Transcript Document
1 (G. gloutos, buttocks) transitional region between trunk & lower limbs . 2 Deep lateral rotators of the femur @ hip joint . piriformis, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris Superficial abduct and extend the hip gluteus minimus, gluteus medius, and gluteus maximus 3 . 4 Anterior surface of sacrum Sacrotuberous ligament Superior border of greater trochanter of femur 5 • Ischial spine • Pelvic surface of obturator membrane and surrounding bones • Ischial tuberosity Medial surface of greater trochanter (trochanteric fossa) of femur 6 Ischial tuberosity Quadrate tubercle on intertrochanteric crest of femur and area inferior to it 7 . External surface of ilium between anterior and posterior gluteal lines External Ilium posterior surfacetoofposterior gluteal ilium between line; dorsal surface of sacrum anterior and coccyx; inferior Lateraland surface of Anterior surface of sacrotuberous gluteal lines ligament greater trochanter of greater trochanter femur of femur Iliotibial tract & gluteal tuberosity of femur 8 Muscles in the gluteal region mainly abduct, extend, and laterally rotate the femur . relative to the pelvic bone. 9 Superior gluteal nerve Inferior gluteal nerve Gluteus minimus & medius . Tensor fascia latae Gluteus maximus Nerve to the quadratus femoris Quadratus femoris Gemellus inferior Nerve to the obturator internus Obturator internus Gemellus superior Nerve to the piriformis Piriformis 10 Between gluteus maximus & greater trochanter Present @ birth 11 1. 2.. 3. 4. 5. 6. 7. Superior gluteal nerve Inferior gluteal nerve Sciatic nerve Nerve to the quadratus femoris Nerve to the obturator internus Posterior cutaneous nerve of the thigh Pudendal nerve 12 . tensor fasciae latae 13 Superficial muscles Deep muscles . lies just deep to gluteus maximus midpoint between ischial tuberosity & greater trochanter Enters thigh 14 . * anterior to the plane of the deep muscles 15 between . posterior cutaneous nerve of thigh & pudendal nerve + GS 16 . Skin over the gluteal fold 17 . 18 Nerve . Superior clunial nerves Medial clunial nerves Inferior clunial nerves Origin (Contributing spinal nerves) L1-L3 posterior rami Course Penetrate thoracodorsal fascia; course laterally and inferiorly in subcutaneous tissue S1-S3 posterior Emerge from dorsal sacral foramina; rami directly enter overlying subcutaneous tissue Posterior Arise deep to gluteus maximus; cutaneous nerve of emerge from beneath inferior thigh (S2-S3) border of muscle T12 anterior ramus Courses along inferior border of 12th rib; lateral cutaneous branch descends over iliac crest Iliohypogastric Lumbar plexus (L1; Parallels iliac crest; divides into lateral and anterior cutaneous occasionally T12) branches Subcostal Distrubition Skin overlying superior and central parts of buttock Skin of medial buttock and intergluteal cleft Skin of inferior buttock (overlying gluteal fold) Lateral cutaneous branch supplies skin of hip region inferior to anterior part of iliac crest and anterior to greater trochanter Lateral cutaneous branch supplies superolateral quadrant of buttock Lateral cutaneous nerve of thigh skin overlying the lower lateral quadrant of the buttock. Perforating cutaneous nerve skin over the medial aspect of the gluteus maximus. 19 . 20 . 21 Lymph from deep tissue superior & inferior gluteal lymph nodes . internal,external,common iliac lymph nodes lateral lumbar (aortic/caval) lymph nodes Lymph from superficial tissue superficial inguinal lymph nodes external iliac lymph nodes 22