Download 3...deep muscles of the gluteal region?

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Transcript
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