Gluteal Region of Lower Limb

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Gluteal Region of Lower Limb
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Superficial Nerves

• After the skin of the gluteal region has been
  removed, you should be able to identify the
  superficial (cutaneous) nerves in the gluteal
  area.
• The cutaneous nerves in the gluteal area are the
  
• branches of the subcostal nerve (T12)
• dorsal rami of lumbar nerves
• superior cluneal nerves
• dorsal rami of sacral nerves
• middle cluneal nerves
• inferior cluneal nerves
• posterior femoral cutaneous nerve

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Fascia of the Gluteal Region

• superficial fascia is a little thicker and
  tougher than other areas of the body
• deep fascia
• 1. encloses the gluteus maximus and tensor
  fascia lata muscles between two layers
• 2. very tough above the gluteus maximus
  superficial to the gluteus medius gives partial
  origin for gluteus medius

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Muscles of the Gluteal Region

• The muscles of the gluteal region are responsible
  for extension, abduction, lateral rotation and
  slight medial rotation of the hip joint.
• Starting from superficial and going deep identify
  the following muscles
• gluteus maximus
• gluteus medius
• gluteus minimus
• tensor fascia latae
• piriformis
• superior gemellus
• obturator internus
• inferior gemellus
• obturator externus
• quadratus femorus

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• The tensor fascia latae is seen from the lateral
  side of the gluteal region.

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Table of Muscles
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Nerves of the Gluteal Region

• The nerves of the gluteal region are branches of
  the lumbosacral plexus. Again, as with the
  arteries, the nerves arise in the pelvis and pass
  through the greater sciatic foramen to reach the
  gluteal region. The piriformis muscle separates
  the greater sciatic foramen into superior and
  inferior parts. The branches either come through
  the superior part or the inferior part. The
  nerves are
• superior gluteal (the only branch that comes
  through the superior part). The longest branch of
  this nerve supplies the tensor fasciae latae
  muscle.
• inferior gluteal
• sciatic
• posterior femoral cutaneous
• pudendal
• nerve to quadratus femoris and inferior gemellus
  muscles
• nerve to obturator internus and superior gemellus
  muscles

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Arteries of the Gluteal Region

• There are three arteries coming into the gluteal
  region through the greater sciatic foramen
• superior gluteal
• inferior gluteal
• internal pudendal
• These arteries are branches of the internal iliac
  artery which lies inside the

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Posterior Compartment of the Thigh

• As a group, the muscles of the posterior
  compartment of the thigh are called the
  hamstrings. To be called a hamstring, the muscle
  must arise from the ischial tuberosity. The
  hamstrings are
• biceps femoris (long head)
• semimembranosus
• semitendinosus
• hamstring part of the adductor magnus (not shown
  in the diagram)
• These muscles extend the thigh at the hip and
  flex the leg at the knee

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Nerves of Posterior Thigh

• The muscles of the posterior compartment of the
  thigh are innervated by the tibial (medial) part
  of the sciatic nerve. The short head of the
  biceps is innervated by a branch of the common
  peroneal nerve.

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Arteries of Posterior Thigh

• The arteries of the posterior compartment of the
  thigh arise from two major arteries
• inferior gluteal (upper posterior compartment)
• perforating branches of the profunda femoris

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Table of Muscles
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Popliteal Fossa

• Start by identifying the bony background of the
  popliteal fossa and then visualizing the
  boundaries. The bones of the popliteal fossa are
  
• femur
• medial condyle
• lateral condyle
• tibia
• medial condyle
• lateral condyle
• The boundaries are
• superior and medial - semitendinosus (ST)
• inferior and medial - medial head of
  gastrocnemius (MG)
• superior and lateral - biceps femoris (B)
• inferior and lateral - lateral head of
  gastrocnemius (LG)
• Roof is the deep fascia
• Floor is the popliteal surface of the femur, the
  back of the knee joint, and the popliteus muscle

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• The muscles and contents of the popliteal fossa
  are
• Muscles
• semitendinosus
• biceps femoris
• medial head of gastrocnemius
• lateral head of gastrocnemius
• Arteries
• popliteal artery - continuation of femoral artery
  
• superior medial and lateral genicular arteries
• inferior medial and lateral genicular arteries
• Nerves
• tibial nerve
• common peroneal nerve