Gluteal Region Anatomy PDF

 Gluteal Region Transitional region between the ❖.trunk and free lower limb :Boundaries ❖ Superiorly: the iliac crest Medially: the intergluteal (natal) cleft Inferiorly: the skin fold (gro...

 Gluteal Region Transitional region between the ❖.trunk and free lower limb :Boundaries ❖ Superiorly: the iliac crest Medially: the intergluteal (natal) cleft Inferiorly: the skin fold (groove) underlying the buttock, the gluteal fold  Structures in the gluteal region Muscles ❖ Three glutei, Tensor fasciae lata, piriformis, quadratus femoris, obturator internus and two gemelli Blood Vessels❖ Superior and Inferior gluteal vessels Nerves❖ Superior gluteal nerve, Sciatic nerve, Nerve to the quadratus femoris, Nerve to the obturator internus, Posterior cutaneous nerve of the thigh, Pudendal nerve, and.Inferior gluteal nerve  Muscles :They are divided into two groups ❖ Superficial Group: Gluteus.1 Maximus, Gluteus Medius, Gluteus Minimus and Tensor Fasciae latae  Muscles :They are divided into two groups ❖ Deep Group: Piriformis,.2 Obturator internus, Superior Gemellus, Inferior Gemellus and Quadratus Femoris MUSCLE ORIGIN INSERTION INNERVATION ACTION External surface of ilium behind posterior Posterior aspect Hip extension, gluteal line, dorsal of iliotibial tract, Gluteaus Inferior gluteal Lateral surface of lower and gluteal Maximus sacrum, external tuberosity of nerve (L5,S1,S2) rotation and surface of sacro proximal femur abduction tuberous ligament External surface of Lateral surface Gluteus ilium between ant. Superior gluteal of the greater Hip Medius and post. gluteal nerve (L4,L5,S1) trochanter lines Abduction External surface of Antero-lateral and Medial Gluteus aspect of the Superior gluteal rotation ilium between inf. Minimus greater nerve (L4,L5,S1) and ant. gluteal lines trochanter Lat. aspect of crest Tensor of ilium between Stabilizes the Iliotibial tract Superior gluteal Fasciae ant. Sup. iliac spine knee in and tubercle of the of fascia lata nerve (L4,L5,S1) Latae extension crest  INNERVATIO MUSCLE ORIGIN INSERTION ACTION N Anterior surface of superior border of Branches from Piriformis sacrum between anterior greater trochanter of sacral foramina femur (S1,S2) Laterally deep surface of obturator Obturator membrane and Medial side of greater rotates the internus surrounding bone trochanter of femur Nerve to extended obturator femur and internus Gemellus abducts External surface of ischial (L5,S1) superior spine flexed femur with obturator at hip joint internus tendon Gemellus Upper aspect of ischial inferior tuberosity Nerve to quadratus Lateral aspect of the femoris (L5,S1) Laterally Quadratus Quadrate tubercle on the ischium just anterior to intertrochanteric crest rotates femur femoris the ischial tuberosity at hip joint  Iliotibial Tract A tendinous thickening of the fascia ❖ lata passes over the lateral surface of the greater trochanter and descends.down the thigh and into the upper tibia It forms an apponeurotic insertion of ❖ tensor fasciae latae and the upper and superficial lower parts of the gluteus maximus to lateral surface of upper.tibia Function: Stabilization of hip joint and ❖.Knee joint in extension  Gluteal Blood Vessels Superior Gluteal artery It originates from the posterior trunk of the internal iliac artery in the.pelvic cavity It leaves the pelvic cavity with the superior gluteal nerve through the greater sciatic foramen above the.piriformis muscle :In the gluteal region, it divides into Superficial branch passes onto (a the deep surface of the gluteus maximus muscle Deep branch passes between the (b gluteus medius and minimus.muscles  Gluteal Blood Vessels Inferior Gluteal artery It originates from the anterior trunk of the internal iliac artery in the.pelvic cavity It leaves the pelvic cavity with the inferior gluteal nerve through the greater sciatic foramen below the.piriformis muscle It supplies adjacent muscles and descends through the gluteal region and into the posterior thigh where it supplies adjacent structures and anastomoses with perforating branches of the femoral artery. It also.supplies a branch to the sciatic nerve  Gluteal Nerves Superior Gluteal Nerve ❖ Of all the nerves that pass through the greater sciatic foramen, the superior gluteal nerve (L4,5,S1) is the only one that passes above the piriformis muscle :It supplies Gluteus medius (1 Gluteus minimus (2 Tensor fasciae latae (3  Gluteal Nerves Inferior Gluteal Nerve ❖ The inferior gluteal nerve (L5,S1,2) enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and along the posterior surface of.the sciatic nerve It penetrates and supplies the.gluteus maximus muscle  Sciatic Nerve The sciatic nerve (L4,5,S1,2,3) enters the gluteal region through the greater sciatic foramen inferior to the.piriformis muscle It descends in the plane between the superficial and deep group of gluteal region muscles. At the lower margin of the quadratus femoris muscle, the sciatic nerve enters the posterior.thigh It is the largest nerve in the body and innervates all muscles in the posterior compartment of the thigh and all muscles that work the ankle and foot. It also innervates a large area of skin.in the lower limb  Nerve to Obturator internus The nerve to the obturator internus (L5,S1) enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and between the posterior cutaneous nerve of the thigh and.the pudendal nerve It supplies a small branch to the gemellus superior and then passes over the ischial spine and through the lesser sciatic foramen to innervate the obturator internus muscle  Nerve to Quadratus Femoris The nerve to the quadratus femoris (L5,S1) enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and deep to the sciatic nerve Unlike other nerves in the gluteal region, it lies anterior to the plane.of the deep muscles It penetrates and innervates the quadratus femoris and gives a small branch to the gemellus.inferior  Posterior Ctaneous Nerve of Thigh The posterior cutaneous nerve of the thigh (S1,2,3) enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and immediately medial to.the sciatic nerve It supplies more skin than any :other cutaneous nerve Inferior clunial branches to (a.buttock Perineal branches (b Posterior thigh and proximal leg (c  Pudendal Nerve The pudendal nerve (S2,3,4) enters the gluteal region through the greater sciatic foramen inferior to the piriformis muscle and medial.to the sciatic nerve It passes over the sacrospinous ligament and immediately passes through the lesser sciatic foramen.to enter the perineum The pudendal nerve is the major somatic nerve of the perineum and has no branches in the gluteal.region  Greater Sciatic Foramen It is formed on the posterolateral pelvic wall and is the major route for structures to pass between the pelvis and the gluteal.region of the lower limb The margins of the foramen are formed :by ;the greater sciatic notch (a parts of the upper borders of the (b sacrospinous and sacrotuberous ligaments.the lateral border of the sacrum (c  Greater Sciatic Foramen :Contents Piriformis muscle.1 Superior gluteal nerve and vessels.2 Inferior gluteal nerves and vessels.3 Sciatic Nerve.4 Pudendal nerve.5 Internal pudendal vessels.6 Posterior cutaneous nerve of thigh.7 Nerve to the Obturator internus.8 Nerve to the Quadratus femoris.9  Lesser Sciatic Foramen It is inferior to the greater sciatic foramen on the posterolateral.pelvic wall It is also inferior to the lateral attachment of the pelvic floor to the pelvic wall and therefore connects the gluteal region with.the perineum Contents Tendon of obturator internus.1 Pudendal nerve.2 Internal pudendal vessels.3 THANK YOU