Re: Gluteal Region and the Ischio Rectal Fossa - Study Guide Part I

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: : : 1. The spinal cord ends at the vertebral level of L2(3) whereas the spinal canal continues to the level of S2. : : TRUE. : : The spinal cord in an adult can end as proximally as T12 or as distally as between L2 and L3, although it usually ends between L1 and L2. Additionally, the subarachnoid space (and thus the spinal canal) extends to S2. : Agreed. This is false, but not a big deal right now. The canal continues to the sacral hiatus. The dural sac ends at S2. I did not mean to ask this question at this time. My bad. : : : 2. The sacrospinous ligament contributes the inferior border of the of the greater sciatic foramen. : : TRUE. : : The sacrospinous ligament forms the inferior border of the greater sciatic foramen, and additionally contributes the superior border of the lesser sciatic notch. Additionally, the superior portion of the sacrotuberous ligament forms the medial border of the greater sciatic foramen, the anterior iliac while the superolateral border is contributed by the greater sciatic notch itself. : Agreed. Mostly. : : : 3. The sacrotuberous ligament contributes the superior border of the greater sciatic foramen. : : FALSE. : : The superior portion of the sacrotuberous ligament forms the superomedial border of the greater sciatic foramen. : Agreed. : : : 4. The gluteus maximus muscle takes origin, in part, from the sacrotuberous ligament. : : TRUE. : : The gluteus maximus takes its origin from the outer edge of the iliac crest, and the gluteal aponeurosis. : Agreed. Great. : : : 5. In addition to the iliotibial tract, the gluteus maximus muscle inserts onto the gluteal tuberosity of the femur. : : TRUE. : : The gluteal tuberosity, which is on the intertrochanteric line on the posterior aspect of the femur, is one of the main insertions of the gluteus maximus. : Agreed. But the intertrochanteric line is anterior. Correct? : : : 6. The gluteus maximus muscle receives the inferior gluteal artery but not the inferior gluteal nerve. : : FALSE. : : The gluteus maximus receives both the gluteal arteries, as well as the inferior gluteal nerve (but not the superior gluteal nerve.) : Agreed. Excellent. : : : 7. The gluteus maximus muscle receives the superior gluteal artery but not the superior gluteal nerve. : : TRUE. : : The gluteus maximus receives both the gluteal arteries, as well as the inferior gluteal nerve (but not the superior gluteal nerve.) : Agreed. : : : : : 8. When standing with just one lower extremity planted (on one foot), the gluteus medius stabilizes the pelvis to prevent excessive pelvic drop on the supported (swing phase) lower extremity. : : TRUE. : : When standing with just one lower extremity planted, the gluteus medius (along with gluteus minimus) stabilizes the pelvis to prevent excessive pelvic drop on the supported lower extremity. Because the gluteus medius is solely innervated by the superior gluteal nerve, this can lead to Trendelenburg’s gait when the nerve is damaged. : I worded this badly. I meant to write that gluteus medius prevents pelvic drop "on the unsupported (swing phase) lower extremity. My bad again. : : : 9. The quadratus femoris muscle, by virtue of inserting onto the intertrochanteric line, is a medial rotator of the hip joint. : : FALSE. Quadratus femoris is a lateral rotator and also adducts the thigh. It inserts on the intertrochanteric crest, which is on the posterior aspect of the proximal femur, giving it this action. : Agreed. Good. : : : 10. The superior and inferior gemelli insert onto the trochanteric fossa by way of the obturator externus tendon. : : FALSE. : : The superior and inferior gemelli insert onto the trochanteric fossa by way of the obturator internus tendon, not the obturator externus. : Agreed. But obturator internus inserts on the greater trochanter (superior crest), not the fossa. : : : 11. The superior gluteal artery, but not the superior gluteal nerve, enters the gluteus maximus muscle. : : TRUE. : : The superior gluteal artery supplies the Gluteus Maximus (as well as Medius and Minimus). The superior gluteal nerve does NOT innervate the Gluteus Maximus (which is innervated instead by the inferior gluteal nerve). : Agreed. : : : 12. The pudendal nerve, as it crosses the posterior surface of the ischial spine, is accompanied by the the internal pudendal artery. : : TRUE. : : The pudendal artery and the internal pudendal vein (as well as the internal pudendal vein and nerve to obturator internus) pass out of the greater sciatic foramen, then sharply turn posteriorly around the ischial spine, and then pass back into the pelvic bowl by way of the lesser sciatic foramen. : Agreed. Excellent. : : : 13. The posterior cutaneous nerve of the thigh, within the gluteal region is located immediately medial to the tibial portion of the sciatic nerve. : : TRUE. : : The posterior cutaneous nerve of the thigh nerve passes inferiorly and medially to the sciatic nerve as they both pass out of the greater sciatic foramen. : Agreed. good. : : : 14. The sciatic nerve consists of a peroneal portion that innervates original dorsal musculature and a tibial portion that innervates original ventral musculature. : : FALSE. : : Since the limb buds of the lower limb flip during development such that the original dorsal musculature appears on the anterior side of the leg, this means that the peroneal branch of the sciatic nerve innervates what would be the original ventral musculature. : The common peroneal nerve follows the original dorsal surface. The anterior compartment of the leg is original dorsal. : : : 15. The lateral femoral cutaneous nerve contributes to the L2 and L3 dermatome. : : TRUE. : : The lateral femoral cutaneous nerve comes from roots of L2 and L3. : Agreed. : : : 16. The lateral femoral cutaneous nerve, by way of the lumbar plexus, receives contributions from the dorsal rami of spinal nerves L1 and L2. : : FALSE. : : The lateral femoral cutaneous nerve receives contributions from the dorsal rami of spinal nerves L2 and L3. : Agreed. Except that it is the ventral rami, not dorsal, that enter into somatic plexuses. : : : 17. A region of numbness matching the distribution of the lateral femoral nerve indicates compression of the L2 spinal nerve (spend money on an MRI). : : FALSE. : : Lateral femoral nerve originates from the roots of L2 and L3. Therefore it is possible that L3 is the root that is compressed and causing the numbness. It is not necessarily just one of the roots, both could be involved. : Agreed. Think about entrapment and Dr. Bollards clinical correlate. : : If you could please comment/correct these thoughts, Dr. Evey, it would be muchly appreciated! Hooray anatomy! : Uber Hooray Anatomy! Hey, I'm cool. At least, I used to be.

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