Objectives Identify the bony landmarks of the pelvis and hip on
the articulated skeleton and bones. Enlist the prominent bony
features of the femur. Identify the muscles of the gluteal region
in terms of their origin, insertion, nerve supply and actions.
Identify the superior gluteal and inferior gluteal nerves in
relation to Piriformis muscle. Explain how the anatomical position
affects the muscle function.
Slide 3
Gluteal region Popliteal fossa
Slide 4
The Gluteal Region It extends from the iliac crest (waist)
above to the gluteal fold below. Buttock: The lower part of the
gluteal region which presents a rounded bulge due to fat is called
buttock. Gluteal fold indicates the lower border of the gluteus
maximus muscle (gluteal sulcus/crease is a skin crease for the hip
joint) A deep midline groove, the natal (intergluteal) cleft
separates the buttocks from each other. Hip: It is the
anterosuperior part of the gluteal region.
Slide 5
Bony Pelvis
Slide 6
Slide 7
Hip Bone
Slide 8
Slide 9
Femur
Slide 10
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Movements at Hip Joint
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Slide 15
Ligaments of the Gluteal Region 1.Sacrospinous: connecting
sacrum to ischial spine 2.Sacrotuberous: connecting sacrum to
ischial tuberosity Function : Stabilize the sacrum Prevent its
posterior rotation at the sacroiliac joint N.B: They convert the
greater & lesser sciatic notches into greater & lesser
sciatic foramina
Slide 16
Slide 17
Gluteus medius Gluteus minimus Piriformis Tendon of obturator
internus Superior gemillus Inferior gemillus Quadratus femoris
Adductor magnus Muscles of the Gluteal Region
Slide 18
Gluteus Maximus ilium S C
Slide 19
Most powerful & the bulkiest muscle of the body (Anti-
gravity muscle) Nerve supply Inferior gluteal nerve (L 5, S 1, S 2
) Actions: Chief extensor and lateral rotator of thigh at hip.
Helps in rising from sitting, bending or squatting positions and in
climbing upstairs & cycling. Extend knee through iliotibial
tract Gluteus Maximus (Chief extensor)
Slide 20
Slide 21
Ilio-tibial tractr Iliac tubercle Tensor fasciae lata
Slide 22
Gluteus Medius Origin: outer surface of ilium Insertion:
Lateral surface of greater trochanter Nerve supply: Superior
gluteal nerve (L4,5, S1) Action: Powerful abductor and Medially
rotation of thigh. Steady pelvis prevent the opposite side of the
pelvis tilting downwards as in walking & running
Slide 23
Gluteus Minimus Origin: outer surface of ilium Insertion:
Anterior surface of greater trochanter Nerve supply: Superior
gluteal nerve (L4,5, S1) Action: Abduction & medial rotatation
of the thigh
Slide 24
Tensor Fascia Lata Origin: Outer edge of iliac crest Insertion:
iliotibial tract Nerve supply: Superior gluteal nerve (L4,5, S1)
Action: Extension of the knee
Slide 25
Piriformis Origin: Anterior surface of S2,3,4 Insertion: Upper
border of greater trochanter Nerve supply: S1,2 Action: Lateral
rotator of thigh
Slide 26
Obturator Internus Origin: Inner surface of obturator membrane
Insertion: medial border of greater trochanter Nerve supply: nerve
to obturator internus (L4,S1) Action: Lateral rotator of thigh
Slide 27
Superior & Inferior Gemelli Origin: Superior: from ischial
spine Inferior: from ischial tuberosity Insertion: tendon of
obturator internus Nerve supply: Superior: nerve to obturator
internus (L4, S1) Inferior: nerve to quadratus femoris (L4, S1)
Action: Lateral rotators of thigh
Slide 28
Quadratus Femoris Origin: Lateral border of ischial tuberosity
Insertion: Quadrate tubercle of femur Nerve supply: nerve to
quadratus femoris (L4,S1) Action: Lateral rotator of thigh
Slide 29
Greater and Lesser Sciatic Foramen
Slide 30
Structures passing through greater sciatic foramen 1.
Piriformis Muscle 2. Above Piriformis: Superior gluteal nerve
Superior gluteal vessels 3. Below Piriformis: Inferior gluteal
nerve Inferior gluteal vessels Sciatic nerve Post. Cutaneous nerve
of thigh Nerve to quadratus femoris Nerve to obturator internus
Pudendal nerve Internal Pudendal vessels
Slide 31
Structures passing through lesser sciatic foramen 1.Nerve to
obturator internus 2.Pudendal nerve 3.Internal Pudendal vessels
4.Tendon of obturator internus
Slide 32
Site for Intramuscular Injection
Slide 33
Trendelenburg Test Observe patient from behind, ask him/her to
stand on one foot and then the other Negative test: Pelvis tilts up
on contralateral side Positive test: Pelvis sags on contralateral
side as in: 1.Fracture neck of femur 2.Dislocation of hip joint
3.Nonfunctioning gluteus medius and minimus due to: Neurological
damage (L4 5 disc herniation) Any disease affecting muscles
(myopathy
