Gluteal Region and Posterior Thigh
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| What attaches the inferior and anterior surface of the sacrum to the ischial spine? | Sacrospinous ligament
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| What extends from the lateral and inferior surface of the sacrum to the ischial tuberosity? | Sacrotuberous ligament
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| Most of the gluteal muscles have their attachments to the greater trochanter, in the trochanteric fossa, or to the intertrochanteric crest. Where does the gluteus maximus attach? | Gluteal tuberosity
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| What arises from the posterior surface of the distal half of the femur in the posterior thigh? | Short head of biceps femoris
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| What muscles have important functions in gait? | Gluteus maximus
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| When is gluteus maximus most active? | Extension of hip from flexed position (running, climbing stairs, or rising from seated position)
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| Where does the guteus maximus arise? | Posterior iliac crest, posterior sacrum and sacroiliac ligaments, coccyx, and sacrotuberous ligament
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| Where are the two insertions of the gluteus maximus? | Gluteal tuberosity of femur and iliotibial tract
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| Where does the iliotibial tract attach? | Anterior surface of lateral condyle of tibia
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| What protects and cushions the deep surface of the gluteus maximus as it passes over the ischial tuberosity and greater trochanter? | A bursa
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| What is the smaller muscle lying on the anterolateral thigh, which acts on the deep enveloping fascia of the thigh and movement of thigh? | Tensor fasciae latae
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| What are the attachments of the tensor fasciae latae? | Superiorly to anterior part of iliac crest and inferiorly to deep surface of iliotibial tract
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| What is the function of the tensor fasciae latae muscle? | Abduct and flex the thigh - also assists in knee flexion
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| What muscles have a principal function of preventing tilt of the pelvis when the contralateral lower limb is not bearing weight equally (as with the contralateral limb off the ground during walking)? | Gluteus medius and minimus
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| What are the attachments of gluteus medius? | Superiorly in the fossa between anterior and posterior gluteal lines of the ala of the ilium
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| What are the attachments of the gluteus minimus? | To ala between anterior and inferior gluteal lines
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| The gluteus medius and minimus attach to the ala. What is their other place of attachment? | Greater trochanter - gluteus minimus attaches more anteriorly
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| What are the functions of gluteus medius and gluteus minimus? | Because of their attachments, gluteus minimus can assist with medial rotation of the thigh and gluteus medius can assist with lateral rotation of the thigh
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| What is the principal function of the deep gluteal muscles? | Lateral rotation of the thigh - but they also provide significant tonic contraction to maintain the head of the femur in the acetabulum
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| What are the attachments of the piriformis muscle? | Arises as series of muscle slips that attach between anterior sacral foramina; passes through greater sciatic foramen and converges to tendon that attaches to the superior border of greater trochanter
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| What are the attachments of obturator internus? | Proximally to lateral wall of true pelvis (including obturator membrane); fibers converge to tendon which passes inferior to the ischial spine; the tendon turns laterally to attach to superior end of trochanteric fossa
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| What are the attachments of obturator externus? | Arises from lateral surface of obturator membrane and adjacent area of pubis and ischium on lateral os coxa; fibers converge to tendon, which passes inferior to neck of femur to insert into trochanteric fossa
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| What are the locations and attachments of superior and inferior gemelli muscles? | Arise on or near ischial spine superior and inferior to tendon of obturator internus muscle; fibers merge with tendon of obturator internus and have similar attachments
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| What is the short, quadrangular muscle lying inferior to obturator interus/gemelli complex? | Quadratus femoris
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| What are the attachments of quadratus femoris? | Proximally to ischial tuberosity and distally to the intertrochanteric crest
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| In general, what innervates the gluteal muscles? | Sacral plexus
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| What innervates gluteus maximus? From what spinal cord level is it derived? | Inferior gluteal nerve (L5-S2)
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| What innervates gluteus medius and minimus and tensor fascia lata? From what spinal cord level is it derived? | Superior gluteal nerve (L5-S1)
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| What innervates piriformis? From what spinal cord level is it derived? | Small nerve fibers from (S1-S2)
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| What innervates superior gemellus and obturator internus? From what spinal cord level is it derived? | Small nerve (L5-S1)
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| What innervates inferior gemellus and quadratus femoris? From what spinal cord level is it derived? | A small nerve independent from the small nerve innervating superior gemellus and obturator internus (L5-S1)
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| What innervates obturator externus? | Branch of obturator nerve
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| What provides cutaneous sensation to the buttock area? | Dorsal rami of lumbar and sacral spinal nerves (cluneal nerves) and by branches of posterior femoral cutaneous nerves (inferior cluneal nerves)
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| What artery supplies the gluteus medius, gluteus minimus, and tensor fasciae latae? | Superior gluteal artery
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| What artery supplies the gluteus maximus? | Inferior gluteal artery
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| The venous drainage of the gluteal region is by veins that accompany the arteries. Where do these veins drain to in the pelvic region? | Internal iliac vein
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| Where do the lymphatics drain in the gluteal region? | Drains to sites inside pelvis
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| What separates the posterior thigh from other muscular compartments of the thigh? | Femur and fascial septa
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| What are the functions of the "hamstring" muscles? | Hip extension (particularly during walking) and knee flexion
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| What are the hamstring muscles? | Semimembranosus, semitendinosus, biceps femoris, and inferior, medial portion of adductor magnus
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| What are the attachments of semimembranosus? | Arises from anterior portion of ischial tuberosity and attaches distally to posterior portion of medial tibial condyle
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| What are the attachments of semitendinosus? | Arises from ischial tuberosity, immediately posterior to attachment of semimembranosus; attaches to anterior surface of medial tibial condyle
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| What forms the pes anserinus? | Semitendinosus, gracilis, and sartorius attachments at the anterior surface of the medial tibial condyle
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| What envelopes semitendinosus as it passes inferiorly? | Semimembranosus
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| Biceps femoris has two components: a long head and a short head. What is the proximal attachment of the long head? | Ischial tuberosity - shares this site of attachment with semitendinosus
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| Biceps femoris has two components: a long head and a short head. What is the proximal attachment of the short head? | Arises from lateral lip of linea aspera and lateral supracondylar line and from lateral intramuscular septum
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| What is the common distal attachment for biceps femoris? | Head of fibula
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| What are the actions of the long head of biceps femoris? | Hip extension and knee flexion
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| What are the actions of the short head of biceps femoris? | Knee flexion
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| What is the function of the inferior, medial portion of adductor magnus muscle? | Hip extension
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| What spinal nerves form the sciatic nerve? | L4-S3
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| In general, what does the sciatic nerve supply? | Posterior thigh, leg, and foot
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| The sciatic nerve leaves the pelvis through the greater sciatic foramen, usually inferior to piriformis. Describe the course of the sciatic nerve from this point. | Emerges into thigh deep to long head of biceps, between that muscle and medial group of hamstring muscles
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| The sciatic nerve consists of a medial tibial portion and a lateral fibular portion that are bound together in a common fascial bundle. What does the tibial division innervate? | Semimembranosus, semitendinosus, the "hamstring" division of adductor magnus, and long head of biceps
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| The sciatic nerve consists of a medial tibial portion and a lateral fibular portion that are bound together in a common fascial bundle. What does the common fibular nerve innervate? | Short head of biceps femoris
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| What provides innervation to the posterior thigh? Where is this nerve derived? | Posterior cutaneous nerve of thigh (S1-S3)
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| What artery supplies the posterior thigh? | Perforating (usually 4 branches) of profunda femoris artery
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| Describe the venous return from the posterior thigh. | Principally via veins that accompany perforating arteries to drain to deep vein of the thigh, thence to femoral vein; they are valved veins that move blood centrally during muscular contraction withinthe confined space of posterior compartment
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| Describe the lymphatic drainage. | Lymph channels and nodes that accompany veins
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