Gluteal Gait
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Gluteal Gait
Gluteal gait is an abnormal gait caused by neurological problems. If the superior gluteal nerve or obturator nerves are injured, they fail to control the gluteus minimus and medius muscles properly, thus producing an inability to tilt the pelvis upward while swinging the leg forward to walk. To compensate for this loss, the leg swings out laterally so that the foot can move forward, producing a shuffling or waddling gait. Injury to the superior gluteal nerve results in a characteristic motor loss, resulting in a disabling gluteus medius limp, to compensate for weakened abduction of the thigh by the gluteus medius and minimus, and/or a gluteal gait, a compensatory list of the body to the weakened gluteal side. As a result of this compensation, the center of gravity is placed over the supporting lower limb. Medial rotation of the thigh is also severely impaired. When a person is asked to stand on one leg, the gluteus medius and minimus normally contract as soon as the contralater ...
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Gait
Gait is the pattern of movement of the limbs of animals, including humans, during locomotion over a solid substrate. Most animals use a variety of gaits, selecting gait based on speed, terrain, the need to maneuver, and energetic efficiency. Different animal species may use different gaits due to differences in anatomy that prevent use of certain gaits, or simply due to evolved innate preferences as a result of habitat differences. While various gaits are given specific names, the complexity of biological systems and interacting with the environment make these distinctions "fuzzy" at best. Gaits are typically classified according to footfall patterns, but recent studies often prefer definitions based on mechanics. The term typically does not refer to limb-based propulsion through fluid mediums such as water or air, but rather to propulsion across a solid substrate by generating reactive forces against it (which can apply to walking while underwater as well as on land). Due to th ...
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Superior Gluteal Nerve
The superior gluteal nerve is a nerve that originates in the pelvis. It supplies the gluteus medius muscle, the gluteus minimus muscle, the tensor fasciae latae muscle, and the piriformis muscle. Structure The superior gluteal nerve originates in the sacral plexus. It arises from the posterior divisions of L4, L5 and S1. It leaves the pelvis through the greater sciatic foramen above the piriformis muscle. It is accompanied by the superior gluteal artery and the superior gluteal vein.''Thieme Atlas of Anatomy'' (2006), p 476 It then accompanies the upper branch of the deep division of the superior gluteal artery. It ends in the gluteus minimus muscle and tensor fasciae latae muscle. Function The superior nerve supplies: * tensor fasciae latae muscle.Platzer (2004), p 420 * gluteus minimus muscle. * gluteus medius muscle. * piriformis muscle. The superior gluteal nerve also has a cutaneous branch. Clinical significance Gait In normal gait, the small gluteal muscles on the sta ...
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Obturator Nerve
The obturator nerve in human anatomy arises from the ventral divisions of the second, third, and fourth lumbar nerves in the lumbar plexus; the branch from the third is the largest, while that from the second is often very small. Structure The obturator nerve originates from the anterior divisions of the L2, L3, and L4 spinal nerve roots. It descends through the fibers of the psoas major, and emerges from its medial border near the brim of the pelvis. It then passes behind the common iliac arteries, and on the lateral side of the internal iliac artery and vein, and runs along the lateral wall of the lesser pelvis, above and in front of the obturator vessels, to the upper part of the obturator foramen. Here it enters the thigh, through the obturator canal, and divides into an anterior and a posterior branch, which are separated at first by some of the fibers of the obturator externus, and lower down by the adductor brevis. An accessory obturator nerve may be present in approx ...
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Nerves
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the electrochemical nerve impulses called action potentials that are transmitted along each of the axons to peripheral organs or, in the case of sensory nerves, from the periphery back to the central nervous system. Each axon, within the nerve, is an extension of an individual neuron, along with other supportive cells such as some Schwann cells that coat the axons in myelin. Within a nerve, each axon is surrounded by a layer of connective tissue called the endoneurium. The axons are bundled together into groups called Nerve fascicle, fascicles, and each fascicle is wrapped in a layer of connective tissue called the perineurium. Finally, the entire nerve is wrapped in a layer of connective tissue called the epineurium. Nerve cells (often called ...
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Gluteus Minimus
The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius. Structure It is fan-shaped, arising from the outer surface of the ilium, between the anterior and inferior gluteal lines, and behind, from the margin of the greater sciatic notch. The fibers converge to the deep surface of a radiated aponeurosis, and this ends in a tendon which is inserted into an impression on the anterior border of the greater trochanter, and gives an expansion to the capsule of the hip joint. It is also a local stabilizer for the hip. Relations A bursa is interposed between the tendon and the greater trochanter. Between the gluteus medius and gluteus minimus are the deep branches of the superior gluteal vessels and the superior gluteal nerve. The deep surface of the gluteus minimus is in relation with the reflected tendon of the rectus femoris and the capsule of the hip joint. Variations The muscle may be div ...
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Gluteus Medius
The gluteus medius, one of the three gluteal muscles, is a broad, thick, radiating muscle. It is situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeurosis, which separates it from the superficial fascia and integument. Structure The gluteus medius muscle starts, or "originates", on the outer surface of the ilium between the iliac crest and the posterior gluteal line above, and the anterior gluteal line below; the gluteus medius also originates from the gluteal aponeurosis that covers its outer surface. The fibers of the muscle converge into a strong flattened tendon that inserts on the lateral surface of the greater trochanter. More specifically, the muscle's tendon inserts into an oblique ridge that runs downward and forward on the lateral surface of the greater trochanter. Relations A bursa separates the tendon of the muscle from the surface of the trochanter over which it glid ...
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Pelvis
The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The pelvic region of the trunk includes the bony pelvis, the pelvic cavity (the space enclosed by the bony pelvis), the pelvic floor, below the pelvic cavity, and the perineum, below the pelvic floor. The pelvic skeleton is formed in the area of the back, by the sacrum and the coccyx and anteriorly and to the left and right sides, by a pair of hip bones. The two hip bones connect the spine with the lower limbs. They are attached to the sacrum posteriorly, connected to each other anteriorly, and joined with the two femurs at the hip joints. The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath the abdomen and mainly consists of the reproductive organs (sex organs) and the rectum, while the pelvic f ...
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Trendelenburg's Sign
Trendelenburg's sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus. It is named after the German surgeon Friedrich Trendelenburg. It is often incorrectly referenced as the Trendelenburg test which is a test for vascular insufficiency in the lower extremities. The Trendelenburg sign is said to be positive if, when standing on one leg (the 'stance leg'), the pelvis severely drops on the side opposite to the stance leg (the 'swing limb'). The muscle weakness is present on the side of the stance leg. If the patient compensates for this weakness (by tilting their trunk/thorax to the affected side), then the pelvis will be raised, rather than dropped, on the side opposite to the stance leg. Ergo, in the same situation, the patient's hip may be dropped or raised, dependent upon whether the patient is actively compensating, as above, or not. Compensation shifts the centre of gravity to the affected side, and also decrea ...
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