Gluteal Region Anatomy and Hip Joint Motions

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Questions and Answers

What is the primary function of the ascending cervical arteries in the hip joint anatomy?

  • To facilitate pelvic rotation during gait
  • To form the intra-articular ring via the artery of ligamentum teres (correct)
  • To innervate the major nerves in the hip area
  • To supply blood to the gluteal muscles

Which of the following statements accurately describes pelvic rotation during gait?

  • It occurs predominantly in the frontal plane
  • It is responsible for lateral stability of the hip joint
  • It occurs in the transverse plane with approximately 4 degrees of movement (correct)
  • It involves rotation of approximately 10 degrees

What is the clinical significance of the arterial supply to the femoral head?

  • It is sometimes inadequate in cases of displaced fractures (correct)
  • It ensures adequate blood supply even after femoral neck fractures
  • It solely depends on the external rotators for its supply
  • It has no impact on the functionality of hip abductors

During normal gait, what angle of pelvic list is observed?

<p>Approximately 5 degrees medially and laterally (C)</p> Signup and view all the answers

Which muscles are primarily involved in the external rotation of the hip joint?

<p>Gluteal muscles and external rotators (A)</p> Signup and view all the answers

Which structure exits from the gluteal region to the perineum through the lesser sciatic foramen?

<p>Internal pudendal vessels (D)</p> Signup and view all the answers

Which plane of motion includes extension and flexion at the hip?

<p>Sagittal plane (D)</p> Signup and view all the answers

What action is primarily performed by the gluteus medius during hip movement?

<p>ABduction and internal rotation (A)</p> Signup and view all the answers

What is the main action associated with the quadratus femoris muscle?

<p>External rotation of the hip (B)</p> Signup and view all the answers

Which muscle's weakness is most commonly linked to the Trendelenburg sign?

<p>Gluteus medius (B)</p> Signup and view all the answers

Which of the following nerves innervates the gluteus maximus muscle?

<p>Inferior gluteal nerve (D)</p> Signup and view all the answers

What structure is formed by the combination of the obturator foramen and the obturator membrane?

<p>Obturator canal (D)</p> Signup and view all the answers

What is the primary role of the gluteal muscles in relation to the pelvis and knee?

<p>To stabilize the pelvis and knee (B)</p> Signup and view all the answers

Which nerve primarily innervates the posterior thigh?

<p>Sciatic nerve (A)</p> Signup and view all the answers

What is the primary role of the interosseous ligament in the sacroiliac joint?

<p>To stabilize the joint with the strongest support (D)</p> Signup and view all the answers

What is the primary role of the medial and lateral circumflex femoral arteries?

<p>Supply blood to the hip joint (D)</p> Signup and view all the answers

Which of the following ligaments is NOT involved in stabilizing the sacroiliac joint?

<p>Costocaval ligament (D)</p> Signup and view all the answers

Which ligament provides the strongest support for the hip joint?

<p>Ischiofemoral ligament (C)</p> Signup and view all the answers

Which structure contributes to the formation of the greater sciatic foramen?

<p>The greater sciatic notch and sacrotuberous ligament (C)</p> Signup and view all the answers

Which motion at the hip joint requires approximately 30° of extension for normal gait?

<p>Extension (A)</p> Signup and view all the answers

What vascular structure passes through the greater sciatic foramen?

<p>Inferior gluteal artery (A)</p> Signup and view all the answers

Which joint types articulate the pelvis and sacrum?

<p>Synovial and cartilaginous joints (B)</p> Signup and view all the answers

What provides the main blood supply to the gluteal region?

<p>Internal iliac artery (B)</p> Signup and view all the answers

What is the approximate range of internal and external rotation at the hip joint?

<p>45° (D)</p> Signup and view all the answers

Which muscle is primarily associated with the external rotation and stabilization of the hip?

<p>Quadratus femoris (A), Obturator internus (D)</p> Signup and view all the answers

What is the anatomical significance of the lesser sciatic foramen?

<p>It connects the pelvis to the gluteal region (A)</p> Signup and view all the answers

Which nerve may provide sensory input to the hip joint?

<p>Nerve to quadratus femoris (B)</p> Signup and view all the answers

Which muscle group is mainly associated with external rotation of the hip joint?

<p>External rotators (A)</p> Signup and view all the answers

Which artery is primarily responsible for intracapsular supply to the head of the femur?

<p>Medial circumflex femoral artery (C)</p> Signup and view all the answers

What is the main innervation source for the Obturator externus muscle?

<p>Obturator nerve (D)</p> Signup and view all the answers

Which of the following statements about the hip joint is incorrect?

<p>The hip joint does not permit any axial rotation (C)</p> Signup and view all the answers

Which muscle has origins from the ischial spine and ischial tuberosity?

<p>Gemellus inferior (C)</p> Signup and view all the answers

Which nerve does NOT innervate the gluteus maximus?

<p>Pudendal nerve (B), Superior gluteal nerve (C)</p> Signup and view all the answers

Which of the following muscles assists the obturator internus?

<p>Gemellus superior (B)</p> Signup and view all the answers

What is the origin of the Piriformis muscle?

<p>Sacrum (A)</p> Signup and view all the answers

Which muscles are innervated by the inferior gluteal nerve?

<p>Gluteus maximus (C)</p> Signup and view all the answers

What common action do the muscles represented by the sacral and lumbar plexi share?

<p>External rotation of the thigh (B)</p> Signup and view all the answers

Flashcards

Quadratus Femoris Action

External rotation and stabilization of the hip.

Quadratus Femoris Innervation

L4, L5, S1

Sacroiliac Joint

A joint between the sacrum and the pelvic bones, allowing limited movement.

Sacroiliac Ligaments (Anterior, Posterior, Interosseous)

Strong ligaments that further stabilize the sacroiliac joint, connecting specific points on the sacrum and pelvis.

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Pubic Symphysis

A joint between the right and left pubic bones, made of fibrocartilage, allowing minimal movement.

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Greater Sciatic Foramen

A large opening between the pelvis and the gluteal region, formed by the greater sciatic notch and ligaments.

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Lesser Sciatic Foramen

A small opening near the greater sciatic foramen, also providing a pathway for structures to pass through.

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Obturator Foramen

A bony canal formed by the ischium and pubis, providing passage for nerves and vessels.

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Hip Joint

The articulation between the femur and the pelvis, permitting a wide range of motion.

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Gluteal Muscles

Muscles located in the gluteal region, responsible for hip extension, abduction, and external rotation.

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Hip extension/flexion

The movement of the hip joint in the sagittal plane, where the leg moves forwards and backwards.

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Hip abduction/adduction

The movement of the hip joint in the frontal plane, where the leg moves away from and towards the midline of the body.

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Hip internal/external rotation

The movement of the hip joint in the transverse plane, where the leg rotates inwards and outwards.

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Gluteus maximus

A major muscle of the buttocks responsible for hip extension, external rotation, and stabilization of the pelvis and knee.

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Gluteus medius

A muscle that helps with hip abduction and internal rotation, keeping the pelvis stable during single-leg stance.

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External rotators of the hip

A group of muscles responsible for external rotation of the hip.

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Extracapsular Arterial Ring

A ring of arteries at the base of the femoral neck, formed by the medial and lateral circumflex arteries. It provides the main blood supply to the femoral head.

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Intra-articular Arterial Ring

A smaller arterial ring within the hip joint, supplying the ligamentum teres. It's usually derived from the obturator or medial circumflex arteries.

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Pelvic Rotation during Gait

The motion of the pelvis in the transverse plane during gait. It involves approximately 4 degrees of anterior and posterior rotation.

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Pelvic List during Gait

The motion of the pelvis in the frontal plane during gait. It involves approximately 5 degrees of medial and lateral tilting.

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Hip Joint's Role in Gait

The movement of the hip joint during gait plays a vital role in ensuring a smooth transition of the body's center of mass. Smooth gait depends on coordinated pelvic motions.

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What does the sciatic nerve innervate?

The sciatic nerve innervates the posterior thigh, lower leg, and foot. It's a major nerve that helps with movement and sensation in these areas.

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What are the main arteries supplying the hip joint?

The hip joint receives blood supply from several arteries, including branches of the internal iliac artery and femoral arteries.

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Where do the superior and inferior gluteal arteries pass through?

The superior and inferior gluteal arteries, both branches of the internal iliac artery, pass through the greater sciatic foramen.

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How are different parts of the hip joint supplied with blood?

The head of the femur is supplied by the posterior branch of the obturator artery, while the rest of the hip joint gets blood from the medial and lateral circumflex femoral arteries.

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What is the range of motion at the hip joint?

The hip joint allows for about 40 degrees of abduction, 25 degrees of adduction, 120 degrees of flexion, and 30 degrees of extension.

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What ligaments help to support the hip joint?

Strong ligaments like the iliofemoral, ischiofemoral, and pubofemoral ligaments provide stability to the hip joint.

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How much flexion and extension is required for walking?

During walking, the hip joint needs approximately 30 degrees of flexion and 10 degrees of extension.

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What is the hip joint capsule made of?

The hip joint's capsule is made up of a fibrous connective tissue layer that surrounds and protects the joint.

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Study Notes

Gluteal Region Anatomy

  • The gluteal region is a complex anatomical area encompassing bones, joints, attachments, muscles, nerves, and vascular structures.

  • The region includes the lumbar spine, sacrum, pelvis (ilium, ischium, pubis), femur, sacroiliac joint, hip joint, and the pubic symphysis.

  • Key foramina within the gluteal region include the obturator, greater sciatic, and lesser sciatic foramina.

  • The sacroiliac joint is a cartilaginous joint characterized by limited movement and supported by powerful ligaments (anterior sacroiliac, posterior sacroiliac, interosseous). Further stabilization is provided by sacrospinous and sacrotuberous ligaments

  • The pubic symphysis is a fibrocartilage joint where the pubic bones articulate, also supported by ligaments.

Hip Joint Motions

  • The hip joint allows for various motions in different planes.

  • Sagittal plane motions include flexion and extension.

  • Frontal plane motions include abduction and adduction.

  • Transverse plane motions include internal and external rotation.

  • Circumduction encompasses all three planes.

Muscles of the Gluteal Region

  • Gluteal muscles include gluteus maximus, gluteus medius, and gluteus minimus.
  • External rotator muscles are piriformis, gemelli, quadratus femoris, obturator internus, and obturator externus.
  • Each muscle has specific origins, insertions, actions (e.g., extension, abduction, rotation), antagonists (opposing muscle groups), and innervation (nerves that control them).

Nerves of the Gluteal Region

  • Nerves of this area emerge from lumbar and sacral plexuses.
  • There are branches for the major muscles and sensory (cutaneous) nerves.
  • Key nerves include the superior gluteal, inferior gluteal, obturator, sciatic, and pudendal nerves.
    • The sciatic nerve is the major nerve, important for posterior thigh, lower leg and foot.
    • The pudendal nerve innervates the 'naughty bits'.
  • Specific variations in the relation of the sciatic nerve to the piriformis muscle are recognized.
  • Safe areas for injection can help to avoid nerve damage.

Vascular Structures of the Gluteal Region

  • Blood supply to the gluteal region comes from superior gluteal artery and inferior gluteal artery, both branches of the internal iliac artery.
  • These vessels travel through the greater sciatic foramen.
  • Anastomosis (joining) occurs between the vessels.
  • The femoral head receives blood supply from both intra and extra-capsular structures, primarily through branches of the obturator or medial circumflex arteries, which are crucial for the head's blood supply.

Clinical Significance

  • Various conditions like fractures, dislocations, osteoarthritis (OA), developmental dysplasia of the hip (DDH), and bursitis can affect the gluteal region.
  • The understanding of gluteal structures is vital for diagnosis and management of such conditions.

Other important findings

  • Pelvic motion during gait is important, with rotation and list noted in the transverse and frontal planes respectively.

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