Gluteal Region Flashcards
Name the muscles in the superficial layer of the gluteal region
Gluteus maximus
Gluteus medius
Gluteus minimus
Name the muscles in the deep layer of the gluteal region
Piriformis
Obturator Internus
Superior + Inferior Gemelli
Quadratus Femoris
Give the origin, insertion, innervation, action, and test for:
Gluteus Maximus
Origin:
Posterior to the posterior gluteal line of the ilium, dorsum of sacrum + coccyx, and sacrotuberous ligament
Insertion:
Most fibres go to the iliotibial tract whilst some go to the gluteal tuberosity.
Innervation:
Inferior Gluteal Nerve (L5,S1,2)
Action: Extends thigh (especially from flexed position), assists in lateral rotation of thigh. Also helps in steadying thigh + standing from a sitting position.
Test:
Patient in prone position tightening their buttocks whilst extending the lower limb at the hip joint. Whilst they do this, examiner examines + palpated the muscle.
Give the origin, insertion, innervation, action, and test for:
Gluteus medius
Origin:
External surface of ilium between the anterior and posterior gluteal lines.
Insertion:
Lateral surface of the greater trochanter of the femur
Innervation:
Superior gluteal nerve (L4,5,S1)
Action:
Abducts + medially rotates the thigh. Also keeps pelvis level when the acting side is weight bearing and the other leg is unsupporting and swinging to move.
Test:
Ask patient to lie on their side (testing side upwards) and their lower limb should be flexed at hip and knee (for stability). Ask them to abduct their upper limb without flexion or rotation. Gluteus medius can then be palpated inferior to the iliac crest (posterior to tensor fasciae latae which is also contraction during abduction of thigh).
Give the origin, insertion, innervation, action, and test for:
Gluteus minimus
Origin:
External surface of ilium, between anterior and inferior gluteal lines.
Insertion:
Anterior surface of the greater trochanter of the femur
Innervation:
Superior gluteal nerve (L4,5,S1)
Action:
Abducts and medially rotates the thigh. Also keeps the pelvis level when the acting side is weight-bearing and the other side is unsupporting + swinging to move.
Test:
Ask patient to lie on their side (testing side upwards) and get them to flex their hip and knee of their lower leg (to act as a support). Ask them to abduct their upper leg without flexion or rotation. Gluteus medius can be palpated inferior to the iliac crest (posterior to tensor fasciae latae which is also contracting during abduction).
Give the origin, insertion, innervation, action, and test for:
Tensor Fasciae Latae
Origin:
Anterior Superior Iliac Spine (ASIS) + anterior surface of iliac crest
Insertion: Iliotibial tract (which continues to anterolateral tubercle of the tibia.
Innervation:
Superior Gluteal Nerve (L4,5,S1)
Action:
- Assists Iliopsoas + rectus Femoris in flexing the thigh
- Assists abductors/medial rotators (gluteus medius + minimus)
- Tenses fascia lata and iliotibial tract. When the knee is fully extended, it assists in increasing the extending force and adding stability.
Test:
None listed.
Give the origin, insertion, innervation, action, and test for:
Piriformis
Origin:
Anterior surface of sacrum and sacrotuberous ligament
Insertion:
Superior border of greater trochanter of femur
Innervation:
Branches of anterior rami of S1 and S2.
Action:
- Lateral rotation of extended thigh
- Abduction of flexed thigh
- Steady femoral head in acetabulum
Test:
None listed.
Give the origin, insertion, innervation, action, and test for:
Obturator Internus
Origin:
Pelvic surface of Obturator membrane and surrounding bones
Insertion:
Medial surface of greater trochanter (trochanteric fossa) of femur
Innervation:
Nerve to Obturator Internus (L5,S1,2)
Action:
- Lateral rotation of extended thigh
- Abduction of flexed thigh
- Steady femoral head in acetabulum.
Test:
None listed.
Give the origin, insertion, innervation, action, and test for:
Superior + Inferior Gemelli
Origin:
Superior-Ischial spine
Inferior-Ischial tuberosity
Insertion:
Medial surface of the greater trochanter (trochanteric fossa) of femur
Innervation:
Superior-Nerve to Obturator Internus (L5,S1,2)
Inferior-Nerve to Quadratus Femoris (L4,5,S1)
Action:
- Lateral rotation of extended thigh
- Abduction of flexed thigh
- Steady femoral head in acetabulum
Test:
None listed.
Give the origin, insertion, innervation, action, and test for:
Quadratus Femoris
Origin:
Lateral border of Ischial tuberosity
Insertion:
Quadrate tubercle on intertrochanteric crest of femur and area below it
Innervation:
Nerve to Quadratus Femoris (L4,5,S1)
Action:
- Laterally rotates thigh
- Stabilises femoral head in acetabulum
Test:
None listed.
Name the muscles in the gluteal region
Gluteus maximus Gluteus minimus Gluteus medius Tensor fasciae latae Piriformis Obturator Internus Superior + Inferior Gemelli Quadratus Femoris
