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Flashcards in gluteal region Deck (50):
1

what is different in terms of timing when it comes to lower and upper limb development

lower limb develops a week after upper (4th and 5th week)

2

where do you begin to see the lower limb buds? upper limb buds? what is located on the superior aspect of these buds?

lower limb- L2-S2
upper- C5-T1
big toes and the thumbs

3

what occurs to the upper and lower limbs in the 7th week of gestation?

-upper limb rotates laterally around its axis
-lower rotates medially- continues even post birth-explains why baby feet meet sole to sole

4

what accounts for the barber-pole pattern of the cutaneous innervation (dermatome pattern) of the limbs?

the rotation of the limbs in utero

5

where do the hip bones meet anteriorly and posteriorly

anteriorly at the pubic symphysis and posteriorly at the sacroiliac joint (meets with sacrum)

6

when do the ilium, ischium and pubis fuse

at the end of teen yrs

7

what two bones the hip bones articular with

sacrum and femur

8

what comprises the pelvic girdle? how does the bony pelvis differ?

-the pelvic girdle is the two hip bones together
- bony pelvis includes sacrum and coccyx

9

what it the largest of the three parts of the hip and describe some of its characteristics

-ilium
-ala- wing, attachment side for gluteal muscles laterally and iliacus on the medial side

10

what part of the acetabulum does the ilium make up?

the superior 2/5

11

what part of the lumbar spines does the line between the anterior superior iliac spine to the posterior superior iliac spines go thru?

L4-5

12

what is the attachment site for the posterior sacroiliac ligament

posterior inferior iliac spine

13

what comprises the posterior 2/5 of the acetabulum

the ischium

14

what are the two parts of the ischium

-body (consists of all the good stuff IT's etc) and the ramus(consists of just the ramus

15

at the bottom of the ischium, what two things come together to fuse the pubis with the ischium

the ichial ramus and the inferior ramus of the pubis to form the ischiopubic ramus

16

what fraction of the acetabulum does the pubis make up?? what are the three main parts of the pubis

-1/5
-three parts- body, superior ramus and inferior ramus

17

what part of the pubis fuses with the ischium and the ilium within the acetabulum

superior ramus of the pubis

18

what is the greater sciatic foramen formed of? what is ita a passageway for?

- made up of the
1) sacrospinous ligament- ligament that goes from sacrum to the spine of the ischium
2) sacrotuberous ligament- ligament from the sacrum to the IT
3) greater sciatic notch

19

what muscles traverses the greater sciatic foramen? Nerves and vessels?

- piriformis
- internal pudendal vessels and nerve
- sciatic nerve
- posterior femoral cutaneous nerve
- nerve to quadratus femoris and inferior gemellus
- nerve to the obturator internus and superior gemellus

20

what makes up the lesser sciatic foramen?

- formed by lesser sciatic notch and the sacrospinous and sacrotuberous ligaments

21

what structures traverse the lesser sciatic foramen

1) the tendon of the obturator internus
2) internal pudendal vessels and pudendal nerve
3) nerve to the obturator internus

22

the gluteal muscles are split into superficial and deep. what are the superficial muscles comprised of? what are their primary fxn?

- gluteus max, med, min- mainly extensors and abductors of the thigh

23

gluteus max:
origin
insertion
action
nerve
blood supply

origin- (CISS my gluteus max): coccyx, ilium, sacrotuberous ligament, sacrum

insertion- (TI loves butts) gluteal tuberosity and iliotibial tract

action-extend and laterally rotate thigh, rising from sitting position and running

nerve- inferior gluteal

blood supply- superior and inferior gluteal arteries

24

Gluteus medius
origin
insertion
action
nerve
blood supply

origin- ilium between anterior and POSTERIOR gluteal line
insertion- greater trochanter
action- abduction and medial rotation of thigh; along with gluteus min, stops the hip from sagging on the unsupported side
nerve- superior gluteal
blood supply- superior gluteal

25

gluteus minimus
origin
insertion
action
nerve
blood supply

origin- ilium between the anterior and INFERIOR gluteal lines
insertion- greater trochanter
action- abduction and medial rotation- stops the hip from sagging on unsupported side with the glut. med
nerve- superior gluteal
blood supply- superior gluteal

26

what's a positive trendelenburg sign?

-damage to superior gluteal nerve
-would cause blockage of innervation to the glut med/min
-waddling gait, high stoppage gait and swing out gait

27

what comprises the deep layer of the gluteal muscles

4 things-
piriformis, obturator internus, inferior gemellus, quadratus femoris

28

piriformis
origin-
insertion-
nerve-
action-
location-

origin-anterior surface of the sacrum
insertion- greater trochanter (gluteal and pelvic regions)
nerve-S1-2
action-lateral rotation of the thigh
location is right under the glut min

29

obturator internus
origin-
insertion-
nerve-
action-
location

origin- obturator membrane surrounding bone
insertion:-greater trochanter- LEAVES PELVIS THRU THE LESSER SCIATIC FORAMEN
nerve-nerve to the obturator internus (L5, S1-2)
action- lateral rotation of the thigh, extension, abduction of flexed thigh
location- right under the superior gemellus and over the inferior gemellus

30

superior gemellus
origin-
insertion-
nerve-
action-
location

origin- ischial spine
insertion- tendon of obturator internus
nerve-nerve to the obturator internus (L5, S1-2) (same as obturator internus)
action-lateral rotation of thigh, extension,. abduction of flexed thigh (same as obturator internus)
location- above obturator internus

31

inferior gemellus
origin-
insertion-
nerve-
action-
location

origin- ischial tuberocity
insertion-tendon to the obturator internus
nerve-nerve to the quadratus femoris (L5, S1) (like QF)
action- lateral rotate thigh (like QF)
location -under the obturator internus

32

quadratus femoris
origin-
insertion-
nerve-
action-
location

origin- ischial tuberocity
insertion- interotrocanteric crest
nerve- nerve to the quadratus femoris (L5-S1)
action-laterally rotate the thigh
location- under the inferior gemellus

33

the sacral plexus is the lower part of the ____ and is covered by branches from what artery

lumbosacral plexus- ventral primary rami (L4-5,s1-4)
internal iliac artery

34

where does the major part of the plexus lie? what foramen does do the large branches of the sacral plexus pass thru to get to the gluteal regions

on top of the piriformis
they pass thru the greater sciatic foramen

35

what is the sacral plexus made up of

-ventral primary rami of the

36

where do the S1-4 nerves enter the pelvis thru?

the sacral formina

37

what do they nerves of the sacral plexus supply the muscles and skin of?

gluteal region
the posterior thigh and the entire leg and foot

38

__to__ divisions of the sacral plexus give rise to anterior and posterior divisions

L4-S4

39

*what are the posterior divisions of the sacral plexus?

posterior- common peroneal, superior gluteal, inferior gluteal, posterior femoral cutaneous, nerve to the piriformis

40

*what are the anterior divisions of the sacral plexus?

QPLOT:
- N. to quadratus femoris
- Pudendal n
- Nerve to the levator ani
- N. to obturator internus
- Tibial nerve

41

What is different about the superior gluteal nerve than all other nerves of the sacral plexus

- it exists the pelvis thru the greater sciatic foramen like all of them BUT DOES SO OVER THE PIRIFORMIS VS UNDER

42

what spinal levels is superior gluteal? what would injury to the superior gluteal cause?

L4-S1
injury- probs with tensor fasciae latae muscles and glut medius and minimus

43

inferior gluteal levels? injury?

L5-S2
injury gluteus max

44

sciatic nerve levels? what two nerves does it give rise to? what would injury to the sciatic nerve cause?

L4-S3
largest branch of the plexus
gives rise to Tibial and common peroneal
injury will not cause any injury to the gluteal region

45

what levels are the tibial and common peroneal

tibial L4-5, S1-4
common peroneal L4-5, S1-2

46

what levels are the
posterior femoral cutaneous-
nerve to quadratus femoris-
nerve to the obturator internus-
pudendal nerve-

posterior femoral cutaneous- S1-S3- post. div sacral plexus
nerve to quadratus femoris- L4-S1 -ant div
nerve to the obturator internus-L5-S2
pudendal nerve-(near superior gemellus) -S2-4

47

what does the cutaneous innervation of the gluteal region

superior cuneal- dorsal primary rami
medial cuneal- dorsal
inferior cuneal-ventral

48

what arteries supply the muscles of the gluteal region and what major artery do they stem off of and where do they enter the gluteal region

- they stem off of the internal iliac artery and enter the gluteal region via GREATER sciatic foramen
-superior gluteal artery- glut max, med, min plus tensor facia lata
-inferior gluteal- glut max and short lateral rotators of the thigh
- internal pudendal- supplies perineal region

49

what are the veins of the gluteal region? what do they drain into?

-superior and inferior gluteal veins as well as the internal pudental vein
-the internal iliac vein

50

what is the safe zone?

where you can do intragluteal injections
-near piriformis and glut med