This simple presentation is about the neurovascular supply of the gluteal region , including viens , arteries and nerves

1. NEUROVASCULAR SUPPLY OF
GLUTEAL REGION
MOHAMMED MUNEER
University of Karbala

5. • Superior gluteal artery
• Inferior gluteal artery
• They are branches of the internal
iliac artery
• They supply the gluteal region
• Obturator artery is abranch of
the internal iliac artery
• It passes through obturator
foramen
• It supplies the medal side of the
upper thigh

6. Femoral Artery
• It is the contiuation of
the external iliac artery
at the mid inguinal point
• It descends in the
femoral triangle
• Then, it continues in the
adductor canal
• It reaches the adductor
hiatus where it becomes
the popliteal artery
• It supplies all structures
in the thigh

8. Femoral Artery
In the femoral triangle, it gives the
following branches:
 3 superficial branches
Superficial circumflex iliac artery
Superficial Epigastric artery
External pudendal artery
 3 deep branches
Deep artery of the thigh
Deep external pudendal
Descending genicular

9. Deep Artery of the Thigh
• It is the main artery of the thigh
• It gives the following branches
• Medial circumflex femoral artery
• Lateral circumflex femoral artery
which gives a descending branch
• Perforating arteries

11. Arteries of Gluteal Region
Superior gluteal-from internal iliac posterior division above piriformis
Inferior gluteal-from internal iliac anterior division-below piriformis
Trochanteric anastomosis- main supply to head of femur. Retinacular
nutrient arteries pass along neck of femur to head.
Formation
1. Superior gluteal A
2. Inferior gluteal A
3. Medial Circumflex A
4. Lateral circumflex A
Cruciate anastomosis
1. Inferior gluteal
2. MCF and LCF
3. 1st perforating branch of PFA

12. Superior gluteal artery
• Branch from posterior division of the internal iliac artery
• Leaves the pelvis by passing through the greater sciatic
foramen above the piriformis muscle

13. INFERIOR GLUTEAL ARTERY
Arises from anterior division of Internal iliac artery.
• Leaves the pelvis by passing through the greater
sciatic foramen below the piriformis muscle

18. Trochanteric Anastomosis
 Is the main supply to the head &
neck of femur
 Provides a connection between
internal iliac and femoral arteries
 Lies near the trochanteric fossa,
branches run along the femoral
neck beneath the reticular fibers of
the capsule
 Formed by:
 Descending branches of
superior and inferior gluteal
arteries &
 Ascending branches of lateral
and medial circumflex arteries

19. Posterior view
Arterial supply to Femoral
head
• Medial & lateral femoral
circumflex arteries
• Superior and inferior
gluteal arteries
• Post. obdurator artery
via artery of femoral
ligament
TROCHANTERIC
ANASTOMOSIS

20. Cruciate Anastomosis
 Lies at the level of lesser
trochanter
 Provides a connection between
internal iliac and femoral
arteries
 Formed by:
 Descending branch of
inferior gluteal artery
 Transverse branches of
medial and lateral circumflex
arteries &
 Ascending branch of first
perforating artery

22. •The sacral plexus supplies
innervation to the pelvic muscles,
gluteal muscles, and perineal muscles.
It also forms the sciatic nerve.
Sacral plexus
Formed by the 4th & 5th lumbar
ventral rami (lumbosacral trunk)
and S1234
• Forms on the ventral surface of
the piriformis muscle

28. Sciatic nerve
(L4, L5, SI, S2, S3)
• Is the largest branch of the sacral
plexus and the largest nerve in body
• Consists of two separate nerves,
the common peroneal nerve and the
tibial nerve
• Leaves the pelvis through the
greater sciatic foramen below the
piriformis muscle

29. Superior gluteal nerve
(L4, L5, S1)
• Leaves the pelvis through
the greater sciatic foramen above
the piriformis muscle with the superior gluteal artery
and vein
• In the gluteal region supplies the gluteus medius, the
gluteus minimus, the tensor fasciae latae, and the hip
joint

32. Inferior gluteal nerve
(L5, S1, S2)
• Leaves the pelvis through the
greater sciatic foramen below the
piriformis muscle with the inferior
gluteal artery and vein
• In the gluteal region supplies the
gluteus maximus muscle

33. Posterior femorai cutaneous nerve
(SI, S2, S3)
• Leaves the pelvis through the greater sciatic foramen
inferior to the piriformis
• In the gluteal region descends on the posterior
surface of the sciatic nerve
• Supplies the skin of the buttocks, posterior thigh,
popliteal fossa, and external genitalia

34. Nerve to the obturator internus
(L5, S1, S2)
• Leaves the pelvis through the greater sciatic
foramen below the piriformis muscle
• In the gluteal region descends on the superior
gemellus muscle to pass below the ischial spine and
enter the lesser sciatic foramen
• Supplies the superior gemellus and obturator
internus muscles

35. Nerve to the quadratus femoris
(L4, L5, SI)
• Leaves the pelvis through the greater sciatic
foramen below the piriformis muscle and deep to the
sciatic nerve
• In the gluteal region runs anterior to the superior
and inferior gemellus and obturator internus
muscles
• Supplies the inferior gemellus and quadratus
femoris muscles

36. Pudendal nerve
(S2, S3, S4)
• Leaves the pelvis through the greater sciatic
foramen inferior to the piriformis muscle along with
the internal pudendal artery and vein
• In the gluteal region descends posterior to the
ischial spine and enters the lesser sciatic foramen
• Is distributed to the perineum and has no branches
in the gluteal region