Gluteal Region, Posterior Thigh, & Popliteal Fossa | B2, WK5

Question 1

What’s the action of the gluteal region

Answer 1

extension, abduction, and lateral rotation at hip

Question 2

What are the muscles of the gluteal region [9]

Answer 2

1. Gluteus maximus
2. Gluteus medius
3. Gluteus minimus
4. TFL
5. Piriformis
6. Obturator internus
7. Superior gemelli
8. Inferior gemelli
9. Quadratus femoris

Question 3

What is the innervation to the gluteal region?

Answer 3

1. Superior gluteal nerve (L4-S1)
2. Inferior gluteal nerve (L5-S2)
3. Branches of sacral plexus

Question 4

Gluteus Maximus O, I, & A

Answer 4

O: Posterior ilium, sacrum, & sarcotuberous ligament
I:
Superficial: Anterolateral tubercle of tibia (via IT Tract)
Deep: Gluteal tuberosity

A: Extend thigh and assist in lateral rotation

Question 5

Gluteus Medius & Minimus O, I, & A

Answer 5

O:
Medius - gluteal surface of ilium between anterior & posterior gluteal lines
Minimus - gluteal surface of ilium between anterior & inferior gluteal lines

I: Greater trochanter

A: Abduct & medially rotate thigh, keep pelvis level when opposite foot is lifted

Question 6

Gluteus Maximus - innervation

Answer 6

Inferior gluteal N (L5-S2)

Question 7

Gluteus medius & minimus innervation

Answer 7

Superior gluteal N (L4-S1)

Question 8

TFL O, I, & A

Answer 8

O: ASIS
I: anterolateral tubercle of tibia (Gerdy’s tubercle) via IT tract
A: Assist in flexion and medial rotation of the thigh, tenses IT tract to stabilize knee extension

Question 9

TFL innervation

Answer 9

Superior gluteal N

Question 10

What muscles laterally rotate the hip/thigh?

Answer 10

1. Piriformis
2. Obturator internus
3. Sup & Inf Gemelli
4. Quadratus femoris

Question 11

Where do a majority of the lateral rotators of the thigh insert?

Answer 11

Greater trochanter
Exception: Quadratus femoris - inserts on intertrochanteric crest

Question 12

What structures exit superior to the piriformis?

Answer 12

-Superior gluteal N
-Superior gluteal vessels

Question 13

What structures exit inferior to the piriformis?

Answer 13

-Inf. gluteal N
-Inf. gluteal vessels
-Pudendal N & internal pudenal vessels
-Post. cutaneous n of the thigh
-Sciatic nerve

Question 14

Describe blood supply of the gluteal region

Answer 14

1. internal illiac artery
   -s. gluteal a.
   -inf. gluteal a.
2. Deep a. of thigh (& 1st perforating branch)
3. Cruciate anastomosis
4. Anastomosis between branches of femoral a. and internal iliac a.

Question 15

Innervation of the gluteal region is supplied by what plexus (branches)?

Answer 15

Sacral

Question 16

What does the superior gluteal N. innervate?

Answer 16

-Gluteus medius
-Gluteus minimus
-TFL

Question 17

What N supplies the gluteus maximus

Answer 17

Inferior gluteal N

Question 18

N. to obturator internus innervates/supplies what structure?

Answer 18

Superior gemellus

Question 19

N. to quadratus femoris also supplies what structure?

Answer 19

Inferior gemellus

Question 20

What is the piriformis innervated by?

Answer 20

Branches of S1 & S2

Question 21

Where would you give an intragluteal injection (safely)

Answer 21

-Superior lateral injection
-avoid Nerves & arteries

Question 22

What would happen when a patient has a superior gluteal nerve injury?

Answer 22

-Pelvis drops
-Opposite side of pelvis drops when the opposite foot is lifted

EX: injury of R. Superior Gluteal N = left hip drop

Question 23

Someone with a superior gluteal nerve injury typically leans the upper body in which direction?

Answer 23

-Toward the injured side to lift opposite hip

Question 24

What type of gait is seen in a superior gluteal nerve injury

Answer 24

Tredelenburg Gait

Question 25

What actions occur in the posterior thigh?

Answer 25

- Extension of thigh - Flexion of knee

Question 26

What muscles make up the posterior thigh?

Answer 26

- Biceps Femoris - Semitendinosus - Semimembranosus - "hamstring part" of adductor magnus

Question 27

What nerves innervate the posterior thigh?

Answer 27

- Tibial division of sciatic N Note: Short head of biceps innervated by common fibular division

Question 28

Biceps Femoris LONG and SHORT head - O, I, & A

Answer 28

O: SH - lateral lip of linea aspera LH - Ischial tuberosity I: Both on Head of fibula A: Flexion of leg at knee joint (laterally rotates leg when knee is flexed, long head extends the thigh)

Question 29

Bicep femoris long head innervation

Answer 29

tibial division of sciatic N

Question 30

Bicep femoris short head innervation

Answer 30

common fibular division of sciatic N

Question 31

What is the origin of the semitendinosus & semimembranosus?

Answer 31

Ischial tuberosity

Question 32

The semitendinosus and semimembranosus complete what actions?

Answer 32

-extend thigh -flex knee

Question 33

The semitendinosus and semimembranosus are innervated by?

Answer 33

Tibial division of sciatic N

Question 34

Action of adductor magnus

Answer 34

Extend thigh

Question 35

Adductor magnus innervation

Answer 35

Tibial division of Sciatic N

Question 36

What is the pes anserinus?

Answer 36

"Goose's Foot" 1. Sartorius 2. Gracilis 3. Semitendinosus

Question 37

What is the function of the pes aserinus?

Answer 37

Stabilizes medial aspect of knee joint in extension

Question 38

What posterior thigh muscles are innervated by the tibial division of the sciatic N? What about common fibular division of sciatic N.

Answer 38

Tibial Division: -Long head of biceps femoris -Semitendinosus -Semimembranosus -Adductor Magnus *Hamstring part* Common fibular division of sciatic N: -Short head of biceps femoris

Question 39

What is the main blood supply of the posterior thigh?

Answer 39

Perforating branches of deep femoral a.

Question 40

What are the boundaries of the popliteal fossa?

Answer 40

-Biceps Femoris -Semimembranosus -Lateral & medial heads of gastrocnemius

Question 41

What are the contents of the popliteal fossa from superficial to deep?

Answer 41

1. Termination of small saphenous vein and cutaneous nerves 2. Tibial & Common fibular nerves 3. Popliteal vein 4. Popliteal artery 5. Popliteal lymph nodes (surrounding vessels)

Question 42

In the popliteal fossa, the sciatic nerve divides. What does it divide into?

Answer 42

1. Tibial N (L4-S3) 2. Common fibulr nerve (L4-S2)

Question 43

What are the cutaneous nerves in the popliteal fossa?

Answer 43

-Posterior cutaneous n. of the thigh -Medial sural cutaneous nn. (from tibial n)

Question 44

The _________________ artery is a continuation of the femoral artery

Answer 44

Popliteal

Question 45

What does the popliteal artery divide into?

Answer 45

anterior + posterior tibial aa.