Slideshow: Gluteal Region The Funky Professor videos can be viewed here; http://publishing.rcseng.ac.uk/journal/video?videoTaxonomy=FUNK

1. The Gluteal Region

2. The Gluteal Region lies
on the posterolateral
aspect of the pelvis
posterior view

3. The Gluteal Region lies
on the posterolateral
aspect of the pelvis
It is occupied by large
powerful muscles
Several important
nerves and vessels
traverse this area
posterior view

4. Muscles of the Gluteal Region

5. Largest and most superficial muscle
Has an extensive origin from
-lateral surface of ala of ilium
posterior to posterior gluteal line
-posterior surface of sacrum and
coccyx
- sacrotuberous ligament
Gluteus Maximus
right gluteal region

6. Gluteus Maximus
IliotibialIliotibial
TractTract
Largest and most superficial muscle
Its coarse fibers run obliquely
downwards and laterally behind the
hip joint
Most of the muscle inserts into the
Iliotibial Tract
right gluteal region

7. Gluteus Maximus
IliotibialIliotibial
TractTract
It extends the Hip Joint
and
laterally rotates the Hip Joint
right gluteal region

8. Gluteus Medius
Lies beneath
Gluteus Maximus
Originates from the lateral surface
(gluteal surface) of the Ilium,
between the anterior and posterior
Gluteal Lines.
right gluteal region

9. Gluteus Medius
It runs above the hip joint
Inserts onto the lateral aspect of
the Greater Trochanter
right gluteal region

10. Gluteus Medius
Gluteus MediusGluteus Medius
Gluteus Maximus,Gluteus Maximus,
turned away toturned away to
reveal Gluteusreveal Gluteus
MediusMedius
Iliotibial TractIliotibial Tract
It runs above the hip joint
Inserts onto the lateral aspect
of the Greater Trochanter
It abducts the Hip Joint
right gluteal region

11. Gluteus Minimus
Gluteus Medius is cut
Lies beneath Gluteus Medius
Originates from lateral surface
of Ilium between the anterior
and inferior Gluteal Lines
right gluteal region

12. Lies beneath Gluteus Medius
Originates from lateral surface
of Ilium between the anterior
and inferior Gluteal Lines
Gluteus Minimus
Inserts onto anterior aspect of
the Greater Trochanter of the
Femur
right gluteal region

13. Gluteus Minimus
Inserts onto anterior aspect of
the Greater Trochanter of the
Femur
Gluteus Medius is cut
Gluteus Minimus
Gluteus Medius is cut and
reflected downwards
Lies beneath Gluteus Medius
Originates from lateral surface
of Ilium between the anterior
and inferior Gluteal Lines
right gluteal region

14. Greater Sciatic Foramen

15. One of the major gateways
between the
pelvic cavity and the lower limb
The Greater Sciatic Foramen
posterior view

16. The Greater Sciatic Foramen
Formed by the
Greater Sciatic Notch
and
Sacrospinous ligament
attaching to the Ischial Spine
Sacrotuberous Ligament
One of the major gateways
between the
pelvic cavity and the lower limb
posterior view

17. The Greater Sciatic Foramen
Sacrotuberous Ligament
One of the major gateways
between the
pelvic cavity and the lower limb
posterior view
Formed by the
Greater Sciatic Notch
and
Sacrospinous ligament
attaching to the Ischial Spine

18. A number of
− Muscles
− Arteries and Veins
− Nerves
pass through the Greater
Sciatic Foramen
The Greater Sciatic Foramen
Sacrotuberous Ligament
posterior view

19. Muscles related to the Greater Sciatic Foramen

20. Piriformis
Lies centrally in the gluteal region
Originates from the
−anterior surface of lateral process
of sacrum
−dorsal aspect of ilium around
margin of the greater sciatic notch

21. Piriformis
Inserts onto the upper border
of
Greater Trochanter

22. Iliotibial TractIliotibial Tract
GluteusGluteus
MaximusMaximus
GluteusGluteus
MediusMedius
PiriformisPiriformis
SciaticSciatic
NerveNerve
Piriformis
Externally rotates the
hip joint when the
thigh is extended

23. Obturator Internus
Originates from the
-inner surface of
obturator membrane and
contiguous bone

24. PiriformisPiriformis
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus
(turned away)(turned away)
Obturator InternusObturator Internus
Sciatic NerveSciatic Nerve
Obturator Internus
Common insertion with
Superior and Inferior Gemelli
onto medial aspect of
Greater Trochanter of Femur

25. Superior Gemellus
Originates from a small area on the
outer surface of hip bone below
Ischial Spine

26. Superior Gemellus
Inferior Gemellus
Originates from the superior aspect of the
Ischial Tuberosity
Originates from a small area on the
outer surface of hip bone below
Ischial Spine

27. Superior Gemelli
&
Inferior Gemelli
Insert in common with
Obturator Internus
via the Tricipital Tendon

28. PiriformisPiriformis
ObturatorObturator
InternusInternus
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus
(reflected inferiorly)(reflected inferiorly)
Sciatic NerveSciatic Nerve
SuperiorSuperior
GemellusGemellus
InferiorInferior
GemellusGemellus
Superior Gemellus
&
Inferior Gemellus
Insert in common with
Obturator Internus
via the Tricipital Tendon

29. Quadratus Femoris
Originates from the lateral aspect
of the Ischial Tuberosity

30. Quadratus Femoris
Originates from the lateral aspect
of the Ischial Tuberosity
Inserts onto
Quadrate tubercle on
Intertrochanteric Crest and
adjacent area of posterior
Femur

31. Originates from the lateral aspect
of the Ischial TuberosityPiriformisPiriformis
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus
(reflected inferiorly)(reflected inferiorly)
Sciatic NerveSciatic Nerve
QuadratusQuadratus
FemorisFemoris
Quadratus Femoris
Inserts onto
Quadrate tubercle on
Intertrochanteric Crest and
adjacent area of posterior
Femur

32. PiriformisPiriformis
ObturatorObturator
InternusInternus
Gluteus MediusGluteus Medius
Gluteus MaximusGluteus Maximus
(reflected inferiorly)(reflected inferiorly)
Sciatic NerveSciatic Nerve
Collectively
•Superior Gemellus
•Inferior Gemellus
•Obturator Internus
•Quadratus Femoris
SuperiorSuperior
GemellusGemellus
InferiorInferior
GemellusGemellus
are known as the
Short Lateral Rotators
of the Hip Joint

33. Structures that cross
The Greater Sciatic Foramen

34. Nerves of the
Gluteal Region

35. Gluteus Minimus
Piriformis

36. Superior Gluteal Nerve

37. Superior Gluteal Nerve
Emerges superior to
Piriformis and splits into
-Superior division that
supplies Gluteus Medius
-Inferior division that
supplies Gluteus Minimus

38. Sciatic Nerve

39. Sciatic Nerve
Thickest nerve in the body
2cm at origin
Emerges below Piriformis
Divides into its two components
in the posterior thigh
•Tibial Nerve
•Common Peroneal Nerve

40. Inferior Gluteal Nerve

41. Inferior Gluteal Nerve
Arises from dorsal divisions of
•5th
Lumbar
•1st
and 2nd
sacral ventral rami
Supplies Gluteus Maximus

42. Posterior Cutaneous
Nerve of the Thigh

43. Posterior Cutaneous
Nerve of the Thigh
Purely sensory and mainly
cutaneous nerve
Arises from sacral plexus
-2nd
, 3rd
and 4th
sacral ventral
rami
Supplies gluteal and perineal
region and back of lower limb

44. Nerve to Obturator Internus

45. Nerve to Obturator Internus
Arises from ventral divisions of
-5th
Lumbar ventral rami
-1st
and 2nd
Sacral ventral rami
Supplies
-Obturator Internus
-Superior Gemellus

46. Nerve to Quadratus Femoris

47. Nerve to Quadratus Femoris
Arises from ventral divisions of
-4th,
5th
Lumbar ventral rami
-1st
Sacral ventral ramus
Supplies
-Quadratus Femoris
-Inferior Gemellus

48. Pudendal Nerve

49. Pudendal Nerve
Arises from ventral rami of
2nd
, 3rd
and 4th
sacral nerves
Exits the pelvis via the
Greater Sciatic Foramen
and enters the perineum
through the
Lesser Sciatic Foramen
Supplies Perineal structures

50. Perforating Cutaneous Nerve

51. Perforating Cutaneous Nerve
Arises from posterior aspect of
2nd
, 3rd
sacral ventral rami
Pierces Sacrotuberous Ligament
supplies skin over
inferior and medial part of
buttock

52. Superior Gluteal Artery
Branch of the
Internal Iliac Artery

53. Superior Gluteal Artery
Branch of the
Internal Iliac Artery
Supplies muscles of the
gluteal region and hip joint

54. Inferior Gluteal Artery
Branch of the
Internal Iliac Artery

55. Inferior Gluteal Artery
Branch of the
Internal Iliac Artery
Supplies muscles of the
gluteal region and hip joint

56. Summary of Muscles of the
Gluteal Region

57. Gluteus Maximus
Origin Gluteal surface of ilium
posterior to posterior gluteal
line, posterior superior iliac
crest, dorsal sacrum and
coccyx, and sacrotuberous
ligament
Insertion Iliotibial tract (band); gluteal
tuberosity posterior femur
Action Extends and laterally rotates
hip
Nerve Supply Inferior gluteal nerve (L5, S1,
S2)
Blood Supply Inferior and superior gluteal
arteries
Gluteal Region

58. Gluteus Medius
Origin Outer surface of ilium between
posterior and middle gluteal lines
Insertion Lateral surface of greater
trochanter of femur
Action Abducts thigh; medially rotates
hip
Nerve Supply Superior gluteal nerve (L4, L5, S1)
Blood Supply Superior gluteal artery
Gluteal Region

59. Gluteus Minimus
Origin Outer surface of ilium between
inferior and anterior gluteal lines
Insertion Anterior surface of greater
trochanter of femur
Action Abducts and medially rotates the
hip joint
Nerve Supply Superior gluteal nerve (L4, L5, S1)
Blood Supply Superior gluteal artery
Gluteal Region

60. Piriformis
Origin Anterior surface of lateral
process of sacrum and gluteal
surface of ilium at the margin of
the greater sciatic notch
Insertion Superior aspect greater
trochanter of femur
Action Lateral rotator of the hip joint
Nerve Supply Anterior primary rami S1, S2
Blood Supply Superior and inferior gluteal
arteries
Gluteal Region

61. Gluteal Region
Obturator Internus
Origin Inner surface of obturator
membrane and adjacent bone
Insertion Medial aspect greater
trochanter of femur, in
common with superior and
inferior gemelli
Action Laterally rotates hip
Nerve Supply Nerve to the obturator
internus (L5, S1, S2)
Blood Supply Internal pudendal and
superior and inferior gluteal
arteries

62. Gluteal Region
Superior Gemellus
Origin Outer surface hip bone below
Ischial spine
Insertion Medial surface of greater
trochanter of femur, in
common with obturator
internus
Action Laterally rotates hip
Nerve Supply Nerve to the obturator
internus
Blood Supply Inferior gluteal artery

63. Gluteal Region
Inferior Gemellus
Origin Superior aspect ischial
tuberosity
Insertion Medial surface of greater
trochanter of femur, in
common with obturator
internus
Action Laterally rotates hip
Nerve Supply Nerve to quadratus femoris
(L4, 5, S1)
Blood Supply Inferior gluteal artery

64. Gluteal Region
Quadratus Femoris
Origin Lateral border ischial
tuberosity
Insertion Quadrate tubercle and
adjacent bone of
intertrochanteric crest of
posterior aspect femur
Action Laterally rotates hip
Nerve Supply Nerve to the quadratus
femoris
Blood Supply Medial circumflex femoral
artery, inferior gluteal artery,
obturator artery