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Xie-Xie. Dr. Xiaoming Zhang, Professor Dr. Ji-cheng Li, and Professor Dr. Lizhong Du. Gluteal Region. Teaching Objectives. Discuss the functional and clinical importance of the gluteal region.

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Xie-Xie

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  1. Xie-Xie Dr. Xiaoming Zhang, Professor Dr. Ji-cheng Li, and Professor Dr. Lizhong Du

  2. Gluteal Region • Teaching Objectives • Discuss the functional and clinical importance of the gluteal region • Illustrate the muscles, nerve supply, and vasculature of the gluteal region, in the context of their clinical importance

  3. Gluteal Region • Functional and clinical importance of the gluteal region? • Locomotion • Site for intramuscular injection • Site for nerve injury • Gateway for neurovascular structures to the perineum

  4. Overview of the Gluteal Region • Location • Posterior region of the os coxae (pelvic bone or hip bone)

  5. Overview of the Gluteal Region • Contents • Gluteal muscles (three) • Nerves for the gluteal muscles • Nerves for the lower limb, including the sciatic nerve (largest nerve in the body), and the perineum • Vessels to the gluteal muscles and perineum

  6. Gluteus maximus Muscles of the Gluteal Region Gluteus medius • Gluteus maximus • Gluteus medius • Gluteus minimus • Piriformis • Superior gemellus • Obturator internus • Inferior gemellus • Quadratus femoris

  7. Muscles of the Gluteal Region • Deep muscles • Gluteus minimus • Piriformis • Superior gemellus • Obturator internus • Inferior gemellus • Quadratus femoris 

  8. Muscles of the Gluteal Region 1. Gluteus maximus (cut) 2. Gluteus medius (cut) 3. Gluteus minimus

  9. Muscles of the Gluteal Region • Deep muscles • 4. Piriformis • 5. Superior gemellus • 6. Obturator internus • 7. Inferior gemellus • 8. Quadratus femoris 

  10. Muscles of the Gluteal Region

  11. Muscles of the Gluteal Region

  12. Gluteal Region • Functional and clinical importance of the gluteal region • Locomotion • Site for intramuscular injection

  13. Gluteal Region- Locomotion - • Gluteus medius and minimus are key muscles • Hold the pelvis secure over the stance leg • Prevent pelvic drop on the opposite swing-side during walking

  14. Gluteal Region- Site of Intramuscular Injection - Safe area for injections

  15. Gluteal Region- Site of Intramuscular Injection - Tubercle of the iliac crest Safe area (Gluteus medius) Anterior superior iliac spine Location of the sciatic nerve

  16. Located deep to the gluteus maximus and piriformis* muscles * >87% of cadavers Gluteal Region • Sciatic nerve • Largest nerve in the body • Spinal segments L4-S3

  17. Sciatic Nerve

  18. Sciatic Nerve

  19. Superior Gluteal Nerve

  20. Gluteal Region • Functional and clinical importance of the gluteal region • Locomotion • Site for intramuscular injection • Site for nerve injury

  21. Gluteal Region- Injury - • Injury to the superior gluteal nerve • Gluteus medius limp and gluteal gate

  22. Gluteal Vessels • Superior gluteal a and v • Inferior gluteal a and v

  23. Internal pudendal a Gluteal Vessels • Internal pudendal a and v

  24. Perineum- Today’s Word & Intellectual Challenge - • The region that closes the pelvic outlet • Means “modest or private” • Divided into two spaces (triangles) • Ischioanal (Anal) triangle • Urogenital (UG) triangle • Relevant to the gluteal region • Thoroughfare for the internal pudendal a and v, and pudendal n

  25. Perineum Abdominopelvic Region

  26. Sacrotuberous ligament Perineum – 2 Triangles

  27. Int. pudendal a. Pudendal n. Scrotum Ext. anal sphincter m. Ischial tuberosity Levator ani m. Sacrotuberous lig. Coccyx Gluteus max m.

  28. Wild moose Park City, Utah, USA Jeremy Ranch (my home’s backyard) Thank you!

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