Gluteal Region Flashcards
boundaries
superior = iliac crest
inferior = gluteal fold
anterolateral = buttocks/greater trochanter + hip/ASIS
L and R buttocks sep by intergluteal cleft
sacro-iliac joint
highly reinforced bc holds vert column to pelvis + critical for supporting body mass
anterior and posterior sacroiliac ligs + sacrospinous and tuberous ligs
greater sciatic foramen
pelvis > gluteal region
has a ton of stuff aka everything except tendon of obturator internus
lesser sciatic foramen
pelvis > perineum
only has tendon of obturator internus
long route to perineum structures
internal pudendal A and V
pudendal N
N to obturator internus
pelvis>greater sciatic foramen>gluteal>lesser sciatic foramen>perineum
obturator canal
small hole in obturator membrane in obturator foramen
pelvis>medial thigh w/ obturator A,V,N
greater trochanter inserts
gluteus medius + minimus + most of lateral hip rotators
superficial layer muscles
gluteus maximus + medius + minimus
TFL
hip extension OR hip abduction + medial rotation
vascular supply = superior gluteal A
deep layer muscles
piriformis + superior gemellus + obturator internus + inferior gemellus + quadratus femoris
lateral hip rotators
vascular: inferior gluteal
gluteus maximus
function
main hip extensor + assist in lateral hip rotation and knee stabilization
-if knee fully flexed then only extensor bc hamstrings can’t assist (rising from chair, climbing stairs, running)
gluteus maximus
O/I/N/V
og @ post ilium + sacrum + coccyx + sacrotuberous lig
in @ gluteal tuberosity on femur + IT band
N = inferior gluteal N
V = superior and inferior gluteal A
gluteus medius
function
main hip abductor and medial rotator of hip/thigh
-assists in stabilizing pelvis when walking
gluteus medius
O/I/N/V
og @ post ilium + b/t post and ant gluteal lines
in @ lateral surface greater troch on femur (anterior to center of greater troch so medial rotate)
N: superior gluteal N
V: superior gluteal A
gluteus minimus
function
co-main hip abductor and medial rotator hip/thigh
-assist in stabilize pelvis walking
gluteus minimus
O/I/N/V
og @ post ilium + b/t ant and inferior gluteal lines
in @ lateral surface greater troch of femur (anterior to center of greater troch so medial rotate)
N = superior gluteal N
V = superior gluteal A
tensor fascia latae
function
assist in hip abduction + medial rotation hip/thigh + stabilize hip when walking + stabilize knee w/ IT band
TFL
O/I/N/V
og @ ASIS + ant iliac crest
in @ IT band directly + gerdy tubercle (indirect)
N= superior gluteal N
V= superial gluteal A (main) + ascending branch lateral circumflex femoral A
hip stabilization walking
by gluteus medius + minimus + TFL
normally muscles on weight bearing side contract
when abductors on weight bearing side contract = hip bones on lifted side pulled up
trendelenburg sign/gait
damage to superior gluteal N weakens or paralyzes all 3 (med, min, TFL) so no abduct or keep weight bearing extended
piriformis
lateral rotate hip/thigh when hip extended OR
abduct thigh when hip flexed
exit greater sciatic foramen
above = superior gluteal N
below = inferior gluteal N and sciatic
piriformis
O/I/N/V
og @ anterior surface sacrum inside pelvis
in @ superior border/apex of greater troch
N= N to piriformis
V= inferior gluteal main + superior gluteal A sometimes
piriformis syndrome
N compression from piriformis muscle
if sheath around sciatic never forms then common fib run thru piriformis
triceps coxae
SG + OI + IG as unit
laterally rotate hip/thigh when hip extended OR
abduct thigh when hip flexed
+ hold femoral head steady in acetabulum
triceps coxae
O/I/N/V
SG og @ ischial spine
OI og @ obturator membrane + surrounding bone
IG og @ ischial tuberosity
in @ all on medial surface greater troch
V= all inferior gluteal A
N = SG + OI N to obturator internus, IG N to quadratus femoris
quadratus femoris
function
laterally rotate hip/thigh
hold femoral head in actetabulum
quadratus femoris
O/I/N/V
og @ lateral surface of ischial tuberosity
in @ quadrate tubercle on intertrochanteric rest of femur
-only lateral rotator that not insert on greater troch so does not abduct hip
N= to quadratus femoris
V= inferior gluteal A
intragluteal injections
only safe to inject superolateral/anterolateral quadrant to avoid major motor Ns
if too medial can injure superior gluteal N
cutaneous innervation
dorsal rami = superior (L1-3, anterolateral quadrant) + middle (S1-3, superior and medial quadrant) cluneals
ventral rami = inferior cluneal (S1-3 both divs, inferior half of buttocks) fro gluteal branch of posterior femoral cutaneous
vascular supply
internal iliac A
1. superior gluteal A
-superficial branch = glute max
-deep branch = glute med + min + TFL
2. inferior gluteal A
-glute max + all lateral rotators
lymphatics
- deep vessels @ below deep fascia, run w/ gluteal vessels > superior and inferior lymph nodes > internal iliac > common iliac
- superficial lymph vessels @superficial fascia > superficial inguinal nodes @ anterior thigh
