1. Gluteal region IN 10 QUESTIONS Kaan Yücel M.D., Ph.D.
25.April Friday

2. Anterior superior iliac spine
1. What is gluteal region?
(G. gloutos, buttocks)
transitional region between trunk & lower limbs .
Anterior superior iliac spine

3. 2. How are the muscles of the gluteal region organized?
Deep
lateral rotators of the hip joint
piriformis, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris
Superficial
abduct and extend the hip
gluteus minimus, gluteus medius, and gluteus maximus .

4. Gluteus medius et minimus
Gluteus maximus
Powerful extensor of (especially) flexed femur at hip joint; lateral stabilizer of hip joint and knee joint; laterally rotates and abducts thigh; steadies thigh and assists in rising from sitting position.
Gluteus medius et minimus
Abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase

5. Gluteus medius
paralysis

6. 3...deep muscles of the gluteal region?

7. Piriformis Anterior surface of sacrum Sacrotuberous ligament
Superior border of greater trochanter of femur

8. Medial surface of greater trochanter (trochanteric fossa) of femur
Superior gemellus-Obturator internus-Inferior gemellus
Ischial spine
Pelvic surface of obturator membrane and surrounding bones
Ischial tuberosity
Medial surface of greater trochanter (trochanteric fossa) of femur

9. Quadratus femoris Ischial tuberosity Quadrate tubercle
on intertrochanteric crest of femur and area inferior to it

10. 4...superficial muscles in the gluteal region?
External surface of ilium between anterior and posterior gluteal lines .
External surface of ilium between anterior and inferior gluteal lines
Ilium posterior to posterior gluteal line; dorsal surface of sacrum and coccyx; sacrotuberous ligament
Lateral surface of greater trochanter of femur
Anterior surface of greater trochanter of femur
Iliotibial tract & gluteal tuberosity of femur

11. 5...functions of the gluteal region muscles?
Muscles in the gluteal region mainly
abduct, extend, and laterally rotate the femur relative to the pelvic bone. .

12. 6....innervation of the gluteal region muscles? Superior gluteal nerve
Gluteus minimus & medius
Tensor fascia latae
Inferior gluteal nerve
Gluteus maximus .
Nerve to the quadratus femoris
Quadratus femoris
Gemellus inferior
Nerve to the obturator internus
Obturator internus
Gemellus superior
Nerve to the piriformis
Piriformis

13. G L U T E A BURSAE Between gluteus maximus & greater trochanter
birth

14. greater sciatic foramen
7....nerves of the gluteal region?
Superior gluteal nerve
Inferior gluteal nerve
Sciatic nerve
Nerve to the quadratus femoris
Nerve to the obturator internus
Posterior cutaneous nerve of the thigh
Pudendal nerve
greater sciatic foramen .

15. Superior & inferior gluteal nerves
* Above the piriformis .
tensor fasciae latae
Posterior to

16. Sciatic nerve lies just deep to gluteus maximus
Superficial muscles
Deep muscles .
lies just deep to
gluteus maximus
midpoint between ischial tuberosity
&
greater trochanter
Enters thigh

17. Nerve to Quadratus Femoris
Inferior to piriformis
Deep to sciatic nerve
* anterior to the plane of
the deep muscles .

18. Nerve to Obturator Internus
between posterior cutaneous nerve of thigh
&
pudendal nerve .
+ GS

19. Posterior Cutaneous Nerve of Thigh Medial to sciatic nerve.
Medial to sciatic nerve
Skin over the gluteal fold

20. Pudendal nerve .

21. Sensory Innervation of the Gluteal Region
Nerve
Origin (Contributing spinal nerves)
Course
Distrubition
Superior clunial nerves
L1-L3 posterior rami
Penetrate thoracodorsal fascia; course laterally and inferiorly in subcutaneous tissue
Skin overlying superior and central parts of buttock
Medial clunial nerves
S1-S3 posterior rami
Emerge from dorsal sacral foramina; directly enter overlying subcutaneous tissue
Skin of medial buttock and intergluteal cleft
Inferior clunial nerves
Posterior cutaneous nerve of thigh (S2-S3)
Arise deep to gluteus maximus; emerge from beneath inferior border of muscle
Skin of inferior buttock (overlying gluteal fold)
Subcostal
T12 anterior ramus
Courses along inferior border of 12th rib; lateral cutaneous branch descends over iliac crest
Lateral cutaneous branch supplies skin of hip region inferior to anterior part of iliac crest and anterior to greater trochanter
Iliohypogastric
Lumbar plexus (L1; occasionally T12)
Parallels iliac crest; divides into lateral and anterior cutaneous branches
Lateral cutaneous branch supplies superolateral quadrant of buttock .
Lateral cutaneous nerve of thigh skin overlying the lower lateral quadrant of the buttock.
Perforating cutaneous nerve skin over the medial aspect of the gluteus maximus.

23. 8...arteries in the gluteal region?

25. 9...veins in the gluteal region? Internal iliac veins
Femoral vein

26. 10...lymphatics of the gluteal region?
Lymph from deep tissue
superior & inferior gluteal lymph nodes
internal,external,common iliac lymph nodes
lateral lumbar (aortic/caval) lymph nodes .
Lymph from superficial tissue
superficial inguinal lymph nodes
external iliac lymph nodes