Test 05.44 Gluteal Region

Question 1

1. What week do the upper limbs develop? What level are they?

Answer 1

4th week

C5-T1 level

Question 2

2. When do the lower limbs develop? What level?

Answer 2

5th week

L2-S2

Question 3

3. When do the upper/lower limbs rotate? What direction?

Answer 3

7th week
Upper laterally
Lower medially

Question 4

4. What is the difference between the pelvic girdle and the bony pelvis?

Answer 4

The pelvic girdle is the 2 hip bones together, whereas the bony pelvis includes the pelvic girdle, sacrum, and coccyx bound together by ligaments.

Question 5

5. What does the ala(wing) of the Illium provide attachment for? Which side?

Answer 5

Laterally: gluteal muscles
Medial: iliacus muscle

Question 6

6. From where to where does the iliac crest run?

Answer 6

Superiorly up to L4 level (disc b/n 4th/5th L) ->

Extends from ASIS to PSIS

Question 7

7. Draw the iliacus labeling the following:

Answer 7

2. Body
3. Iliac fossa (concavity in the ala)
4. Superior 2/5 of acetabulum
5. Iliac crest :
6. Anterior inferior iliac spine
7. Posterior inferior iliac spine
8. Greater sciatic notch
9. Auricular surface
10. Gluteal lines
    Anterior
    Posterior
    Inferior

Question 8

8. Draw the Ischium with the following parts labeled:

Answer 8

1. Body

       Ischial tuberosity
       Ischial spine Lesser sciatic notch
       Greater sciatic notch

2. Ramus

Question 9

9. Draw the pubis and label the following parts:

Answer 9

1. Body

       Symphysis pubis
       Pubic crest
       Pubic tubercle

2. 	Superior ramus
			Pectin line (pectin pubis)

3. Inferior ramus
   obturator crest

       obturator foramen 
   
       acetabulum

Question 10

10. What does the PSIS serve as an attachment point for?

Answer 10

The posterior sacroiliac ligament

Question 11

11. What does the auricular surface articulates with?

Answer 11

Sacrum

Question 12

12. What 3 things form the sciatic foramen?

Answer 12

Greater sciatic noth
Sacrospinous ligament
Sacrotuberous ligament

Question 13

13. Name the structures that pass through the greater sciatic foramen

Answer 13

a. Piriformis muscle
b. Superior and inferior gluteal vessels and nerves
c. Internal pudendal vessels and pudendal nerve
d. Sciatic nerve

e. Posterior femoral cutaneous nerve
f. Nerve to quadratus femoris and inferior gemellus

g. Nerve to obturator internus and superior gemellus

Question 14

14. What structures pass through the lesser sciatic foramen?

Answer 14

Tendon of obturator internus
Internal pudendal vessels and pudendal nerve
Nerve to obturator internus

Question 15

15. What makes up the superficial layer of gluteal muscles? What is their action?

Answer 15

Gluteus maximus
Gluteus medius
Gluteus minimus

Mostly extensors and abductors of thigh

Question 16

16. For the gluteus maximus give the origin and insertion

Answer 16

Origin – sacrotuberous ligament, ilium (posterior to posterior gluteal line), sacrum and coccyx
Insertion – gluteal tuberosity and iliotibial tract

Question 17

17. For the gluteus maximus give the action, nerve, and blood vessels

Answer 17

Action: Extension and lateral rotation of thigh
Rising from sitting
Nerve: Inferior gluteal
Blood: Superior and inferior gluteal arteries

Question 18

18. Give the gluteus medius’ origin and insertion

Answer 18

Origin – ilium between anterior and posterior gluteal line

Insertion – Gr. Trochanter

Question 19

19. What is the gluteus medius’ action, nerve, and blood vessel?

Answer 19

Action: Abduction/medial rotation of thigh
Prevent sagging (w/ gluteus minimus)
Nerve: Superior gluteal
Blood: Superior gluteal artery

Question 20

20. What is the gluteus minimus’ origin and insertion?

Answer 20

Origin: ilium b/n anterior and inferior gluteal lines
Insertion: Greater trochanter

Question 21

21. What is the gluteus minimus’ action, nerve, and blood vessel?

Answer 21

Action: Abduction and medial rotation
Nerve: Superior gluteal
Blood: Superior gluteal artery

Question 22

22. What is the sacral plexus covered by?

Answer 22

Internal iliac artery

Question 23

23. What does the sacral plexus lie over?

Answer 23

Ant. Surface of piriformis m.

Question 24

24. What do the branches of the sacral plexus pass through?

Answer 24

Greater sciatic foramen

Question 25

25. What is the sacral plexus formed by?

Answer 25

Ventral primary rami of lumbosacral trunk (L4-L5), (S1-S4)

Question 26

26. What kinds of fibers contribute to the sacral plexus? From what chain?

Answer 26

It receives postganglionic sympathetic fibers from the lower end of sympathetic chain

Question 27

27. What does the sacral plexus provide innervation for?

Answer 27

Gluteal region Posterior thigh Entire leg Entire foot

Question 28

28. What are the nerves of the posterior division of the sacral plexus?

Answer 28

``` Superior gluteal nerve Inferior gluteal nerve Nerve to piriformis Common peroneal nerve Posterior femoral cutaneous (partly) ```

Question 29

29. What is the level of the superior gluteal nerve? What would be affected by its injury?

Answer 29

L4-S1 | Affects gluteus medius, gluteus minimus, and tensor fasciae latae m’s

Question 30

30. What level is the inferior gluteal nerve? What would injury do?

Answer 30

L5-S2 | Injury to this nerve would affect gluteus maximus muscle

Question 31

31. What level is the sciatic nerve at? What are its parts and what levels are they? Injury would?

Answer 31

Common peroneal –posterior part (L4, L5, S1,S2) Tibial –anterior part (L4, L5, S1, S2, S3) Injury to sciatic n. would not affect muscles in gluteal region

Question 32

``` 32. What are the levels for: Nerve to quadratus femoris Nerve to obturator internus Posterior femoral cutaneous Pudendal nerve ```

Answer 32

1. Nerve to quadratus femoris (L4-S1) 2. Nerve to obturator internus (L5-S2) 3. Posterior femoral cutaneous (S1-S3) 4. Pudendal nerve (S2-S4)

Question 33

33. Where to the gluteal arteries originate from?

Answer 33

Originate directly/indirectly from internal iliac artery

Question 34

34. What does the superior gluteal artery supply?

Answer 34

Gluteus maximus, medius, minimus and tensor fasciae latae

Question 35

35. What does the inferior gluteal artery supply?

Answer 35

Gluteus maximus and short lateral rotators of thigh

Question 36

36. What does the internal pudendal supply?

Answer 36

Perineal region

Question 37

37. What are the veins of the gluteal region and what do they drain into?

Answer 37

Superior and inferior gluteal veins Internal pudendal veins Tributaries of internal iliac vein

Question 38

38. Know region of intragluteal injections

Answer 38

Top right/left of gluteal region