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ASSIGNMENT NO.

8
THE GLUTEAL REGION AND POSTERIOR THIGH

At the end of the course the students must be able to:


GLUTEAL REGION

1. Name the boundaries of the gluteal region.


2. Describe the surface anatomy of the gluteal region.
3. Enumerate the gluteal muscles.
4. Give the proximal and distal attachments, innervation and main action of the
gluteal muscles.
5. Enumerate the gluteal ligaments.
6. Enumerate the gluteal nerves.
7. Give the origin, course and distribution of the nerves in the gluteal region.
8. Name the gluteal arteries and gluteal veins.
9. Briefly describe the lymphatic drainage of the gluteal region.
10. Enumerate and discuss the structures that pass through the greater sciatic
foramen.

POSTERIOR THIGH

1. Describe the surface anatomy of the posterior thigh.


2. Name the muscles of the posterior thigh.
3. Give the proximal and distal attachments, innervation and main action of the
posterior thigh muscles.
4. Describe the course of the sciatic nerve from the gluteal region to the posterior
thigh.
5. Name the terminal branches of the sciatic nerve and its general distribution.

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ASSIGNMENT NO.8
THE GLUTEAL REGION AND POSTERIOR THIGH
LABORATORY PROCEDURE

1.Position the cadaver in prone position.

2.Examine the buttocks, natal cleft an inferior gluteal fold.


Label the surface anatomy of the gluteal region.

Level of Iliac Crest

Hip region
Intergluteal
cleft

Skin dimple over


the left Posterior
Iliac Spine Gluteal fold

Thigh

3.Incise the skin transversely from the spine of the last lumbar vertebra going laterally to
the iliac crest and extending the incision as far anteriorly as the ASIS.

4.Make a vertical incision from the spine of the last lumbar down to the coccyx. From
here, make another transverse incision laterally to the side of the thigh below the
trochanter.

5.Do a blunt dissection subcutaneously going laterally to reflect the skin. After
examining the cutaneous nerves and vessels in the fatty superficial fascia, clear
ovea of fats to expose the deep fascia.

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6.Incise the deep fascia and expose the gluteus maximus. Cut the whole thickness of the
gluteus maximus near to its insertion. As you reflex the extends away from each
other, take note of the blood vessels and nerves at its under surface.
Tabulate the origin, insertion, nerve supply and main action of the gluteus
maximus.

Gluteus maximus
Origin: Ilium posterior to posterior gluteal line, dorsal surface of sacrum and coccyx,
sacrotuberous ligament.
Insertion: Iliotibial tract and gluteal tuberosity.
Nerve supply: Inferior gluteal nerve.
Main action: Extends flexed thigh, assists in lateral rotation, and abducts thigh

7.Identify the piriformis muscle. Follow the course of this muscle from the margin of the
greater sciatic foramen to its insertion.

Examine and enumerate the structures that accompany the piriformis:

- Gluteus medius,
- Gluteus maximus
- Obturator internus
- Gemelli muscles

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Tabulate the origin, insertions, nerve supply and main action of piriformis, gluteus medius and
gluteus minimus.

Muscles Origin Insertion Nerve supply Action

Piriformis Anterior surface of the (Apex of) Sacral plexus,5 and Lateral Rotation of the
sacrum (between the S2 Greater S1,2 hip when it is extended
and S4), Gluteal surface trochanter of (that is when in
of ilium (near posterior the femur standing).
inferior iliac spine),
(Sacrotuberous ligament) Abduction of the hip
when it is flexed.

Aids slightly in tilting


pelvis laterally.

Also aids in tilting pelvis


posteriorly by pulling the
sacrum down towards the
thigh

Gluteus medius Gluteal surface of ilium Lateral aspect Superior gluteal nerve Hip joint: Thigh
(between anterior and of greater (L4-S1 abduction, thigh internal
posterior gluteal lines) trochanter of rotation (anterior part);
femur Pelvis stabilization

Gluteus Gluteal surface of ilium Anterior Superior gluteal nerve Hip joint: Thigh
minimus (between anterior and aspect of (L4, L5, S1) abduction, thigh internal
inferior gluteal lines) greater rotation (anterior part);
trochanter of Pelvis stabilization
femur

8.Identify the gluteus medius and minimus.

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9.Identify the structure below the piriformis. Follow the course of the sciatic nerve and identify its two
terminal branches.

Label the course sciatic nerve from its emergence below the piriformis to its terminal branches

Sciatic nerve

Common
Fibular Nerve

Tibial nerve

10.Separate the bellies of the gemelli to expose the obturator internus.


Tabulate the origin, insertion, nerve supply and main action of the rotators of the hip joint.

Name of muscle Origin Insertion Nerve supply Action


Laterally rotates
Superior border of
Anterior surface of extended thigh,
Piriformis greater trochanter of S1-S2 nerve
sacral segments abducts flexed
femur
thigh at hip
Gemellus superior ischial spine nerve to quadratus Laterally rotates
Medial surface of femoris
Gemellus inferior ischial tuberosity extended and
greater trochanter of
inner surface of nerve to obturator abducts flexed
Obturator infernus femur
obturator membrane internus thigh

lateral border of quadrate tubercle of nerve to quadratus Laterally rotates


Quadratus femoris
ischial tuberosity femur femoris thigh at hip

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Label the following diagram

Gluteus maximus

Gemellus superior
Piriformis

Gemellus inferior Obturator internus

Quadratus femoris

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11.Clean the anterior part of the gluteal region and expose the tensor fascia lata.
Tabulate the origin, insertion, nerve supply and main action of the tensor fascia lata. Label the
following diagram

Tensor Fascia latae


muscle

Muscle Origin Insertion Nerve Supply Action


Tensor Fascia latae Anterior superior Iliotibial tract that Femoral artery bducts, medially
iliac spine and attaches to lateral rotates, and flexes
anterior part of condyle of tibia thigh at hip; helps
iliac crest to keep knee
extended

12.Make a longitudinal skin incision along the midline of the posterior thigh down to the
level of below the head of the fibula. Make a circular skin incision around the leg at this level.

13.Do a blunt dissection separating the skin from the underlying tissue and reflect the
skin laterally and medially. Identify the posterior cutaneous nerve of the thigh.

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14.Identify the biceps femoris, semitendinosus and semimembranosus.
Tabulate the origin, insertion, nerve supply and main action of the hamstring muscles.

Name of muscles Origin Insertion Nerve Action


supply
Biceps femoris Long head: Head of fibula Sciatic nerve Flexes and laterally
Ischial Tuberosity rotates the leg, extends
thigh at hip
Short head:
Linea aspera and lateral
supracondylar ridge
Ischial tuberosity Medial surface of Sciatic nerve Extends thigh, flexes leg
Semitendinosus the tibia
Semimembranosus Ischial tuberosity Medial epicondyle Sciatic nerve Extends thigh, flexes leg
of tibia
Adductor magnus Ischial tuberosity Adductor tubercle Sciatic nerve Adductor part: Adducts
of femur and flexes thigh

Hamstring part: Extends


the thigh

Label the following parts of the hamstring muscles.

Adductor magnus

Semitendinosus

Biceps femoris

Semimembranosus

15.Incise the skin traversely from the spine of the last lumbar vertebra going to the iliac crest and
extending the incision as for anteriorly on the ASIS

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