Gluteal and Posterior Thigh

Question 1

What is the function of the Labrum in the Hip joint?

Answer 1

It extends the acetabulum deeper than just the boney structure (makes the cup bigger/deeper)

Question 2

What artery supplies the head of the Femur during adolescence?

Answer 2

Acetabular branch of the Obturator Artery

Question 3

What are the three ligaments that hold the Hip joint together?

Answer 3

• Iliofemoral ligament (“y” ligament of Bigelow)
• Ischiofemoral ligament
• Pubofemoral ligament

Question 4

When is the Hip joint most stable?

Answer 4

At extension

Question 5

When is the Hip joint most vulnerable?

Answer 5

At flexion

Question 6

Describe: Coxa Vara

Answer 6

• Abnormally decreased angle of inclination at the hip joint (right angle)
• Increased congruity of joint (stable joint)
• Decreased range of motion (cannot fully abduct leg)

Question 7

Describe: Coxa Valga

Answer 7

• Abnormally increased angle of inclination at the hip joint (obtuse angle)
• Decreased congruity of joint (unstable joint)
• Increased risk of dislocation

Question 8

What is the biggest risk during a hip fracture in the Femoral Neck?

Answer 8

• Risk for avascular necrosis of the Femoral Head
• A fracture of the Femoral Neck will be within the joint capsule where all of the blood vessels that supply the head and neck of the Femur are located

Question 9

What is a Clinical Sign of a Fractured Hip?

Answer 9

Shortened, laterally rotated leg

Question 10

What is a Clinical Sign of a Dislocated Hip?

Answer 10

Shortened, medially rotated leg

Question 11

Why would a young person receive a cement-less implant during a Hip Arthroplasty?

Answer 11

• Without cement, the bone will grow into the implant providing a more stable joint over a longer period of time
• Patient cannot bear weight on the joint right away
• For younger, active patients

Question 12

What nerve plexus is responsible for innervating the Gluteal region and Posterior thigh?

Answer 12

Sacral Plexus

Question 13

True or False: Two spinal nerve must be knocked out to lose sensation in a dermatome

Answer 13

True

Question 14

What are the nerve roots that comprise the Lumbosacral Trunk?

Answer 14

L4-L5

Question 15

What are the nerve roots that comprise the Superior Gluteal Nerve?

Answer 15

L4-S1

Question 16

What are the nerve roots that comprise the Inferior Gluteal Nerve?

Answer 16

L5-S2

Question 17

What are the nerve roots that comprise the Nerve to the Piriformis?

Answer 17

S1-S2

Question 18

What are the nerve roots that comprise the Sciatic Nerve?

Answer 18

L4-S3

Question 19

What are the nerve roots that comprise the Common Fibular Nerve?

Answer 19

L4-S2

Question 20

What are the nerve roots that comprise the Tibial Nerve?

Answer 20

L4-S3

Question 21

What are the nerve roots that comprise the Posterior Femoral Cutaneous Nerve?

Answer 21

S1-S3

Question 22

What are the nerve roots that comprise the Pudendal Nerve?

Answer 22

S2-S4

Question 23

What muscle is located in the Fascia Lata?

Answer 23

Tensor Fascia Lata

Question 24

What are the three nerves that run down the Posterior Thigh?

Answer 24

• Sciatic Nerve
• Common Fibular Nerve
• Tibial Nerve

Question 25

What is the function of the Posterior compartment of the Thigh?

Answer 25

- Extend the hip | - Flex the knee

Question 26

What are the three Gluteal muscles?

Answer 26

- Gluteus maximus - Gluteus medius - Gluteus minimus

Question 27

What are the six Lateral Rotator muscles? | "PGOGOQ"

Answer 27

- Piriformis - Superior Gemellus - Obturator Internus - Inferior Gemellus - Obturator Externus - Quadratus Femoris

Question 28

What nerve sits in between the Gluteus Medius and Gluteus Minimus?

Answer 28

Superior Gluteal Nerve | sits directly on top of Gluteus Minimus

Question 29

True or False: The Sciatic Nerve runs over the Piriformis muscle

Answer 29

False | -Sciatic nerve runs underneath the Piriformis

Question 30

Describe: Trendelenburg Gait (Gluteus Medius Lurch)

Answer 30

- Superior Gluteal Nerve lesion - High stepping gait to compensate for toe drag (leans over to the side of the injury) - Side of lesion makes the opposite leg fall and drag toe (lesion in right leg leads to toe drag of the left leg)

Question 31

Describe: Extensor Lurch (Gluteus Maximus Lurch)

Answer 31

- Inferior Gluteal Nerve lesion - Pelvis is shifted forward causing difficulty rising from chair, walking up stairs, or running - Patient leans backwards to maintain balance

Question 32

Describe: Piriformis Syndrome

Answer 32

- Compression of Sciatic Nerve by Piriformis - Results in pain in the buttocks and down the leg - Can be tested by having patient lie down, toes will stick out laterally

Question 33

Describe: Intermuscular Injection

Answer 33

- Injection of medication given in the Upper Outer Quadrant of the Gluteal Region to avoid injuring the Superior Gluteal Nerve - In between the Tubercle of Iliac Crest and the ASIS

Question 34

What are the muscles of the Posterior Thigh ("Hamstring muscles")?

Answer 34

- Biceps Femoris - Semimembranosus - Semitendinosus

Question 35

Describe: Hamstring Injury

Answer 35

- Can be a pull or tear caused by a sudden change in motion (moving fast to a sudden stop) - You will hear an audible "pop" - Grades 1-3 (Grade 3 with avulsion requires surgery)

Question 36

What nerve provides motor innervation to the Biceps Femoris (long head)?

Answer 36

Tibial Nerve

Question 37

What nerve provides motor innervation to the Biceps Femoris (short head)?

Answer 37

Common Fibular Nerve

Question 38

What nerve provides motor innervation to the Semitendinosus?

Answer 38

Tibial Nerve

Question 39

What nerve provides motor innervation to the Semimembranosus?

Answer 39

Tibial Nerve

Question 40

What vessel provides blood supply to the Hamstring muscles?

Answer 40

Perforating branches of the Profunda Femoris

Question 41

What are the borders of the Popliteal Fossa?

Answer 41

Superior Lateral: Biceps Femoris (long head) Superior Medial: Semitendinosus Inferior Lateral: Gastrocnemius (lateral head) Inferior Medial: Gastrocnemius (medial head)

Question 42

What are the contents of the Popliteal Fossa?

Answer 42

- Popliteal Artery (and Genicular Branches) - Popliteal Vein - Sciatic Nerve (Tibial and Fibular portions)

Question 43

What nerve provides provides Cutaneous innervation to the Posterior aspect of the leg?

Answer 43

Sural Nerve

Question 44

Describe: Baker's Cyst

Answer 44

- Collection of fluid in Semimembranosus bursa (in the Popliteal Fossa) - No treatment necessary unless it causes a problem - Cortisone injections to manage pain