Gluteal Region

Question 1

Where is the ischial spine?

Answer 1

Between the lesser and greater sciatic notch

Question 2

What is the crest between the trochanters called?

Answer 2

Intertrochanteric crest

Question 3

What is the big hole the sciatic nerve runs through?

Answer 3

Greater sciatic foramen

Question 4

What goes through the greater sciatic foramen?

Answer 4

Structures leaving/entering the pelvis

Sciatic nerve

Superior and Inferior gluteal vessels and nerves

Piriformis muscle

Question 5

What goes through the lesser sciatic foramen?

Answer 5

Internal Pudendal Artery

Pudendal Nerve

Question 6

What ligament connects the ischial tuberosity to the sacrum?

Answer 6

Sacrotuberous Ligament

Question 7

What innervates the gluteus maximus?

Answer 7

Inferior gluteal neurovascular bundle

Question 8

What innervates the gluteus minimums and medius?

Answer 8

Superior gluteal neurovascular bundle

Abduct/medial rotatation of thigh

Keep pelvis level during swing phase of contralateral leg

Question 9

What are the 5 deep muscles of the glute?

Answer 9

Piriformis
Triceps Coxae
Superior Gemellus
Inferior Gemellus
Quadratus Femoris

Question 10

What do the 5 deep glute muscles do?

Answer 10

Lateral rotate the EXTENDED thigh

Abduct the flexed thigh

Steady the femoral head in the acetabulum

Question 11

Where does the Piriformis arise?

Attach

Answer 11

The anterior surface of the sacrum and sacrotuberous ligament

(Attaches to the superior border of the greater trochanter)

Question 12

What is between the piriformis and quadratus femoris?

Answer 12

Triceps Coxae

Question 13

Which muscle arises form the pelvic surface of the obturator membrane?

Answer 13

Obturator interns

Question 14

Where do the Gemelli arise?

Answer 14

Superior Gemellus- From the ischial spine

Inferior Gemellus- Ischial tuberosity

Question 15

Where does the quadratus femoris attach?

Answer 15

Quadratus tubercle of femur

Question 16

Superior Cluneal Nerves

Answer 16

Lateral cutaneous branches of the posterior rami of L1- L3

Question 17

Middle Cluneal Nerves

Answer 17

Lateral cutaneous branches of the posterior rami of S1-S3

Question 18

Inferior Cluneal Nerves

Answer 18

Arise from the posterior femoral cutaneous nerve (ANTERIOR rami of S2- S3)

Question 19

Superior Gluteal Nerve

Where?

Rami?

Innervates?

Answer 19

Enters great sciatic foramen superior to the piriformis

Lateral cutaneous branches of the POSTERIOR rami of L4-S1

Innervates gluteus medius, minimus and TFL

Question 20

Inferior Gluteal Nerve

Where?

Rami?

Innervates?

Answer 20

Enters greater sciatic foramen inferior to piriformis

From the sacral plexus (POSTERIOR divisions of the anterior rami of L5-S2)

Gluteus maximus

Question 21

Sciatic Nerve

Where?

Rami?

Innervates?

Answer 21

Greater sciatic foramen inferior to the piriformis

ANTERIOR and POSTERIOR of the anterior rami of L4-S3

Innervates muscles of the posterior thigh compartment, none of the gluteal muscles

Question 22

What is the lateral branch of the sciatic nerve called?

Answer 22

Common Fibular

Question 23

What is the medial branch of the sciatic nerve called?

Answer 23

The Common fibular

Question 24

Pudendal Nerve

Where?

Rami?

Innervates?

Answer 24

Inferior to piriformis through the greater sciatic foramen

Exits the gluteal region via the lesser sciatic foramen

S2-S4 (sacral plexus)

Principal nerve to the perineum

Question 25

Nerve to the quadratus femoris Where? Rami? Innervates?

Answer 25

Enters the greater sciatic foramen inferior to the piriformis, deep to the sciatic nerve L4-S1 (Sacral plexus) Innervates quadratus femoris, inferior gemellus and hip joint

Question 26

Check all of the Nerves!!!!

Answer 26

Ok? You may have messed some up. You did actually

Question 27

Blood flow from Abdominal Aorta to Superior Gluteal Artery

Answer 27

Abdominal Aorta, Common iliac artery (R/L), Internal Iliac artery, Internal iliac artery posterior branch- superior gluteal artery

Question 28

Blood flow from Abdominal Aorta to inferior gluteal artery

Answer 28

Abdominal Aorta, Common iliac artery (R/L), Internal Iliac artery, Internal iliac artery anterior branch- inferior gluteal artery

Question 29

Internal Pudendial Artery Where

Answer 29

Abdominal Aorta, Common iliac artery (R/L), Internal Iliac artery, Internal iliac artery anterior branch- Internal pudendial artery Exits gluteal region through inferior sciatic foramen Supplies external genitalia and muscles of the perineal region

Question 30

What are the articulate surfaces of the hip?

Answer 30

Lunate surface (articulate area of acetabulum) Articular cartilage Acetabular labrum

Question 31

Stand on one leg and see if the other side drops. Which nerve/muscle are you checking? What is this test called?

Answer 31

Superior gluteal nerve Gluteus medius Trendelenburg Test (Other causes are fracture of greater trochanter)

Question 32

Safe place for injection?

Answer 32

Lateral glute, otherwise you might paralyze the thigh extension/leg flexion Digit II on ASIS, digit III spread

Question 33

Common causes of piriformis syndrome

Answer 33

Hypertrophy and spasm, Cyclist/ mountain climbers (Compression of sciatic nerve by muscle)

Question 34

Irritation of any root from L4-S3 can produce _____

Answer 34

Sciatica to a varying degree

Question 35

Where does the Tricep coxae attach?

Answer 35

Trochanteric Fossa

Question 36

Where does the inferior Gemellus arise?

Answer 36

Ischial tuberosity

Question 37

What nerves do we not see in lab a lot?

Answer 37

Superior Cluneal Nerves

Question 38

What does the Sciatic nerve innervate?

Answer 38

Posterior thigh compartment.

Question 39

Labrum means?

Answer 39

Lip

Question 40

The ligaments are cool because?

Answer 40

They limit extension and hyper extension but give you a lot of flexion.

Question 41

Which artery supplies the round ligament of the femur?

Answer 41

Obturator artery

Question 42

What happens if the final position of the femoral head is posterior?

Answer 42

Hip forced into flexion Adduction Medial rotation

Question 43

What happens if the final position of the femoral head is anterior

Answer 43

Hip is forced into extension Abduction Medial rotation

Question 44

What happens if the final position of the femoral head is medial?

Answer 44

Femoral head is forced into pelvis

Question 45

Gluteal gait

Answer 45

A way of compensating walking if you have lack of innervation in gluteus medius. Basically they don't let their leg drop, so they swing their hips around

Question 46

Paralysis and fracture of the superior gluteal nerve can cause a positive trendelenburg test?

Answer 46

Yes

Question 47

Structures you don't wanna hit with a needle in the gluteal area. Which side is dangerous?

Answer 47

The superior lateral quadrant is the safe zone. Medial is dangerous