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37 Cards in this Set

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Cutaneous innervation of gluteal region
Superior Cluneal nerves - (Posterior rami L1-3) Supply upper buttock.
Medial Cluneal Nerve - (Posterior rami S1-3) Supply medial buttock.
Inferior Cluneal Nerve - (Anterior rami S1-3 and posterior femoral cutaneous nerve. Supplies lower buttock.
Gluteus Maximus Muscle
Origin: Back of ilium and sacrum, and sacrotuberous ligament
Inserts: Iliotibial tract and gluteal tuberosity of femur.
Action: Extends and laterally rotates thigh at hip. Upper fibers abduct, lower fibers adduct.
Innervation: Inferior gluteal nerve
Tensor fascia lata miscle
Origin: Anterior part of crest of ilium
Inserts: Into the iliotibial tract and lateral condyle of the tibia
Action: Flexes and medially rotates thigh at hip. stabalizes bone and hip and knee joints.
Innervation: Superior gluteal nerve
Gluteus medius muscle
Origin: Below the iliac crest and between the anterior and posterior
gluteal lines.
Inserts: On the greater trochanter
Action: Strong major abductor of thigh. Anterior fibers medially rotate thigh, posterior fibers laterally rotate.
Innervation: Superor gluteal nerve
Gluteus minimus muscle
Origin: From Ilium, beneath gluteus medius
Inserts: On greater trochanter of femur
Action: Strong abductor of thigh at hip and stabilizes pelvis during walking.
Small lateral rotators of the hip
All stabilize the head of femur:
Piriform muscle
Obturator internus muscle
Superior and inferior gemelli muscles
Quadratus femoris muscle
Piriformis muscle
Origin: Front of sacrum inside pelvis
Inserts: Passes through greater sciatic foramen and inserts on greater trochanter of femur.
Action: Lateral rotator of thigh at hip.
Innervation: Nerve to piriformis
Obturator internus muscle
Origin: Inside of pelvis off obturator membrane and surrounding bone.
Inserts: Goes through lesser sciatic foramen, turns 90 degrees, inserts on greater trochanter.
Action: Action: Lateral rotator of thigh at hip.
Innervation: Nerve to obturator internus
Superior/Inferior Gemelli muscles
Origin: From superior and inferior margins of the lesser sciatic notch, respectively.
Insert: Tendon of obturator internus muscle
Action: Aid in lateral rotation
Innervation: Superior - Nerve to the obturator internus
Inferior - nerve to wuadratus femoris
Quadratus femoris muscle
Origin: Lateral side of ischial tuberosity
Inserts: Intertrochanteric crest of femur and quadrate tubercle of femur.
Action: Action: Lateral rotator of thigh.
Innervation: Nerve to quadratus femoris
Superior Gluteal Nerve
(posterior branches of L4, 5, S1)
Supplies: gluteus medius, gluteus minimus, and tensor fascia lata muscles
Emerges from greater sciatic foramen above the piriformis muscle with superior gluteal vessels
Inferior gluteal nerve
(posterior branches of L5, S1, 2)
Supplies: gluteus maximus muscle
Appears below piriformis muscle, accompanied by inferior gluteal vessels
Posterior femoral cutaneous nerve
(anterior branches S2, 3; and posterior
branches S1, 2)
Supplies: skin of lower buttocks, perineum, posterior thigh
Gives off the inferior cluneal nerves and perineal branch
Continues down back of the thigh under the deep fascia as far as the popliteal fossa
Sciatic Nerve
Formed from 2 nerves:
Tibial nerve (anterior branches L4, 5, S1, 2, 3)
Common fibular (posterior branches L4, 5, S1, 2)
Appears below piriformis muscle
and crosses quadratus femoris muscle.
Pudendal Nerve
(anterior branches S2, 3, 4)
Crosses sacrospinous ligament and re-enters the pelvis through the lessersciatic foramen.
Lateral to the nerve are the internal pudendal vessels.
Nerve to obturator internus muscle
(anterior branches L5, S1, 2)
Supplies: superior gemellus and obturator internus muscles
Exits the pelvis through greater sciatic foramen below piriformis muscle and gives off branch to the superior gemellus muscle. it Re-enters the pelvis through lesser sciatic foramen to supply
obturator internus muscle.
Appears lateral to internal pudendal vessels
Nerve to quadratus femoris muscle
(anterior branches L4, 5, S1)
Supplies: the inferior gemellus and quadratus femoris muscles, as well as
hip joint.
Lateral to the nerve to the obturator internus and passes deep to the gemelli and obturator internus muscles to reach the anterior surface of the quadratus femoris muscle.
Nerve to the piriformis
(Posterior branches, S1-2)
Nerves to pelvic diaphragm
Levator ani innervated by anterior branches of S3-4.
Coccygues muscle innervated by anterior branches of S4-5.
Given off in pelvis.
Blood Vessels of the gluteal region
All anastomose:
Superior and Inferior gluteal
Medial and lateral femoral circumflex
First perforating vessels
Superior Gluteal Artery
Branch of the posterior division of the internal iliac. Supplies 3 gluteus muscles and tensor fascia lata muscle. Appears above piriformis muscle with superior gluteal nerve.
Inferior Gluteal Artery
Terminal branch of the anterior division of the internal iliac. Supplies gluteus maximus, piriformis, and quadratus femoris. Appears below piriformis muscle with inferior gluteal nerve
Medial femoral circumflex artery
Branch of deep femoral artery. Supplies neck of femur and upper thigh. Appears between quadratus femoris and adductor magnus near hamstring muscle.
First perforating artery of deep femoral artery.
Pierces adductor magnus muscle adjacent to the linea aspera
Lateral femoral circumflex artery
Branch of deep femoral artery. Supplies neck of femur and upper thigh. Appears above the neck of the femur and lateral to the shaft, below greater trochanter.
Cruciate anastomosis
Cross shaped anastomoses around hip joint to maintain blood supply to hip throughout range of motion. Consists of:
Inferior gluteal vessels
Medial femoral circumflex vessels
First perforating vessels
Lateral femoral circumflex vessels
Hamstring muscles
Insert on tibia and fibula. Extend thigh at hip and flex leg at knee.
Semimembranous muscle
Semitendinous muscle
Biceps femoris muscle
Semimembranous muscle
Origin: Ischial Tuberosity
Inserts: Medial condyle of tibia. Sends collagen fibers across back of knee to form oblique popliteal ligament.
Action: Extends thigh at hip, flexes leg at knee.
Innervation: Tibial Division of sciatic nerve.
Semitendonous muscle
Origin: Ishcial tuberosity
Inserts: On anterior/medial aspect of tibia below medial condyle of tibia. Forms part of pes anserinus.
Action: Extends thigh at hip, flexes leg at knee.
Innervation: Tibial division of sciatic nerve
Biceps femoris muscle
Origin: Long head - Ischial tuberoscity
Short head - Linea aspera and lateral intermuscular septum
Insertion: head and neck of fibula
Action: Extends thigh at hip, flexes leg at knee.
Innervation: Long head - tibial division of sciatic
Short head - fibular division of sciatic
Boundaries of popliteal fossa
Superior/Medial: Semmimembranous and semitendinous muscles
Superior/Lateral: Biceps femoris muscle
Inferior: 2 heads of gastrocnemius muscle
Roof: Deep fascia
Floor: Popliteal surface of femur, back of knee joint, and popliteus muscle
Contents of popliteal fossa
Tibial nerve, Common fibular nerve, and popliteal vessels. Vessels enter deep portion of fossa through adductor canal and hiatus in adductor magnus muscle. Vein is more superficial.
Superior genicular arteries
Branchs of the popliteal artery. 1 medial, one lateral. Go immediately
above corresponding condyles of the femur and right on the bone.
Inferior genicular arteries
Branches of the popliteal artery. One medial, one lateral.
Medial - Parallel the upper border of the popliteus muscle to pass between medial collateral ligament and tibia.
Lateral - travel horizontally to pass under the lateral collateral ligament of knee joint
Middle gencular artery
Branch of popliteal artery. Enters knee joint directly
Popliteal Artery
Name of femoral artery after it emerges from the adductor hiatus (of the adductor magnus muscle). Terminate by dividing into anterior and posterior tibial arteries.
Pes Anserinus
Insertion of conjoined tendons of 3 muscles:
Sartorius, gracilis, semitendinosus.