3 - Zill - Gluteal Region, Posterior Thigh, Popliteal Fossa Flashcards
5B - 60B (34 cards)
What is the action of gluteal region muscles?
Extend the hip and flex the knee!
Gluteus Maximus
Origin: Ilium, sacrum, coccyx, sacrotuberous ligament
Insertion: Upper fibers at Iliotibial Track of the Fascia Lata
Innervation: Inferior Gluteal Nerve
Action: Extend, lateral rotate hip joint
Differences in three gluteal muscles?
Gluteus Maximus:
Intert: Femur/IT Tract
Act: Extend, Laterally Rotate
Inn: Inferior Gluteal Nerve
Gluteus Medius/Minimus:
Insert: Greater Trochanter (Femur)
Act: Abduct/Medially Rotate
Inn: Superior Gluteal Nerve
What can damage to the superior gluteal nerve produce?
What is the clinical presentation?
What is this test/sign called?
Gluteal Gait (Foot Drop)
Also caused by poliomyelitis, cong. hip dislocation
Paralyzed Glut. Medius/Minimus
Pelvis tilts down on NON-PARALYZED SIDE
Positive Trendelenburg Sign
How does one locate the piriformis?
Directly above the Sciatic nerve, or it looks the Sciatic nerve is passing directly underneath
What vessels separate the Gluteus Medius and Minimus?
Superior Gluteal Artery and Nerve
LANDMARK FOR PRACTICAL!
Tensor Fascia Lata
Origin: Anterior Superior Iliac Spine (ASIS)
Insertion: iliotibial Tract
Action: ABduct Hip, maintains leg extension
Innervation: Superior Gluteal Nerve (same as glut med/min)
Bursa(e)
Major in hip joint?
Bags of fluid surrounded by connect tissue
Function as shoch absorbers, reduce friction
Ischial Tuberosity
Greater Trochanter
Trochanteral Bursa
Ischial Bursa
Separates Gluteus Maximus from Greater Trochanter (Femur) and Vastus Lateralis
Separates Gluteus Maximus from Ischial Tuberosity
Ischial Bursitis (Weaver’s Bottom)
Inflammation of bursa at Ischial Tuberosity
Clinically important for wheelchair patients
What are the three muscles directly below piriformis?
What landmark is useful in identifying them?
Superior Gemellus
Obturator internus
Inferior Gemellus
Quadratus Femoris
Obturator Internus will appear as a WHITE TENDON flanked above/below by Gemelluses
Piriformis
Origin: Sacrum
Insert: Greater Trochanter
Act: Laterally Rotate Femur, “Rotator Cuff”
Superior Gemellus
Obturator Internus
Inferior Gemellus
Quadratus Femoris
Superior Gemellus:
O: Ischial Spine
I: Greater Trochanter
A: Laterally Rotate Femur
Inferior Gemellus:
O: Ischial Tuberosity
I: Greater Trochanter
A: Laterally Rotate Femur
Obturator Internus (LANDMARK):
O: Obturator Membrane
I: Greater Trochanter
A: Laterally Rotate Femur
Quadratus Femoris:
O: Ischial Tuberosity
I: Greater Trochanter
A: Laterally Rotate Femur
Superior Gluteal Artery
Inferior Gluteal Artery
Superior Gluteal Artery:
Above piriformis, between Glut Medius/Minimus
Inferior Gluteal Artery:
Below piriformis, branches join Cruciate Anastomosis at hip joint
What is a possible outcome of damage to the superior gluteal nerve?
Trendelenburg Sign
Sciatic Nerve
From L4,5 / S 1, 2, 3
Composed of Tibial and Peroneal parts–splits to Tibial Nerve (medial) and Common Peroneal Nerve (lateral)
Where should you place intramuscular injections in the gluteal region? Why?
Upper Lateral Quadrant
Avoid hitting Sciatic Nerve
Piriformis Syndrome
Sciatic Nerve runs through Piriformis, and can be compressed
What innervates the hamstring portion of the Adductor Magnus?
Tibial part of Sciatic Nerve
What is the attachment for the hamstring muscles?
Action?
Ischial Tuberosity (except bicep short head)
Action: Extend Thigh, Flex Leg
Semitendinosus
Semimembranosus
Semitendinosus - Sits above semimembranosus
Semimembranosus - Sits below semitendinosus
O: Ischial Tuberosity
I: Tibia (SemiTen. = part of Pes Anserinus)
A: Extend Thigh / Flex Leg
Biceps Femoris
O: Long - Ischial Tuberosity, Short - Femur
I: Fibula
A: Long - Extend Thigh / Flex Leg, Short - Flex Leg
How are hamstring muscles innervated?
All = Tibial part of Sciatic Nerve
*Short Head of Bicep = Peroneal part of Sciatic Nerve
Pulled Hamstring
Tear or avulse from ischial tuberosity
Extreme cases can cause fracture of ischial tuberosity
