Defect in Gluteus Maximus lead to all EXCEPT:
Correct Answer: Positive Trendelenburg's sign
Description: ANSWER: (A) Positive Trendelenburg's testREF: Essential Clinical Anatomy, Keith .L. Moore 4th edition p-348/354 Indirect repeat from June 2009"Positive trendelenburg's sign is seen in superior gluteal nerve (Gluteus medius & minimus) injury and not in Inferior gluteal nerve injury (Gluteus maxim us)"The main actions of the Gluteus Maximus are extension and lateral rotation of the thigh. It functions primarily between the flexed and the standing positions, as when rising from the sitting position, straightening from the bending position, walking uphill and upstairs, and running.A positive Trendelenburg's sign is found in:Any condition that brings the origin and insertion of gluteus medius together:1. Subluxation or dislocation of the hip2. Coxa vara3. Greater trochanter fractures4. Slipped upper femoral epiphysis* Abductor paralysis or weakness e.g.:1. Polio2. Nerve root lesion3. Superior gluteal nerve damage4. Muscle-wasting disease* Any painful hip disorder which results in gluteal inhibitionPositive Trendelenburg's sign due to Injury to Superior Gluteal Nerve:The Trendelenburg's sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg.Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in unilateral superior gluteal nerve injury, when the patient lifts the opposing leg, the shift is not created and the patient cannot maintain balance leading to instability. Bilateral superior gluteal nerve injury results in a waddling gaitNOTE: Not to be confused with Trendelenburg's sign. The Trendelenburg Test or Brodie-Trendelenburg test is a test which can be carried out as part of a physical examination to determine the competency of the valves in the superficial and deep veins of the legs in patients with varicose veins
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