Gluteal sulcus | |
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Details | |
Nerve | Perforating cutaneous nerve |
Identifiers | |
Latin | sulcus glutaeus, ruga glutaea horizontalis |
TA98 | A01.2.08.004 |
TA2 | 315 |
FMA | 20233 |
Anatomical terminology |
The gluteal sulcus (also known as the gluteal fold, tuck, fold of the buttock,, horizontal gluteal crease, or gluteal furrow) is an area of the body of humans and anthropoid apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. [1] The gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and overlying fat and is not formed by the lower border of the gluteus maximus muscle, which crosses the fold obliquely. It is one of the major defining features of the buttocks. Children with developmental dysplasia of the hips are born with uneven gluteal folds and can be diagnosed with a physical examination and sonogram.
The gluteal muscles can be classified into two main groups: The superficial gluteal muscles are responsible for extension and abduction of the hip as well as stabilizing and maintaining the balance of the pelvis during the gait cycle. Deep gluteal muscles control external rotation of the extended hip and abduction of the flexed hip. [2]
The superolateral region, which is free of nerves and vessels, is used for intramuscular injections. The Trendelenburg gait, consisting of gluteus medius and minimus muscles, is essential to maintaining the balance of the pelvis during the gait cycle. The piriformis syndrome, which is also called deep gluteal syndrome or gluteal pain syndrome, is the pain or numbness in the posterior thigh, the buttock, and the hip, with radiation or radicular pain in the sciatic nerve distribution. [3] This condition may be caused by trauma, hematoma, excessive sitting, and anatomic variations of the muscle and nerve. [4] Superior gluteal nerve palsy causes injury to the superior gluteal nerve, which results in motor loss that manifests as a disabling gluteus medius limp. [5] The most common cause is an iatrogenic injury during hip surgery or an intramuscular injection. Lesions of the inferior gluteal nerve occur through iatrogenic injuries like surgery, trauma, hernias, or pelvic tumors. This condition may result in a functional deficiency of the gluteus maximus muscle, leading to difficulties climbing the stairs or standing up from a chair, also known as the gluteus maximus lurch. [4]
The gluteus maximus is the main extensor muscle of the hip in humans. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. It is the single largest muscle in the human body. Its thick fleshy mass, in a quadrilateral shape, forms the prominence of the buttocks. The other gluteal muscles are the medius and minimus, and sometimes informally these are collectively referred to as the glutes.
The gluteus medius, one of the three gluteal muscles, is a broad, thick, radiating muscle. It is situated on the outer surface of the pelvis.
The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius.
The piriformis muscle is a flat, pyramidally-shaped muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group.
In vertebrate anatomy, the hip, or coxa in medical terminology, refers to either an anatomical region or a joint on the outer (lateral) side of the pelvis.
Gluteoplasty denotes the plastic surgery and the liposuction procedures for the correction of congenital, traumatic, and acquired defects/deformities of the buttocks and the anatomy of the gluteal region; and for the aesthetic enhancement of the contour of the buttocks.
Trendelenburg's sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus. It is named after the German surgeon Friedrich Trendelenburg. It is often incorrectly referenced as the Trendelenburg test which is a test for vascular insufficiency in the lower extremities.
The tensor fasciae latae is a muscle of the thigh. Together with the gluteus maximus, it acts on and is continuous with the iliotibial band, which attaches to the tibia. The muscle assists in keeping the balance of the pelvis while standing, walking, or running.
The gluteal muscles, often called glutes, are a group of three muscles which make up the gluteal region commonly known as the buttocks: the gluteus maximus, gluteus medius and gluteus minimus. The three muscles originate from the ilium and sacrum and insert on the femur. The functions of the muscles include extension, abduction, external rotation, and internal rotation of the hip joint.
Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal human gait. It is caused by weakness or ineffective action of the gluteus medius muscle and the gluteus minimus muscle.
In human anatomy, the muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the gluteal group; the lateral rotator group; the adductor group; and the iliopsoas group.
The posterior cutaneous nerve of the thigh is a sensory nerve of the thigh. It is a branch of the sacral plexus. It supplies the skin of the posterior surface of the thigh, leg, buttock, and also the perineum.
The inferior gluteal nerve is the main motor neuron that innervates the gluteus maximus muscle. It is responsible for the movement of the gluteus maximus in activities requiring the hip to extend the thigh, such as climbing stairs. Injury to this nerve is rare but often occurs as a complication of posterior approach to the hip during hip replacement. When damaged, one would develop gluteus maximus lurch, which is a gait abnormality which causes the individual to 'lurch' backwards to compensate lack in hip extension.
The superior gluteal nerve is a mixed nerve of the sacral plexus that originates in the pelvis. It provides motor innervation to the gluteus medius, gluteus minimus, tensor fasciae latae, and piriformis muscles; it also has a cutaneous branch.
The sacrotuberous ligament is situated at the lower and back part of the pelvis. It is flat, and triangular in form; narrower in the middle than at the ends.
The superior gluteal artery is the terminal branch of the posterior division of the internal iliac artery. It exits the pelvis through the greater sciatic foramen before splitting into a superficial branch and a deep branch.
The inferior gluteal artery is a terminal branch of the anterior trunk of the internal iliac artery. It exits the pelvis through the greater sciatic foramen. It is distributed chiefly to the buttock and the back of the thigh.
Gluteal gait is an abnormal gait caused by neurological problems. If the superior gluteal nerve or obturator nerves are injured, they fail to control the gluteus minimus and medius muscles properly, thus producing an inability to tilt the pelvis upward while swinging the leg forward to walk. To compensate for this loss, the leg swings out laterally so that the foot can move forward, producing a shuffling or waddling gait.
The buttocks are two rounded portions of the exterior anatomy of most mammals, located on the posterior of the pelvic region. In humans, the buttocks are located between the lower back and the perineum. They are composed of a layer of exterior skin and underlying subcutaneous fat superimposed on a left and right gluteus maximus and gluteus medius muscles. The two gluteus maximus muscles are the largest muscles in the human body. They are responsible for movements such as straightening the body into the upright (standing) posture when it is bent at the waist; maintaining the body in the upright posture by keeping the hip joints extended; and propelling the body forward via further leg (hip) extension when walking or running.
Deep gluteal syndrome describes the non-discogenic extrapelvic entrapment of the sciatic nerve in the deep gluteal space. In simpler terms this is sciatica due to nerve irritation in the buttocks rather than the spine or pelvis. It is an extension of non-discogenic sciatic nerve entrapment beyond the traditional model of piriformis syndrome. Where sciatic nerve irritation in the buttocks was once thought of as only piriformis muscle, it is now recognized that there are many other causes. Symptoms are pain or dysthesias in the buttocks, hip, and posterior thigh with or without radiating leg pain. Patients often report pain when sitting. The two most common causes are piriformis syndrome and fibrovascular bands, but many other causes exist. Diagnosis is usually done through physical examination, magnetic resonance imaging, magnetic resonance neurography, and diagnostic nerve blocks. Surgical treatment is an endoscopic sciatic nerve decompression where tissue around the sciatic nerve is removed to relieve pressure.