ANA 211: Gluteal region

Dr Olatunde Owoeye, Lower Limb Lectures,

4/2/2021 1
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 By

Dr. Olatunde OWOEYE, MB;BS, M. Sc,

Ph.D.
Reader
Department of Anatomy,
College of Medicine
University of Ibadan
Ibadan.
Thursday, April 01, 2021
Dr Olatunde Owoeye, Lower Limb Lectures,
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 Lecture Outline
• Learning Objectives
• Expected learning Outcome
• Introductory vignettes
• The Gluteal region
• Contents of the gluteal region
• Clinical Correlates
• Golden Nugget

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 Learning Objectives
To teach students:
The topography of the gluteal region: bony
landmarks, cutaneous nerves, blood vv., muscles
etc.

How to define and locate the Post. Sup. iliac spine

& iliac crest in the living.

How to locate the safe quadrant for intramuscular

injections
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 Expected Learning Outcomes

 By the end of this lecture, students

should:
Be familiar with the topography of the gluteal
region: bony landmarks, cutaneous nerves, blood
vv., muscles etc.

Be able to define and locate the post. Sup. iliac

spine & iliac crest in the living.

Appreciate the location of the safe quadrant for

intramuscular injections
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 Introductory Vignettes
We sit on the muscles and bones of the
gluteal region

Medications may be administered

through the muscles of this region.

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Surface anatomy of the gluteal region
• 1. iliac crest
• 2. Gluteus medius
• 3. tip of gtr trochanter
• 4. Gluteus Medius
• 5. fold of buttock
• 6. ischial tuberosity
• 7. tip of coccyx
• 8. natal cleft
• 9. PSIS
• 10. Sciatic n.
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 Approach to the Gluteal Region
• Osteology of the gluteal • Muscles of the gluteal
region: Os coxae, femur. region: 9 mm.

• Skin of the buttock: 4 • Nerves of the gluteal

Quadrants; cutaneous nn. region: 6 nn.

• Fascia of the buttock: SF, • Arteries of the gluteal

Adipose, DF.
region: 4 aa.
• Ligaments of the gluteal
region: STL, SSL
• Functions of the gluteal
region: 2 Support, stabilization for
• Foramina of the gluteal S.W.R.
region: GSF, LSF Dr Olatunde Owoeye, Lower Limb Lectures
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 Bones of the gluteal region
• Os coxae:
• Ilium

• Ischium

• Pubis

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Bony landmarks of the gluteal Maping out GM, Piriformis and
region Q. femoris

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Landmark structures of gluteal region

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Cutaneous innervation of the hip

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 Cutaneous nerves of the buttock
Upper:
• Upper Medial Quadrant: L 1,2, 3; S 1, 2, 3
• Upper Lat. Quad: L 1 & T 12

Lower:
• L. Med. Q: S 1, 2, 3
• L. Lat. Q: L 2, 3

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 FASCIA

• Superficial fascia: Thick in women.

Impregnated with large quantities of FAT,
hence prominence of the buttock.

• Deep fascia is continuous with fascia lata of

the thigh

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Fascia of gluteal region & back of thigh

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 Nerves of gluteal region
• Sciatic n.
• Post. cut. n. of the thigh
• Sup. glut. n.
• Inf. glut. n.
• Nerve to Quadratus femoris
• Pudendal n.
• Nerve to obturator internus

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 Sciatic nerve

• L 4, 5; S 1, 2, 3
• Curves downward midway
between the tuber ischii and the
greater trochanter.
• Has a side of danger and a side of
safety
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Surface anatomy of the gluteal region
• 1. iliac crest
• 2. gluteus medius
• 3. tip of gtr trochanter
• 4. GM
• 5. fold of buttock
• 6. ischial tuberosity
• 7. tip of coccyx
• 8. natal cleft
• 9. PSIS
• 10. Sciatic n.
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Posterior relations of sciatic n.

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 Arteries of gluteal region
• Sup. Gluteal a. (SGA)
• Inf. Glut. a. (IGA)
• The trochanteric anastomosis [TA](main bld supply
to the HoF): SGA, IGA, Medial femoral circumflex
artery (MFCA), Lateral femoral circumflex artery
(LFCA)
• The cruciate anastomosis [CA] (situated at the level
of the lesser trochanter): IGA, MFCA, LFCA, 1st
perforating br. of Profunda femoris.
CA jointly with TA provides a connection between
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femoral aa & the internal iliac aa.
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 Ligaments of Gluteal region
• Sacrotuberous ligament (STL)

• Sacrospinous ligament (SSL)

• Functions of STL & SSL:

(1) Both stabilize the sacrum & prevents its
rotation at the sacroiliac joint by the weight of the
vertebral column.
(2) in conjunction with bones, form the greater
sciatic foramen (GSF) & lesser sciatic foramen (LSF)
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Landmark structures of gluteal region

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 Roles of GSF & LSF
GSF provides an EXIT from the pelvis into the
gluteal region.

LSF (1) provides an ENTRANCE into the

perineum from the gluteal region.
(2) enables nerves & vessels that left the
pelvis thru the GSF above the pelvic floor to
enter the perineum below the pelvic floor.

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 Greater Sciatic Foramen (GSF)
• GSF: 14 structures exit thru it:
1 muscle: Piriformis (LANDMARK)

7 nerves:
sciatic n., post. cut. n. of the thigh, sup. Glut. n., inf.
Glut. n., n. to obturator int., n. to quadratus
femoris, pudendal n.

 6 vessels:
sup glut aa & vv, inf. Glut. aa & vv., and Internal
pudendal aa & vv Dr Olatunde Owoeye, Lower Limb Lectures
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 Lesser Sciatic Foramen (LSF)
• LSF: 5 structures passed thru it :
2 nerves:
 Pudendal n., n. to obturator internus.

2 vessels:
 int. pudendal a. & v.,

1 tendon:
 tendon of obt. Internus

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Landmark structures of gluteal region

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Origin & insertion: Gluteal muscles

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 Muscles of the gluteal region
Do the OCIANA of the 9 mm:
• Glut. maximus
• Glut. medius
• Glut. minimus
• Tensor Fasciae Latae
• Piriformis
• Obt. Internus
• Gemellus superior
• Gemellus inferior
• Quadratus femoris
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 OCIANA Table
Muscle Origin Course Insertion Action Nerve Arterial
supply supply
Gluteus
maximus
Gluteus
medius
Gluteus
minimus
Tensor
fascia latae
Piriformis

Obturator
Internus
Gemellus
superior
Gemellus
inferior Dr Olatunde Owoeye, Lower Limb Lectures
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Quadratus
 The Glutei

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 Greater trochanter
• Tendons of 7 mm insert into it viz:
• 1. Gluteus medius
• 2. Gluteus minimus
• 3. Piriformis
• [Link] internus
• 5 Obturator externus
• 6. Gemellus superior
• 7. Gemellus superior

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 The 6 small lateral rotators of the hip
joint
• 1. Quadratus femoris…..forms a red carpet for
sciatic n.
• 2. Obturator internus
• 3. Gemellus superior
• 4. Gemellus inferior
• 5. Obturator externus
• 6. Piriformis

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 Common heritage
Joint insertion: upper border of greater trochanter
of femur.
Same innervations: L5,S1.
Same action: Lateral rotator of the hip joint

They are:
Piriformis
Obturator internus
Gemellus superior
Gemellus inferiorDr Olatunde Owoeye, Lower Limb Lectures
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 Gluteus maximus
The great extensor of the hip joint
Acts majorly in:
 Rising from the sitting position
 Straightening up
 Walking upstairs
 Running
 Lateral rotation

Has little action in gentle walking

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The back transiting into the gluteal
region

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Gluteal region: GM excised

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Gluteal region: Course of Sciatic
nerve with GM excised

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Deep structures of the hip

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Gluteal region: GM excised

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 Clinical Correlates
• Intramuscular injection site is the upper
lateral quadrant.

• A boil, abscess, perianal disease prevents

normal sitting on the buttocks.

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 ASSIGNMENT #1 of 26/03/2021

• In your gross anatomy atlases,

identify the surface anatomy of
structures listed on SLIDE #14 of
Lecture on OSTEOLOGY of Lower
Limbs

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 ASSIGNMENT #2 of 26/03/2021

• WRITE AN ESSAY ON “SESAMOID

BONES”
• SUBMIT ON OR BEFORE APRIL 01,
2021.
• SEND TO [Link]@[Link]
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 Golden Nugget #4

Let your purpose

regulate your life style.

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Thank you for your attention

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