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GLUTEAL REGION DR TAHIR HUSSAIN OBJECTIVES • Arrange the muscles of the gluteal region and give their actions and nerve supply. • Enumerate the structures deep to gluteus maximus muscle. GLUTEUS MAXIMUS ARRANGEMENT OF MUSCLES GMax GMed GMin Piri GS OI GI QF MUSCLES OF GLUTEAL REGION MUSCLE NERVE SUPPLY 1 2 Gluteus maximus Inferior gluteal N Gluteus medius Superior gluteal N 3 Gluteus minimus Superior gluteal N 4 Pyriformis N. to pyriformis 5 Obturator externus Obturator N 6 Obturator internus N. to obturator internus 7 Gamellus superior N. to obturator internus 8 Gamellus inferior N. To qudratus femoris 9 Quadratus femoris N. To qudratus femoris MUSCLES OF GLUTEAL REGION ACTION MUSCLE 1 Gluteus maximus 2 3 Gluteus medius 4 5 6 7 8 9 Pyriformis Gluteus minimus ACTION Extension of thigh Lat. Rotation of thigh Supports the extended knee Abduction of thigh Med. Rotation of thigh Maintain balance of the body when the opposite foot is off the ground Obturator externus Obturator internus Gamellus superior Gamellus inferior Quadratus femoris Lat. Rotation of thigh STRUCTURES DEEP TO GLUTEUS MAXIMUS • MUSCLES • VESSELS • NERVES • BONES AND JOINTS • LIGAMENTS • BURSAE MUSCLES DEEP TO GLUTEUS MAXIMUS 1. Gluteus medius 2. Gluteus minimus 3. Reflected head of rectus femoris 4. Pyriformis 5. Gemillus superuir 6. Obturator internus 7. Gamellus inferior 8. Quadratus femoris 9. Obturator externus 10. Origin of hamstrings 11. Attachment of pubic fibres of adductor magnus 1 2 4 8 GM VESSELS DEEP TO GLUTEUS MAXIMUS • • • • Superior gluteal Inferior gluteal Internal pudendal Ascending br. Of med. Circumflex femoral • Trochanteric anastomosis • Cruciate anastomosis • First perforating NERVES DEEP TO GLUTEUS MAXIMUS 1. 2. 3. 4. 5. 6. 7. 8. Superior gluteal Inferior gluteal Sciatic Post. Cut. N of thigh N. to quadratus femoris Pudendal N N to obturator internus Perforating cut. nerves 3 4 3 • • • • • • BONES AND JOINTS DEEP TO GLUTEUS MAXIMUS Ilium Ischium with ischial tuberosity Upper end of femor with greater trochanter Sacrum and coccyx Hip joint Sacro-iliac joint LIGAMENTS AND BURSAE DEEP TO GLUTEUS MAXIMUS • LIGAMENTS – Sacrotuberous – Sacrospinus – Ischiofemoral • BURSAE – Trochanteric bursa of gluteus maximus – Bursa over the ischial tuberosity – Bursa b/w the gluteus maximus and vastus lateralis THE END ANY QUESTIONS THE END
