Anatomy of the Gluteal Region: Bones, Muscles, and Nerves, Exams of Physiology

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Gluteal region

DR. GITANJALI KHORWAL

Gluteal region

• The transitional area between the trunk and

the lower extremity.

• The gluteal region includes the rounded,

posterior buttocks and the laterally placed hip

region.

Gluteal Aponeurosis

• This is attached to the

lateral border of the

iliac crest superiorly,

and

• splits anteriorly to

enclose tensor fasciae

latae and posteriorly

to enclose gluteus

maximus.

Muscles of Gluteal region

Superficial Layer

• Gluteus maximus
• Tensor fasciae latae

Muscles of Gluteal region

Intermediate layer

• Gluteus medius
• Piriformis
• Superior gemellus.
• Tendon of obturator internus.
• Inferior gemellus
• Quadratus femoris
• Upper part of Adductor magnus
• And Hamstrings

Gluteus Maximus Origins : posterior end of the iliac crest, posterior surface of the sacrum, coccyx and sacrotuberous ligament. Insertions : ilio-tibial tract( 3/4)and gluteal tuberosity.(1/4 ) Innervation: inferior gluteal nerve - [ Ventral rami of L5, S1,2] - emerges below the piriformis muscle to penetrate the deep surface of the gluteus maximus with accompanying vessels.

 Actions

• Extensor at hip joint during running and climbing upstairs.
• Chief antigravity muscle in the standing up from a seated position.
• Strong lateral rotation of the thigh. Its upper fibres are active in powerful abduction of the thigh.
• It is a tensor of the fascia lata, and through the iliotibial tract it stabilizes the femur on the tibia when the extensor muscles of the knee are relaxed.

Structures under cover of gluteus maximus

• Bones
• Ligaments
• Bursae Trochanteric Gluteofemoral Ischial
• Muscles
• Blood vessels and
• Nerves
• Arterial Anastomosis Trochanteric cruciate

GLUTEUS MEDIUS Covered partially by Gluteus maximus Origins: dorsal surface of the ilium between the anterior and posterior gluteal lines and from the gluteal aponeurosis. Insertion: lateral surface of the greater trochanter on an oblique ridge.

GLUTEUS MINIMUS Covered completely by Gluteus medius. Origins: gluteal surface of the ilium between the anterior and inferior gluteal lines upto margin of greater sciatic notch. Insertion: lateral part of anterior surface of the greater trochanter.

The Trendelenburg’s Sign

• Trendelenburgs sign is positive in

 paralysis of gluteus medius & minimus,

 congenital dislocation of hip joint,

 fracture of the neck of femur