Muscle of Gluteal region and their clinical significance .ppt Reshi idrees

1. Submitted by:- Idrees Ashraf
Mur 2304985
Subject: Human anatomy
Submitted to: Dr Anjali tripathi

2. Gluteal region muscles
and
Their clinical significance

3. The lower part of the Gluteal region which present at rounded bulge due
to excessive amount of subcutaneous fat is known as the buttocks
Introduction
The Gluteal (Greek rump) region over lies the side and back of the pelvis ,
extending from the iliac crest above the Gluteal fold below.
The antero superior part of the region seen in a side view is called the
hip

4. Muscles of Gluteal region
1.Gluteus maximus
2.Gluteus Medius
3.Gluteus Minimus
4.Piriformis
5.Gemellus superior
6.Gemellus inferior
7.Obturator internus
8.Quadratus femoris
9.Obrurator externus
10.Tensor Fasciae
Latae

5. 1. Gluteus maximus
This is a large quadrilateral powerful muscle covering mainly the posterior
surface of pelvis. It comprises red muscle fibres

6. Insertion
• The deep fibres of the lower part of the muscle are inserted into the Gluteal
tuberosity (14
• The greater part of the muscle is inserted into the iliotibial tract (1/4 part)
Nerve supply
Interior Gluteal nerve (
L5,S1,S2)

7. Actions of gluteus maximus
• Chief extensor of the thing at the
hip joint.This action is very
important in rising from a sitting
position
• Lateral Rotation of the thigh
• Abduction of the thigh

8. 2 .Gluteus Medius
It is fan- shaped and covers the lateral surface of the pelvis and hip
Origin
Gluteal surface of ilium Between the anterior and posterior Gluteal lines
Insertion
Greater Trochanter of femur
Nerve supply
Superior Gluteal
nerve+L4,L5,S1)

9. 3. Gluteus Minimus
Origin
Gluteus surface of ilium Between the anterior and inferior Gluteal lines
Insertion
Greater Trochanter of femur on a ridge on its anterior surface
Nerve supply of Gluteus Medius & Minimus
Superior Gluteal nerve (L4,L5,S1)

10. Actions
• These are powerful abductors of the
thigh.
• The most important action is to
maintain the balance of the body
when the opposite foot is off the
ground as in walking and running

11. 4.Piriformis
Lies below and parallel to the posterior border of the Gluteal medius
ORIGIN
Internal surface of the sarum upper margin of the greater sciatic
notch
Insertion
At the superior border of the Trochanter of the femur
Nerve supply
Ventral rami of S1,S2

12. 5. Gemellus superior
Small muscle lying along the upper border of the tendon of thee obturator
internus
Origin
Upper part of lesser sciatic notch
Insertion
Medial surface of greater Trochanter of femur
Nerve supply
Nerve to obturator internus (L5,S1,S2)

13. 6.Gemellus inferior
Small muscle lying along the lower border of the tendon of the
obtusutor internus
Origin
Lower part of lesser sciatic notch
Nerve supply
Nerve to quadratus femoris

14. 7.Obtusutor internus
Flattened belly lies in pelvis and the tendon in the Gluteal region
Origin
• Pelvic surface of obturator membrane
• obtusutor fascia
Insertion
Medial surface of the greater Trochanter of the femur
Nerve supply
Nerve to obturator internus

15. 8.Quadratus femoris
Origin
Upper part of the outer border of ischial tuberosity
Insertion
Quadrate tubercle and the area below
it.
Nerve supply
Nerve to quadratus femoris( L4,L5,S1)

16. 9.Obturator externus
Triangular in shape, covers the outer surface of the anterior wall of
the pelvis
Origin
Outer surface of obturator membrane
Insertion
At the Trochanter fossa ( on medial Sideof the greater
Trochanter)
Nerve supply
Posterior division of obturator nerve
(L2,L3,L4)

17. Actions 6-
9
Lateral Rotator of thigh at the hip joint
10.Tensor Fasciae Latae
Lies between the Gluteal region and the front of the thigh
Origin
Anterior 5cm of the outer lip of the iliac crest up to the tubercle of iliac crest

18. Insertion
Iliotibial tract 3-5cm below the level of greater Trochanter
Nerve supply
Superior Gluteal nerve (L4,L5,S1)
Actio
n
Abductor and medial rotator of thigh
and an extensor of knee joint

19. Clinical significance
When the gluteus maximus is paralysed as in muscular dystrophy,the
patient cannot stand up from a sitting posture with out support.such
patients, while trying to stand up ,rose gradually, supporting their
hands first on legs and then on the thighs ; they climb on themselves

20. Intermuscular injection are given in the the upper lateral quadrant of
the Gluteal region,i.e.in the Gluteal medius muscle,to avoid injury to
large vessels and nerves which pass through the lower part of this
region. Gluteal region is not the prominence at the buttock, This is
known as positive Gower's sign.

21. When the gluteus Medius and minimumz (
of right side are paralysed , the patient
cannot walk normally.she bends or
lurches on the right side or paralysed side
to clear the opposite foot,i.e.left ,off the
ground.this is known as lurching gait
when bilateral,it is called waddling gait.

22. Normally when the body weight is supported on one (say right)
limb,the glutei of the supported (right) side raise the opposite and
unsupported (left) side of the pelvis. However,if the abductor
mechanism is defective the unsupported (left) side. Of the pelvis
drop , and this is known as as a positive trendelenburg's sign
The sign is positive in defects of power i.e paralysis of the glutei
Medius and Minimus, detects of the fulcrum,i.e congenital or
pathological dislocation of the hip , and defects of the weight , i.e
ununited fracture of the neck of femer
Trendelenburg's sign