slideshow: gluteal region

The Gluteal Region

The Gluteal Region lies on the

posterolateral aspect of the pelvis

posterior view

The Gluteal Region lies on the

posterolateral aspect of the pelvis

It is occupied by large powerful

muscles Several important nerves and vessels traverse this area

posterior view

Muscles of the Gluteal Region

Largest and most superficial muscle

Has an extensive origin from-lateral surface of ala of ilium posterior to posterior gluteal line-posterior surface of sacrum and coccyx - sacrotuberous ligament

Gluteus Maximus

right gluteal region

Gluteus Maximus

Iliotibial Iliotibial TractTract

Largest and most superficial muscle

Its coarse fibers run obliquely downwards and laterally behind the hip joint

Most of the muscle inserts into the Iliotibial Tract


Gluteus Maximus

Iliotibial Iliotibial TractTract

It extends the Hip Jointand

laterally rotates the Hip Joint


Gluteus Medius

Lies beneath Gluteus Maximus

Originates from the lateral surface (gluteal surface) of the Ilium,

between the anterior and posterior Gluteal Lines.


Gluteus Medius

It runs above the hip joint

Inserts onto the lateral aspect of the Greater

Trochanter


Gluteus Medius

Gluteus MediusGluteus Medius

Gluteus Maximus, Gluteus Maximus, turned away to turned away to reveal Gluteus reveal Gluteus MediusMedius

Iliotibial TractIliotibial Tract

It runs above the hip joint

Inserts onto the lateral aspect of the Greater

TrochanterIt abducts the Hip Joint


Gluteus Minimus Gluteus Medius is cut

Lies beneath Gluteus Medius

Originates from lateral surface of Ilium between the anterior

and inferior Gluteal Lines





Gluteus Minimus

Inserts onto anterior aspect of the Greater Trochanter of the

Femur


Gluteus Minimus

Inserts onto anterior aspect of the Greater Trochanter of the

Femur

Gluteus Medius is cut

Gluteus Minimus

Gluteus Medius is cut and reflected downwards





Greater Sciatic Foramen

One of the major gateways between the

pelvic cavity and the lower limb

The Greater Sciatic Foramen

posterior view


Formed by the Greater Sciatic Notch

and Sacrospinous ligament

attaching to the Ischial Spine

Sacrotuberous Ligament



posterior view





posterior view

Formed by the Greater Sciatic Notch

and Sacrospinous ligament

attaching to the Ischial Spine

A number of

− Muscles− Arteries and Veins − Nerves

pass through the Greater Sciatic Foramen



posterior view

Muscles related to the Greater Sciatic Foramen

Piriformis

Lies centrally in the gluteal region

Originates from the

−anterior surface of lateral process of sacrum

−dorsal aspect of ilium around margin of the greater sciatic notch

Piriformis

Inserts onto the upper border of

Greater Trochanter

Iliotibial TractIliotibial Tract

Gluteus Gluteus MaximusMaximus

Gluteus Gluteus MediusMedius

PiriformisPiriformis

Sciatic Sciatic NerveNerve

Piriformis

Externally rotates the hip joint when the thigh is extended

Obturator Internus

Originates from the

-inner surface of obturator membrane and contiguous bone

PiriformisPiriformisGluteus MediusGluteus Medius

Gluteus MaximusGluteus Maximus(turned away)(turned away)

Obturator InternusObturator Internus

Sciatic NerveSciatic Nerve

Obturator Internus

Common insertion with Superior and Inferior Gemelli

onto medial aspect of Greater Trochanter of Femur

Superior Gemellus

Originates from a small area on the outer surface of hip bone below

Ischial Spine

Superior Gemellus

Inferior Gemellus

Originates from the superior aspect of the Ischial Tuberosity

Originates from a small area on the outer surface of hip bone below

Ischial Spine

Superior Gemelli&

Inferior Gemelli

Insert in common with

Obturator Internusvia the Tricipital Tendon

PiriformiPiriformiss

Obturator Obturator InternusInternus


Gluteus MaximusGluteus Maximus(reflected inferiorly)(reflected inferiorly)


Superior Superior GemellusGemellus

Inferior Inferior GemellusGemellus

Superior Gemellus&

Inferior Gemellus

Insert in common with

Obturator Internusvia the Tricipital Tendon

Quadratus Femoris

Originates from the lateral aspect of the Ischial Tuberosity

Quadratus Femoris

Originates from the lateral aspect of the Ischial Tuberosity

Inserts onto Quadrate tubercle on

Intertrochanteric Crest and adjacent area of posterior

Femur

Originates from the lateral aspect of the Ischial TuberosityPiriformiPiriformi

ss




Quadratus Quadratus FemorisFemoris

Quadratus Femoris

Inserts onto Quadrate tubercle on

Intertrochanteric Crest and adjacent area of posterior

Femur

PiriformiPiriformiss

Obturator Obturator InternusInternus




Collectively

•Superior Gemellus•Inferior Gemellus •Obturator Internus•Quadratus Femoris

Superior Superior GemellusGemellus

Inferior Inferior GemellusGemellus

are known as the

Short Lateral Rotators of the Hip Joint

Structures that crossThe Greater Sciatic Foramen

Nerves of the Gluteal Region

Gluteus Minimus

Piriformis

Superior Gluteal Nerve

Superior Gluteal Nerve

Emerges superior to Piriformis and splits into

-Superior division that supplies Gluteus Medius

-Inferior division that supplies Gluteus Minimus

Sciatic Nerve

Sciatic Nerve

Thickest nerve in the body2cm at origin

Emerges below Piriformis

Divides into its two components in the posterior thigh•Tibial Nerve•Common Peroneal Nerve

Inferior Gluteal Nerve

Inferior Gluteal Nerve

Arises from dorsal divisions of

•5th Lumbar •1st and 2nd sacral ventral rami

Supplies Gluteus Maximus

Posterior Cutaneous Nerve of the Thigh

Posterior Cutaneous Nerve of the Thigh

Purely sensory and mainly cutaneous nerve

Arises from sacral plexus

-2nd, 3rd and 4th sacral ventral rami

Supplies gluteal and perineal region and back of lower limb

Nerve to Obturator Internus

Nerve to Obturator Internus

Arises from ventral divisions of-5th Lumbar ventral rami-1st and 2nd Sacral ventral rami

Supplies -Obturator Internus-Superior Gemellus

Nerve to Quadratus Femoris

Nerve to Quadratus Femoris

Arises from ventral divisions of-4th, 5th Lumbar ventral rami-1st Sacral ventral ramus

Supplies -Quadratus Femoris-Inferior Gemellus

Pudendal Nerve

Pudendal Nerve

Arises from ventral rami of 2nd, 3rd and 4th sacral nerves

Exits the pelvis via the Greater Sciatic Foramen and enters the perineum

through theLesser Sciatic Foramen

Supplies Perineal structures

Perforating Cutaneous Nerve

Perforating Cutaneous Nerve

Arises from posterior aspect of 2nd, 3rd sacral ventral rami

Pierces Sacrotuberous Ligament supplies skin over

inferior and medial part of buttock

Superior Gluteal Artery

Branch of the Internal Iliac Artery

Superior Gluteal Artery


Supplies muscles of the gluteal region and hip joint

Inferior Gluteal Artery


Inferior Gluteal Artery


Supplies muscles of the gluteal region and hip joint

Summary of Muscles of the Gluteal Region

Gluteus Maximus Origin Gluteal surface of ilium

posterior to posterior gluteal line, posterior superior iliac crest, dorsal sacrum and coccyx, and sacrotuberous ligament

Insertion Iliotibial tract (band); gluteal tuberosity posterior femur

Action Extends and laterally rotates hip

Nerve Supply Inferior gluteal nerve (L5, S1, S2)

Blood Supply Inferior and superior gluteal arteries

Gluteal Region

Gluteus Medius Origin Outer surface of ilium between

posterior and middle gluteal linesInsertion Lateral surface of greater

trochanter of femurAction Abducts thigh; medially rotates

hipNerve Supply Superior gluteal nerve (L4, L5, S1)

Blood Supply Superior gluteal artery

Gluteal Region

Gluteus MinimusOrigin Outer surface of ilium between

inferior and anterior gluteal linesInsertion Anterior surface of greater

trochanter of femurAction Abducts and medially rotates the

hip jointNerve Supply Superior gluteal nerve (L4, L5, S1)

Blood Supply Superior gluteal artery

Gluteal Region

PiriformisOrigin Anterior surface of lateral

process of sacrum and gluteal surface of ilium at the margin of the greater sciatic notch

Insertion Superior aspect greater trochanter of femur

Action Lateral rotator of the hip jointNerve Supply Anterior primary rami S1, S2 Blood Supply Superior and inferior gluteal

arteries

Gluteal Region

Gluteal Region Obturator Internus

Origin Inner surface of obturator membrane and adjacent bone

Insertion Medial aspect greater trochanter of femur, in common with superior and inferior gemelli

Action Laterally rotates hip

Nerve Supply Nerve to the obturator internus (L5, S1, S2)

Blood Supply Internal pudendal and superior and inferior gluteal arteries

Gluteal Region Superior Gemellus

Origin Outer surface hip bone below Ischial spine

Insertion Medial surface of greater trochanter of femur, in common with obturator internus

Action Laterally rotates hipNerve Supply Nerve to the obturator

internusBlood Supply Inferior gluteal artery

Gluteal Region Inferior Gemellus

Origin Superior aspect ischial tuberosity

Insertion Medial surface of greater trochanter of femur, in common with obturator internus

Action Laterally rotates hipNerve Supply Nerve to quadratus femoris

(L4, 5, S1)Blood Supply Inferior gluteal artery

Gluteal Region Quadratus Femoris

Origin Lateral border ischial tuberosity

Insertion Quadrate tubercle and adjacent bone of intertrochanteric crest of posterior aspect femur

Action Laterally rotates hipNerve Supply Nerve to the quadratus

femorisBlood Supply Medial circumflex femoral

artery, inferior gluteal artery, obturator artery

slideshow: gluteal region

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