L8

Gluteal Region

• The gluteal region comprises superficial and deep layers of muscles.
• Superficial layer muscles include gluteus maximus, medius, and minimus.
• Deep layer muscles comprise piriformis, superior & inferior gemellus, obturator internus, and quadratus femoris.
• Gluteus maximus originates behind the posterior gluteal line of the ilium, inserts into the iliotibial tract and gluteal tuberosity of the femur, and is innervated by the inferior gluteal nerve.
• Gluteus medius originates between the anterior and posterior gluteal lines of the ilium, inserts into the lateral surface of the greater trochanter, and is innervated by the superior gluteal nerve.
• Gluteus minimus originates between the anterior and inferior gluteal lines of the ilium, inserts into the front of the greater trochanter, and is innervated by the superior gluteal nerve.
• Tensor fascia lata (iliotibial tract) originates from the outer lip of the iliac crest and anterior superior iliac spine (ASIS), inserts into the lateral condyle of the tibia via iliotibial tract, and is innervated by the superior gluteal nerve.
• The gluteal muscles work together to abduct, extend and rotate the hip and stabilize the knee.
• The piriformis, superior gemellus, obturator internus, inferior gemellus, and quadratus femoris are deep gluteal muscles, responsible for lateral rotation of the thigh.

Trendelenburg's Sign

• Trendelenburg's sign indicates weakness or paralysis of the gluteus medius and minimus muscles.
• In this sign, the unsupported side of the pelvis dips during walking or running.

Femoral Triangle & Anterior Aspect of Thigh

• The femoral triangle is a triangular depression in the upper anterior thigh.
• Its boundaries include the inguinal ligament (base), medial border of the adductor longus muscle (medial border), and medial border of the sartorius muscle (lateral border).
• The floor of the triangle is formed by the adductor longus, pectineus, psoas major, and iliacus muscles.
• The apex of the triangle is the meeting point of the sartorius and adductor longus muscles.
• The roof is formed by the skin, superficial fascia, and fascia lata.
• Contents of the femoral triangle (from lateral to medial) are: femoral nerve, femoral artery, femoral vein, and femoral lymph nodes.
• The femoral sheath is a funnel-shaped sleeve of fascia that encompasses the femoral artery, vein, and lymphatics.
• It is 3–4 cm long with a shorter medial wall compared to its lateral wall.
• It has three compartments:
  • Lateral: femoral artery and femoral branch
  • Intermediate: femoral vein
  • Medial: femoral canal (contains lymph nodes)
• The femoral artery, a continuation of the external iliac artery, passes under the inguinal ligament.
• It traverses the femoral triangle and the adductor hiatus in the adductor magnus muscle.
• The artery continues as the popliteal artery at the posterior aspect of the knee.
• Branches of the femoral artery include: superficial epigastric, superficial circumflex iliac, superficial external pudendal, deep external pudendal, profunda femoris, medial circumflex femoral, lateral circumflex femoral.
• Profunda femoris supplies muscles in the thigh, providing perforating arteries to the adductor magnus and hamstring muscles.
• Femoral vein receives blood from the deep veins (profunda femoris) and great saphenous vein.
• It returns to the external iliac vein beneath the inguinal ligament.
• The femoral nerve originates from the lumbar plexus, passes beneath the inguinal ligament,enters the femoral triangle, and divides into anterior and posterior divisions supplying the quadriceps muscles.

Hip Joint

• The hip joint is a ball-and-socket type synovial joint.
• The articulating bones are the head of the femur and the acetabulum.
• The acetabular labrum is a fibrocartilaginous rim attached to the margin of the acetabulum and helps deepen the socket.
• The ligamentum teres attaches to the fovea on the head of the femur and blends with the transverse acetabular ligament.
• Iliofemoral, ischiofemoral, and pubofemoral ligaments are important for structural stability and support, preventing hyperextension, and controlling abduction and adduction.
• Muscles that produce flexion are the iliopsoas muscle.
• Muscles that produce extension are the gluteus maximus and hamstrings.
• Muscles that produce abduction include gluteus maximus, medius, minimus, and tensor fascia lata.
• Muscles that produce adduction are the adductor magnus, brevis, longus, gracilis, and pectineus.
• Muscles that produce medial rotation are the gluteus medius, minimus and tensor fascia lata.
• Muscles that produce lateral rotation are the gluteus maximus and all the deep muscles.

Femoral Necrosis

• Femoral necrosis can result from fractures, dislocations, and congenital causes.
• The blood supply to the head and neck of the femur is from branches of the obturator, lateral femoral circumflex, and medial femoral circumflex arteries.

Test your knowledge on the anatomy of the gluteal region. This quiz covers the superficial and deep layer muscles, including their origins, insertions, and innervations. Perfect for students studying human anatomy and physiology.