30 Questions
Which muscle abducts the thigh at the hip joint and tilts the pelvis when walking to permit the opposite leg to clear the ground?
Tensor Fascia Latae
What is the nerve supply of the Quadratus Femoris muscle?
Sacral plexus
Which muscle originates from the spine of the Ischium and acts as a lateral rotator of the thigh at the hip joint?
Superior Gemellus
What is the insertion point of the Gluteus Minimus muscle?
Anterior surface of the Greater Trochanter of the Femur
Which nerve supplies the Piriformis muscle?
1st & 2nd Sacral nerves
What action does the Obturator Internus muscle perform at the hip joint?
Laterally rotates the thigh
Through which structure does the Sciatic Nerve leave the buttock region?
Long head of the Biceps Femoris
Which nerve innervates the skin in the Popliteal fossa?
Posterior Cutaneous Nerve to the Thigh
In which region does the Sciatic Nerve usually give no branches?
Gluteal region
What is the relationship of the Common Peroneal Nerve to the Sciatic Nerve in the gluteal region?
It leaves the Sciatic Nerve high in the Pelvis
Which structure does the Posterior Cutaneous Nerve to the Thigh pass downward on?
Sciatic nerve
Where does the Posterior Cutaneous Nerve to the Thigh enter the gluteal region?
Above Piriformis muscle
What structure forms an entrance into the Perineum from the Gluteal region?
Sacrotuberous ligament
Which ligament connects the back of the Sacrum to the Ischial tuberosity?
Sacrotuberous ligament
What provides an exit from the Pelvis into the Gluteal region?
Greater Sciatic Foramen
Which nerve exits the Greater Sciatic Foramen?
Sciatic Nerve
What arteries and veins exit through the Greater Sciatic Foramen?
Superior & Inferior Gluteal Arteries & Veins
Which foramen provides an entrance into the Perineum from the Gluteal region?
Lesser Sciatic Foramen
What is the most common cause of osteoarthritis (OA) in the hip joint?
Auto collisions
What does stiffness in the hip joint caused by osteoarthritis result from?
Reflex spasm of surrounding muscles
How is deformity initially produced in osteoarthritis of the hip joint?
Muscle spasm
What is the primary cause of congenital hip dislocation (CHD) in children?
Abnormal formation of the hip joint during fetal development
Which factor is NOT listed as a contributing factor to congenital hip dislocation (CHD)?
Genetic predisposition
What is another term for Congenital Acetabular Dysplasia?
Developmental Dysplasia of the Hip
Which artery provides the main blood supply to the Head of the Femur?
Superior Gluteal artery
What is the main function of the Cruciate Anastomosis?
Connects the Internal iliac and Femoral arteries
Which artery enters the gluteal region through the lower part of the Greater Sciatic Foramen?
Inferior Gluteal artery
Where does the Venous Drainage of the Gluteal Region ultimately lead to?
Internal Iliac vein
Which arteries form part of the Trochanteric Anastomosis?
Superior & Inferior Gluteal arteries, and Medial & Lateral Femoral Circumflex arteries
What is the significance of Nutrient arteries passing along the Femoral neck beneath the capsule?
To supply nutrients to the Head of the Femur
Study Notes
Gluteus Minimus
- Origin: Outer surface of the Ilium
- Insertion: Anterior surface of the Greater Trochanter of the Femur
- Nerve Supply: Superior Gluteal nerve
- Action: Abducts thigh at Hip joint; tilts Pelvis when walking to permit opposite leg to clear the ground
Tensor Fasciae Latae
- Origin: Iliac crest
- Insertion: Iliotibial tract
- Nerve Supply: Superior Gluteal nerve
- Action: Assists Gluteus maximus in extending the knee joint
Quadratus Femoris
- Origin: Inner surface of the Obturator membrane
- Insertion: Upper border of the Greater Trochanter of the Femur
- Nerve Supply: Sacral plexus
- Action: Lateral rotator of the Thigh at Hip joint
Piriformis
- Origin: Anterior surface of the Sacrum
- Insertion: Upper border of the Greater Trochanter of the Femur
- Nerve Supply: 1st & 2nd Sacral nerves
- Action: Lateral rotator of Thigh at the Hip joint
Obturator Internus
- Origin: Inner surface of Obturator membrane
- Insertion: Upper border of the Greater Trochanter of the Femur
- Nerve Supply: Sacral plexus
- Action: Lateral rotator of the Thigh at Hip joint
Superior Gemellus
- Origin: Spine of Ischium
- Insertion: Upper border of the Greater Trochanter of the Femur
- Nerve Supply: Sacral plexus
- Action: Lateral rotator of the Thigh at Hip joint
Inferior Gemellus
- Origin: Ischial Tuberosity
- Insertion: Upper border of Greater Trochanter of the Femur
- Nerve Supply: Sacral plexus
- Action: Lateral rotator of the Thigh at the Hip joint
Nerve Supply of the Gluteal Region
- Posterior Cutaneous Nerve of the Thigh
- Superior & Inferior Gluteal Nerve
- Nerve to the Quadratus Femoris
- Pudendal Nerve
- Nerve to the Obturator Internus
Sciatic Nerve
- A branch of the Sacral plexus (L4 & 5; S1, S2, & S3)
- Consists of the Tibial & Common Peroneal Nerves bound together with fascia
- Emerges from the Pelvis through the lower part of the Greater Sciatic Foramen
- Curves downward & laterally, lying successively on the root of the Ischial spine, the Superior Gemellus, the Obturator Internus, the Inferior Gemellus, & the Quadratus Femoris to reach the back of the Adductor Magnus muscle
Posterior Cutaneous Nerve of the Thigh
- A branch of the Sacral plexus
- Enters the gluteal region through the lower part of the Greater Sciatic Foramen below the Piriformis muscle
- Passes downward on the posterior surface of the Sciatic nerve & runs down the back of the Thigh beneath the deep fascia
- Innervates the skin in the Popliteal fossa
Sacrotuberous Ligament
- Connects the back of the Sacrum to the Ischial tuberosity
Posterior View Sacrospinous Ligament
- Connects the back of the Sacrum to the Spine of the Ischium
Foramina of the Gluteal Region
- Greater Sciatic Foramen
- Lesser Sciatic Foramen
Greater Sciatic Foramen
- Formed by the Greater Sciatic Notch of the Hip bone & the Sacrotuberous & Sacrospinous Ligaments
- Provides an exit from the Pelvis into the Gluteal region
- Contents:
- Piriformis
- Sciatic Nerve
- Posterior Cutaneous Nerve of the Thigh
- Superior & Inferior Gluteal Nerves
- Nerves to the Obturator Internus & Quadratus Femoris
- Pudendal nerve
- Superior & Inferior Gluteal Arteries & Veins
- Internal Pudendal Artery & Vein
Lesser Sciatic Foramen
- Formed by the Lesser Sciatic Notch of the Hip bone & the Sacrotuberous & Sacrospinous Ligaments
- Provides an entrance into the Perineum from the Gluteal region
Arthritis of the Hip Joint
- Osteoarthritis (OA), the most common disease of the hip joint in the adult, causes pain, stiffness, & deformity
- Pain may be in the hip joint itself or referred to the knee (Obturator nerve supplies both joints)
- Stiffness is caused by the pain & reflex spasm of the surrounding muscles
- Deformity is flexion, adduction, & external rotation & is produced initially by muscle spasm & later by muscle contracture
Congenital Hip Dislocation (CHD)
- A.k.a. Congenital Acetabular Dysplasia Developmental Dysplasia of the Hip
- Condition where the ‘Ball & Socket' joint of the hips doesn't properly form in babies & young children
- Complete or partial displacement of the Femoral head out of the Acetabulum
- Occurs when a child is born with an UNSTABLE HIP
- Caused by abnormal formation of the hip joint during their early stages of fetal development
- Contributing factors:
- Low levels of Amniotic Fluid (AF) in the Uterus
- Breech presentation
- A family history of the condition
Inferior Gluteal Artery
- Branch of the Internal Iliac artery
- Enters the gluteal region through the lower part of the Greater Sciatic Foramen, below the Piriformis
- Divides into numerous branches that are distributed throughout the Gluteal region
Trochanteric Anastomosis
- Provides the main blood supply to the Head of the Femur
- Nutrient arteries pass along the Femoral neck beneath the capsule
- The following arteries take part in the anastomosis:
- Superior & Inferior Gluteal arteries
- Medial & Lateral Femoral Circumflex arteries
Test your knowledge on the anatomy of the sacrotuberous and sacrospinous ligaments, as well as the foramina of the gluteal region. Identify important structures and their connections in the posterior view anatomy.
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