lec 2 gluteal region.pptx anatomy detail

complete detail of gluteal region

1. Contents of GLUTEAL REGION DR. MEHREEN JABBAR

2. Gluteal Region: The gluteal region is the prominent area posterior to the pelvis and inferior to the level of iliac crest. It extends laterally and anteriorly to the greater trochanter.

3. Muscles of gluteal region Gluteus maximus Gluteus medius Gluteus minimus Tensor fasciae latae Piriformis Superior gamellus Inferior gamellus Obturator internus Quadratus femoris

4. Deep Nerves: Sciatic nerve Posterior cutaneous nerve of thigh Superior gluteal nerve Inferior gluteal nerve Pudendal nerve Internal pudendal nerve

5. Arteries: Superior gluteal artery Inferior gluteal artery Internal pudendal artery Femoral artery

6. Ligaments: Sacrotuberous ligament Sacrospinous ligament

7. Sacrotuberous ligament: Slender, fan shaped ligament present on posterior pelvis Attachments: From: 1 : posterior inferior iliac spine 2: sacrum 3: coccyx To: ischial tuberosity

8. Sacrospinous ligament: Small, thin and triangular ligament Attachments: From: 1. outer edge of sacrum 2. coccyx To: Ischial spine

9. Sciatic foramens Greater sciatic foramen is formed by greater sciatic notch of hip bone and Sacrotuberous and sacrospinous ligament. It provides an exit from pelvis into gluteal region. Lesser sciatic foramen is formed by lesser sciatic notch of hip bone and sacrotuberous and sacrospinous ligaments. It provides an entrance into the perineum from the gluteal region. its presence enables nerves and blood vessels that have left the pelvis through greater sciatic foramen to enter the perineum

10. Structure passing through greater sciatic foramen: Above piriformis : Superior gluteal nerve Superior gluteal vessels Below piriformis : Sciatic nerve Inferior gluteal nerve Inferior gluteal vessels Pudendal nerve Posterior femoral cutaneous nerve Nerve to Obturator internus and quadratus femoris Internal pudendal artery and vein

11. Structure passing through lesser sciatic foramen: Tendon of obturator internus Nerve to obturator internus Pudendal nerve Internal pudendal artery and vein

12. Fascia of Thigh Fascia  is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place.

13. Skin Superficial fascia Deep fascia

14. Superficial fascia of thigh: Superficial fatty layer Deep membranous layer Both layers continuous with corresponding layers of anterior abdominal wall Most distinct in uppermost part of thigh

15. Membranous layer is loosely attached to deep fascia of thigh except near inguinal ligament, where it is firmly attached along horizontal line, known as holden’s line

16. Importance of Holden's line When urethra is injured in the perineum, urine may flow out or extravasated into the membranous layer of superficial fascia. Urine can pass into anterior abdominal wall from where it can enter the upper part of thigh Firm attachment of membranous layer to deep fascia along Holden's line prevents urine from descending into the thigh beyond the line

17. Deep fascia of thigh/ fascia lata: Tough fibrous sheath, envelop the whole thigh Superiorly: to the boundary line between lower limb and pelvis’ Anteriorly: inguinal ligament Posteriorly: sacrum , coccyx Laterally: iliac crest Medially: pubis, ischial tuberosity

18. IT band Fascia lata is thickened laterally where it forms 5cm wide band known as IT band Superiorly the tract split into Superficial lamina ( attached to iliac crest) Deep lamina ( attached to capsule of hip joint)

19. Importance 2 muscles inserts into IT band Gluteus maximus and tensor fascia lata Stabilize the knee in both extension and partial flexion, used constantly in running and walking

20. Any questions?

21. Thank you!!