Gluteal Region Flashcards
Describe the anatomical location of the gluteal region
-Lies between the back and the posterior thigh
-Posterior to the pelvis
- Bounded superiorly by the iliac crests and inferiorly by the gluteal fold/sulcus
- The intergluteal cleft lies between the buttocks
- The greater trochanter of the femur marks its lateral extent
Where is the superficial muscle layer found? Name its actions
- Deep to the skin, superficial and deep fascia
- Abduct and extend the lower limb at the hip joint
- Helps to define the gluteal fold
What is the most superficial and largest gluteal muscle?
Gluteus maximus
Name the proximal and distal attachments of the gluteus maximus
- Proximal: iliac crest, sacrum, sacrotuberous ligament and coccyx
- Distal: iliotibial tract
What is the action of the gluteus maximus
Most powerful extensor of the hip
What innervates the gluteus maximus?
Inferior gluteal nerve (L5-S2)
Name the proximal and distal attachments of the gluteus medius
- Proximal: external ileum between anterior and posterior gluteal lines
- Distal: lateral surface of greater trochanter of femur
What is the action of the gluteus medius
Abduct and medially rotate the thigh at the hip joint
What innervates the gluteus medius?
Superior gluteal nerve (L4-S1)
Name the proximal and distal attachments of the gluteus minimus
- Proximal: external ileum between anterior and inferior gluteal lines
- Distal: superior surface of greater trochanter of femur
What is the action of the gluteus minimus?
Abduct and medially rotate the thigh at the hip joint
What innervates the gluteus minimus?
Superior gluteal nerve (L4-S1)
Name the actions of the deep muscle layer and what it is innervated by
- Lateral rotators of the thigh and hip stabilises
- Innervated by nerves from the sacral plexus
Name the proximal and distal attachments of the piriformis
- Proximal: anterior surface of sacrum
- Distal: superior surface of greater trochanter of femur
- Also divides the greater sciatic foramen into suprapiriform and infrapiriform foramina
- Innervation: anterior ramus of S1, S2
Name the actions of the pirifomis
-Laterally rotates the extended thigh
-Abducts the flexed thigh
-Also divides the greater sciatic foramen into suprapiriform and infrapiriform foramina
What is the piriformis innervated by?
Anterior ramus of S1, S2
Name the proximal and distal attachments of the superior and inferior gemelli
Proximal: ischial spine
Distal: ischial tuberosity
Name the actions of the superior and inferior gemelli
-Laterally rotates the extended thigh
-Abducts the flexed thigh
What is the superior and inferior gemelli innervated by?
- Superior: nerve to obturator internus
- Inferior: nerve to quadratus femoris
Name the proximal and distal attachments of the obturator internus
-Proximal: internal surface of obturator membrane,
-Distal: trochanteric fossa
Name the actions of the obturator internus
-Laterally rotates the extended thigh
-Abducts the flexed thigh
What is the obturator internus innervated by?
Nerve to obturator internus
Name the proximal and distal attachments of the obturator femoris
-Proximal: ischial tuberosity
-Distal: intertrochanteric crest (quadrate tubercle)
Name the action of the obturator femoris
Laterally rotates the thigh
What is the obturator femoris innervated by?
Nerve to quadratus femoris
What does the inferior gluteal neurovascular bundle contain? What does it supply? Where is it located
-Contains the inferior gluteal artery, vein and nerve (L5, S1, S2)
- Supplies gluteus maximus
- Located deep to gluteus maximus
What does the superior gluteal neurovascular bundle contain? What does it supply? Where is it located
- Contains the superior gluteal artery, vein and nerve (L4, L5, S1)
- Supplies the gluteus medius and minimus muscles
- Located deep to gluteus medius
Damage to what results in the clinical sign identified in the ‘Trendelenburg Test’…
Damage to the gluteus medius/gluteus minimus or their nerve supply (superior gluteal nerve)
What does a positive Trendelenburg sign indicate?
Gluteal muscle weakness e.g. if the left gluteal muscles are weak, the right side of the pelvis will drop when the patient stands on their left leg (with the right leg unsupported)
