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Muscles of the gluteal region and posterior thigh

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Notes

Figure 1: Ligaments of the gluteal region.
Figure 2: Contents of the greater and lesser sciatic foramina
Figure 3: Superficial muscles of the gluteal region and posterior thigh. A. Posterior view and B. Lateral view
Figure 4: Deep muscles of the gluteal region and posterior thigh, posterior view.
Muscle
Origin
Insertion
Innervation
Action
Gluteus maximus
  • Posterior to posterior gluteal line of ilium
  • Dorsal surface of sacrum and coccyx
  • Sacrotuberous ligament
  • Via Iliotibial tract - anterolateral tubercle of tibia
  • Gluteal tuberosity of femur
  • Inferior gluteal nerve
  • Steadies, extends, and laterally rotates the thigh
  • Helps with standing from a sitting position
  • Assists and stabilizes the extended knee
Gluteus medius
  • Between the posterior and anterior gluteal lines
  • Lateral surface of greater trochanter
  • Superior gluteal nerve
  • Abducts, stabilizes, and medially rotates thigh
  • Keeps pelvis level during walking when ipsilateral leg is planted
Tensor fascia latae:
  • Flexes hip and stabilized extended knee via IT tract
Gluteus minimus
  • Between the anterior and inferior gluteal lines
  • Anterior surface of the greater trochanter
Tensor fascia latae
  • Anterior superior iliac spine
  • Anterior part of the iliac crest
  • Via iliotibial tract - lateral condyle of the tibia
Piriformis
  • Anterior surface of the sacrum
  • Sacrotuberous ligament
  • Superior border of the greater trochanter
  • Anterior rami of S1 and S2
  • Laterally rotates the extended thigh
  • Abducts the flexed thigh
  • Steadies head of femur in acetabulum
Obturator internus
  • Pelvic surface of the obturator membrane and surrounding bone
  • Medial surface of the greater trochanter
  • Nerve to obturator internus
Superior gemellus
  • Ischial spine
Inferior gemellus
  • Ischial tuberosity
  • Nerve to quadratus femoris
Quadratus femoris
  • Lateral border of the ischial tuberosity
  • Inter-trochanteric crest of the femur
  • Rotates thigh laterally
  • Steadies head of femur in acetabulum
Semitendinosus
  • Ischial tuberosity
  • Medial surface of the superior part of the tibia
  • Tibial division of Sciatic nerve
  • Extends the thigh
  • Flexes the knee
  • Rotates the leg medially when the knee is flexed
Semi-membranosus
  • Posterior aspect of the medial tibial condyle
Biceps femoris
Long head:
  • Ischial tuberosity
Short head:
  • Linea aspera and lateral supracondylar line of the femur
  • Lateral surface of the head of the fibula
Long head:
  • Tibial division of the Sciatic nerve
Short head:
  • Common fibular division of the Sciatic nerve
  • Flexes the leg
  • Rotates the leg laterally when the knee is flexed
  • Extends the thigh

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Transcript

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Content Reviewers

Viviana Popa, MD,Scott Caterine, BSc (Hons.), MSc, MB, BCh, BAO (Hons.)

When looking at the lower limb from the posterior view, there are two regions that stand out immediately: the gluteal region and the posterior thigh.

Let’s start with what’s arguably the most popular one of the two and which has been featured in countless pop songs - the gluteal region.

The gluteal region is situated posterior to the pelvis and inferior to the iliac crest.

Laterally it overlies the greater trochanter, and anteriorly, it extends up to the anterior superior iliac spine.

It also extends from the iliac crest superiorly to the gluteal fold inferiorly.

The gluteal fold is the crease formed by the inferior aspect of the buttocks and the posterior upper thigh.

Medially, the region extends to the mid-dorsal line and is called the intergluteal cleft, which is the groove that separates the buttocks from each other.

Actually, before we move on, let’s review some important landmarks to help you understand this region’s anatomy better.

First, the posterior sacroiliac ligament is the posterior continuation of the fibrous capsule of the synovial part of the sacroiliac joint, and continues inferiorly with the sacrotuberous ligament.

The sacrotuberous ligament goes from the posterior surface of the ilium and the lateral surfaces of the sacrum to the ischial tuberosity.

A similar ligament, called the sacrospinous ligament, passes from the lateral surface of the sacrum and the coccyx to the ischial spine.

These two ligaments convert the greater and lesser sciatic notches into greater and lesser sciatic foramina.

Simply put, the greater and lesser sciatic foramina are passageways, or “doors” for structures leaving the pelvis and entering the gluteal region and vice versa.

The structures passing through the greater sciatic foramen include the piriformis muscle and the structures that leave the pelvis above it, mostly represented by the superior gluteal vessels and nerve and the structures that leave the pelvis below it - the sciatic nerve, pudendal nerve and internal pudendal vessels, inferior gluteal nerve and vessels, posterior femoral cutaneous nerve and the nerves to obturator internus and quadratus femoris.