anatomy of gluteal region

2. Presentation of gluteal region by
MARIA AKRAM F09021
AMNA AHMAD F09013
FARYAL NAVEED F09015
NADIA AZHAR F09049
SAIRA AKHTAR CHEEMA F09003

3. Gluteal region
The gluteal region means; the region of
Buttocks.
It is bounded superiorly by the iliac crest &
inferiorly by the fold of buttock. The
region is largely made up of muscles & a
thick layer of superficial fascia.

5. Fascia of gluteal region
Superficial fascia
It is thicker and tougher than the other areas
of the body, especially in women and is
impregnated with large quantity of fat. It
contributes to the prominence of buttock

6. Deep fascia
• It is also called fascia lata.
• It encloses the gluteus maximus and tensor fascia lata b/w
two layers.
• It continues as a single layer that covers the outer surface of
gluteus maximus and is attached to iliac crest.
• It is very tough above the gluteus maximus superficial to
gluteus medius gives partial origin to gluteus medius. On
the lateral side of the thigh it is thickened to form a strong
wide band, iliotibial tract. It forms the sheath for tensor
fascia latae and receives the greater part of insertion of
gluteus maximus.

7. The cutaneous nerves are derived from posterior & anterior rami of
spinal nerves which are;
The upper medial quadrant is supplied by the posterior rami of the upper
three lumbar nerves & the upper three sacral nerves.
The upper lateral quadrant is supplied by lateral branches of
iliohypogastric & 12th thoracic nerves(anterior rami).
The lower lateral quadrant is supplied by branches from the lateral
cutaneous nerve of the thigh.(L2 & 3 anterior rami)
The lower medial quadrant is supplied by branches from the posterior
nerve of the thigh(S1,2 & 3 anterior rami)

8. The skin over the thigh in the floor of
the cleft is bw the buttocks is supplied
by small branches of the lower sacral &
coccygeal nerves.

9. Ligaments of the Gluteal
Region.
The two important ligaments in the gluteal
region are;
oSacrotuberous Ligament
oSacrospinous Ligament

10. Continued…
Sacrotuberous ligament
It connects the back of the sacrum to
the ischial tuberosity.
Sacrospinous ligament
It connects the back of the sacrum to
the spine of ischium.

11. Foramina of gluteal region
The two important foramina in the gluteal region are the greater sciatic
foramen & the lesser sciatic foramen.
The following structures exit the greater sciatic foramen are;
Piriformis
Sciatic nerve
Posterior cutaneous nerve of the thigh
Superior & inferior gluteal nerves
Nerve to the obturator internus & quadratus femoris
Pudendal nerve
Superior & inferior arteries & veins
Internal pudendal artery & vein

12. Continued…
Lesser sciatic foramen
The following structures pass through the
foramen are;
Tendon of obturator internus muscle
Nerve to obturator internus
Pudendal nerve
Internal pudendal artery & vein

14. Arteries of the Gluteal Region
•superior gluteal
• it enters the gluteal region through upper part of greater
sciatic foramen above the piriformis.it divides into branches
that are distributed throughout the glutel region.
•inferior gluteal
• it enters the gluteal region through lower part of greater
sciatic foramen. It divides into numerous branches that are
distributed throughout the gluteal region
These arteries are branches of the internal iliac artery.

16. Continued….
Anastomosis
• Trochanteric anastomosis
• it provides main blood supply head of femur.
Following arteries take part in anasntomosis
Superior and inferior gluteal artery, medial and lateral circumflex artery
• Cruciate anastomosis
• it is situated at the level of trochanter of femur and , together with the
trochanteric anastomosis, provides connection b/w internal iliac and
femoris arteies
Following arteries take place in cruciate anastomosis
Medial and lateral circumflex artery, inferior gluteal artery, 1st
perforating artery.

17. NERVES OF GLUTEAL
REGION
• Sciatic Nerve
• Posterior Cutaneous Nerve Of Thigh
• Superior Gluteal Nerve
• Inferior Gluteal Nerve
• Nerve To Quadratus Femoris
• Pudendal Nerve
• Nerve To Obturator Internus

18.  Nerves of the gluteal region are the branches of the
lumbosacral plexus.
Like the arteries, the nerves arise in the pelvis
and pass through the greater sciatic foramen to
reach the gluteal region.
The piriformis muscle separates the greater sciatic
foramen into
superior and inferior parts.
The branches either come through the superior
part or the inferior part.

20. Sciatic nerve
The sciatic nerve is the branch of sacral plexus,
ORIGINATES….
From: L4 and L5 and also
From: S1,S2 and S3.
emerges from the pelvis through the lower part
of the greater sciatic foramen.
It lies just deep to the gluteus maximus at the
midpoint between the ischial tuberosity and the
greater trochanter

21. Divisions…
It divides into:
Tibial & common peroneal nerves.
The common peroneal nerve leves the
sciatic nerve high in the pelvis
It descends in the plane between the
superficial and deep group of gluteal
region muscles, crossing the posterior
surfaces of first the obturator internus
and associated gemellus muscles and
then the quadratus femoris muscle.

22. POSTERIOR RELATION….
It is related posteriorly by the posterior cutaneous
nerve of the thigh & the gluteus maximus.
The sciatic nerve usually gives no branches in the
gluteal region.
It leave the buttock region by passing deep to the
long head of biceps femoris to enter back of thigh. .
INNERVATION..
It is largest nerve of the body and innervates all
muscles in the posterior compartment of the thigh
that flex the knee and all muscles that work the
ankle and foot. It also innervates a large area of skin
in the lower limb.

23. Posterior cutaneous nerve
It is the branch of sacral plexus, enters
into the gluteal region through the lower
part of greater sciatic foramen below the
priformis muscle.
It passes downward on the posterior
surface of sciatic nerve and runs down
the back of the thigh beneath the deep
fascia.

24. Branches
Gluteal branches …
To the skin over the lower medial quadrant of the
buttock.
Perineal branches…
To the skin over the back of sacrotum.
Cutaneous branches …
To the back of thigh and upper part of leg.

25. Superior Gluteal Nerve
• Branch of sacral plexus
• Leaves pelvis through upper part of greater
sciatic foramen above piriformis.
• INNERVATION…
• It innervates the
• Gluteus medius and minimus.

26. Inferior Gluteal Nerve
• Branch of sacral plexus
• Leaves pelvis through lower part of greater
sciatic foramen below piriformis.
INNERVATION…
It innervates the
Gluteus maximus
muscle.

27. Nerve To Quadratus Femoris
• Branch of sacral plexus
• Leaves pelvis through lower part of greater
sciatic foramen below piriformis.
• INNERVATION…
• It innervates the
• Quadratus Femoris and
• Inferior gemellus

28. Pudendal Nerve
and Nerve To Obturator Internus
• Branches of sacral plexus
• Leaves pelvis through lower part of greater sciatic
foramen below piriformis.
• They cross the ischial spine with the internal
PUDENDAL ARTERY and then re_enters the
pelvis through LESSER SCIATIC
FORAMEN,then lie in the ISCHIORECTAL
FOSSA.
• INNERVATION…
• Pudendal nerve innervates the
• Perineum

29. .
AND
Obturator internus innervates the
obturator internus.