Gluteal RegionGluteal RegionMuscles of Gluteal Muscles of Gluteal RegionRegion

Arterial SupplyArterial SupplyNerve SupplyNerve Supply

Gluteal Gluteal Region & Region & BoundaryBoundary

Superior:Superior: Iliac crestIliac crest

Inferior: Inferior: Gluteal FoldGluteal Fold

Medial: Medial: Median sacral Median sacral crest & Natal cleftcrest & Natal cleft

Lateral: Lateral: Imaginary Imaginary line between Iliac line between Iliac crest & Greater crest & Greater trochanter of femor trochanter of femor

Superficial Fascia Superficial Fascia & Contents& Contents

Deep Fascia & Deep Fascia & partsparts

Gluteal Gluteal RegionRegion

Muscles Muscles

Arterial Arterial Supply Supply

Nerve Supply Nerve Supply

Superficial:Superficial:

Gluteus MaximusGluteus Maximus

Gluteus MediusGluteus Medius

Gluteus MinimusGluteus Minimus

Deep:Deep:

PiriformisPiriformis

Gemelus SuperiorGemelus Superior

Obterator InternusObterator Internus

Gemelus InferiorGemelus Inferior

Quadratus FemoriQuadratus Femori

Superior Gluteal ArterySuperior Gluteal Artery

Inferior Gluteal ArteryInferior Gluteal Artery

(branches of Internal Iliac (branches of Internal Iliac a.)a.)Branches of Sacral PlexusBranches of Sacral Plexus

Sacral Plexus is formed from anterior rami of L4, L5, S1, S2, S3, S4

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Muscles of the gluteal regionMuscles of the gluteal region

MuscleMuscle OriginOrigin InsertionInsertion InnervationInnervation FunctionFunction

Gluteus Gluteus maximusmaximus

External surface of ilium External surface of ilium behind posterior gluteal behind posterior gluteal line, fascia of erector line, fascia of erector spinae, dorsal surface of spinae, dorsal surface of lower sacrum, lateral lower sacrum, lateral margin of coccyx, margin of coccyx, external surface of external surface of sacrotuberous ligamentsacrotuberous ligament

Posterior aspect Posterior aspect of iliotibial tract of iliotibial tract of fascia lata and of fascia lata and gluteal gluteal tuberosity of tuberosity of femurfemur

Inf. gluteal nerve Inf. gluteal nerve (L5,S1,S2)(L5,S1,S2)

Powerful extensor of flexed Powerful extensor of flexed femur at hip joint; lateral femur at hip joint; lateral stabilizer of hip joint and knee stabilizer of hip joint and knee jointjoint

Gluteus Gluteus mediusmedius

External surface of ilium External surface of ilium between anterior and between anterior and posterior gluteal linesposterior gluteal lines

Lateral surface Lateral surface of the greater of the greater trochantertrochanter

Sup. gluteal Sup. gluteal nerve nerve (L4,L5,S1)(L4,L5,S1)

Abducts femur at hip joint; Abducts femur at hip joint; holds pelvis secure over stance holds pelvis secure over stance leg and prevents pelvic drop on leg and prevents pelvic drop on the opposite swing side during the opposite swing side during walking walking Anterior fibers Med. Rot.of HipAnterior fibers Med. Rot.of Hip

Gluteus Gluteus minimusminimus

External surface of ilium External surface of ilium between inferior and between inferior and anterior gluteal linesanterior gluteal lines

Antero-lateral Antero-lateral aspect of the aspect of the greater greater trochantertrochanter

Sup. gluteal Sup. gluteal nerve nerve (L4,L5,S1)(L4,L5,S1)

Like Gluteus mediusLike Gluteus medius

Tensor Tensor fasciae fasciae lataelatae

Lateral aspect of crest of Lateral aspect of crest of ilium between anterior ilium between anterior superior iliac spine and superior iliac spine and tubercle of the cresttubercle of the crest

Iliotibial tract of Iliotibial tract of fascia latafascia lata

Sup. gluteal Sup. gluteal nerve nerve (L4,L5,S1)(L4,L5,S1)

Stabilizes the knee in extensionStabilizes the knee in extension

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Muscles of the gluteal region (continue)Muscles of the gluteal region (continue)

MuscleMuscle OriginOrigin InsertionInsertion InnervationInnervation FunctionFunction

PiriformisPiriformis Anterior surface of Anterior surface of sacrum between sacrum between anterior sacral anterior sacral foramina(S2,S3,S4) foramina(S2,S3,S4)

superior border (apex) of superior border (apex) of greater trochanter of greater trochanter of femurfemur

Branches Branches from,S1,S2from,S1,S2

Laterally rotates the Laterally rotates the extended femur at hip joint; extended femur at hip joint;

Obturator Obturator internusinternus

Anterolateral wall Anterolateral wall of true pelvis; deep of true pelvis; deep surface of obturator surface of obturator membrane and membrane and surrounding bonesurrounding bone

Medial side of greater Medial side of greater trochanter of femurtrochanter of femur

Nerve to Nerve to obturator obturator internus internus (L5,(L5,S1)S1)

Laterally rotates the Laterally rotates the extended femur at hip joint; extended femur at hip joint;

Gemellus Gemellus superiorsuperior

Posterior surface of Posterior surface of ischial spineischial spine

Along length of superior Along length of superior surface of the obturator surface of the obturator internus tendon and into internus tendon and into the medial side of greater the medial side of greater trochanter of femur trochanter of femur

Nerve to Nerve to obt.int. (L5,S1)obt.int. (L5,S1)

Laterally rotates the Laterally rotates the extended femur at hip joint; extended femur at hip joint; abduction of flexed femur at abduction of flexed femur at hip jointhip joint

Gemellus Gemellus inferiorinferior

Upper part of Upper part of ischial tuberosityischial tuberosity

Along length of inferior Along length of inferior surface of the obturator surface of the obturator internus tendon and into internus tendon and into the medial side of greater the medial side of greater trochanter of femur trochanter of femur

Nerve to Nerve to quad.femoris quad.femoris (L5,S1)(L5,S1)

Laterally rotates the Laterally rotates the extended femur at hip joint;extended femur at hip joint;

Quadratus Quadratus femorisfemoris

Lateral aspect of Lateral aspect of the ischium just the ischium just anterior to the anterior to the ischial tuberosityischial tuberosity

Quadrate tubercle on the Quadrate tubercle on the intertrochanteric crest of intertrochanteric crest of the femur the femur

Nerve to Nerve to quad.femoris quad.femoris (L5,S1)(L5,S1)

Laterally rotates femur at Laterally rotates femur at hip jointhip joint

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Gluteal Region Gluteal Region (continue)(continue)

Review of MusclesReview of MusclesSacral PlexusSacral PlexusVesselsVessels

Gluteal Gluteal RegionRegion

Muscles Muscles

Arterial Arterial Supply Supply

Nerve Supply Nerve Supply

Superficial:Superficial:

Gluteus MaximusGluteus Maximus

Gluteus MediusGluteus Medius

Gluteus MinimusGluteus Minimus

Deep:Deep:

PiriformisPiriformis

Gemelus SuperiorGemelus Superior

Obterator InternusObterator Internus

Gemelus InferiorGemelus Inferior

Quadratus FemorisQuadratus Femoris

Superior Gluteal ArterySuperior Gluteal Artery

Inferior Gluteal ArteryInferior Gluteal Artery

(branches of Internal Iliac (branches of Internal Iliac a.)a.)

Branches of Sacral PlexusBranches of Sacral Plexus

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Arterial Supply

Sacral PlexusSacral Plexus

Easy way to learn Sacral Plexus:Easy way to learn Sacral Plexus:

L4, L5, S1: Sup. Gluteal N. & N. to Quadratus L4, L5, S1: Sup. Gluteal N. & N. to Quadratus FemorisFemoris

L5, S1, S2: Inf. Glutal N. & N. to Obturator L5, S1, S2: Inf. Glutal N. & N. to Obturator InternusInternus

S1, S2, S3: Post. Cutaneous N. of ThighS1, S2, S3: Post. Cutaneous N. of Thigh S2, S3, S4: Pudendal N. & Pelvic SplanchnicS2, S3, S4: Pudendal N. & Pelvic Splanchnic S1, S2: N. to PiriformisS1, S2: N. to Piriformis L4, L5, S1, S2, S3: Sciatic N.L4, L5, S1, S2, S3: Sciatic N.

MUSCLE:MUSCLE:

Piriformis Muscle Piriformis Muscle

ARTERIES:ARTERIES:

Sup.& Inf. Gluteal ArterySup.& Inf. Gluteal Artery

Internal Pudendal ArteryInternal Pudendal Artery

NERVES:NERVES:

All of the branches of Sacral All of the branches of Sacral PlexusPlexus

Structures Passed to

Greater Sciatic Foramen

MUSCLE:MUSCLE:

Obturator Internus MuscleObturator Internus Muscle

ARTERARTERyy::

Internal Pudendal ArteryInternal Pudendal Artery

NERVE:NERVE:

Pudendal NervePudendal Nerve

Nerve to Obturator Internus Nerve to Obturator Internus Muscle Muscle

Structures Passed to Lesser Sciatic Foramen