HLSC 4011- Lecture 8 Gluteal Region and Posterior Thigh

origin of gluteus maximus

posterior gluteal line and crest of ilium, dorsal surface of sacrum, lateral surface of coccyx

insertion of gluteus maximus

IT band, gluteal tuberosity of femur

innervation of gluteus maximus

inferior gluteal n

action of gluteus maximus

hip extension, lat rotation, upper fibers abduct hip, lower fibers adduct hip

origin of gluteus medius

ilium between anterior and posterior gluteal lines

insertion of gluteus medius

greater trochanter

innervation of gluteus medius

superior gluteal n

action of gluteus medius

abducts hip, anterior fibers medially rotate and posterior fibers posterior fibers laterally rotate

origin of gluteus minimus

ilium between anterior and inferior gluteal lines

insertion of gluteus minimus

greater trochanter

innervation of gluteus minimus

superior gluteal n

action of gluteus minimus

abduct and medially rotate hip

origin of tensor fasciae latae

iliac crest, ASIS, fascia latae

insertion of tensor fasciae latae

IT band

innervation of tensor fasciae latae

superior gluteal n

action of tensor fasciae latae

hip flexion, medial rotation, and abduction

origin of piriformis

anterior surface of sacrum, gluteal surface of ilium near PIIS, and capsule of SI joint and sacrotuberous ligament

insertion of piriformis

greater trochanter of femur

innervation of piriformis

nerve to piriformis

action of piriformis

lateral rotation of hip

origin of obturator internus

internal surface of obturator membrane and margin of obturator foramen

insertion of obturator internus

medial surface of greater trochanter of femur

innervation of obturator internus

nerve to obturator internus

action of obturator internus

lateral rotation of hip

origin of superior gemellus

ischial spine

insertion of superior gemellus

medial surface of greater trochanter of femur

innervation of superior gemellus

nerve to obturator internus

action of superior gemellus

lateral rotation of hip

origin of inferior gemellus

proximal part of ischial tuberosity

insertion of inferior gemellus

medial surface of greater trochanter of femur

innervation of inferior gemellus

nerve to quadratus femoris

action of inferior gemellus

lateral rotation of hip

origin of quadratus femoris

lateral border of ischial tuberosity

insertion of quadratus femoris

quadrate tubercle

innervation of quadratus femoris

nerve to quadratus femoris

action of quadratus femoris

lateral rotation of hip

origin of semitendinosus

ischial tuberosity

insertion of semitendinosus

medial surface of proximal tibia

innervation of semitendinosus

sciatic n (t)

action of semitendinosus

knee flexion, medial rotation, hip extension

origin of semimembranosus

ischial tuberosity

insertion of semimembranosus

medial condyle of tibia

innervation of semimembranosus

sciatic n (t)

action of semimembranosus

knee flexion, medial rotation, hip extension

origin of biceps femoris long head

ischial tuberosity

origin of biceps femoris short head

lateral lip of linea aspera, lateral supracondylar line

insertion of biceps femoris

head of fibula, lateral tibial condyle

innervation of biceps femoris long head

sciatic n (t)

innervation of biceps femoris short head

sciatic n (f)

action of biceps femoris

knee flexion and lateral rotation, hip extension

what are the superior and inferior boundaries of the gluteal region

superiorly by iliac crest and inferiorly by gluteal fold

what ligaments support the pubic symphysis

superior and inferior public ligaments

what kind of joint is the pubic symphysis

fibrous joint

what forms the lumbosacral joint

L5 and S1

what kind of joint is the lumbosacral joint

synovial

what kind of joint is the sacrococcygeal

cartilaginous

what are the three ligaments of the sacroiliac joint

anterior synovial, interosseous, and posterior syndesmosis

where is the anterior SI ligament

between the auricular surfaces of sacrum and ilium

where is the interosseous SI ligament

between sacral and iliac tuberosities

how would you describe the interosseous SI ligament

deep, primary weight-transfer structures

where is the posterior SI joint

an external continuation of interosseous lig

what is the function of the posterior SI joint

to lock sacrum in place (fibers run obliquely)

where does the sacrotuberous ligament run

from sacrum/coccyx to ischial tuberosity

the sacrotuberous ligament divides the sciatic _____ into sciatic _______

notch; foramen

where does the sacrospinous ligament run?

from sacrum/coccyx to ischial spine

the sacrospinous ligament divides the sciatic _________ into what?

foramen; greater and lesser

what are three ways contents of the pelvis/abdomen can pass into the LE

greater/lesser sciatic foramen, gap between inguinal lig and pelvis, obturator canal

what are the boundaries of the greater sciatic foramen

greater sciatic notch, SS and ST ligaments

what muscles run out the GSF

piriformis

what nerves run out the GSF

superior gluteal (suprapiriform), posterior femoral cutaneous, inferior gluteal, n. to quadratus femoris, n. to obturator internus, pudendal, sciatic (infrapiriform)

what vessels run out GSF

superior gluteal artery and vein

what are the boundaries of the lesser sciatic foramen

lesser sciatic notch, ST, and SS lig

what muscles run in LSF

tendon of obturator internus

what nerves run in LSF

pudendal, n to obutator internus

what vessels run in LSF

internal pudendal artery and vein

what runs out the greater sciatic foramen and reenters through lesser sciatic foramen

pudendal n

what muscles compose the superficial layer of the gluteal region

glute max, med, min, and TFL

what is the main function of the superficial layer of the gluteal region

Hip ABD and extension

what muscles compose the deep layer of the gluteal region

piriformis, superior gemellus, obturator internus, inferior gemellus, and quadratus femoris

what is the main function of the deep layer of the gluteal region

Hip lateral rotation

what is special about the TFL

located more anteriorly, but innervated by same as gluteal superficial region

the deep layer of the gluteal region has a common insertion where

greater trochanter

what injury is related to trendelenburg's sign

nerve injury to superior gluteal n

what does a positive trendelenburg test look like

Hip drop to opposite side of impairment

what does a compensated trendelenburg look like

trunk leans ipsilaterally to side of the stance leg

the sacral plexus is formed from what ventral rami

L4-S4

what are the branches of the sacral plexus in the gluteal region

superior gluteal, inferior gluteal, n to piriformis, n to obturator internus, and n to quadratus femoris

what branches of the sacral plexus are formed in the gluteal region

sciatic, posterior cutaneous n of the thigh, pudendal

sciatic n divides into what

tibial and common fibular branches

what is the pathway of the sciatic nerve

inferior to piriformis, out GSF

what is the pathway of the posterior cutaneous n of the thigh

out GSF, medial to sciatic n

what is the pathway of the pudendal n

leaves pelvis via GSF and renters pelvis via LSF

what composes the main blood supply in the gluteal region

superior and inferior gluteal arteries

superior and inferior gluteal arteries branch from where

internal iliac artery

what is the pathway of the superior and inferior gluteal arteries

exit GSF superior to piriformis, to supply the glute muscles

what is included in the trochanteric anastomosis

superior and inferior gluteal a, medial and lateral circumflex a, retinacular a

if there is a fx to neck of femur, what can result

avascular necrosis of femoral head

what veins supply the gluteal region

superior and inferior gluteal vein

where do the superior and inferior gluteal veins drain ?

internal iliac vein

where does the common iliac vein drain?

IVC