and abduction lower limb

Innervation: nerve to piriformis

Question 16

Obturator internus

Answer 16

Lateral wall of pelvic cavity

Originates: pubis and ischium at obturator foramen. Travels through lesser sciatic foramen

Inserts: greater trochanter (below piriformis and superior gemellus)

Actions: lateral rotation, abduction lower limb

Innervation (nerve to obturator internus)

Question 17

Superior and inferior gemelli

Answer 17

Two triangles

Seperated by obturator internus tendon

Question 18

Superior gemelli

Answer 18

Originates: Ischial spine

Insert: greater trochanter above obturator internus

Actions: lateral rotation, abduction lower limb

Innervation: nerve to obturator internus

Question 19

Inferior gemelli

Answer 19

Originates: ischial tuberosity

Insert: greater trochanter, below obturator internus

Actions: lateral rotation, abduction of lower limb

Innervation: nerve to quadratus femoris

Question 20

Obturator externus

Answer 20

Originates: external obturator membrane, travels posterior to neck of femur

Inserts: posterior aspect of greater trochanter

Actions: adduction and lateral rotation of thigh

Innervation: obturator nerve (L2-L4)

Question 21

Quadratus femoris

Answer 21

Flat, square

Originate: ischial tuberosity

Insert: quadrate tuberosity (intertrochanteric line)

Action: lateral rotation

Innervation: nerve to quadratus femoris

Question 22

Function of gluteal muscles (except gluteus minimus and medius)

Answer 22

Lateral (external) rotators of hip

GM and GM internal (medial) rotators