1. 2. (g. gloutos, buttocks) transitional region between trunk & lower limbs
TRANSCRIPT
1Kaan Yücel M.D., Ph.D. 27.February.2013 Wednesday
GLUTEAL REGION
IN 10 QUESTIONS
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1. What is gluteal region?
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(G. gloutos, buttocks) transitional region between trunk & lower limbs
Anterior superior iliac spine
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2. How are the muscles of the gluteal region organized?
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Deeplateral rotators of the femur @ hip joint piriformis, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris
Superficialabduct and extend the hip gluteus minimus, gluteus medius, and gluteus maximus
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3...deep muscles of the gluteal region?
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PiriformisAnterior surface of sacrumSacrotuberous ligament
Superior border of greater trochanter of femur
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Superior gemellus-Obturator internus-Inferior gemellus• Ischial spine• Pelvic surface of obturator membrane and surrounding bones• Ischial tuberosity
Medial surface of greater trochanter (trochanteric fossa) of femur
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Quadratus femoris Ischial tuberosity
Quadrate tubercle on intertrochanteric crest of femur and area inferior to it
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4...superficial muscles in the gluteal region?
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Ilium posterior to posterior gluteal line; dorsal surface of sacrum and coccyx; sacrotuberous ligament
Iliotibial tract & gluteal tuberosity of femur
External surface of ilium between anterior and posterior gluteal lines
Lateral surface of greater trochanter of femur
External surface of ilium between anterior and inferior gluteal lines Anterior surface of
greater trochanter of femur
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5...functions of the gluteal region muscles?
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Muscles in the gluteal region mainly abduct, extend, and laterally rotate the femur relative to the pelvic bone.
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6....innervation of the gluteal region muscles?
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Superior gluteal nerveGluteus minimus & mediusTensor fascia latae
Inferior gluteal nerveGluteus maximus
Nerve to the quadratus femorisQuadratus femorisGemellus inferior
Nerve to the obturator internusObturator internusGemellus superior
Nerve to the piriformisPiriformis
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GLUTEAL
BURSAEBetween gluteus maximus & greater trochanterPresent @ birth
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7....nerves of the gluteal region?
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1. Superior gluteal nerve2. Inferior gluteal nerve3. Sciatic nerve4. Nerve to the quadratus femoris5. Nerve to the obturator internus6. Posterior cutaneous nerve of the thigh7. Pudendal nerve
greater sciatic foramen
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Superior & inferior gluteal nerves
* Above the piriformis
tensor fasciae latae
Posterior to
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Sciatic nerve
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Superficial musclesDeep muscles
lies just deep to gluteus maximus midpoint between ischial tuberosity&greater trochanter
Enters thigh
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Nerve to Quadratus Femoris
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Inferior to piriformis
Deep to sciatic nerve
* anterior to the plane of the deep muscles
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Nerve to Obturator Internus
. between posterior cutaneous nerve of thigh &pudendal nerve
+ GS
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Posterior Cutaneous Nerve of Thigh
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Medial to sciatic nerveSkin over the gluteal fold
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Pudendal nerve
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Sensory Innervation of the Gluteal RegionNerve Origin
(Contributing spinal nerves)
Course Distrubition
Superior clunial nerves
L1-L3 posterior rami
Penetrate thoracodorsal fascia; course laterally and inferiorly in subcutaneous tissue
Skin overlying superior and central parts of buttock
Medial clunial nerves
S1-S3 posterior rami
Emerge from dorsal sacral foramina; directly enter overlying subcutaneous tissue
Skin of medial buttock and intergluteal cleft
Inferior clunial nerves
Posterior cutaneous nerve of thigh (S2-S3)
Arise deep to gluteus maximus; emerge from beneath inferior border of muscle
Skin of inferior buttock (overlying gluteal fold)
Subcostal T12 anterior ramus Courses along inferior border of 12th rib; lateral cutaneous branch descends over iliac crest
Lateral cutaneous branch supplies skin of hip region inferior to anterior part of iliac crest and anterior to greater trochanter
Iliohypogastric Lumbar plexus (L1; occasionally T12)
Parallels iliac crest; divides into lateral and anterior cutaneous branches
Lateral cutaneous branch supplies superolateral quadrant of buttock
Lateral cutaneous nerve of thigh skin overlying the lower lateral quadrant of the buttock.Perforating cutaneous nerve skin over the medial aspect of the gluteus maximus.
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8...arteries in the gluteal region?
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9...veins in the gluteal region?
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Internal iliac veins
Femoral vein
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10...lymphatics of the gluteal region?
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Lymph from deep tissuesuperior & inferior gluteal lymph nodes
internal,external,common iliac lymph nodes
lateral lumbar (aortic/caval) lymph nodes
Lymph from superficial tissue
superficial inguinal lymph nodes
external iliac lymph nodes