Gluteal region
          Dr. Rania sherif
 Lecturer of Anatomy, Mansoura university
Deep fascia (fascia lata)




      Iliotibial tract         Saphenous
                                opening
        Attachment
Sup: tubercle of iliac crest
 Inf: lat condyle of tibia
Muscles
 Gluteal ms Lat. hip rotators
Gluteus maximus Piriformis

Gluteus medius       Quadratus femoris
                     Obturator internus &
Gluteus brevis
                     externus
                     Sup & inf gemellus
Tensor fascia lata
Gluteus medius
             Gluteus
Piriformis   minimus

                       Sup gemellus


                       Inf gemellus


Obturator
 internus     Quadratus
               femoris
Middle gluteal
                          line



               minimus
maximus
                           Inferior
                          gluteal line
 Posterior
gluteal line
Gluteus maximum
Origin:
Back of sacrum & coccyx
Back of sacrotuberous ligament
Gluteal surface behind post
gluteal line
Insertion:
Superficial ¾ into iliotibial tract
Deep ¼ into gluteal tuberosity
NS: inferior gluteal n
Action:
Extension of hip joint
Lateral rotation of thigh
Help in extension of knee joint
Gluteus medius
Origin:
Gluteal surface () post & middle
gluteal lines
Insertion:
Greater trochanter (lat surface)
NS: superior gluteal n
Gluteus minimus
Origin:
() middle & inferior gluteal lines
Insertion:
Greater trochanter (ant surface)
NS: superior gluteal n
Action:
Abduction & med rotation of thigh
Prevent pelvic drop during walking
Superior gluteal n injury
Tensor fascia lata
Origin: iliac crest () ASIS &
tubercle
Insertion:
Iliotibial tract
NS: superior gluteal n
Action:
Tense iliotibial tract
Abduction & med rotation of hip
Piriformis muscle
Origin:
Middle 3 pieces of sacrum
(ant)
Insertion:
Upper border of greater
trochanter
NS: sacral plexus S1,2
Obturator externus
Origin:
Obturator        membrane
(outer surface) & adjacent
bones
Insertion:
Trochanteric fossa
NS: obturator nerve
Obturator internus
Origin:
Obturator membrane (inner
surface)
Front & sides of pelvis
Insertion:
Medial surface of greater
trochanter
NS:     N   to    obturator
internus
Superior gemellus
Origin:
Lesser sciatic notch (upper)
Insertion:
Tendon of obturator internus
NS: N to obturator internus

Inferior gemellus
Origin:
Lesser sciatic notch (lower)
Insertion:
Tendon of obturator internus
NS: N to quadratus femoris
Quadratus femoris
Origin:
Ischeal    tuberosity   (lat
border)
Insertion:
Quadrate tubercle
NS:     N    to   quadratus
femoris
Sacrotuberous ligament
Attachment:
PSIS, PIIS
Side & back of sacrum & coccyx
Ischeal tuberosity
Ramus of ischium

Function:
Fix sacrum in oblique direction
Sacrospinous ligament

Attachment:
Ischeal spine
Lat margin of sacrum &
  coccyx
Greater sciatic foramen
 Structures passing through it:
 Superior gluteal vs & nerve
 Piriformis ms
 Inferior gluteal vs & nerve
 Nerve to obturator internus
 Internal pudendal vs
 Pudendal n
 Sciatic n
 Post cutaneous n of thigh
 Nerve to quadratus femoris
Lesser sciatic foramen
Structures passing through it:
Tendon of obturator internus
Nerve to obturator internus
Internal pudendal vs
Pudendal n
Sciatic nerve
Origin:
Sacral plexus L4,5, S1,2,3
Course:
Greater sciatic foramen below
piriformis muscle
Deep to gluteus maximus
Midpoint () ischial tuberosity and
greater trochanter.
Branches:
Tibial nerve (medial popliteal)
Common peroneal nerve (lateral
popliteal)
Distribution:
Hamstring ms & adduct magnus
(ischeal part)
Safe Area - Intramuscular Injection
Gluteal region

Gluteal region

  • 1.
    Gluteal region Dr. Rania sherif Lecturer of Anatomy, Mansoura university
  • 3.
    Deep fascia (fascialata) Iliotibial tract Saphenous opening Attachment Sup: tubercle of iliac crest Inf: lat condyle of tibia
  • 5.
    Muscles Gluteal msLat. hip rotators Gluteus maximus Piriformis Gluteus medius Quadratus femoris Obturator internus & Gluteus brevis externus Sup & inf gemellus Tensor fascia lata
  • 6.
    Gluteus medius Gluteus Piriformis minimus Sup gemellus Inf gemellus Obturator internus Quadratus femoris
  • 7.
    Middle gluteal line minimus maximus Inferior gluteal line Posterior gluteal line
  • 8.
    Gluteus maximum Origin: Back ofsacrum & coccyx Back of sacrotuberous ligament Gluteal surface behind post gluteal line Insertion: Superficial ¾ into iliotibial tract Deep ¼ into gluteal tuberosity NS: inferior gluteal n Action: Extension of hip joint Lateral rotation of thigh Help in extension of knee joint
  • 9.
    Gluteus medius Origin: Gluteal surface() post & middle gluteal lines Insertion: Greater trochanter (lat surface) NS: superior gluteal n Gluteus minimus Origin: () middle & inferior gluteal lines Insertion: Greater trochanter (ant surface) NS: superior gluteal n Action: Abduction & med rotation of thigh Prevent pelvic drop during walking
  • 10.
  • 11.
    Tensor fascia lata Origin:iliac crest () ASIS & tubercle Insertion: Iliotibial tract NS: superior gluteal n Action: Tense iliotibial tract Abduction & med rotation of hip
  • 12.
    Piriformis muscle Origin: Middle 3pieces of sacrum (ant) Insertion: Upper border of greater trochanter NS: sacral plexus S1,2
  • 13.
    Obturator externus Origin: Obturator membrane (outer surface) & adjacent bones Insertion: Trochanteric fossa NS: obturator nerve
  • 14.
    Obturator internus Origin: Obturator membrane(inner surface) Front & sides of pelvis Insertion: Medial surface of greater trochanter NS: N to obturator internus
  • 15.
    Superior gemellus Origin: Lesser sciaticnotch (upper) Insertion: Tendon of obturator internus NS: N to obturator internus Inferior gemellus Origin: Lesser sciatic notch (lower) Insertion: Tendon of obturator internus NS: N to quadratus femoris
  • 16.
    Quadratus femoris Origin: Ischeal tuberosity (lat border) Insertion: Quadrate tubercle NS: N to quadratus femoris
  • 17.
    Sacrotuberous ligament Attachment: PSIS, PIIS Side& back of sacrum & coccyx Ischeal tuberosity Ramus of ischium Function: Fix sacrum in oblique direction
  • 18.
  • 19.
    Greater sciatic foramen Structures passing through it: Superior gluteal vs & nerve Piriformis ms Inferior gluteal vs & nerve Nerve to obturator internus Internal pudendal vs Pudendal n Sciatic n Post cutaneous n of thigh Nerve to quadratus femoris
  • 20.
    Lesser sciatic foramen Structurespassing through it: Tendon of obturator internus Nerve to obturator internus Internal pudendal vs Pudendal n
  • 21.
    Sciatic nerve Origin: Sacral plexusL4,5, S1,2,3 Course: Greater sciatic foramen below piriformis muscle Deep to gluteus maximus Midpoint () ischial tuberosity and greater trochanter. Branches: Tibial nerve (medial popliteal) Common peroneal nerve (lateral popliteal) Distribution: Hamstring ms & adduct magnus (ischeal part)
  • 22.
    Safe Area -Intramuscular Injection