Gluteal Region Muscles of Gluteal Region Arterial Supply Nerve Supply Gluteal Region & Boundary Superior: Iliac crest Inferior: Gluteal Fold Medial: Median sacral crest & Natal cleft Lateral: Imaginary line between Iliac crest & Greater trochanter of femor Superficial Fascia & Contents Deep Fascia & parts Gluteal Region Muscles Arterial Supply Nerve Supply Superficial: Gluteus Maximus Gluteus Medius Gluteus Minimus Deep: Piriformis Gemelus Superior Superior Gluteal Artery Inferior Gluteal Artery Obterator Internus (branches Internal Iliac a.) Gemelus of Inferior Branches of Sacral Plexus Quadratus Femori Sacral Plexus is formed from anterior rami of L4, L5, S1, S2, S3, S4 Back Back Muscles of the gluteal region Muscle Origin Insertion Innervation Function Gluteus maximus External surface of ilium behind posterior gluteal line, fascia of erector spinae, dorsal surface of lower sacrum, lateral margin of coccyx, external surface of sacrotuberous ligament Posterior aspect of iliotibial tract of fascia lata and gluteal tuberosity of femur Inf. gluteal nerve Powerful extensor of flexed (L5,S1,S2) femur at hip joint; lateral stabilizer of hip joint and knee joint Gluteus medius External surface of ilium between anterior and posterior gluteal lines Lateral surface of the greater trochanter Sup. gluteal nerve (L4,L5,S1) Abducts femur at hip joint; holds pelvis secure over stance leg and prevents pelvic drop on the opposite swing side during walking Anterior fibers Med. Rot.of Hip Gluteus minimus External surface of ilium between inferior and anterior gluteal lines Antero-lateral aspect of the greater trochanter Sup. gluteal nerve (L4,L5,S1) Like Gluteus medius Tensor fasciae latae Lateral aspect of crest of ilium between anterior superior iliac spine and tubercle of the crest Iliotibial tract of fascia lata Sup. gluteal nerve (L4,L5,S1) Stabilizes the knee in extension Muscles of the gluteal region (continue) Muscle Origin Insertion Innervation Function Piriformis Anterior surface of sacrum between anterior sacral foramina(S2,S3,S4) superior border (apex) of greater trochanter of femur Branches from,S1,S2 Laterally rotates the extended femur at hip joint; Obturator internus Anterolateral wall of true pelvis; deep surface of obturator membrane and surrounding bone Medial side of greater trochanter of femur Nerve to obturator internus (L5,S1) Laterally rotates the extended femur at hip joint; Gemellus superior Posterior surface of ischial spine Along length of superior surface of the obturator internus tendon and into the medial side of greater trochanter of femur Nerve to obt.int. (L5,S1) Laterally rotates the extended femur at hip joint; abduction of flexed femur at hip joint Gemellus inferior Upper part of ischial tuberosity Along length of inferior surface of the obturator internus tendon and into the medial side of greater trochanter of femur Nerve to quad.femoris (L5,S1) Laterally rotates the extended femur at hip joint; Quadratus femoris Lateral aspect of the ischium just anterior to the ischial tuberosity Quadrate tubercle on the intertrochanteric crest of the femur Nerve to quad.femoris (L5,S1) Laterally rotates femur at hip joint Back Back Gluteal Region (continue) Review of Muscles Sacral Plexus Vessels Gluteal Region Muscles Arterial Supply Nerve Supply Superficial: Gluteus Maximus Gluteus Medius Gluteus Minimus Deep: Piriformis Gemelus Superior Obterator Internus Gemelus Inferior Quadratus Femoris Superior Gluteal Artery Inferior Gluteal Artery (branches of Internal Iliac a.) Branches of Sacral Plexus Back Back Arterial Supply Sacral Plexus Easy way to learn Sacral Plexus: L4, L5, S1: Sup. Gluteal N. & N. to Quadratus Femoris L5, S1, S2: Inf. Glutal N. & N. to Obturator Internus S1, S2, S3: Post. Cutaneous N. of Thigh S2, S3, S4: Pudendal N. & Pelvic Splanchnic S1, S2: N. to Piriformis L4, L5, S1, S2, S3: Sciatic N. Structures Passed to Greater Sciatic Foramen MUSCLE: Piriformis Muscle ARTERIES: Sup.& Inf. Gluteal Artery Internal Pudendal Artery NERVES: All of the branches of Sacral Plexus Structures Passed to Lesser Sciatic Foramen MUSCLE: Obturator Internus Muscle ARTERy: Internal Pudendal Artery NERVE: Pudendal Nerve Nerve to Obturator Internus Muscle