Vessels and nerves of the gluteal region and posterior thigh

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Notes

Figure 1: Nerves of the gluteal region and posterior thigh.
Figure 2: Vessels of the gluteal region and posterior thigh.
Figure 3: Lymphatic drainage of the gluteal region and posterior thigh.

Questions

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The superior gluteal nerve is indicated in the image below.

Transcript

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The gluteal region and posterior thigh contains an abundance of large and small muscles, and coursing through these muscles is a vast network of nerves and vessels.

These nerves mainly originate from the lumbosacral plexus, whereas the vascular supply derives either directly or indirectly from the internal iliac arteries.

Ok, so let’s start with the nerves of the gluteal region and posterior thigh.

Most nerves of the lower limb arise from the lumbosacral plexus, a network of nerves derived from the roots of lumbar and sacral spinal nerves that branch out to form the nerves of the lower limb.

However, out of all the resulting nerves, the gluteal region and posterior thigh is only supplied by the cluneal nerves, superior and inferior gluteal nerves, the sciatic and pudendal nerves, the posterior cutaneous nerve of the thigh, and nerves to quadratus femoris and to obturator internus.

Let's start off with the cluneal nerves which innervate the skin of the gluteal region.

The superior cluneal nerves arise from L1-L3, and supply the skin of the superior buttock.

The middle cluneal nerve arises from S1-S3 and supplies skin over the sacrum and adjacent area of the buttocks.

And finally the inferior cluneal nerve is a branch of the posterior cutaneous nerve of the thigh from S2-S3 and supplies skin over the inferior half of the buttocks as far as the greater trochanter.

Next, there’s the superior gluteal nerve which is formed by the L4, L5, and S1 nerve roots.

The nerve courses laterally between the gluteus medius and minimus along the deep branch of the superior gluteal artery, and it exits the pelvis through the greater sciatic foramen above the piriformis muscle.

It then goes on to innervate the the gluteus medius, the gluteus minimus, and the tensor fasciae latae.

Summary

The gluteal region and posterior thigh contain various blood vessels and nerves that supply the muscles, bones, and skin of the region.

The main artery in the gluteal region is the internal iliac artery, which gives off branches, namely the superior gluteal artery, inferior gluteal artery, and internal pudendal artery. The veins accompany the arteries and drain blood from the tissues. Major veins in the region include the superior and inferior gluteal veins, the internal pudendal veins, and the perforating veins.

The sciatic nerve, the largest nerve in the body, runs through the posterior thigh, supplying the posterior thigh muscles, all leg and foot muscles, and the skin of most of the leg and foot. The gluteal region and posterior thigh also contain other nerves, including the pudendal nerve and the posterior femoral cutaneous nerve. The pudendal nerve supplies the perineum and external genitalia, while the posterior femoral cutaneous nerve supplies the skin on the back of the thigh and the lower part of the buttocks.

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