Exam 2: Gluteal Region
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What provides cutaneous innervation of the gluteal region?
- lateral cutaneous branches of T12
- iliohypogastric (L1) n.
What is the chief cutaneous nerve supply of the buttock provided by?
three sets of cluneal nerves
What are the three sets of cluneal nerves?
superior, middle, and inferior cluneal nerves
Where do the superior cluneal nerves arise from?
lateral branches of dorsal primary rami of L13
Where do the middle cluneal nerves arise from?
lateral branches of dorsal primary rami of S1-3
Where do the inferior cluneal nerves arise from?
posterior femoral cutaneous nerve
What is the superficial fascia of the buttock made up of?
relatively thik superficial layer of fat
What is the superficial fascia of the buttock continuous with?
adjoining regions including superficial fascia of back, abdomen, perineum and thigh
Where does the deep fascia of the gluteal region attach?
above to the crest of ilium and the sacrum
What does the deep fascia of the gluteal region cover?
gluteus maximus and gluteus medius
What does the deep fascia of the gluteal region become continuous with?
fascia lata of the thigh
Where do the gluteal muscles originate?
on the os coxae and sacrum
Where do the gluteal muscles insert?
upper portion of femur
What actions are the gluteal muscles responsible for?
abduction, medial and lateral rotation of the thigh
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)
Which gluteal muscle is an important anatomical landmark?
What structure does the piriformis pass through?
greater sciatic foramen
What structure does the obturator internus exit through when it exits the pelvis?
lesser sciatic foramen
What arteries supply the obturator internus?
inferior gluteal artery
The gluteal region is nourished by which artery?
branches of internal iliac artery
Where does the superior gluteal artery exit the pelvis?
greater sciatic foramen
Where does the superior gluteal artery go when it exits the pelvis?
to the buttock
What muscles does the superior gluteal artery lie between?
between piriformis below and gluteus medius and minimus above
Where does the superior gluteal artery send a branch to?
sends a superficial branch into the overlying gluteus maximus
What does the superficial branch of the the superior gluteal artery divide into?
two deep branches
Where are the two deep branches from the superficial branch of the superior gluteal artery?
between gluteus medius and gluteus minimus
What do the deep branches from the superfcial branch of the superior gluteal artery supply?
gluteus medius, gludteus minimus and tensor faciae lata
Where does the inferior gluteal artery enter the buttock?
What does the inferior gluteal artery supply?
gluteus maximus, obturator internus, gemelli, quadratus femoris, and superior part of hamstring muscles
Where does the inferior gluteal artery send an unnamed branch?
laterally and downward
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
What forms the cruciate anastomosis?
- inferior gluteal a.
- 2 circumflex AA ( medial and lateral femoral circumflex aa)
- 1st perforating branch of profunda femoris
What structures pass through the greater sciatic foramen?
- 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.
The pudendal n. and the internal pudendal a. and v. exit the greater sciatic foramen and pass through what?
the lesser sciatic foramen
Do the pudendal n. and the internal pudendal a. and v. have anything to do with the gluteal region?
What is the destination of the pudenal n. and the internal pudendal a. and v.?
perineum (external genitalia and anal canal)
Where is the sacrotuberous ligament?
from sacrum to ischial tuberosity
Where is the sacrospinous ligament?
from sacrum to ishial spine
How is the greater sciatic foramen formed?
By the greater sciatic notch of the os coxae, sacrum, and sacrospinous ligament
How is the lesser sciatic foramen formed?
By the lesser sciatic notch of the os coxae, sacrotuberous ligament, and sacrospinous ligament
What is the largest nerve in the body?
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
Where is the posterior femoral cutaneous n. found?
running along the medial side of the sciatic n.
What are the branches of the sciatic n?
- tibial (continues straight down)
- cmmon peroneal (goes toward lateral side of leg)
From the medial side of the sciatic nerve, which muscles are supplied?
- biceps femoris (long head)
From the lateral side of the sciatic nerve, which muscles are supplied?
biceps femoris (short head)
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