Gluteal Region Flashcards
(23 cards)
Pathology
Damage the normal and assess effect
Identify effected systems in injury and assess effect
Comparison
Compare human normal condition to normal condition in organisms with different configurations of the same structures
Structural differences that effect gait
Vertebral column, femoral angle, foot, pelvis
quadrupeds- vertebral column doesn’t bear weight
Apes- vertebra bent over, ilium longer
humans- successively larger vertebrae, lordosis and kyphosis
Joint wear from bipedal motion
Lumbar spine, hips, knees, feet. All starts at the feet and goes up.
Greater sciatic foramen
All exit: Gluteal neurovascular bundles Piriformis m. -sciatic nerve -posterior femoral cutaneous n. -pudendal n and internal pudendal n -obturator internus/superior gemellus nerve
Lesser sciatic foramen
pudendal n and internal pudendal artery (enter)
obturator internus/superior gemellus nerve (enter)
Obturator internus muscle (exit)
Sacrospinous ligament
Forms greater sciatic foramen
Sacrotuberous ligament
Forms lesser sciatic foramen
Cluneal nerves
Superior (L1-L3) and Middle (S1-S3):
-Lateral branches of dorsal rami
-Supply superior 2/3 of sacrum and adjacent area
Inferior (S1-S3):
-Gluteal branches of posterior femoral cutaneous nerve
-supply inferior 1/3
Superior Gluteal Nerve
Leaves pelvis superior to performs with superior gluteal artery
Runs between gluteus menus and gluteus minimum
Supplies gluteus medius, gluteus minimus, tensor fasciae latae
Inferior gluteal nerve
Leaves pelvis inferior to piriformis with inferior gluteal artery
Supplies gluteus maximus
Sciatic Nerve
L4-S3 ventral Rami
Largest nerve in the body
Leaves pelvis inferior to piriformis
Runs inferior and deep to gluteus maximus
Usually divides half way into tibial and common fibular nerves
Doesn’t supply gluteal structures
Posterior hip dislocations main cause of damage
Posterior Femoral cutaneous nerve
Supplies more skin than any other cutaneous nerve
Basically entire hamstring into popliteal surface
Obturator internus/superior Gemellus nerve
nerve of small lateral rotators
Leaves pelvis via greater sciatic foramen
Reenters via lesser sciatic foramen
Pudendal nerve
Nerve of small lateral rotators
Anterior divisions of S2-S4 Ventral rami
Most medial structure exiting greater sciatic foramen
Reenters pelvis via lesser sciatic foramen to supply perineal structures
Superior Gluteal Artery
Largest internal iliac artery branch
Superficial branch: gluteus maximus
Deep branch: Gluteus medius, minimus, tensor fascia lata
Inferior Gluteal Artery
Supplies: Gluteus Maximus, Small lateral rotators, superior hamstrings
Involved in cruciate anastomosis of the thigh:
-transverse branch of medial circumflex femoral artery
- Terminal part of transverse branch of lateral circumflex femoral artery
-first perforating artery
-inferior gluteal artery
Internal Pudendal Artery
Reenters pelvis via lesser sciatic foramen with pudendal nerve
Supplies perineal muscles and external genitalia
Does not supply gluteal structures
Gluteus Maximus
Largest Gluteal muscle
A: Chief extensor of the thigh and lateral rotation.
-Slight extension when working with tensor fascia late
N: inferior gluteal nerve
Gait Cycle
Heel strike (Gluteus Maximus, Tibialis Anterior)
Loading Response (Quadriceps Femoris)
Midstance (Triceps Surae)
Terminal Stance (Triceps Surae)
Preswing (Rectis Femoris, Iliopsoas)
Terminal Swing (Quadriceps Femoris, Tibialis anterior, hamstrings)
Heel Strike (Gluteus maximus, tibialis anterior)
Duchenne’s Limp
Insert Picture
IT Band
Runs from iliac tubercle to Gerdy’s tubercle
Reinforced fibers from tensor fasciae late and gluteus maximus
assists with abduction
Laterally stabilizes the knee
Extends leg. Can compensate for quad paralysis
Glutea Gait or Duchenne’s Limp
Positive Trendelenburg sign (Hip drop)
Caused by Superior gluteal nerve injury
Effect: patient loses steadying action of gluteus medius and minimum
-Lean toward effected side during stance phase of gait
