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Anatomy Exam 3 GLUTEAL REGION, POSTERIOR COMPARTMENT OF THE
GLUTEAL REGION, POSTERIOR COMPARTMENT OF THE THIGH & HIP JOINT
88
Anatomy
Graduate
08/23/2016

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Term
boundaries of the gluteal region
Definition
-superiorly: the iliac crest , greater trochanter and ASIS.
-Inferiorly: the gluteal fold
Term
pelvic girdle
Definition
bony ring composed of sacrum and right and left hip bones
Term
sacrum articulates with:
(include names of joints)
Definition
-Each hip bone via a sacro-iliac joint
-Lumbar vertebrae L5 via lumbosacral joint
Term
gluteal ligaments
Definition
Sacrotuberous ligament
Sacrospinous ligament
Term
greater sciatic foramen
Definition
passageway for structures entering or leaving the pelvis
Term
lesser sciatic foramen
Definition
passage way for structures entering or leaving the perineum
Term
job of the gluteal ligaments
Definition
-stabilize
-resisting the upward tilting of the inferior aspect of sacrum .
Term
3 bones that make up the hip
-name of the bones
-name of their fusion point
Definition
-fused at the triradiate cartilage
ilium
ischium
pubis
Term
parts of the ischium
Definition
-Body
-Ischial ramus
-Ischial spine
-Greater & Lesser sciatic notch
-Ischial tuberosity
Term
parts of the pubis
Definition
Body
--Pubic tubercle
--Pubic crest
Superior & Inferior pubic ramus
--Pecten pubis (superior)
Term
hip pointer
Definition
contusion of the iliac crest, often on the anterior part, by direct blow or fall
Term
avulsion fractures of the hip
-where are the vulnerabilies?
-when?
Definition
-Immature skeleton is prone
-common at muscle origins
---ischial tuberosity for hamstrings
---ASIS for sartorius
---AIIS for rectus femoris
Term
Superficial gluteal muscles
Definition
-Gluteus maximus
-Gluteus medius
-Gluteus minimus
-Tensor fasciae latae
Term
Deep gluteal muscles
Definition
-Piriformis
-Obturator internus
-Superior Gemellus
-Inferior Gemellus
-Quadratus femoris
Term
GLUTEUS MAXIMUS
-attachments
-innervation
-action
Definition
-ilium & sacrum to iliotibial tract and gluteal tuberosity of the femur
-innervated by inferior gluteal nerve ( L5,S1,S2)
-extends from flexion, laterally rotates
Term
GLUTEUS MEDIUS
-attachments
-innervation
-action
Definition
-from outer surface of ilium to greater trochanter of femur.
-Superior gluteal nerve( L4, L5,S1)
-It abducts & medially rotates thigh, keeps pelvis level
Term
GLUTEUS MINIMUS
-attachments
-innervation
-action
Definition
-outer surface of ilium to greater trochanter of femur
-Superior gluteal nerve( L4, L5,S1)
-It abducts & medially rotates thigh, keeps pelvis level
Term
TENSOR FASCIAE LATAE
-attachments
-innervation
-action
Definition
-FROM “ASIS” & anterior part of iliac crest TO iliotibial tract.
-SUPERIOR GLUTEAL NERVE ( L4,L5,S1)
-abducts, medially rotates, helps flex thigh
---stabilizes EXTENDED knee joint by supporting femur on tibia
Term
Trendelenburg sign
-what is injured/affected?
-what to look for/the sign
Definition
-damaged superior gluteal nerve disables gluteus medius and minimus,
-hip tilts down on the opposite to injury when walking.
Term
DEEP MUSCLES OF GLUTEAL REGION
Definition
-piriformis
-obturator internus
-superior gemellus
-inferior gemellus
-quadratus femoris
Term
piriformis
-attachments
-innervation
-action
Definition
-from anterior surface of sacrum and sacrotuberous ligament TO greater trochanter via the greater sciatic foramen
-by branches of anterior rami of S1 & S2.
-laterally rotate the extended thigh (hip joint) & abduct flexed thigh
Term
OBTURATOR INTERNUS
-attachments
-innervation
-action
Definition
-from obturator membrane, obturator foramen, & sacrotuberous ligament TO greater trochanter via the greater sciatic foramen
-by nerve to obturator internus L5,S1
-laterally rotate the extended thigh (hip joint) & abduct flexed thigh
Term
SUPERIOR GEMELLUS
-attachments
-innervation
-action
Definition
-from ischial spine TO greater trochanter via obturator internus tendon
-by nerve to obturator internus L5,S1)
-laterally rotate the extended thigh (hip joint) & abduct flexed thigh
Term
INFERIOR GEMELLUS
-attachments
-innervation
-action
Definition
-from ischial tuberosity TO greater trochanter via obturator internus tendon
-nerve to quadratus femoris ( L5, S1)
-laterally rotate the extended thigh (hip joint) & abduct flexed thigh
Term
QUADRATUS FEMORIS
-attachments
-innervation
-action
Definition
-from ischial tuberosity TO quadrate tubercle of intertrochanteric crest
-nerve to quatdartus femoris L5.S1
-laterally rotate the extended thigh (hip joint)
Term
gluteal muscles that medially rotate the thigh
Definition
Gluteus medius
Gluteus minimus
Tensor fasciae latae
Term
gluteal muscles that laterally rotate the thigh
Definition
-Gluteus maximus
-Piriformis
-Obturator internus
-Superior Gemellus
-Inferior Gemellus
-Quadratus femoris
Term
bursae surrounding the gluteus maximus
Definition
Trochanteric bursa
Ischial bursa
Gluteofemoral bursa
Term
Trochanteric bursitis
-s&s
Definition
-diffuse pain in the lateral thigh region especially during stair climbing or rising from a seated position
-point tenderness over greater trochanter and radiating pain along the ITB
Term
greater sciatic foramen (above piriformis) is a gateway for...
Definition
superior gluteal nerve, artery, and vein
Term
lesser sciatic foramen is a gateway for...
Definition
-obturator internus muscle tendon
-pudendal nerve and internal pudendal vessels
Term
greater sciatic foramen (below piriformis) is a gateway for...
Definition
-sciatic nerve
-inferior gluteal nerve, artery, vein
-pudendal nerve
-internal pudendal artery and vein
-posterior femoral cutaneous nerve
-nerve to obturator internus and superior gemellus muscles
-nerve to quadratus femoris and inferior gemellus muscles
Term
superior gluteal artery
-emerges from
-branches (what to they supply?)
Definition
-emerges from greater sciatic foramen above the piriformis
-superficial branch supplies gluteus maximus
-deep branch supplies gluteus medius, minimus, and TFL
Term
inferior gluteal artery
-emerges from
-what does it supply?
Definition
-emerges from greater sciatic foramen below the piriformis
-supplies gluteus maximus and deep muscles of gluteal region
Term
Medial femoral circumflex
-branched from
Definition
from femoral artery
Term
Ascending branch of first perforating artery
-branches from
Definition
from deep artery of thigh (profunda femoris artery)
Term
Lateral femoral circumflex artery
-where is it? (branches from, goes to..)
Definition
first branch off the profunda femoris artery, wraps around the neck of the femur
Term
ideal site of intramuscular injection
Definition
upper lateral quadrant of the gluteal region
Term
risk with injection to the lower medial quadrant
Definition
damage to the sciatic nerve, paralysis of posterior thigh muscles & all muscles below knee joint
Term
risk with injection to the upper medial quadrant
Definition
damage to the superior gluteal nerve branches, paralysis of gluteal muscles
Term
Hamstring muscles
-what are they
-innervation
Definition
1. Semitendinosus
2. Semimembranosus
3. Biceps femoris ( long head )
INNERVATED BY the tibial division of the Sciatic nerve
Term
Semitendinosus attachements
Definition
attaches from ischial tuberosity TO upper medial tibia with pes anserine
Term
Semimembranosus attachments
Definition
from ischial tuberosity TO posterior part of medial condyle
Term
biceps femoris
-heads
-attachments
Definition
-long head: arises from ischial tuberosity
short head: arises from linea aspera & lateral supracondylar line of femur
--both insert into the head of the fibula
Term
hamstring action
-with adductor magnus
-w/o adductor magnus
Definition
-w/ AM, extend thigh (HIP joint)
-w/o AM, they flex leg (KNEE joint)
Term
PES ANSERINUS
Definition
aka. goose foot, a common insertion point on the tibia for the semitendinosus , gracilis and Sartorius
Term
tibial division of the sciatic nerve supplies
Definition
-hamstring part of Adductor magnus
-Long head of biceps femoris,
-Semitendinosus
-Semi-membranosus
Term
common fibular division of the sciatic nerve supplies
Definition
Short head of biceps femoris
-divides into deep and superficial fibular nerves
Term
piriformis syndrome
Definition
sciatic nerve irritated or compressed, often due to hypertrophy if piriformis causing pain and/or paresthesia of gluteal region and posterior thigh
Term
inferior gluteal artery and vein supplies
Definition
Supply superior hamstring & sciatic nerve
Term
4 Perforating branches of deep artery of thigh (& corresponding veins)
-supply
Definition
supply central hamstring, femur & sciatic nerve
Term
tributaries to femoral vein
Definition
Gluteal veins
Term
POPLITEAL FOSSA
-boundaries
Definition
SUPEROMEDIALLY: semimembranosus
SUPEROLATERALLY : biceps femoris
INFEROMEDIALLY : medial head of gastrocnemius
INFEROLATERALLY :lateral head of gastrocnemius
ROOF : skin and popliteal fascia
FLOOR : popliteal surface of femur
Term
Contents of Popliteal Fossa
Definition
-Popliteal artery and vein
-Termination of small saphenous vein
-Tibial and common fibular branches of the sciatic nerve (superficial to vein)
-posterior cutaneous nerve of thigh
-popliteal lymph nodes and vessels
Term
genicular branches from the popliteal fossa
-list them
Definition
-superior medial
-superior lateral
-middle
-inferior medial
-inferior lateral genicular arteries
Term
genicular branches from the popliteal fossa
-purpose
Definition
-genicular anastomoses around the knee.
-collateral circulation to the leg during full flexion
Term
popliteal artery
-continuation of
-branches into
Definition
-from the femoral artery via adductor hiatus
-divides into the anterior and posterior tibial arteries
Term
popliteal artery
-complications with leg fractures
Definition
-laceration of the artery
-spasm and occlusion due to sudden traction
-compression (from cast or bandage)
-thrombosis
Term
position for finding the popliteal pulse
Definition
in prone position with the knee flexed to relax popliteal fascia and hamstrings
Term
Popliteal aneurysm leads to...
Definition
edema and pain in the popliteal fossa
Term
blood can access the popliteal artery when the femoral artery is ligated via...
Definition
the genicular anastomosis
Term
path of the small saphenous vein
Definition
from the posterior aspect of lateral malleolus to the popliteal fossa, pierces the deep popliteal fascia and enters the popliteal vein
Term
medial sural cutaneous nerve
-comes from
-is joined by
-supplies
Definition
-from the tibial nerve in the popliteal fossa
-joined by the sural communicating branch of common fibular nerve
-as the SURAL NERVE, supplies the skin on the posterior and lateral aspect of leg and lateral side of the foot .
Term
common fibular nerve path
Definition
breaks from the sciatic nerve in the popliteal fossa -> follows medial border of the biceps femoris -> exits the popliteal fossa superficial to the lateral gastroc -> around the neck of the fibula (INJURY RISK) -> branches into superficial and deep fibular nerves
Term
lateral sural cutaneous nerve
-branches from
-supplies
Definition
from common fibular nerve
-supplies the skin of lateral aspect of leg .
Term
jip joint type
Definition
ball and socket
Term
features on the head of the femur
Definition
-hyaline cartilage
-fovea capitis femoris
-ligament of the head of the femur
Term
ligament of the head of the femur
Definition
-non-strengthening
-contains the artery to the head of the femur, a branch of the obturator artery
Term
acetabular notch
Definition
the inferior "insufficiency" of the acetabulum
Term
the semilunar articular surface of the acetabulum
Definition
lunate surface
Term
acetabular labrum
Definition
makes the acetabulum deeper
-is fibrocartilaginous
Term
transverse acetabular ligament
Definition
bridges the acetabular notch,
-is connected to the ligament of the head of the femur
Term
reaches of the hip joint's fibrous capsule
Definition
-Reaches the intertrochanteric line anteriorly
-proximal to the intertrochanteric crest posteriorly.
Term
three ligaments of the hip joint that reinforce the fibrous capsule
Definition
-Iliofemoral ligament
-Pubofemoral ligament
-Ischiofemoral ligament
Term
Iliofemoral ligament
-attachment points
-protects against
Definition
-from the anterior inferior iliac spine and acetabular rim to the intertrochanteric line
-prevents hyperextension
Term
Pubofemoral ligament
-attachment points
-protects against
Definition
-from the obturator crest to blend with the iliofemoral ligament
-limits excess extension and abduction
Term
Ischiofemoral ligament
-attachment points
-protects against
Definition
-from the ischial part of the acetabular rim to the neck of the femur
-it helps prevent hyperextension
Term
hip ligaments are relaxed in what position?
Definition
relaxed during flexion and adduction of the thigh
Term
direction of most hip dislocations
Definition
posterior
Term
Most traumatic hip dislocations
Definition
-dislocates posterior
-posterior acetabulum may fracture
-sciatic nerve may be damaged
-avascular necrosis risk
Term
hip joint movements
Definition
-Flexion & extension
-Abduction & Adduction
-Medial & lateral rotation
-Circumduction
Term
blood supply to the hip joint
Definition
MAINLY Retinacular branches of the medial femoral circumflex artery
-also retinacular branches of the lateral femoral circumflex artery
-artery to the head of the femur
Term
traumatic injuries that may interrupt blood to the head of the femur
Definition
-fracture of the neck of the femur
-a posterior hip dislocation
Term
Collateral circulation around hip joint formed by...
-When would this come into play?
Definition
allows blood past obstruction of external iliac or femoral artery
-medial femoral circumflex
-lateral femoral circumflex
-inferior gluteal
-first perforating arteries
Term
Nerve supply of hip joint
Definition
-Femoral nerve or its muscular branches anteriorly
-Obturator nerve inferiorly
-Superior gluteal nerve superiorly
-Nerve to quatratus femoris posteriorly
Term
why is hip pain often referred to the knee?
Definition
articular branches of the femoral and obturator nerves innervate both the hip and knee joints
Term
Osteoarthritis of Hip Joint
-higher risk populations
Definition
-elderly
-women
Term
complications with total hip replacemetn
Definition
hip dislocation due to deep internal rotation
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