GLUTEAL REGION
📌 1. Boundaries of the Gluteal Region
• Superiorly: Iliac crest
• Medially: Intergluteal cleft (natal cleft)
• Inferiorly: Gluteal fold
• Laterally: Greater trochanter of femur
📌 2. Skin and Fascia
• Super cial fascia: Contains cutaneous nerves, vessels, and fat.
• Deep fascia (fascia lata): Thick and strong; encloses gluteal muscles.
📌 3. Muscles of the Gluteal Region
🔹 Super cial group:
1. Gluteus maximus
• Origin: Ilium, sacrum, coccyx, sacrotuberous ligament
• Insertion: Iliotibial tract and gluteal tuberosity of femur
• Nerve supply: Inferior gluteal nerve (L5, S1, S2)
• Action: Extension and lateral rotation of thigh
2. Gluteus medius
• Origin: Ilium between anterior and posterior gluteal lines
• Insertion: Greater trochanter
• Nerve: Superior gluteal nerve
• Action: Abducts and medially rotates thigh; stabilizes pelvis
3. Gluteus minimus: Deep to medius, same nerve and action.
4. Tensor fasciae latae: Flexes, abducts, and medially rotates thigh
🔹 Deep group:
1. Piriformis
2. Obturator internus
3. Superior and inferior gemelli
4. Quadratus femoris
(All involved in lateral rotation of the thigh)
📌 4. Nerves of the Gluteal Region
• Sciatic nerve (L4-S3) – largest nerve, exits via greater sciatic foramen
• Superior gluteal nerve (L4-S1) – supplies gluteus medius, minimus, TFL
• Inferior gluteal nerve (L5-S2) – supplies gluteus maximus
• Posterior cutaneous nerve of thigh
• Nerve to quadratus femoris and obturator internus
📌 5. Blood Supply
• Superior gluteal artery (from internal iliac)
• Inferior gluteal artery (from internal iliac)
• Accompany respective nerves
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📌 6. Clinical Anatomy
• Intramuscular injection site: Upper outer quadrant to avoid sciatic nerve
• Trendelenburg sign: Weakness/paralysis of gluteus medius/minimus
• Piriformis syndrome: Compression of sciatic nerve by piriformis
• Trochanteric bursitis: In ammation near gluteus medius insertion
📘 LONG ANSWER QUESTIONS (LAQs)
1. Describe the origin, insertion, nerve supply, and actions of gluteus maximus.
Answer:
• Origin: Outer surface of ilium behind posterior gluteal line, sacrum, coccyx,
sacrotuberous ligament
• Insertion: Iliotibial tract and gluteal tuberosity
• Nerve supply: Inferior gluteal nerve (L5-S2)
• Actions: Extension of thigh (climbing stairs, rising from sitting), lateral rotation of
thigh
2. Discuss the muscles of the gluteal region and their importance.
Answer:
• Divided into super cial (gluteus maximus, medius, minimus, TFL) and deep
(piriformis, obturator internus, gemelli, quadratus femoris) groups.
• Important for movement (abduction, rotation), stabilization of pelvis during walking,
and clinical relevance in injection and nerve injury.
📘 SHORT ANSWER QUESTIONS (SAQs)
1. Name the muscles supplied by the superior gluteal nerve.
Answer:
• Gluteus medius
• Gluteus minimus
• Tensor fasciae latae
2. What is Trendelenburg sign?
Answer:
• A clinical sign of weakness or paralysis of gluteus medius/minimus.
• When standing on one leg, pelvis drops on the opposite side.
3. Why is the upper outer quadrant of the gluteal region preferred for IM injection?
Answer:
To avoid injury to the sciatic nerve, which lies in the lower medial quadrant.
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4. List the deep muscles of the gluteal region.
Answer:
• Piriformis
• Obturator internus
• Superior gemellus
• Inferior gemellus
• Quadratus femoris
