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Gluteal Region of the thigh
Gluteal Region of the thigh
36
Anatomy
Graduate
07/13/2011

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Cards

Term
  • Nerve to piriformis 
Definition
(some texts do not name this): S1-2, innervates piriformis
Term
  • Pudendal nerve
Definition
S2-S4, innervates perineum
Term
  • Posterior femoral cutaneous nerve
Definition
S1-S3, cutaneous to posterior thigh
Term
  • Nerve to quadratus femoris
Definition
L5-S1, innervates quadratus femoris and inferior gemellus
Term
  • Nerve to obturator internus:
Definition
 L5-S2, innervates obturator internus and superior gemellus
Term
  • Sciatic nerve:
Definition
 L4-S3, largest nerve in the body, is composed of a tibial part (anterior division) and a common fibular part (posterior division), does not innervate muscles in gluteal region
Term
  • Inferior gluteal nerve
Definition
L5-S2, innervates gluteus maximus
Term
  • Superior gluteal nerve:
Definition
 L4-S1, innervates gluteus medius and minimus and tensor fascia lata
Term
Branches of the Sacral Plexus (8)
Definition
  • Superior gluteal n.
  • inferior gluteal n.
  • sciatic n.
  • nerve to obturator internus
  • n. to quadratus femoris
  • posterior femoral cutaneous n.
  • pudendal n.
  • n. to piriformis
Term
  • _____nerves- superior and medial clunial nerves are dorsal primary rami from the lumbar and sacral regions; inferior clunial nerves arise from the posterior cutaneous nerve of thigh.  They are seen superficially and supply skin in the buttock region.
Definition
Term
  • The _____ nerve of thigh- exits the greater sciatic foramen below piriformis and medial to the sciatic nerve; it supplies skin inferior to the gluteal fold
Definition
  • The posterior cutaneous nerve of thigh- exits the greater sciatic foramen below piriformis and medial to the sciatic nerve; it supplies skin inferior to the gluteal fold
Term
  • The _____ nerve and _____ vessels- exit the greater sciatic foramen below piriformis and then enter the lesser sciatic foramen to supply structures of the perineum.
Definition
  • The pudendal nerve and internal pudendal vessels- exit the greater sciatic foramen below piriformis and then enter the lesser sciatic foramen to supply structures of the perineum.
Term
  • The_____nerve- exits the greater sciatic foramen, typically below piriformis and descends into the posterior thigh.  
Definition
  • The sciatic nerve- exits the greater sciatic foramen, typically below piriformis and descends into the posterior thigh.  
Term
  • The _____ nerve and vessels- exit the greater sciatic foramen and run deep to the gluteus maximus. They exit below piriformis.
Definition
  • The inferior gluteal nerve and vessels- exit the greater sciatic foramen and run deep to the gluteus maximus. They exit below piriformis.
Term
  • The _____ nerve and vessels- exit the greater sciatic foramen and run in a plane between the gluteus medius and minimus.  They exit above piriformis.
Definition
  • The superior gluteal nerve and vessels- exit the greater sciatic foramen and run in a plane between the gluteus medius and minimus.  They exit above piriformis.
Term
Quadratus Femoris
Definition
    1. Origin- Ischial tuberosity
    2. Insertion- Intertrochanteric crest
    3. Innervation- Nerve to quadratus femoris L5, S1
    4. Function- Externally rotates thigh
Term
Superior and Inferior Gemelli
Definition
    1. Origin-
      1. Superior- ischial spine
      2. Inferior- ischial tuberosity
    2. Insertion- trochanteric fossa (tendons blend with obturator internus tendon)
    3. Innervation- 
      1. Superior-  Nerve to obturator internus; L5, S1
      2. Inferior- Nerve to quadratus femoris; L5, S1
    4. Function- Externally rotates extended thigh; abducts flexed thigh
Term
Obturator Internus
Definition
    1. Origin- Pelvic surface of obturator foramen and membrane
    2. Insertion- Trochanteric fossa  (medial aspect of greater trochanter)
    3. Innervation- Nerve to obturator internus; L5, S1
    4. Function- Externally rotates extended thigh; abducts flexed thigh
Term
Piriformis
Definition
    1. Origin- Anterior sacrum, sacrotuberous ligament
    2. Insertion- Superior aspect of greater trochanter
    3. Innervation- Direct branches of S1 and S2 or nerve to piriformis; S1, S2
    4. Function- Externally rotates extended thigh; abducts flexed thigh
Term
Muscles of the deep layer of the gluteal region (4)
Definition
  • piriformis
  • obturator internus
  • superior and inferior gemellli
  • quadratus femoris
Term

Deep Layer (the “Short Rotator” group)- 

Definition

Deep Layer (the “Short Rotator” group)- all are external rotators of the thigh and help to steady the femoral head in the acetabulum.  With the exception of quadratus femoris, all also abduct the flexed thigh.

Term
  • Ischial bursa
Definition
  • Ischial bursa- separates gluteus maximus from ischial tuberosity, common site of friction bursitis
Term
  • Trochanteric bursa
Definition
  • Trochanteric bursa- separates gluteus maximus/ITB from greater trochanter; common site of friction bursitis
Term
Gluteal bursae (2)
Definition
  • trochanteric bursa
  • ischial bursa
Term

Clinical Correlate- Trendelenburg Sign

Definition

Clinical Correlate- Trendelenburg Sign- In single leg stance, the gluteus medius/minimus complex on the stance side contracts to keep the pelvis from sagging to the opposite unsupported side.  If the pelvis sags to the opposite side during stance, this is a positive Trendelenburg sign and indicates weakness of the gluteus medius/minimus complex.

Term
Gluteus Minimus - deep to gluteus medius
Definition
    1. Origin- Lateral aspect of ilium, between anterior and inferior gluteal lines
    2. Insertion- Greater trochanter, just anterior to gluteus medius attachment
    3. Innervation- superior gluteal nerve; L4, L5, S1
    4. Function- Abducts and internally rotates thigh, keeps pelvis level during ipsilateral stance (assists gluteus medius)
Term
Gluteus Medius
Definition
    1. Origin- Lateral aspect of ilium, between anterior and posterior gluteal lines
    2. Insertion- Lateral aspect of greater trochanter
    3. Innervation- superior gluteal nerve; L4, L5, S1
    4. Function- Abducts and internally rotates thigh, keeps pelvis level during ipsilateral stance
Term
Gluteus Maximus
Definition
    1. Origin- dorsal sacrum and coccyx, ilium posterior to posterior gluteal line, sacrotuberous ligament
    2. Insertion- iliotibial band/tract (“ITB”)- via ITB to lateral condyle of tibia (“Gerdy’s tubercle”); gluteal tuberosity of femur
    3. Innervation- inferior gluteal nerve; L5, S1, S2
    4. Function- extends thigh (especially from flexion… standing up); external rotation thigh
Term
Superficial Gluteal muscles (3)
Definition
  • gluteus maximus
  • gluteus medius
  • gluteus minimus
Term
  • Sacrospinous ligament
Definition
- from lateral aspect of sacrum to ischial spine; together with the sacrotuberous ligament, converts the sciatic foramens to a greater sciatic foramen and lesser sciatic foramen.
Term
  • Sacrotuberous ligament
Definition
- from lateral aspect of sacrum, PSIS of ilium and coccyx to ischial tuberosity
Term
  • Anterior sacroiliac ligament
Definition
- much thinner; from anterior sacrum to ilium (medial aspect of iliac fossa)
Term
  • Interosseous sacroliliac ligament
Definition
- short and thick; lies deep to the posterior SI ligament
Term
  • Posterior sacroiliac ligament
Definition
- broad and thick; from posterior surface of sacrum to posterior ilium (iliac tuberosity)
Term
Ligaments of the Sacroiliac Joint (5)
Definition
  • posterior sacroiliag l.
  • interosseous sacroiliac l.
  • anterior sacroiliac l.
  • sacrotuberous l.
  • sacrospinous l.
Term
Palpable bony landmarks of the gluteal region (5)
Definition
  • Iliac crest
  • Anterior superior iliac spine (“ASIS”)
  • Posterior superior iliac spine (“PSIS”)
  • Ischial tuberosity
  • Greater trochanter of femur
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