Gluteal region

Gluteal region is bounded above the ridge of the iliac bone, bottom - buttock crease, inside - the sacrum and coccyx, outside - the line from the front to the upper spine of the Ilium to the big spit (Fig). Bone basis buttocks are the back surface of the femoral and iliac bone, sacrum and coccyx, hip and thigh.

gluteal region
Border gluteal region: 1 - sacral region; 2 - buttock; 3 - vertelney; 4 - perineal area.

Sacral - awned bunch, closing greater sciatic notch, forms a large sciatic hole through which pass the piriformis muscle, nerves, arteries and veins, and with the Sacro-bugrovoy a bunch of little sciatic hole.
The skin of the buttocks tight, tense due to the development of the subcutaneous tissue. Between the surface and private fascia in the thickness of fiber lie nerves of the skin, the next layer - gluteal fascia concludes in his case more gluteal muscle. Between mid-and small gluteal muscles is located second fiber space where fascial case of the sciatic nerve.
Innervation gluteal region is short branches sacral plexus, upper and lower gluteal nerves; blood supply - branches of the upper and lower gluteal artery.

Gluteal region (regio glutea) is bounded above the ridge of the iliac bone, bottom - buttock crease, medial line drawn from the rear-upper spine of the Ilium to the outer edge of the coccyx to the intersection with gluteal fold of the lateral line, connecting the front to the top of the iliac spine with the greater trochanter, and lower - up outer intermuscular furrow hips. If there are two gluteal folds border gluteal region is determined by the lower crease.
Bone-ligament basis gluteal region consists of the rear surfaces of the iliac and femoral bone, the side parts of the sacrum and coccyx, posterior capsule of the hip joint, the sacroiliac joints and ligaments (see the Pelvis).
The main bone formations to determine projections vessels and nerves gluteal region are: back-top iliac spine, femoral hillock and a large spit. A line drawn between them, are called the spinous-Hurst (linea spino-tuberalis), spinous-vertelney (linea spino-trochanterica) and hilly-vertelney (linea tubero-trochanterica). Top gluteal artery is projected on the border of the upper and middle thirds of the spinous-vertelney line, more often - 1 cm downwards and inwards from it. Lower gluteal artery is projected downwards and inwards from the middle of the spinous-Hurst line. The sciatic nerve is projected within the middle third hilly-vertelney line. Best determine the place where the sciatic nerve at the outer edge of buttock, 0.5 cm outwards from it.

gluteal region
the muscles of the buttocks
gluteal region anatomy
regio glutea
Fig. 1-4. Vessels, nerves and muscles of the buttocks (Fig. 2 - 4 certain muscles are cut and turned).

1 - nn. clunium sup.;
2 - nn. clunium inf.;
3 - fascia glutea;
4 - nn. clunium medii;
5 - m. gluteus medius;
6 - m. piriformis;
7 and 16 - m. gluteus maximus (cut);
8 - m. obturatorius int.;
9 - m. quadratus femoris;
10 - n. ischiadicus;
11 - n. cutaneus femoris post.;
12 - tuber ischiadicum;
13 - a. et v. gluteae inf.;
14 - a. et v. pudendae;
15 - n. gluteus inf.;
17 - a. et v. gluteae sup.;
18 - m. gluteus min.;
19 - m. obturatorius ext.;
20 - a. et v. gluteae inf.;
21 - n. gluteus sup.;
22 - crista iliaca;
23 - m. gluteus min.;
24 - m. gemellus sup.;
25 - trochanter major (cut);
26 - m. gemellus inf.;
27 - m. obturatorius ext.;
28 - lig. sacrotuberale;
29 - foramen ischiadicum minus;
30 - lig. sacrospinale;
31 - foramen infrapiriforme;
32 - os sacrum;
33 - foramen suprapiriforme.

The skin of the buttocks area thick with a large number of sebaceous glands. Subcutaneous fatty tissue are well-developed, has a cellular structure and separated fascial sheet superficial fascia on two layers. To the borders of the gluteal region cellulose thinner and fascial layer disappears. In the subcutaneous tissue gluteal region are located nn. clunium originating from the back of the branches of the lumbar and sacral nerves. Arteries buttocks were branches of the gluteal artery or arteries surrounding the hip (printing. table, Fig. 1-4). Penetrating through the belly of the gluteus Maximus muscle, these branches form a dense network in the area of the greater trochanter. In the iliac crest region there is another arterial network, formed by the upper branches gluteal artery, a deep environmental Ilium artery, iliopsoas and lumbar arteries. Superficial veins region accompany artery and connected with the deep veins. Lymph drainage is carried out through the surface and deep lymphatic vessels in the superficial inguinal nodes and in lymph nodes of the pelvis.
Own fascia gluteal region consists of two sheets - surface and deep. Within the gluteus Maximus muscle these sheets form the vagina to the muscles. In thicker deep leaf fan out of the top of the buttocks vessels. The front-the top edge of the gluteus Maximus muscles both sheets fascia grow in thick plate that covers the outside of the average gluteal muscle, and underneath turning into the iliac-leg tie bars with a wide fascia of the thigh (tractus iliotibialis). The aponeurosis of the average gluteal muscle is the main fibrous structure of the gluteal region. Related cases all three gluteal muscles and the muscles tense wide fascia of the thigh. From tractus iliotibialis departs curved beam strong, fibrous fibers, going to the buttock. Small gluteus is located directly on the periosteum of the Ilium. Fascia deep layers of muscles of the buttocks - pear, internal locking, twin and square thigh muscles thin, loose. The internal locking muscle internal record of the case is part of parietal sheet pelvic fascia, has the character of aponeurosis, participates in the formation of the side wall of the sciatic-pryamokishechnye holes and channels for private parts neurovascular bundle.
In the area of the big spit is a few synovial bags, which are located on the greater trochanter and on the tendon average gluteal muscle. There is also sinovialnuu bag into the soft tissue between small gluteus and the greater trochanter and the insertion of a large gluteus to the femur.
In the gluteal region there are two deep fiber space (deep gluteal and naturalnoe) and two slits (iliac bone and muscle, Tazo-vertelney joint-myshecnuu). Deep fiber space is located between the deep fascia covering most gluteal muscle and fascia deep layer; fascial spurs it is divided into a number of cells. In this space are the branches of the lower gluteal vessels and nerve private parts neurovascular bundle and sciatic nerve. Naturalnoe fiber space is located between the fascia medium and small gluteal muscles. In the tissue advertising space are branches of the upper buttock vessels and nerves. Iliac bone-muscular-gap is between the rear surface of the Ilium and small gluteal muscle". It is a small layer of loose fiber. Tazo-vertelney muscle and joint gap is the gap between Tazo-vertelney muscles and hip joint.
Aggressivenot hole (foramen suprapiriforme) - musculoskeletal channel 4-5 cm in length, width up to 1 cm Above the channel is limited to the upper edge of the great sciatic clippings, bottom and side - fascia and muscles: pear -, medium-and low gluteal. Outside of the opening of the channel closes the fascia of the gluteus Maximus muscle. The channel has the appearance of a tapered tube that connects the small pelvic cavity with fasciale-fiber space gluteal region.
Podkrashivanie hole (foramen infrapiriforme) is limited to the lower edge of the piriformis muscle, hips tuberous bunch and upper twin muscle. In the lateral parts of the hole closed containers located here muscles, in the middle of it is not closed. In this hole goes sciatic nerve and back cutaneous nerve of thigh, prisoners in their own vagina. At the inner edge of the vagina sciatic nerve, plexus fascial sheets, is lower gluteal the neurovascular bundle. Medially from gluteal vessels, separating themselves from them fascial partition, passes both the neurovascular bundle. The latter through a small sciatic hole goes in fiber sciatic-pryamokishechnye fossa.