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37 terms

Block 2 Lecture 17

Gluteal Region
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Name the bony landmarks of the gluteal region (474)
Hip bone (ilium, ischium & pubis), Obturator foramen & Acetebulum
Describe the landmarks of the ilium (which is 1 of the 3 parts that make up the hip bone)
Ilium contains the ala & the body which is the superior 2/3 of the hip and superior 2/3 of the acetabulum. landmarks are iliac crest & tubercle -L4, ASIS, Posterior Superior Iliac Spine-indicated by dimples on the skin & Anterior & Posterior Inferior Spines
name the landmarks on the Ischium portion of the hip bone
Body is fused with the ilium & the Pubis. Tuberosity-major weight bearing prominence during sitting, Spine which separates the greater and lesser Sciatic notches, Ramus which extends medically to join pubic Ramus to join Ischiopubic Ramus which completes the Obturator for amen
where is the Pubis located, what part of the gluteal landmark is it contained and name its particular landmarks
The pubis is located on the anterior aspect of the hip bone as well as anteromedially on 1/5 of the acetabulum. The landmarks of the Pubis are body-med, Superior Ramus which fuses with the ilium and ischium, Inferior Ramus which joins Ramus of the Ischium, Pubic symphisis joint which is fibrocartilaginous, pubic crest & tubercle
What landmark of the gluteal region is an oval opening and what is it bound by?
The Obturator for amen which is bound by the pubis and the is Ischium-nearly closed by the Obturator membrane
name the bony landmark that articulates with the femur
thefemurs he Acetebulumwhat articulates with the head of the femur
name the 3 joints found in the pelvis (155)
Lumbrosacral, Sacrococcygeal, Sacroiliac joints
Which pelvic joint articulates between L5 & S1 levels what is attached to via which ligament?
The lubrosacral joint which is attaches the Ilium and Sacrum via the ilio lumbar and lumbrosacral ligaments
Describe the Sacrococcygeal joint
its a symphisis with a small intervertebral discs it contains anterior & posterior sacrococcygeal ligaments
what do you call the joint located between the sacrum & the iliac? What type of joint is it and what holds them together tightly allowing for little movement?
Better known as the SI joint which stands for Sacroiliac joint, it is a synovial joint which is held together by strong interosseous, dorsal sacroiliac & ventral sacroiliac ligaments
what function does the iliosacral joints provide what ligaments aid. in this function and what mm cover the SI joints posterity?
they bear considerable weight and forces during gait. The sacrotuberous & sacrospinous ligaments aid in keeping the joint stable and the erector spinae and gluteus Maximus mm cover the posterior aspect of the SI joint
Name the ligaments and apertures found in the gluteal region
Greater Sciatic foremen, Lesser Sciatic foremen, Sacrotuberous ligament & Sacrospinous ligament
What function does the Greater Sciantic Foramen perform?
It is a passageway for vessels & nn to pass into or exit the pelvic region
What function does the Lesser Sciantic Foramen perform?
It is a passageway for vessels to enter or leave the perineum
where does the sacrotuberous ligament attach and which muscle has part of its origin on this ligament?
from the PSIS, PIIS, sacrum and coccyx to the ischial Tuberosity. part of the gluteus Maximus originates here
what is "sandwiched" between the sacrotuberous ligament & the coccygeal muscle?
The sacrospinous ligament. it runs from the Ischial spine to inferior lateral border of the sacrum and coccyx
what is the main function when the sacrotuberous ligament & sacrospinous ligaments are working synergistically?
they resist posterior rotation of the sacrum relative to the hip bones
name the 9 mm of the gluteal region
Gluteus Maximus, Gluteus mediums, Gluteus minimums, Tensor fascia altar, perifrmis
, Obturator internus, Gemellus Superior & Inferior, Quadratus femoris, Obturator externus
Name Origin, Insertion, Action & Innervation of Gluteus Maximus (481,482)
Typically largest & heaviest m in body Attaches: proximally @ ilium, sacrum and sacrotuberous ligament and distally @ iliotibial tract and gluteal Tuberosity of the femur Action: Powerful Extensor of the thigh & Lateral rotator Innenrvation: Inferior Gluteal nerve (L5, S1, S2)
Name Origin, Insertion, Action & Innervation of Gluteus Medius
attaches proximally @ external surface of the ilium-deep to glut max, and distally@ lateral surface of greater trochanter Action: Powerful Abductor-but works in "reverse" During gait phase pulls iliac crest down toward fixed femur, also medial rotator Innervation: Superior gluteal nerve
Name Origin, Insertion, Action & Innervation of Gluteus Minimus
same attachments of glut Medius but slightly inferior and, same action, nerve Innervation, smallest of the gluteal mm
Name Origin, Insertion, Action & Innervation of Tensor fascia late
O: iliac crest posterior to ASIS I: fascia lata
Action: medial rotation, flexion & abduction @ the hip
weakness of what muscle leads to a positiveTrendelenburg sign and aTrendelenburg limp. what are the signs of weakness?
Weakness in Gluteus Medius muscle which the patient would have a dropping of the pelvis on the opposite side of the. The weakness would be on the side without the drop. Often people will compensate by leaning into the weaker side which is called a "compensated Trendelenberg limp"
Name Origin, Insertion, Action & Innervation of Piriformis muscle (490-491)
O: anterior surface of sacrum & sacrotuberous ligament I: Greater trochanter **leaves pelvis via greater sciatic notch & runs behind the head of the femur Action: lateral rotator and abductor I: S1 &S2
Name the major Anatomical landmark gluteal region and the vessels that run superiorly and inferiorly to this muscle
The Piriformis muscle which the superior gluteal vessels and nerve are situated above and inferiorly the inferior gluteal vessels and nerve
Name Origin, Insertion, Action & Innervation of Obturator muscle (478-79 & 483)
Attaches proximally @ pelvic surface of Obturator membrane travels via the Lesser sciatic Foramen leaving the perineum to attach distally @ medial surface of greater trochanter. Action: Lateral rotator of extended thigh & abductor of flexed thigh also helps to stabilize hip joint. Innervated: nerve to Obturator internus
Name Origin, Insertion, Action & Innervation of Gemellus Superior and Inferior Muscles
O: Ischial spine and Ischial Tuberosity I: Tendon of Obturator Internus Action : Assist Obturator internus with lateral rotation during thigh extension, abduction of the flexed thigh and stabilization of the hip joint Innervated: Nerve to Obturator internus- Superior
Nerve to Quadratus femoris-Inferior
What ligament is the lubrosacral ligament an extension of ?
The longitudinal ligament of the spine
What foramen does the sacrotuberous ligament help form? (smaller & inferior) (n155)
The lesser sciatic foramen
What foramen does the sacrospinous ligament form? Relate it to the sacrotuberous ligament
It forms the greater sciantic foramen and it is larger & superior in relation to the the lesser foramen
Which muscle lies immediately deep to gluteus maximus?
Gluteus medius muscle.
How do you know if you are @ gluteus minimus?
You would be able to see sciatic n & a. Otherwise you would be @ Gluteus medius.
Name the deepest muscles of the gluteal region and like all deep muscles their main function is what?
Piriformis m, Obturator internus, Gemellus Superior and Inferior Quadratus femoris & Obturator Externus. Stability of the joint is their main function.
What runs above piriformis muscle and what runs below?
Superior gluteal nerve and inferior gluteal nerve.
If you can see Superior gluteus artery and nerve what muscle of the gluteal region are you looking @ and why?
Gluteus minimus, because the Sperior gluteus artery and nerves run deep/or are sandwiched in between gluteus medius and gluteus minimus
What other nerve runs with sciatic nerve?
Posterior femoral cutaneous nerve
What muscle is sandwich in between the Superior and inferior Gemellus muscles?
The obturator internus