Regiunea gluteală

7/23/2019 Regiunea gluteală

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1Dr. Vohra



2Dr. Vohra

Gluteal Region

&Important anastomosis inthe thigh

Dr. Vohra



Dr. VohraDr. Vohra 33

Gluteal RegionThe bulky region of hip (the buttocks)



4Dr. Vohra

Vessels:Superior & inferior gluteal arteries

Nerve:Sciatic, posterior cutaneous nerve of thigh, superior

gluteal, inferior gluteal, nerve to quaratus fe!oris, nerve

to obturator internus & puenal nerve

"ontents of the Gluteal Region

#ora!inaGreater sciatic & lesser sciatic

$iga!ents

Sacrotuberous & sacrospinous $iga!ents

%usclesGluteal !ai!us, gluteal !eius, gluteal !ini!us,

tensor fasciae latae, pirifor!is, obturator internus,superior'inferior ge!elli & quaratus fe!oris




Ligaments of the Gluteal Region The function of these ligaments is to stabilize thesacrum and prevent its rotation at the sacroiliac

joint by the eight of the vertebral column




!oramina of the Gluteal Region

Is formed by the greater sciatic notch of thehip bone and the sacrotuberous andsacrospinous ligaments"

#tructures e$it the foramen

%" iriformis'" #ciatic nerve(" osterior cutaneous nerve of the thigh)" #uperior and inferior gluteal nerves*" +erves to the obturator internus and

,uadratus femoris

-" udendal nerve." #uperior and inferior gluteal arteries and

veins/" Internal pudendal artery and vein

%"Greater #ciatic !oramen



7Dr. Vohra

Is formed by the lesser sciatic notch of the hipbone and the sacrotuberous andsacrospinous ligaments"

#tructures e$it the foramen

%" Tendon of obturator internus muscle'" +erve to obturator internus(" udendal nerve)" Internal pudendal artery and vein

'"Lesser #ciatic !oramen



8Dr. Vohra

0uscles of the Gluteal Region

Muscle Origin Insertion Nerve SupplyNerveRoots Action

Gluteus

maximus

Outer surface ofilium, sacrum,coccyx,sacrotuberousligament

Iliotibial tract and glutealtuberosity of femur

Inferior gluteal nerve L5; S1, 2 Extends and laterally rotates hip joint;through iliotibial tract, it extends knee

joint

Gluteusmedius

Outer surface ofilium

Lateral surface of greatertrochanter of femur

uperior gluteal nerve L! S1 !bducts thigh at hip joint; tilts pelvis"hen "alking to permit opposite leg toclear ground

Gluteusminimus

Outer surface ofilium

!nterior surface of greatertrochanter of femur

uperior gluteal nerve L! S1 !bducts thigh at hip joint; tilts pelvis"hen "alking to permit opposite leg toclear ground

"ensor#asciaelatae

Iliac crest Iliotibial tract uperior gluteal nerve L#; 5 !ssists gluteus maximus in extendingthe knee joint

$iri#ormis !nterior surfaceof sacrum

$pper border of greatertrochanter of femur

%irst and secondsacral nerves

L5; S1, 2 Lateral rotator of thigh at hip joint

O%turatorinternus

Inner surface ofobturatormembrane

$pper border of greatertrochanter of femur

acral plexus L5; S1 Lateral rotator of thigh at hip joint

Gemellussuperior

pine of ischium $pper border of greatertrochanter of femur

acral plexus L5; & Lateral rotator of thigh at hip joint

Gemellus

in#erior

Ischial tuberosity $pper border of greatertrochanter of femur


&uadratus#emoris

Lateral border ofischial tuberosity

'uadrate tubercle offemur




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13Dr. Vohra

Gluteus 0a$imus and Intramuscular InjectionsGreat thic1ness of gluteus ma$imus muscle ma1esit ideal for intramuscular injections" To avoid injury

to the underlying sciatic nerve2 the injection shouldbe given ell forard on the upper outer ,uadrantof the buttoc1"



14Dr. Vohra

+erves of the Gluteal Region#ciatic +erveIs a branch of the sacral plexus (L4 and 5; S1, , and 3!, e"er#es

fro" the pel$%s throu#h the lo&er part of the #reater sc%at%cfora"en. It %s the lar#est ner$e %n the bod' and cons%sts of thet%b%al and co""on peroneal ner$es bound to#ether &%th fasc%a. he sc%at%c ner$e usuall' #%$es no branches %n the #luteal re#%on.

osterior 3utaneous +erve of the ThighIs a branch of the sacral plexus, enters the #luteal re#%on throu#h

the lo&er part of the #reater sc%at%c fora"en belo& the p%r%for"%s"uscle.

#uperior Gluteal +erveIs a branch of the sacral plexus, lea$es the pel$%s throu#h theupper part of the #reater sc%at%c fora"en abo$e the p%r%for"%s.



15Dr. Vohra

Inferior Gluteal +erveIs a branch of the sacral plexus, lea$es the pel$%s throu#h the

lo&er part of the #reater sc%at%c fora"en belo& the p%r%for"%s.+erve to the 4uadratus !emoris) branch of the sacral plexus, lea$es the pel$%s throu#h the lo&erpart of the #reater sc%at%c fora"en. *nds b' suppl'%n# the+uadratus fe"or%s and the %nfer%or #e"ellus.

udendal +erve & the +erve to the5bturator Internusranches of the sacral plexus, the' lea$e the pel$%s throu#h thelo&er part of the #reater sc%at%c fora"en, belo& the p%r%for"%s



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6rteries of the Gluteal Region

#uperior & Inferior Gluteal 6rtery are branches fromthe internal iliac artery"



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18Dr. Vohra

Important anastomosis inthe thigh



19Dr. Vohra

The Trochanteric 6nastomosisThe trochanteric anastomosis provides the main bloodsupply to the head of the femur" The nutrient arteries

pass along the femoral nec1 beneath the capsule" Thefolloing arteries ta1e part in the anastomosis: thesuperior gluteal artery2 the inferior gluteal artery2 themedial femoral circum7e$ artery2 and the lateralfemoral circum7e$ artery"

The 3ruciate 6nastomosisThe cruciate anastomosis is situated at the level of thelesser trochanter of the femur and2 together ith thetrochanteric anastomosis2 provides a connectionbeteen the internal iliac and the femoral arteries" Thefolloing arteries ta1e part in the anastomosis: theinferior gluteal artery2 the medial femoral circum7e$artery2 the lateral femoral circum7e$ artery2 and the8rst perforating artery2 a branch of the profunda artery"



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Regiunea gluteală