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What provides cutaneous innervation of the gluteal region?
- lateral cutaneous branches of T12
- iliohypogastric (L1) n.
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What is the chief cutaneous nerve supply of the buttock provided by?
three sets of cluneal nerves
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What are the three sets of cluneal nerves?
superior, middle, and inferior cluneal nerves
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Where do the superior cluneal nerves arise from?
lateral branches of dorsal primary rami of L13
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Where do the middle cluneal nerves arise from?
lateral branches of dorsal primary rami of S1-3
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Where do the inferior cluneal nerves arise from?
posterior femoral cutaneous nerve
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What is the superficial fascia of the buttock made up of?
relatively thik superficial layer of fat
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What is the superficial fascia of the buttock continuous with?
adjoining regions including superficial fascia of back, abdomen, perineum and thigh
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Where does the deep fascia of the gluteal region attach?
above to the crest of ilium and the sacrum
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What does the deep fascia of the gluteal region cover?
gluteus maximus and gluteus medius
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What does the deep fascia of the gluteal region become continuous with?
fascia lata of the thigh
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Where do the gluteal muscles originate?
on the os coxae and sacrum
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Where do the gluteal muscles insert?
upper portion of femur
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What actions are the gluteal muscles responsible for?
abduction, medial and lateral rotation of the thigh
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What would happen if the right gluteus medius and minimus were paralyzed?
- can't hold pelvis stable when foot is lifted off ground
- tilt to the left (opposite side)
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Which gluteal muscle is an important anatomical landmark?
piriformis m.
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What structure does the piriformis pass through?
greater sciatic foramen
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What structure does the obturator internus exit through when it exits the pelvis?
lesser sciatic foramen
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What arteries supply the obturator internus?
inferior gluteal artery
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The gluteal region is nourished by which artery?
branches of internal iliac artery
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Where does the superior gluteal artery exit the pelvis?
greater sciatic foramen
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Where does the superior gluteal artery go when it exits the pelvis?
to the buttock
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What muscles does the superior gluteal artery lie between?
between piriformis below and gluteus medius and minimus above
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Where does the superior gluteal artery send a branch to?
sends a superficial branch into the overlying gluteus maximus
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What does the superficial branch of the the superior gluteal artery divide into?
two deep branches
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Where are the two deep branches from the superficial branch of the superior gluteal artery?
between gluteus medius and gluteus minimus
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What do the deep branches from the superfcial branch of the superior gluteal artery supply?
gluteus medius, gludteus minimus and tensor faciae lata
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Where does the inferior gluteal artery enter the buttock?
below piriformis
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What does the inferior gluteal artery supply?
gluteus maximus, obturator internus, gemelli, quadratus femoris, and superior part of hamstring muscles
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Where does the inferior gluteal artery send an unnamed branch?
laterally and downward
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Why does the inferior gluteal artery send a branch laterally and downward?
- to anastomose with other vessels
- -medial and lateral femoral circumflex aa.
- -1st perforating branch of profunda femoris
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What forms the cruciate anastomosis?
- inferior gluteal a.
- 2 circumflex AA ( medial and lateral femoral circumflex aa)
- 1st perforating branch of profunda femoris
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What structures pass through the greater sciatic foramen?
- piriformis
- sciatic n.
- superior gluteal a. v. and n.
- inferior gluteal a. v. and n.
- pudenda n.
- internal pudendal a. and v.
- posterior femoral cutaneous n.
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The pudendal n. and the internal pudendal a. and v. exit the greater sciatic foramen and pass through what?
the lesser sciatic foramen
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Do the pudendal n. and the internal pudendal a. and v. have anything to do with the gluteal region?
no
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What is the destination of the pudenal n. and the internal pudendal a. and v.?
perineum (external genitalia and anal canal)
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Where is the sacrotuberous ligament?
from sacrum to ischial tuberosity
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Where is the sacrospinous ligament?
from sacrum to ishial spine
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How is the greater sciatic foramen formed?
By the greater sciatic notch of the os coxae, sacrum, and sacrospinous ligament
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How is the lesser sciatic foramen formed?
By the lesser sciatic notch of the os coxae, sacrotuberous ligament, and sacrospinous ligament
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What is the largest nerve in the body?
sciatic n.
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What can the size of the sciatic n. be compared to in order to estimate its size?
sciatic nerve is about the size of your thumb
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Where is the posterior femoral cutaneous n. found?
running along the medial side of the sciatic n.
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What are the branches of the sciatic n?
- tibial (continues straight down)
- cmmon peroneal (goes toward lateral side of leg)
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From the medial side of the sciatic nerve, which muscles are supplied?
- semitendinosus
- semimembranosus
- biceps femoris (long head)
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From the lateral side of the sciatic nerve, which muscles are supplied?
biceps femoris (short head)
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