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7 L A B O R A T O R Y Gluteal Identify the gluteal muscles. Describe the attachment points for the gluteal muscles. Relate their primary actions. Identify the primary innervation source for each muscle. Identify the primary source of vascularization for each muscle. Identify the ligaments in the gluteal region. sacrotuberous ligament - greater sciatic foramen sacrospinous ligament - lesser sciatic foramen Gluteal Muscles Muscle Tensor Fascia Lata Origin Insertion Innervation Blood Supply Action Ant. Superior Iliac spine Anterior Iliac crest Posterior Ilium, Sacrum, Coccyx & Sacrotuberous Ligament Iliotibial tract (anterolateral Tibia) Superior Gluteal N (L4-L5) Superior Gluteal A Abduct & M-rotate Flex thigh Iliotibial tract Gluteal tuberosity of Femur Inferior Gluteal N (L5-S2) Sup Gluteal A Inf Gluteal A Circumflex Femoral A Extend & L-rotate thigh Gluteus Medius External Ilium Ant – Post gluteal lines Posterolateral Superior greater trochanter Gluteal N of Femur (L5-S1) Superior Gluteal A Abduct & M-rotate thigh Gluteus Minimus External Ilium Ant – Inferior gluteal lines Anterior greater trochanter of Femur Superior Gluteal N (L5-S1) Superior Gluteal A Abduct & M-rotate thigh Piriformis Anterior Sacrum Superior greater Sacrotuberous trochanter of Ligament Femur Ventral rami of Spinal N (S1–S2) Inf Gluteal A Sup Gluteal A Circumflex A Steady Femoral head, Abduct & L-rotate thigh Obturator Internus Pelvic obturator membrane (inside) Nerve to Inf Gluteal A Obturator Circumflex Internus (L5-S1) Femoral A Steady Femoral head L-rotate thigh Sup – Nerve to Inf Gluteal A Ob Int (L5-S1) Circumflex Inf – N to Quad Femoral A Fem (L5-S1) Steady Femoral head, Abduct & L-rotate thigh Gluteus Maximus Gemelli Superior – Ischial spine Inferior– Ischial tuberosity Quadratus Femoris Lateral Ischial tuberosity Trochanteric fossa of Femur Trochanteric fossa of Femur Intertrochanteric Nerve to Inf Gluteal A crest of Femur Quadratus Pudendal A Femoris (L5-S1) L-rotate thigh Steady Femoral head 48 Laboratory 7 • Gluteal LUMBROSACRAL PLEXUS – POSTERIOR Identify the nerves from the sacral part of the plexus. Sciatic nerve (L4 - S3) Posterior thigh and all leg and foot compartments Tibial nerve (L4 - S3) Posterior leg and plantar foot Common fibular nerve (L4 - S2) Lateral/anterior leg and dorsal foot Pudendal nerve (S2 - S4) Pelvic perineum Identify the nerves from the entire lumbrosacral plexus (Nerve to …… are often quite difficult to see). Superior gluteal nerve (L4 - S1) Gluteus Medius/Minimus and Tensor Fasciae Lata Inferior gluteal nerve (L5 - S2) Gluteus Maximus Nerve to obturator internus (L5 - S1) Obturator Internus and Superior Gemellus Nerve to quadratus femoris (L5 - S1) Innervation to quadratus femoris, inferior gemellus LUMBROSACRAL PLEXUS – ANTERIOR Identify the nerves from the lumbar part of the plexus. Femoral nerve (L2 –L4) Anterior compartment of thigh Obturator nerve (L2 - L4) Medial compartment of thigh (Obturator Externus) 49 Laboratory 7 • Gluteal HIP JOINT Classify the hip joint according to structural and functional criteria – Ball-and-socket, synovial (diarthrotic) joint. Identify the ligaments associated with the hip joint. Ligament to head of femur Transverse Acetabular Ligament (ligamentum teres/femoris) Inguinal ligament Acetabular labrum Iliofemoral - Anterior reinforcement Pubofemoral - Inferior/anterior reinforcement Anterior inferior iliac spine to Pubic bone to joint capsule intertrochanteric line Prevents overabduction Prevents hyperextension while standing Ischiofemoral - Posterior reinforcement Ischial part of acetabular rim to base of greater trochanter Prevents hyperextension Relate muscles acting at the hip joint to their specific actions. Describe blood supply to the hip joint – Lateral/medial circumflex femoral arteries. Describe the innervation for the hip joint. Femoral nerve (L2 - L4) Superior Gluteal nerve (L4 - S1) Nerve to Quadratus Femoris (L5 - S1) Obturator nerve (L2 - L4) SACROILIAC JOINT Classify the sacroiliac joint according to structural and functional criteria – modified plane, synovial, amphiarthrotic joint. Identify the ligaments associated with the sacroiliac joint. Ant/Post Sacroiliac ligaments Sacrotuberous Ligament Sacrospinous Ligament 50 Laboratory 7 • Gluteal LOWER EXTREMITY os coxae = innominate bone = hip bone = ilium + ischium + pubis Ilium iliac crest gluteal lines iliac spines (inf/ant/post) (ant/post/sup/inf ) acetabulum acetabular notch iliac fossa superior sciatic notch ischial tuberosity obturator foramen ramus body inferior sciatic notch ischial spine rami pubic tubercle pubic symphysis arcuate line Ischium Pubis Femur iliac tubercle head/neck fovea greater/lesser trochanter trochanteric crest trochanteric line gluteal tuberosity linea aspera adductor tubercle (med/lat) epicondyles auricular surface trochanteric fossa pectineal line (med/lat) condyles intercondylar fossa/notch Tibia tibial plateau tibial tuberosity articular surfaces Gerdy’s tubercle (med/lat) intercondylar tubercles/eminences soleal line fibular notch medial malleolus Fibula head Tarsal bones Metatarsals (5) lateral malleolus interosseous border calcaneus talar shelf (sustentaculum tali) cuboid medial/intermediate/lateral cuneiforms Phalanges (14) talus Patella navicular Laboratory 7 • Gluteal Page Intentionally Left Blank 51 52 Page Intentionally Left Blank Laboratory 7 • Gluteal