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gluteal region and posterior thigh
physical therapy gross anatomy gluteal region and posterior thigh
129
Anatomy
Graduate
10/10/2011

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Term
what bones form the bony pelvis?
Definition
2 hip bones, sacrum, coccyx
Term
where is the pubic symphysis?
Definition
between the hip bones anteriorly
Term
what is the sacroiliac joint?
Definition
the strong articulation between the sacrum and the hip bones
Term
what are the 3 bones in the hip bone?
Definition
ilium, ischium, pubis
Term
what separates the 3 bones of the hip in children?
Definition
tri-radiate cartilage
Term
when do the 3 bones of the hip bone fuse together?
Definition
early adulthood, ages 20-25
Term
where is the fusion site of the 3 bones of the pelvis?
Definition
acetabulum
Term
what is the acetabulum?
Definition
a large cup-shaped socket that articulates with the head of the femur
Term
what is the lunate surface of the acetabulum?
Definition
the articular surface where the head of the femur articulates with acetabulum
Term
which bone forms the largest portion of the hip bone
Definition
ilium
Term
what is the ala of the ilium?
Definition
the wing-like lateral surface
Term
what is the body of the ilium?
Definition
the part of the ilium that makes up part of acetabulum
Term
what part of the acetabulum does the ilium contribute to?
Definition
superior 2/5ths
Term
what are the gluteal lines?
Definition
rough curved lines on ilium for attachment of the gluteal muscles
Term
what are the names of the 3 gluteal lines?
Definition
anterior gluteal line, posterior gluteal line, inferior gluteal line
Term
where/what is the iliac fossa?
Definition
on the medial surface of the iliac wing, large smooth depression, provides muscular attachment for iliacus muscle
Term
where/what is the auricular surface of the ilium?
Definition
rough ear-shaped area that makes up ilium's portion of sacroiliac joint (articulates with sacrum)
Term
what is the roughened area for ligamentous attachments just superior to the auricular surface?
Definition
iliac tuberosity
Term
what part of the acetabulum does the ischium contribute to?
Definition
posteroinferior 2/5ths of the wall of the acetabulum
Term
what is the ischiopubic ramus
Definition
where the ischial ramus attaches to the pubic ramus, forms the boundary of the obtuartor foramen
Term
what is the ischial tuberosity?
Definition
a large roughened portion on the ischium
Term
what separtes the greater and lesser sciatic notches along the ischium?
Definition
ischial spine
Term
what part of the acetabulum is made by the pubis?
Definition
anterior posterior 1/5th
Term
where is the base of the sacrum?
Definition
superior: articulates with 5th lumbar vertebra
Term
where is the apex of the sacrum?
Definition
posterior: articulates with coccyx
Term
what are the transverse ridges?
Definition
mark the fusion site of each of 5 sacral vertebrae
Term
where/what are the ventral foramina of the sacrum?
Definition
on ventral side of sacrum; for the passage of ventral rami of spinal nerves
Term
where/what is the median sacral crest?
Definition
posterior sacrum, represents the fused spinous processes
Term
where/what are is the intermediate sacral crest?
Definition
on posterior sacrum on either side of the median sacral crest; represent the fused articular processes
Term
where/what are the lateral sacral crests?
Definition
on posterior sacrum on lateral sides of the intermediate sacral crests; represent the fused transverse processes
Term
where/what are the dorsal sacral foramina?
Definition
on dorsal side of sacrum, for the passages of dorsal rami of spinal nerves
Term
describe sacrum's auricular surface
Definition
lateral, articulate with ilium to form sacroiliac joint
Term
describe sacral hiatus
Definition
where lamina and spinous processes of S5 vertebra would be if it existed
Term
describe the sacral cornua?
Definition
on either side of sacral hiatus; rudimentary inferior articular processes of S5 vertebra; important obstetrical landmarks when performing epidural blocks in the sacral canal
Term
what Is the longest and heaviest bone in the boyd?
Definition
femur
Term
how much does the femur contribute to an individual's height?
Definition
1/4 of total height
Term
what is the fovea of the femur?
Definition
small area on the femoral head that is not covered with cartilage that serves as point of attachment for ligamentum capitis femoris
Term
what attaches to the lesser trochanter?
Definition
iliopsoas
Term
describe the linea aspera
Definition
rough prominent ridge on posterior femur that ends as the supracondylar lines; has a medial and lateral lip for muscular attachment; has a broad, rough expansion superiorly that is the gluteal tuberosity
Term
describe the acetabular labrum
Definition
fibrocartilagenous tissue that goes around acetabulum to deepen and protect bone
Term
describe the transverse acetabular ligament
Definition
stretches across the lunate surface of the acetabulum inferiorly
Term
describe the acetabular foramen
Definition
small foramen superior to the transverse acetabular ligament that allows protective passage of vessels
Term
describe the ligamentum capitis femoris
Definition
attaches femoral head at fovea to transverse acetabular ligament
Term
describe the small artery of the femoral head
Definition
travels with the ligamentum capitis femoris and vascularizes this ligament
Term
describe the articular capusle of the hip joint
Definition
strong, dense, fibrous capsule that surrounds the hip joint; made up of 3 ligaments; lined by synovial membrane
Term
describe the iliofemoral ligament
Definition
strongest ligament of the 3 ligaments that make up the joint capsule of the hip; located on anterior aspect of joint; Y shaped
Term
describe the ischiofemoral ligament
Definition
strong, triangular, located posteriorly
Term
how are the iliofemoral, ischiofemoral, and pubofemoral ligaments oriented and what does this do?
Definition
spirally so that they are relaxed in flexion and taut in extension to stabilize hip joint and reduce muscular energy
Term
which 4 artery branches vascularize the hip joint?
Definition
medial circumflex artery, lateral circumflex artery, retinacular arteries, artery of the head
Term
which artery provides most of the blood supply to the head of the femur?
Definition
medial circumflex artery from femoral artery
Term
where do medial and lateral circumflex arteries come from?
Definition
femoral and/or deep arteries
Term
where do the retinacular arteries on the neck of the femur come from?
Definition
circumflex arteries
Term
where does the artery to the head of the femur come from?
Definition
from obturator artery
Term
what does the artery to the head of the femur traverse with?
Definition
ligamentum capitis femoris
Term
femoral neck fractures are often associated with which bone disease?
Definition
osteoporosis
Term
what vascular risk is associated with femoral neck fractures?
Definition
rupture of retinacular arteries
Term
what causes intertrochanteric fractures?
Definition
common in elderly patients, usually from a fall
Term
what causes spiral fractures of the body of the femur?
Definition
violent injury such as motor vehicle accident
Term
what are the lumbosacral joints?
Definition
the joint between the 5th lumbar vertebra and the base of the sacrum (plus intervertebral disc); joints between inferior facets of 5th lumbar vertebra and superior facets of sacrum
Term
describe the sacroiliac joint
Definition
synovial joint between the auricular surfaces of the ilium and the sacrum; sacrum fits like a wedge between the 2 iliac bones
Term
what does the sacroiliac joint do?
Definition
helps transmit weight from upper limbs and trunk to lower limb
Term
describe the sacrococcygeal joint
Definition
joint between sacrum and coccyx, has a thin fibrocartilagenous disc
Term
what happens to sacroiliac joint and pubic symphysis during later months of pregancy?
Definition
they loosen under influence of relaxin
Term
what are the ligaments that restrict movement of the sacroiliac joint?
Definition
dorsal and ventral sacroiliac ligament, iliolumbar ligament, interosseous ligament
Term
describe the dorsal and ventral sacroiliac ligaments
Definition
strengthen and help stabilize sacroiliac joints
Term
describe the fibers of the dorsal sacroiliac ligament
Definition
has both short horizontal and long oblique fibers
Term
describe the iliolumbar ligaments
Definition
go from the 4th and 5th lumbar transverse processes to the iliac crest and base of the sacrum
Term
where is the interosseous ligament of the sacroiliac joint?
Definition
deep to the dorsal sacroiliac ligament
Term
what are the 2 gluteal ligaments that bind together the bony pelvis?
Definition
sacrotuberous and sacrospinous ligaments
Term
describe the sacrotuberous ligament
Definition
goes from lateral margins of sacrum to ischial tuberosity
Term
describe the sacrospinous ligament
Definition
runs from lateral sacrum and coccyx to ischial spine
Term
when do the sacrospinous and sacrotuberous ligaments provide resilience to the sacroiliac joint?
Definition
when vertebral column sustains weight increase such as jumping
Term
what divides the sciatic notches into greater and lesser sciatic foramen?
Definition
the sacrotuberous and sacrospinous ligaments
Term
what is the large, heavy muscle that lies over other gluteal muscles?
Definition
gluteus maximus
Term
describe fibers of gluteus maximus
Definition
fibers course inferolaterally at a 45 degree angle and insert into gluteal tuberosity and IT band
Term
what are the functions of the gluteus maximus?
Definition
extend and laterally rotate thigh (rising to stand, ice skating, going up stairs)
Term
what innervates the gluteus maximus?
Definition
inferior gluteal nerve L5, S1, S2
Term
what do gluteus minimus and medius do?
Definition
abduct hip, stabilize opposite side pelvis during ambulation
Term
what innervates the gluteus minimis and medius?
Definition
superior gluteal nerve L4, L5, S1
Term
what nerve innervates all hip abductors?
Definition
superior gluteal nerve L4, L5, S1 (come get me some)
Term
what causes gluteal gait
Definition
weakness in gluteus minimus and medius or damage to superior gluteal nerve
Term
what happens in gluteal gait?
Definition
compensatory gait: person shifts body weight over weakened side bc otherwise they would lean away from weakened side
Term
describe trendelenburg test
Definition
person stands on one leg: positive trendelenburg = pelvis sags on opposite side of weakness
Term
what are the 5 lateral rotators of the hip from superior to inferior?
Definition
piriformis, superior gemelli, obturator internus, inferior gemelli, quadratus femoris
Term
describe piriformis muscle
Definition
lateral rotator that exits the great sciatic foramen and attaches to greater trochanter
Term
which muscle covers most of the lateral wall of the pelvis?
Definition
obturator internus
Term
what does the obturator internus go through to exit the pelvis?
Definition
lesser sciatic foramen
Term
where does obturator internus insert?
Definition
medial surface of greater trochanter (trochanteric fossa)
Term
what do the gemelli muscles do?
Definition
assist obturator internus
Term
gemelli muscle tendons fuse with what other mucsle tendon?
Definition
obturator internus
Term
describe innervation to lateral rotators of the hip
Definition
piriformis: nerve to piriformis; obturator internus and superior gemelli: nerve to obturator internus; quadratus femoris and inferior gemelli: nerve to quadratus femoris
Term
what nerve innervates the piriformis?
Definition
nerve to piriformis
Term
what are the hamstrings?
Definition
semitendinosus, semimembranosus, biceps femoris
Term
where do the hamstrings arise from?
Definition
ischial tuberosity
Term
hamstrings (except bicep short head) span which joints?
Definition
hip and knee
Term
what action do the hamstrings do?
Definition
extend thigh, flex knee
Term
what is another important function of hamstrings besides hip extension and knee flexion?
Definition
tonic contractions help keep balance while standing = posture
Term
what usually causes pulled hamstrings?
Definition
inadequate warming of the muscles prior to athletic events
Term
what happens when a hamstring is pulled?
Definition
sudden acceleration of hamstring muscles can tear the proximal tendinous attachments and even avulse small fragments of the ischial tuberosity
Term
what accompanies a pulled hamstring?
Definition
hematomas due to traumatic rupture of muscular arteries
Term
where is the trochanteric bursa?
Definition
between the greater trochanter and the overlying gluteus maximus and IT band
Term
where is pain of trochanteric bursitis felt?
Definition
over the outside of the upper thigh
Term
where do the superior gluteal nerve and artery exit the greater sciatic foramen?
Definition
above the piriformis
Term
where do the inferior gluteal nerve and artery exit the greater sciatic foramen?
Definition
below the piriformis
Term
where does sciatic nerve exit the greater sciatic foramen?
Definition
below the piriformis
Term
what area does the piriformis nearly fill?
Definition
greater sciatic foramen
Term
what lies on the lateral surface of the piriformis?
Definition
sacral plexus
Term
does sciatic nerve exit pelvis inferior to piriformis in erveryone?
Definition
no, sometimes a division passes through or over the piriformis
Term
what is the largest nerve in the body?
Definition
sciatic nerve
Term
what are the nerve roots of the sciatic nerve?
Definition
L4, L5, S123
Term
what are the 2 divisions that the sciatic nerve divides into in popliteal region?
Definition
tibial, common fibular branches
Term
where is medicine injected in gluteal region?
Definition
upper lateral quadrant to avoid sciatic nerve, which is in lower medial quadrant
Term
what nerve provides posterior cutaneous innervation to the thigh?
Definition
posterior femoral cutaneous nerve S1, S2
Term
what nerves supply cutaneous sensation to the butt?
Definition
dorsal rami of lumbar and sacral spinal nerves
Term
what is the main flexor of the hip?
Definition
iliopsoas
Term
what are the main extensors of the hip?
Definition
gluteus maximus and hamstrings
Term
what are the main abductors of the hip that also help stabilize hip?
Definition
gluteus medius and minimus
Term
what are the lateral rotators of the hip?
Definition
gluteus maximus, piriformis, quadratrus femoris, gemellis
Term
what are the main adductors of the hip?
Definition
adductor magnus and longus
Term
what are the main medial rotators of the hip?
Definition
anterior fibres of gluteus medius and minimus
Term
what usually causes posterior hip dislocations?
Definition
motor vehicle accidents when femur is flexed and adducted (sitting)
Term
why are posterior hip dislocations often medical emergencies?
Definition
often result in avascular necrosis
Term
what can happen to acetabulum during posterior hip dislocations?
Definition
can fracture posterior aspect of acetabulum, leading to servere osteoarthritis and sciatic nerve injury
Term
what exits greater sciatic foramen above piriformis muscle?
Definition
superior gluteal nerve, artery, vein
Term
what exits lesser sciatic foramen?
Definition
obturator internus
Term
what enters lesser sciatic foramen?
Definition
pudendal nerve, internal pudendal vessels
Term
what exits greater sciatic foramen below piriformis muscle?
Definition
inferior gluteal nerve, inferior gluteal vessels, sciatic nerve, pudendal nerve, internal pudendal artery and vein, posterior femoral cutaneous nerve, nerve to obturator internus, nerve to quadratus femoris
Term
what exits obturator canal?
Definition
obturator nerve, obturator vessels
Term
what exits below inguinal ligament?
Definition
iliopsoas, pectineus, lateral cutaneous nerve of the thigh, femoral nerve, femoral artery, femoral vein, lymphatics, femoral branch of genitofemoral nerve
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