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LEA 2 Midterm 1 (Gluteal/ anterior thigh/ medial thigh)

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Match each gluteal muscle to its origin.

Gluteus Maximus = Posterior Ilium/Crest, sacrum, coccyx, sacrotuberous ligament, fascia lata Gluteus Minimus = Lateral Ilium (Between ant/inf. gluteal lines) Gluteus Medius = Lateral Ilium (Between anterior/post gluteal lines) Tensor fascia latae = Iliac crest/ Lateral ASIS/ Deep fascia lata

Match each gluteal muscle to its insertion

Gluteus Maximus = IT band (Lateral intermuscular septum: superficial 2/3); Gluteal tuberosity (Deep distal 1/4) Gluteus Medius = Greater trochanter (lateral) Gluteus Minimus = Greater trochanter (anterolateral aspect) Tensor Fascia Latae = IT band

Match each muscle to its action

Gluteus Maximus = Extend and laterally rotate the thigh Gluteus Medius = Abduct and medially rotate the thigh Gluteus Minimus = Abduct and medially rotate the thigh Tensor Fascia latae = Abduct/medially rotate the thigh; Stabilize and steady the hip and knee joints

Match each deep gluteal muscle to its origin

Piriformis = Anterior surface of sacrum Superior Gemellus = Ischial spine Obturator Internus = Obturator membrane/ Boney margins of obturator foramen Inferior Gemellus = Superior aspect of ischial tuberosity

Match each deep gluteal muscle to its insertion

Piriformis = Superior aspect of the greater trochanter Superior Gemellus = Medial aspect of the greater trochanter Obturator Internus = Medial aspect of the greater trochanger Inferior Gemellus = Medial aspect of the greater trochanter

Match the deep gluteal muscles to their insertion/ origin

Quadratus Femoris = O: Lateral aspect of ischial tuberosity Obturator Externus = O: External obturator membrane/ Boney margins of obturator foramen (pubis/ischium) Quadratus Femoris = I: Quadrate tubercle in the intertrochanteric crest Obturator Externus = I: Trochanteric fossa of the medial surface of the greater trochanter

What deep gluteal muscles adduct and laterally rotate the thigh?

Quadratus Femoris and Obturator externus

The superior gemellus, obturator internus and inferior gemellus are known as the triceps coxae

True

What innervates the gluteus maximus

Inferior gluteal nerve (L5-S2)

What innervates the gluteus medius and gluteus minimus?

Superior gluteal nerve (L4-S1)

What innervates the piriformis muscle?

Nerve to piriformis (L5-S2)

What lies on the anterior aspect of piriformis

The sacral plexus

The most important function of gluteus medius and minimus is to steady the pelvis when the contralateral leg is off the ground

True

What does a positive Trendelenburg test display?

Injury to the gluteus minimus and gluteus medius (superior gluteal nerve)

Which of the following is not a bursa of the gluteal/ hip region

Suprapatellar bursa (Between the quadricep tendon and femur)

Which muscle exits through the greater trochanter?

Piriformis

Which muscle exits through the lesser sciatic foramen?

Obturator internus muscle

What nerve is compressed in Piriformis syndrome?

Sciatic nerve

The pudendal nerve exits through the lesser sciatic foramen to reenter through the greater sciatic foramen

False

Match each anterior thigh muscle (Flexor of the thigh/hip joint) to its origin

Iliopsoas = Iliac fossa/ lumbar vertebrae Sartorius = ASIS Rectus Femoris = AIIS/ Groove over acetabulum N/A = N/A

Match each anterior thigh muscle to its origin (Extensors of the leg and knee joint)

Vastus Lateralis = Anterior inferior border of the greater trochanter/ gluteal tuberosity/ lateral lip of linea aspera Vastus Intermedius = Anterior, lateral surface of the femur (linea aspera) Vastus Medialis = Spiral line/ medial lip of linea aspera/medial supracondylar ridge N/A = N/A

Which artery is a part of the trochanteric and cruciate anastomoses?

Inferior gluteal artery

The anterior division of the lumbar plexus lies more anteriorly and the posterior division lies more posteriorly.

False

The femoral nerve (L2-L4) divides into 2 divisions 1 cm inferior to the inguinal ligament.

True

The posterior division of femoral nerve is largely sensory and the anterior division is largely motor

False

What structure does not enter the adductor canal?

Femoral nerve

The superior gluteal artery is part of the trochanteric anastomosis

True

What provides sensory innervation to the skin overlying the femoral triangle

Genitofemoral nerve (L1-L2)

Medial circumflex branch of profunda is posterior to the femur.

True

The lateral circumflex branch of profunda femoris is deep to rectus femoris.

True

Which of the following borders of the femoral triangle is not properly matched with its structure?

Medial: fascia lata

What structure is not formed by the aponeurosis of the external oblique?

Sacrotuberous ligament

Which of the following is not a border of the adductor canal?

All of the following are borders of the adductor canal

The fascia lata envelops sartorius

False

What muscles does the anterior obturator branch travel deep to?

A & C

Which muscle is not innervated by the anterior branch of the obturator nerve?

Adductor magnus

What muscle does the posterior division of the obturator nerve travel posterior to?

Adductor brevis

Which muscle is not innervated by the posterior branch of the obturator nerve?

Adductor longus

The profunda femoris artery can be found in the posterolateral surface of the femoral artery

True

The profunda femoris artery is 5-8 centimeters from the inguinal ligament

False

Which muscle is not a border of the profunda femoris artery

Deep to profunda: rectus femoris

Where does the profunda femoris terminate?

The 4th perforating artery

What do the perforating arteries of the profunda supply?

The posterior thigh

The medial circumflex artery may branch from the femoral artery 20% of the time

True

Which branch is part of the medial circumflex femoral branch?

A & B

What are the branches of the lateral circumflex femoral artery?

Ascending branch (trochanteric anastomosis), transverse branch (cruciate anastomosis), descending branch (genicular anastomosis)

Match each medial thigh muscle to its origin

Pectineus = Superior pubic ramus (pectin pubis) Adductor Longus = Pubis (inferior to the pubic crest) Adductor brevis = Pubis (inferior ramus) Adductor magnus = Ischial tuberosity

Match each muscle to its insertion site

Pectineus = Linea aspera (pectineal line) Adductor longus = Middle 1/3 of linea aspera Adductor brevis = Linea aspera (pectineal line) Adductor magnus = Adductor tubercle and Linea aspera

Which muscle is most commonly involved in groin injuries?

Adductor magnus

The superior gluteal, inferior gluteal and posterior cutaneous femoral nerves are part of the posterior division of the sacral plexus

True

Study Notes

Gluteal Muscles

  • Gluteus maximus: origin - gluteal surface of ilium, lumbar fascia, and sacrum; insertion - gluteal tuberosity of femur
  • Gluteus medius: origin - gluteal surface of ilium; insertion - greater trochanter of femur
  • Gluteus minimus: origin - gluteal surface of ilium; insertion - greater trochanter of femur
  • Piriformis: origin - sacrum and gluteal surface of ilium; insertion - superior border of greater trochanter of femur
  • Superior gemellus: origin - ischial spine; insertion - medial border of greater trochanter of femur
  • Obturator internus: origin - internal surface of obturator membrane and surrounding bone; insertion - medial border of greater trochanter of femur
  • Inferior gemellus: origin - ischial tuberosity; insertion - medial border of greater trochanter of femur

Actions of Gluteal Muscles

  • Gluteus maximus: extends and laterally rotates the thigh
  • Gluteus medius: abducts and medially rotates the thigh
  • Gluteus minimus: abducts and medially rotates the thigh
  • Piriformis: laterally rotates the thigh
  • Superior gemellus, obturator internus, and inferior gemellus: adduct and laterally rotate the thigh

Deep Gluteal Muscles

  • Superior gemellus, obturator internus, and inferior gemellus: known as the triceps coxae
  • Origin: superior gemellus - ischial spine; obturator internus - internal surface of obturator membrane and surrounding bone; inferior gemellus - ischial tuberosity
  • Insertion: superior gemellus, obturator internus, and inferior gemellus - medial border of greater trochanter of femur

Innervation

  • Gluteus maximus: innervated by the inferior gluteal nerve
  • Gluteus medius and gluteus minimus: innervated by the superior gluteal nerve
  • Piriformis: innervated by the nerve to piriformis

Functional Importance

  • Gluteus medius and minimus: steady the pelvis when the contralateral leg is off the ground
  • A positive Trendelenburg test displays weak gluteus medius and minimus

Other Muscles and Structures

  • Anterior thigh muscle (Flexor of the thigh/hip joint): iliopsoas muscle; origin - lumbar vertebrae and iliac fossa
  • Anterior thigh muscle (Extensor of the leg and knee joint): quadriceps muscle; origin - femur and tibia
  • Muscle exiting through the greater trochanter: piriformis
  • Muscle exiting through the lesser sciatic foramen: tendon of obturator internus
  • Nerve compressed in Piriformis syndrome: sciatic nerve
  • Pudendal nerve: exits through the lesser sciatic foramen to reenter through the greater sciatic foramen

Blood Supply

  • Superior gluteal artery: part of the trochanteric anastomosis
  • Medial circumflex branch of profunda: posterior to the femur
  • Lateral circumflex branch of profunda: deep to rectus femoris
  • Profunda femoris artery: lies in the posterolateral surface of the femoral artery
  • Termination of profunda femoris: terminates around the level of the femoral shaft
  • Perforating arteries of the profunda: supply the surrounding muscles and fascia

Adductor Canal

  • Anterior obturator branch travels deep to: adductor longus and brevis muscles
  • Muscle not innervated by the anterior branch of the obturator nerve: gracilis
  • Posterior division of the obturator nerve travels posterior to: adductor magnus muscle
  • Muscle not innervated by the posterior branch of the obturator nerve: pectineus

Other

  • Medial thigh muscle: adductor magnus; origin - ischial tuberosity and inferior pubic ramus
  • Muscle most commonly involved in groin injuries: adductor longus

Test your knowledge of gluteal muscles by matching each muscle to its origin. This quiz will help you learn about the anatomy of the gluteal region.

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