Pelvic and Gluteal Regions
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| The nerves of the lumbosacral plexus pass through or arise within the __________? Many of these supply the lower limb. | pelvic cavity
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| The arteries that supply the lower limb arise within the __________? | pelvic cavity
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| The muscles of the pelvic regions that act upon the lower extremity are ________ ________ and ________ ________. | hip joint, thigh flexors
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| What is the origin of the iliacus muscle? | Superior iliac fossa (superior 2/3 and inner lip of the iliac crest)
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| What is the insertion of the iliacus muscle? | Lesser trochanter of the femur
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| The iliacus muscle travels ________ and passes ________ over the hip joint and through the ________ ________ to its insertion. | inferiorly, anteriorly, muscular lacuna
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| What is the action of the iliacus muscle? | Flexes the thigh
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| What is the nerve supply of the iliacus muscle? | Femoral nerve; from dorsal divisions of ventral rami L-2, L-3 & L-4
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| What is the arterial supply of the iliacus muscle? | Muscular branches of common, internal and external iliac arteries
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| What is the origin of the psoas major muscle? | T-12 through L-5 vertebrae (bodies, intervertebral discs and transverse processes)
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| What is the insertion of the psoas major muscle? | Lesser trochanter of the femur
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| The psoas major muscle travels ________, joins the tendon of iliac muscle and passes ________ to the hip joint and through the ________ ________ to its insertion. | inferolaterally, anterior, muscular lacuna
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| What is the action of the psoas major muscle? | Flexes the thigh
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| What is the nerve supply for the psoas major muscle? | Dorsal divisions of ventral rami L-2, L-3, & L-4, as branches exit spinal canal
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| What is the arterial supply of the psoas major muscle? | Muscular branches of common, internal and external iliac arteries
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| The iliac muscle and psoas major muscle are often considered one, and are called the ________ ________. They function to ________ the thigh. | iliopsoas muscle, flex
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| The Levator Ani muscle is a broad muscular sheet composed of ________ muscles. It forms a muscular sling that supports the ________ ________. | three, abdominopelvic viscera
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| What is the origin of the pubococcygeus muscle? | Posterior aspect of the pubic body and the tendinous arch of the obturator fascia
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| What is the insertion of the pubococygeus muscle? | Annococcygeal raphe
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| The puborectalis msucle is the most ________ portion of the pubococcygeus muscle. | medial
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| What is the origin of the iliococcygeus muscle? | Ischial spine and the tendinous arch of the obturator fascia
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| What is the insertion of the iliococcygeus muscle? | Annococcygeal raphe
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| What is the origin of the ischiococcygeus muscle (coccygeus)? | Ischial spine
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| What is the insertion of the ischiococcygeus muscle (coccygeus)? | Inferior end of the sacrum and coccyx
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| What are the three muscles of levator ani muscle? | Pubococcygeus, iliococcygeus, ischiococcygeus (coccygeus)
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| What is the action of the levator ani muscle? | Acting together these three muscles raise the pelvic floor, assist the ab muscle in compression of abdominal & pelvic contents. They resist intra-abdominal pressure. They are important in forced expiration, coughing, vomiting, urination, & defecation.
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| What is the nerve supply of the levator ani muscle? | Nerve to the levator ani (S-4 and S-5) and inferior rectal nerve (branch of the pudendal nerve)
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| What is the arterial supply of the levator ani muscle? | Inferior gluteal artery
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| All nerve branches in the lumbar plexus, sacral plexus, and coccygeal plexus are ________ ________. | ventral rami
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| The lumbar plexus consists of the ventral rami of ________ through ________ with contributions from the ventral rami of ________ and ________. | L-1, L-3, T-12, L-4
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| Most of the lumbar plexus's ventral rami have ________ and ________ divisions. | dorsal and ventral
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| The lumbar plexus lies within the ________ ________ muscle just ________ to the ________ ________ of the ________ ________. | psoas major, anterior, transverse processes, vertebral bodies
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| Which nerve is a sensorimotor nerve with cutaneous supply only in the lower limb and is not usually considered part of the lumbar plexus? | Subcostal nerve
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| The subcostal nerve is a branch of ________ that supplies the superior anterolateral aspect of the thigh. | T-12
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| Which nerve is a sensorimotor n. with cutaneous supply only in the lower limb, pierces the psoas major m. near the kidney & passes within the ab wall, inferior to the subcostal n. to reach the posterolateral gluteal skin near the iliac crest, posteriorly? | Iliohypogastric nerve
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| The iliohypogastric nerve comes from the ________ ________of ________(may have a contribution from ________). | ventral division, L-1, T-12
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| Which n. is a sensorimotor n. with cutaneous supply only in the lower limb and follows a course similar to the iliohypogastric n., but continues ant. along the inguinal lig. & through the inguinal canal to reach the skin of the superior medial thigh? | Ilioinguinal nerve
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| The ilioinguinal nerve comes from the ________ ________ of ________ (may have a contribution from ________). | ventral division, L-1, T-12
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| Which n. is a sensorimotor nerve with cutaneous supply only in the lower limb and pierces the psoas major muscle anteriorly and enters the thigh dorsal to the inguinal ligament, near its center? | Genitofemoral nerve
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| The genitofemoral nerve comes from the ________ ________ of ________ & ________. | ventral divisions, L-1, L-2
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| What branch passes medially, along the inguinal ligament to supply part of the external genitalia? | Genital branch of the genitofemoral nerve
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| What branch passes deep ot the inguinal ligament with the femoral a. through the vascular lacuna to supply the skin of the anterior superior thigh and may aid or replace the intermediate femoral cutaneous nerve? | Femoral branch of the genitofemoral nerve
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| Sensory n w/ cutaneous supply only in the LL that pierces the psoas major lat. & courses along the iliac fossa ant. to the iliac to enter the thigh anterolaterally, near the attachment of the ing. lig. on the ASIS & supplies anterolateral aspect of thigh? | Lateral femoral cutaneous nerve
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| Which nerve usually passes deep to the inguinal ligament but may pass through it? | Lateral femoral cutaneous nerve
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| The lateral femoral cutaneous nerve comes from the _______ _______ of _______ & _______. | dorsal divisions, L-2, L-3
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| Which nerves have branches that usually pass directly into the psoas major muscle belly, without uniting, to supply motor innervation to the muscle? These branches do not exit the pelvis and are not branches of the femoral nerve. | Nerves to psoas major muscle
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| Nerves to psoas major muscle come from the _______ _______ of _______ through _______. | dorsal divisions, L-2, L-4
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| T or F: The branches of the nerves to psoas major muscle do not exit the pelvis. | True
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| T or F: Nerves to psoas major muscle are branches of the femoral nerve. | False
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| Which nerve is a small branch from the femoral nerve (dorsal divisions of L-2 through L-4) and passes directly to the iliacus muscle without exiting the pelvis to provide it with motor innervation? | Nerve to iliacus muscle
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| The nerve to iliacus muscle is a small _______ from the _______ _______, _______ _______ of _______ through _______. | branch, femoral nerve, dorsal divisions, L-2, L-4
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| The femoral nerve is a _______ nerve; from the _______ _______ of _______ through _______. | sensorimotor, dorsal divisons, L-2, L-4
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| Which n. passes inferiorly intermediate to the psoas major & iliacus, enters the thigh by passing thru the muscular lacuna deep to the inguinal ligament near its midpoint to provide muscular br. to the thigh, articular branches to the hip & knee joints. | Femoral nerve
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| The femoral nerve gives rise to which cutaneous nerve branches? | Intermediate femoral cutaneous nerve(s)
Medial femoral cutaneous nerve(s)
Saphenous nerve
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| The intermediate femoral cutaneous nerve(s) come from _______ _______ _______ and _______. | dorsal divisions, L-2, L-3
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| What nerve supplies a long, thin area of the anterior aspect of the thigh? | Intermediate femoral cutaneous nerve(s) of the femoral nerve
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| The medial femoral cutaneous nerve(s) come from _______ _______ _______ and _______. | dorsal divisions, L-2, L-3
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| Which nerve supplies a long, thin area of the anteromedial aspect of the thigh? | Medial femoral cutaneous nerve(s) of the femoral nerve
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| The saphenous nerve comes from _______ _______ of _______ and _______. | dorsal divisions, L-3, L-4
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| What nerve supplies the medial 1/2 of the leg? | Saphenous nerve of the femoral nerve
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| Pierces psoas major muscle medially near linea terminalis, passes anteroinf. into lesser pelvis & passes thru obturator canal to provide muscular br. to the thigh, articular br. to the hip & knee joints & cutaneous br to small area of med aspect of thigh? | Obturator nerve
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| The obturator nerve is a _______ nerve; from the _______ _______ of _______ through _______. | sensorimotor, ventral divisions, L-2, L-4
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| Pierces psoas major med near linea terminalis, passes anteroinferiorly into lesser pelvis & passes thru obturator canal to provide muscular br. to thigh, articular br. to hip & knee joints and cutaneous branch to small area of the medial aspect of thigh? | Obturator nerve
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| The accessory obturator nerve is a _______ nerve that comes from the _______ _______ of _______ & _______. | sensorimotor, ventral divisons, L-3, L-4
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| The accessory obturator nerve is present in what percent of the population? | 8%
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| What's course parallels the obturator nerve and when present it provides muscular supply to pectineus muscle, an articular branch to the hip joint and joins the obturator nerve's cutaneous supply to the thigh? | Accessory obturator nerve
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| Part of the ventral ramus of L-4 and the entire ventral ramus of L-5 unite to form which large nerve which crosses the sacroiliac joint anteriorly at the pelvic brim and joins the sacral plexus? | Lumbosacral trunk
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| The lumbosacral trunk crosses which joint anteriorly? | Sacroiliac joint
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| The sacral plexus is formed by the _______ _______ of _______ through _______ with contributions from _______ _______ of _______ & _______. | ventral rami, L-5, S-3, ventral rami, L-4, S-4
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| What is roughly triangular in shape and passes inferiorly toward the greater sciatic foramen? | Sacral plexus
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| The superior gluteal nerve is a _______ nerve that comes from the _______ _______ of _______, _______, and _______. | motor, dorsal divisions, L-4, L-5, S-1
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| What exits the pelvis via the greater sciatic foramen and passes posterolaterally through the gluteal region to supply the gluteus minimus, gluetus medius and tensor fascia lata muscles? | Superior gluteal nerve
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| The inferior gluteal nerve is a _______ nerve that comes from the _______ _______ of _______, _______, and _______. | motor, dorsal divisions, L-5, S-1, S-2
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| What nerve exits the pelvis via the greater sciatic foramen inferior to the superior gluteal nerve and passes posterolaterally through the gluteal region to supply the gluteus maximus muscle? | Inferior gluteal nerve
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| The nerve to piriformis muscle comes from _______ _______ of _______ but may have contribution from _______ _______ of _______. | dorsal division, S-2, dorsal division, S-1
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| What passes directly into the piriformis muscle and does not exit the pelvis before entering the muscle? | Nerve to piriformis muscle
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| What is the major formation of the sacral plexus? | Sciatic nerve
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| The sciatic nerve is a _______ nerve that comes from the _______ _______ of _______ through _______ and the _______ _______ of _______ through _______. | sensorimotor, dorsal divisions, L-4, S-2, ventral divisions, L-4, S-3
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| What exits the pelvis via the greater sciatic foramen and usually continues as a single nerve to the lower thigh; however it may divide into its two component parts at any level? | Sciatic nerve
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| The common fibular nerve / common peroneal nerve is a _______ nerve that comes from the _______ _______ of _______, _______, _______, and _______. | sensorimotor, dorsal divisions, L-4, L-5, S-1, S-2
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| What is the lateral portion of the sciatic nerve that provides muscular innervation in the thigh and leg, articular innervation to the knee and proximal tibiofibular joints? | Common fibular nerve / Common peroneal nerve
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| What are the cutaneous nerve branches of the common fibular / common peroneal nerves? | 1. Superficial fibular nerve/ Superficial peroneal nerve
2. Deep fibular nerve / Deep peroneal nerve
3. Lateral cutaneous nerve of the calf
4. Sural communicating nerve
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| The superficial fibular nerve / superficial peroneal nerve is a _______ nerve that comes from the _______ _______ of _______, _______, & _______. | sensorimotor, dorsal divisions, L-4, L-5, S-1
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| What supplies part of the anterolateral aspect of the leg and ankle, and most of the dorsum of the foot? | Superficial fibular nerve / Superficial peroneal nerve
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| The deep fibular nerve / deep peroneal nerve is a _______ nerve that comes from the _______ _______ of _______, _______, & _______. | sensorimotor, dorsal divisions, L-5, S-1, S-2
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| What supplies the 1st webspace and adjacent sides of the 1st and 2nd toes? | Deep fibular nerve / Deep peroneal nerve
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| The lateral cutaneous nerve of the calf is a _______ nerve that comes from the _______ _______ of _______, _______, & _______. | sensory, dorsal divisions, L-5, S-1, S-2
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| What suppies the proximal 2/3 of the lateral aspect of the leg? | Lateral cutaneous nerve of the calf
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| The sural communicating nerve is a _______ nerve that comes from the _______ _______ of _______ & _______. | sensory, dorsal divisions, S-1, S-2
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| What passes inferiorly and joins the sural nerve? | Sural communicating nerve
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| The tibial nerve is a _______ nerve that comes from _______ _______ of _______, _______, _______, _______, & _______. | sensorimotor, ventral divisions, L-4, L-5, S-1, S-2, & S-3
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| What is the medial portion of the sciatic nerve that passes inferiorly through the leg, posterior to the medial malleolus and divides into its terminal branches, the medial and lateral plantar nerves, prior to entering the foot through the porta pedis? | Tibial nerve
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| What provides muscular innervation in the knee and leg, articular innervation to the knee and ankle joints? | Tibial nerve
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| What are the cutaneous nerve branches of the tibial nerve? | 1. Sural nerve
2. Medial calcaneal nerve
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| The sural nerve is a _______ nerve that comes from the _______ _______ of _______ & _______. | sensory, ventral divisions, S-1, S-2
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| What nerve supplies the small area of the psoterior leg, posterolateral aspect of hte ankle, the lateral aspect of the foot, and the lateral 1/2 of the 5th toe? | Sural nerve
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| The lateral calcaneal nerve is a _______ nerve that comes from _______ and _______ _______ of _______ & _______ because the sural communicating nerve joins the sural nerve. | sensory, ventral, dorsal, divisions, S-1, S-2
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| What supplies the lateral 1/2 of the calcaneal region? | Lateral calcaneal nerve
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| The medial calcaneal nerve is a _______ nerve that comes from the _______ _______ of _______ & _______. | sensory, ventral divisions, S-1, S-2
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| The posterior femoral cutaneous nerve is a _______ nerve that comes from _______ _______ of _______ and _______, and _______ _______ of _______ and _______. | sensory, dorsal divisions, S-1, S-2, ventral divisions, S-2, S-3
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| What nerve has dorsal divisions that lie close to the inferior gluteal nerve divisions and ventral divisions that lie close to the pudendal nerve divisions? | Posterior femoral cutaneous nerve
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| What nerve exits the pelvis via the greater sciatic foramen with the sciatic nerve and passes distally to the knee, anterior to the deep fascia, to supply cutaneous innervation to the posterior aspects of the thigh and calf? | Posterior femoral cutaneous nerve
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| The inferior cluneal nerves come from the _______ _______ of _______ & _______ and _______ _______ of _______ & _______. | dorsal divisions, S-1, S-2, ventral divisions, S-2, S-3
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| What nerves have small branches of the posterior femoral cutaneous nerve that arise near the exit point from the pelvis and provide cutaneous supply to the inferior gluteal region? | Inferior cluneal nerves
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| The perforating cutaneous nerve is a _______ nerve that comes from the _______ _______ of _______ & _______. | sensory, dorsal divisions, S-2, S-3
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| What nerve exits the pelvis by piercing the sacrotuberous ligament to supply cutaneous innervation to the small area of the inferior medial aspect of the buttock and medial gluteal fold? | Perforating cutaneous nerve
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| The pudendal nerve is a _______ nerve that comes from the _______ _______ of _______, _______, & _______. | sensorimotor, ventral divisions, S-2, S-3, S-4
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| What nerve exits the pelvis via the inferomedial part of the greater sciatic foramen, passes posterior to the sacrospinous ligament and re-enters the pelvis via the lesser sciatic foramen? | Pudendal nerve
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| What nerve supplies motor innervation to structures of the urogenital triangle and sensory innervation to the reproductive organs? | Pudendal nerve
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| The nerve to obturator internus and superior gemellus muscles is a _______ nerve that comes from the _______ _______ of _______, _______, & _______. | motor, ventral divisions, L-5, S-1, S-2
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| What nerve exits the pelvis via the greater sciatic foramen and reenters the pelvis via the lesser sciatic foramen, with the pudendal nerve? | Nerve to obturator internus and superior gemellus muscles
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| What nerve supplies motor innervation to obturator internus and superior gemellus mm. | Nerve to obturator internus and superior gemellus muscles
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| The nerve to quadratus femoris and inferior gemellus muscles is a _______ nerve that comes from the _______ _______ of _______, _______, and _______. | sensorimotor, ventral divisions, L-4, L-5, S-1
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| The nerve to quadratus femoris and inferior gemellus muscles exits the pelvis via what? | Greater sciatic foramen
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| What nerve to quadratus femoris and inferior gemellus muscles supplies motor innervation to quadratus femoris and inferior gemellus muscles, and articular innervation to the hip joint? | Nerve to quadratus femoris and inferior gemellus muscles
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| The pelvic splanchnic nerves are _______ fibers from _______, _______, and _______. | parasympathetic, S-2, S-3, S-4
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| What nerves supply the pelvic viscera (organs which can't be removed without resection - bladder, rectum, and internal reproductive organs) | Pelvic splanchnic nerves
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| The coccygeal plexus is formed by the _______ _______ of _______, _______, and _______ which provide muscular and cutaneous innervation. | ventral rami, S-4, S-5, Co-1
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| The sacral muscular branches come from _______ and supplies _______ innervation to _______ _______, _______, and _______ _______ _______ muscles. | S-4, motor, levator ani, coccygeus, external anal sphincter
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| What comes from all rami and supply sensory innervation to the skin over the cocyx and posterior to anus? | Cutaneous branches
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| The abdominal aorta bifurcates at vertebral level _______ into 2 _______ _______ arteries (one for each lower limb) | L-4, common iliac
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| What is a small branch from the dorsal aortic surface just proximal to the bifurcation that has small branches that pass to the rectum? | Median sacral artery
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| What sends branches to psoas major and iliacus muscles? | Common iliac artery
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| The common iliac artery bifurcates into the _______ and _______ iliac arters at vertebral level _______. | internal, external, L-5
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| What is the larger branch of the common iliac a. that follows the psoas major m. (also sends a branch to this muscle and to the iliacus m.) and enters the thigh deep to the midpoint of the inguinal ligament where it becomes the femoral a. in the thigh? | External iliac artery
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| What arises laterally just prior to the inguinal ligament & passes superolaterally along the deep side of the ligament to reach the anterior superior iliac spine & anastomoses with the iliolumbar & superior gluteal aa. (branches of the internal iliac a.)? | Deep circumflex iliac artery
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| What arteries does the deep circumflex iliac artery anastomose with? | Iliolumbar and superior gluteal arteries
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| What artery arises anteriorly just prior to the inguinal ligament and medial to the deep circumflex iliac artery and passes superiorly along the abdominal wall and anastomoses with the superior epigastric artery? | Inferior epigastric artery
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| The anastomosis between the inferior and superior epigastric arteries can provide collateral circulation between which arteries? | Subclavian artery and external iliac artery
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| What is the medial and smaller branch of the common iliac artery that divides into anterior and posterior trunks at the greater sciatic foramen and supplies the psoas major and iliacus muscles? | Internal iliac artery
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| What passes toward the ischial spine and usually appears to be the direction continuation of the internal iliac artery? | Anterior trunk of the internal iliac artery
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| What is the most lateral branch of the anterior trunk and exits the pelvis via the obturator canal with the obturator nerve and may be a branch form the internal iliac artery or sometimes (40%) a branch of the external iliac artery at the pelvic brim? | Obturator artery
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| What is the larger terminal branch of the obturator artery that supplies medial compartment thigh and obturator externus muscles? | Anterior branch of obturator artery
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| What branch of the obturator a. supplies medial compartment thigh mm., and posterior compartment thigh muscles proximally at the ischial tuberosity & provides branches to the hip joint and anastomoses with the anterior branch and the inferior gluteal a.? | Posterior branch of obturator artery
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| What is the terminal division of the anterior trunk of the internal iliac artery? | Inferior gluteal artery
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| What artery exits the pelvis via the greater sciatic foramen, usually intermediate to the ventral rami of S-1 & S-2 or the ventral rami of S-2 & S-3? | Inferior gluteal artery
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| Before its exit, the inferior gluteal artery supplies what muscle? | Piriformis muscle
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| After its exit, the inferior gluteal artery supplies what? | Gluteal region muscles and the sciatic nerve
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| What anastomoses near hip joint with superior gluteal, obturator, inernal pudendal and medial femoral circumflex arteries? | Inferior gluteal artery
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| What is the terminal branch of the anterior trunk of the internal iliac artery? | Internal pudendal artery
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| What exits the pelvis via the greater sciatic foramen and re-enters the pelvis via the lesser sciatic foramen and supplies the sacral plexus, obturator internus muscle, piriformis muscle and external genitalia? | Internal pudendal artery
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| The pelvic branches of the anterior trunk of the internal iliac artery that supply pelvic organs and structures consist of what 6 arteries? | 1. Umbilical artery
2. Superior vesical artery
3. Inferior vesical artery
4. Middle rectal artery
5. Uterine artery
6. Vaginal artery
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| The umbilical artery obliterates to become what? | Medial umbilical ligament
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| What are the branches of the posterior trunk of internal iliac artery? | Iliolumbar artery, Lateral sacral artery, Superior gluteal artery
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| What arises anterior to the sacroiliac joint and passes superolaterally in the pelvis and anastomoses near iliac crest with the superior gluteal, the deep circumflex iliac and the lateral femoral circumflex arteries? | Iliolumbar artery
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| The iliolumbar artery anastomoses with what 3 arteries? | 1. Superior gluteal
2. Deep circumflex iliac
3. Lateral femoral circumflex
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| What is the terminal branch of the posterior trunk of the internal iliac artery, arises within the true pelvis, and supplies the sacral ala? | Lateral sacral artery
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| T or F: The lateral sacral artery arises within the true pelvis. | True
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| What is the largest branch from either trunk of the internal iliac artery (usually)? | Superior gluteal artery
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| What appears as the direct continuation of the posterior trunk (usually) and exits the pelvis via the greater sciatic foramen, usually intermediate to the lumbosacral trunk and the S-1 ventral ramus? | Superior gluteal artery
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| Before its exit, the superior gluteal artery supplies what 2 muscles? | 1. Piriformis
2. Obturator internus
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| After its exit, the superior gluteal artery supplies what 3 muscles? | 1. Gluteus maximus
2. Gluteus medius
3. Gluteus minimus
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| The superior gluteal artery anastomoses with which 4 arteries at the hip joint? | 1. Deep circumflex iliac
2. Medial femoral circumflex
3. Lateral femoral circumflex
4. Inferior gluteal
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| Small arteries have pair _______ _______. | vena comitantes
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| Large arteries have a _______ _______ (_______ _______). | single vein (vena comitans)
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| What begins at the union of the common iliac veins at vertebral level L-5 and usually travels superiorly at the right of the abdominal aorta and the spinal column? | Inferior vena cava
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| What begins at the union of the internal and external iliac veins at the pelvic brim? | Common iliac vein
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| The right common iliac vein is _______ and _______ to its artery. | shorter, posterolateral
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| The left one is _______ and _______ to its artery. | longer, posteromedial
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| What begins posterior to the inguinal ligament & lies medial to the artery distally & posterior to the artery proximally and has vena comitantes of the deep circumflex iliac & inferior epigastric aa. enter near the origin (at the inguinal ligament level)? | External iliac vein
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| What begins at the superior margin of the greater sciatic foramen where the vena comitantes of the arteries of the anterior and posterior trunks unite and generally lies posterior to the artery? | Internal iliac vein
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| What consists of deep lymph nodes associated with the pelvis and collects lymph fluid from the areas drained by the respective veins? | Lymphatics
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| What lie along the external iliac veins and receive fluid from the superficial and deep inguinal lymph nodes, the iliac fossa and the anterior part of the capsule of the hip joint? | External iliac lymph nodes
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| What lie along the internal iliac veins and receive fluid from the pelvic viscera, the gluteal region and the posterior, medial and lateral aspects of the hip joint? | Internal iliac lymph nodes
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| What lie along common iliac veins and receive fluid from the internal and external iliac lymph nodes? | Common iliac lymph nodes
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| What are large vessels formed by the joining of efferent vessels of the lumbar lymph nodes and receive fluid form the lumbar lymph nodes? | Lumbar trunks
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| What is the dilated area that lies anterior to the vertebral bodies of L-1 and L-2, receives fluid from the lumbar trunks and empties into the thoracic duct which returned the lymph fluid to the systemic circulation? | Cisterna chyli
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| The cisterna chyli lies anterior to which vertebral bodies? | L-1 & L-2
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| The gluteal region is covered by a dense layer of _______ tissue with many strong _______ that pass from the skin to the deep fascia. This gluteal fascia gives this region its shape. | adipose, septae
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| Much of the neurovascular supply to the gluteal region passes throughthe _______ _______ _______. | greater sciatic foramen
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| The muscles of the gluteal region function generally to _______, _______ and _______ rotate the _______ and _______. | extend, abduct, laterally, hip, thigh
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| What is the largest muscle of the buttock and covers the other muscles of this region (six small muscles which together are fan-shaped)? | Gluteus maximus muscle
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| What is the primary extensor of the thigh? | Gluteus maximus muscle
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| What is the origin of the gluteus maximus muscle? | 1. External iliac ala posterior to posterior gluteal line
2. Posterior iliac crest
3. The external surfaces of the sacrum and cocyx
4. The sacrotuberous ligament (also gluteal fascia)
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| What is the insertion of the gluteus maximus muscle? | 1. Gluteal tuberosity of the femur
2. Posterosuperior iliotibial tract
-passes obliquely from superomedial to inferolateral
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| What is the action of the gluteus maximus muscle? | Extends and laterally rotates the thigh
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| What is the nerve supply of the gluteus maximus muscle? | Inferior gluteal nerve; dorsal divisions of ventral rami L-5, S-1 & S-2
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| What is the arterial supply of the gluteus maximus muscle? | 1. Superior gluteal artery
2. Inferior gluteal artery
3. Perforating branches of the profunda femoris artery
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| What bursae are associated with the gluteus maximus muscle? | 1. Trochanteric bursa
2. Ischial bursa
3. Gluetofemoral bursa
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| What bursa is located intermediate to the gluteus maximus muscle and the lateral aspect of the greater trochanter of the femur? | Trochanteric bursa
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| Inflammation of the trochanteric bursa is called what? | Bursitis of the hip
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| What is painful when the trochanteric bursa is inflamed? | 1. Extension of thigh
2. Lateral rotation of thigh
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| What is located intermediate to the gluteus maximus muscle and the ischial tuberosity and is painful with sitting? | Ischial bursa
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| Inflammation of this bursa is associated with prolonged sitting in the tailer position (Indian-style or cross-legged) or from riding horses/bicycles? | Ischial bursa
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| Inflammation of the ischial bursa results in what? | Weaver's bottom (sometimes called saddle sore)
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| What bursa is located intermediate to the gluteus maximus muscle and the vastus lateralis muscle, just inferior to the gluteal tuberosity of the femur? | Gluteofemoral bursa
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| Injections into the buttock must be placed so as to miss the major neurovascular structures of this region, especially the _______ _______. | sciatic nerve
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| Each buttock is divided into quadrants. The injection is given in the _______ / _______ _______ quadrant. | Superolateral, upper outer
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| What is located deep to the gluteus maximus muscle and extends superior to the proximal edge of gluteus maximus muscle near the center of gluteus maximus muscle? | Gluteus medius muscle
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| What is the primary abductor of the thigh? | Gluteus medius muscle
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| What is the origin of the gluteus medius muscle? | External iliac ala intermediate to the anterior and posterior gluteal lines
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| What is the insertion of the gluteus medius muscle? | Lateral aspect of the greater trochanter
-passes inferolaterally
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| What is the action of the gluteus medius muscle? | 1. Abducts the thigh
2. Aids with medial rotation of the thigh
3. Aids with lateral rotation of the thigh
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| What is the nerve supply of the gluteus medius muscle? | Superior gluteal nerve; dorsal divisions of ventral rami L-4, L-5 & S-1
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| What is the arterial supply of the gluteus medius muscle? | Superior gluteal artery
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| Which bursa is located intermediate to the gluteus medius muscle and the superior aspect of the femoral greater trochanter? | Bursa of the gluteus medius muscle
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| The pain from the bursa of the gluteus medius muscle is associated with hip joint _______ and _______. | abduction, palpation
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| What is the smallest of the 3 gluteal muscles? | Gluteus minimus muscle
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| What is the origin of the gluteus minimus muscle? | 1. Iliac ala intermediate to the anterior and inferior gluteal lines
2. Superior edge of the greater sciatic notch
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| What is the insertion of the gluteus minimus muscle? | Anterior aspects of the greater trochanter and the hip joint capsule - passes inferiorly
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| What is the action of the gluteus minimus muscle? | 1. Abduction of the thigh
2. Medial rotation of hte thigh (medial rotation because the insertion of the muscle is anterior to the hip joint axis)
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| What is the nerve supply to the gluteus minimus muscle? | Superior gluteal nerve; dorsal divisions of ventral rami L-4, L-5 & S-1
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| What is the arterial supply of the gluteus minimus muscle? | Superior gluteal artery
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| What is an important anatomic landmark as it aids in the identification of other structures in the gluteal region? | Piriformis muscle
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| What is the origin of the piriformis muscle? | Pelvic surface of the sacrum (S-2, S-3, S-4)
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| What is the insertion of the piriformis muscle? | Superior aspect of the greater trochanter
-passes laterally, exiting the pelvis via the greater sciatic foramen
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| What is the action of the piriformis muscle? | 1. Lateral rotation of the thigh
2. Assists in abduction of thigh
3. Assists in extension of thigh
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| What is the nerve supply of the piriformis muscle? | Nerve to piriformis muscle; dorsal division of ventral ramus of S-2
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| What is the arterial supply for the piriformis muscle? | Superior and inferior gluteal arteries
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| What is a small muscle situated inferior to the piriformis muscle and deep to some neurovascular structures and has its muscle muscle belly lying adjacent to the inferior gemellus muscle belly? | Superior gemellus muscle
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| What is the origin of the superior gemellus muscle? | 1. Ischial spine
2. Superior edge of lesser sciatic notch
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| What is the insertion of the superior gemellus muscle? | Anterior fossa (unnamed) at the medial aspect of the greater trochanter, with the tendons of obturator internus and inferior gemellus muscles - passes laterally
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| What is the action of the superior gemellus muscle? | Lateral rotation of the thigh
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| What is the nerve supply of the superior gemellus muscle? | Nerve to obturator internus and superior gemellus muscles, from the sacral plexus; ventral divisions of ventral rami L-5, S-1 and S-2
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| What is the arterial supply of the superior gemellus muscle? | Inferior gluteal artery
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| What has its muscle belly lying adjacent to the superior gemellus muscle belly? | Inferior gemellus muscle
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| What is the origin of the inferior gemellus muscle? | 1. Inferior margin of lesser sciatic notch
2. Superior border of ischial tuberosity
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| What is the insertion of the inferior gemellus muscle? | Anterior fossa (unnamed) at the medial edge of the greater trochanter, with the tendons of superior gemellus and obturator internus muscles - passes laterally
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| What is the action of the inferior gemellus muscle? | Lateral rotation of the thigh
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| What is the nerve supply of the inferior gemellus muscle? | Nerve to inferior gemellus muscle and quadratus femoris muscle, from the sacral plexus; ventral divisions of ventral rami L-4, L-5 & S-1
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| What is the arterial supply of the inferior gemellus muscle? | Medial femoral circumflex artery
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| What muscle has its tendon generally deep and intermediate to the gemelli muscles? | Obturator internus muscle
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| What is the origin of the obturator internus muscle? | Pelvis surfaces of the obturator foramen and obturator membrane
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| What is the insertion of the obturator internus muscle? | Anterior fossa (unnamed) on the medial edge of the greater trochanter, with the gemelli muscles - passes posterolaterally to exit the plevis via the lesser sciatic foramen, then angles anteriorly around the lesser sciatic notch
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| What is the action of the obturator internus muscle? | 1. Lateral rotation of the thigh
2. Extension and abduction of thigh when the hip is flexed
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| What is the nerve supply to the obturator internus muscle? | Nerve to obturator internus and superior gemellus muscles, from the sacral plexus; ventral divisions of ventral rami L-5, S-1 and S-2
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| What is the arterial supply of the obturator internus muscle? | 1. Superior gluteal artery
2. Internal pudendal artery
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| What is the rectangular shaped muscle that is the most inferior of the gluteal muscles? | Quadratus femoris muscle
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| What is the origin of the quadratus femoris muscle? | External border (of the posterior squared part) of the ischial tuberosity
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| What is the insertion of the quadratus femoris muscle? | Quadrate tubercle of the femur
-passes directly lateral
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| What is the action of the quadratus femoris muscle? | Lateral rotation of the thigh
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| What is the nerve supply of the quadratus femoris muscle? | Nerve to inferior gemellus muscle and quadratus femoris muscle, from the sacral plexus; ventral divisions of ventral rami L-4, L-5 and S-1
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| What is the arterial supply of the quadratus femoris muscle? | Medial femoral circumflex artery
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| What has its tendon that can be found deep to the quadratus femoris muscle in the gluteal region and has its origin that may be seen deep to the pectineus msucle at the anterosuperior thigh region? | Obturator externus muscle
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| What is the origin of the obturator externus muscle? | External surfaces of the obturator foramen and the obturator membrane
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| What is the insertion of the obturator externus muscle? | Trochanteric fossa of the femur
- passes posterolaterally around the inferior surface of the femoral neck (a spiral course)
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| What is the action of the obturator externus muscle? | 1. Lateral rotation of the thigh (due to insertion posterior to the hip joint axis)
2. Aids in flexion and adduction of the thigh (due to its course around the femoral neck)
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| What is the nerve supply of the obturator externus muscle? | Obturator nerve; ventral divisions of ventral rami L-2, L-3 and L-4 - the only gluteal region muscle to receive innervation from the lumbar plexus
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| What is the arterial supply of the obturator externus muscle? | Obturator artery
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| The pudendal nerve comes from the _______ _______ of _______ _______ of _______, _______, and _______. | ventral divisions, ventral rami, S-2, S-3, S-4
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| What exits the pelvis via the greater sciatic foramen, inferior to the piriformis muscle and passes posterior to the sacrospinous ligament and reenters the pelvis via the lesser sciatic foramen? | Pudendal nerve
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| The nerve to obturator internus and superior gemellus muscles comes from the _______ _______ of _______ _______ of _______, _______ and _______. | ventral divisions, ventral rami, L-5, S-1, S-2
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| What exits pelvis via the greater sciatic for, inf to the piriformis m. & lies lat to pudendal n as it passes post to the SS lig & sends a branch lat to supply the superior gemellus m & reenters pelvia via less sciatic foramen to innervate ob internus m? | Nerve to obturator internus and superior gemellus muscles
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| The posterior femoral cutaneous nerve comes from the _______ _______ of _______ _______ of _______ and _______ and _______ _______ of _______ _______ of _______ and _______. | dorsal divisions, ventral rami, S-1, S-2, ventral divisions, ventral rami, S-2, S-3
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| Exits pelvis via g sciatic foramen, inf 2 piriformus & post to sciatic; main br lies within fascia on deep surface of glut max, then passes inf thru post thigh, deep 2 or within fascia lata 2 inf knee reg & cutaneous br penetrate fascia lata along course? | Posterior femoral cutaneous nerve
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| Cutaneous branches of the posterior femoral cutaneous nerve that supply a portion of the gluteal region skin and arise near the proximal end and pass along the deep surface of the gluteus maximus muscle, then pass around its inferior edge to the skin? | Inferior cluneal nerves
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| The nerve to quadratus femoris and inferior gemellus muscles comes from the _______ _______ of _______ _______ of _______, _______ and _______. | ventral divisions, ventral rami, L-4, L-5, S-1
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| What exits the pelvis via the greater sciatic foramen, inferior to the piriformis muscle (usually located anterior the sciatic nerve)? | Nerve to quadratus femoris and inferior gemellus muslces
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| What passes anterior to the obturator internus tendon and the gemelli muscles where it sends a branch to the inferior gemellus muscle; it continues inferiorly and sends branches to the hip joint and the deep side of the quadratus femoris muscle? | Nerve to quadratus femoris and inferior gemellus muscles
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| What is the largest nerve in the body and the primary formation of the sacral plexus? | Sciatic nerve
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| The sciatic nerve comes from _______ _______ of _______ _______ of _______, _______, _______ and _______ and _______ _______ of _______ _______ of _______, _______, _______, _______ & _______. | dorsal divisions, ventral rami, L-4, L-5, S-1, S-2, ventral divisions, ventral rami, L-4, L-5, S-1, S-2, S-3
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| What exits the pelvis via the greater sciatic foramen, deep to the gluteus maximus muscle and usually inferior to the piriformis muscle? | Sciatic nerve
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| What passes inferiorly into the thigh usually midway between the ischial tuberosity and the greater trochanter and continues inferiorly along the posteromedial aspect of thigh, deep to the muscles to the level of the knee region where it normally divides? | Sciatic nerve
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| Variation: The common _______ part may exit the pelvis either _______ to or through the _______ muscle belly and then course with the _______ part. When this occurs, the _______ nerve has split into its component parts already. | fibular, superior, piriformis, tibial, sciatic
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| The inferior gluteal nerve comes from _______ _______ of _______ _______ of _______, _______ and _______. | dorsal divisions, ventral rami, L-5, S-1, S-2
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| What exits the pelvis via the greater sciatic foramen, inferior to the piriformis muscle and passes directly posterior and into the gluteus maximus muscle to innervate it? | Inferior gluteal nerve
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| The superior gluteal nerve comes _______ _______ of _______ _______ of _______, _______ and _______. | dorsal divisions, ventral rami, L-4, L-5, S-1
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| Exits pelvia via greater sciatic foramen, superior to piriformis. Passes laterally, intermediate to gluteus medius & minimu mm.; it supplies both of them and continues anterolaterally to supply the tensor fascia lata muscle (a thigh muscle in this course) | Superior gluteal nerve
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| The perforating cutaneous nerve comes the _______ _______ of _______ _______ of _______ and _______. | dorsal divisions, ventral rami, S-2, S-3
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| Exits pelvis by piercing the ST lig, usually near the sacrum, may be a direct course or pass within the lig for a short distance and passes inferiorly around the distomedial edge of glut max to innervate a small area of skin @ the inferomedial glut region | Perforating cutaneous nerve
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| What comes from the anterior trunk of internal iliac artery & exits the pelvis via the greater sciatic foramen, inferior to the piriformis muscle, usually lies intermediate to the pudendal nerve and the nerve to obturator internus & superior gemellus mm? | Internal pudendal artery
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| What artery passes posterior to the sacrospinous ligament and reenters the pelvis via the lesser sciatic foramen, then supplies obturator internus m.? | Internal pudendal artery
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| What comes the anterior trunk of internal iliac artery and before exiting the pelvis it supplies the piriformis, levator ani and coccygeus mm? | Inferior gluteal artery
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| Exits pelvis via greater sciatic foramen, inferior to piriformis muscles & passes posterior, lateral & inferior to supply gluteal region structures. After exiting, it supplies gluteus maximus & superior gemellus muscles, the sciatic nerve & the hip joint. | Inferior gluteal artery
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| What comes from the posterior trunk of internal iliac artery and before exiting the pelvis, it supplies piriformis and obturator internus muscles. It exits the pelvis via the greater sciatic foramen, superior to the piriformis muscle. | Superior gluteal artery
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| What has a superficial branch that passes posterior to supply the gluteus maximus m. & has a deep branch that passes laterally to supply the gluteus medius, gluteus minimus & tensor fascia lata mm. & the hip joint; travels with the superior gluteal n.? | Superior gluteal artery
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