Superior gluteal nerve

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Superior gluteal nerve
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Nerves of the right lower extremity. Posterior view.
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Plan of sacral and pudendal plexuses. (Superior gluteal labeled at upper left.)
Details
From Sacral plexus (L4-S1)
Innervates Gluteus medius, gluteus minimus, tensor fasciæ latæ
Identifiers
Latin nervus gluteus superior
TA98 A14.2.07.031
TA2 6543
FMA 16510
Anatomical terms of neuroanatomy

The superior gluteal nerve is a mixed (motor and sensory) 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.

Contents

Structure

Origin

The superior gluteal nerve originates in the sacral plexus. It arises from the posterior divisions of L4, L5 and S1. [1]

Course

It exits the pelvis through the greater sciatic foramen superior to the piriformis muscle. [2] [3] [4] It is accompanied by the superior gluteal artery and the superior gluteal vein. [2]

It passes lateral-ward in between the gluteus medius muscle and the gluteus minimus muscle, [1] [5] accompanied by the deep branch of the superior gluteal artery. It divides into a superior branch and an inferior branch. [5] [1]

The inferior branch continues to pass between the two muscles [5] to end in the tensor fasciae latae muscle. [1]

Distribution

Motor

Sensory

The superior gluteal nerve also has a cutaneous branch. [1]

Clinical significance

Gait

In normal gait, the small gluteal muscles on the stance side can stabilize the pelvis in the coronal plane. Weakness or paralysis of these muscles caused by a damaged superior gluteal nerve can result in a weak abduction in the affected hip joint. This gait disturbance is known as Trendelenburg gait. In a positive Trendelenburg's sign the pelvis sags toward the normal unsupported side (the swing leg). The opposite, when the pelvis is elevated on the swing side, is known as Duchenne limp. Bilateral loss of the small gluteal muscles results in a waddling gait. [2]

Iatrogenic damage

The superior gluteal nerve may be damaged by intramuscular injections and nephrectomy. [3]

See also

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Gluteus medius</span> One of the three gluteal muscles

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.

<span class="mw-page-title-main">Gluteus minimus</span> Smallest of the three gluteal muscles

The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius.

<span class="mw-page-title-main">Piriformis muscle</span> One of six small hip muscles in the lateral rotator group

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.

<span class="mw-page-title-main">Hip</span> Anatomical region between the torso and the legs, holding the buttocks and genital region

In vertebrate anatomy, the hip, or coxa(pl.: coxae) in medical terminology, refers to either an anatomical region or a joint on the outer (lateral) side of the pelvis.

<span class="mw-page-title-main">Gluteal sulcus</span> Fold separating the thigh from the buttock

The gluteal sulcus 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. 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.

<span class="mw-page-title-main">Trendelenburg's sign</span> Medical condition

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.

<span class="mw-page-title-main">Sacral plexus</span> Nerve plexus

In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, and part of the pelvis. It is part of the lumbosacral plexus and emerges from the lumbar vertebrae and sacral vertebrae (L4-S4). A sacral plexopathy is a disorder affecting the nerves of the sacral plexus, usually caused by trauma, nerve compression, vascular disease, or infection. Symptoms may include pain, loss of motor control, and sensory deficits.

<span class="mw-page-title-main">Tensor fasciae latae muscle</span> Muscle of the thigh

The tensor fasciae latae is a muscle of the thigh. Together with the gluteus maximus, it acts on the iliotibial band and is continuous with the iliotibial tract, which attaches to the tibia. The muscle assists in keeping the balance of the pelvis while standing, walking, or running.

Trendelenburg gait, named after Friedrich Trendelenburg, is an abnormal gait. It is caused by weakness or ineffective action of the gluteus medius muscle and the gluteus minimus muscle.

<span class="mw-page-title-main">Muscles of the hip</span> Causes movement in the hip

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.

<span class="mw-page-title-main">Posterior cutaneous nerve of thigh</span> Sensory nerve that supplies the back of the thigh, leg, buttock, and perineum

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.

<span class="mw-page-title-main">Inferior gluteal nerve</span>

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.

<span class="mw-page-title-main">Lumbar nerves</span>

The lumbar nerves are the five pairs of spinal nerves emerging from the lumbar vertebrae. They are divided into posterior and anterior divisions.

<span class="mw-page-title-main">Superior gluteal artery</span>

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.

<span class="mw-page-title-main">Inferior gluteal artery</span>

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.

<span class="mw-page-title-main">Nerve to obturator internus</span> Human nerve

The nerve to obturator internus is a mixed nerve providing motor innervation to the obturator internus muscle and gemellus superior muscle, and sensory innervation to the hip joint. It is a branch of the sacral plexus. It is one of the group of deep gluteal nerves.

<span class="mw-page-title-main">Nerve to quadratus femoris</span>

The nerve to quadratus femoris is a nerve of the sacral plexus that provides motor innervation to the quadratus femoris muscle and gemellus inferior muscle, and an articular branch to the hip joint. The nerve leaves the pelvis through the greater sciatic foramen.

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.

<span class="mw-page-title-main">Sacral spinal nerve 1</span>

The sacral spinal nerve 1 (S1) is a spinal nerve of the sacral segment.

References

PD-icon.svgThis article incorporates text in the public domain from page 959 of the 20th edition of Gray's Anatomy (1918)

  1. 1 2 3 4 5 6 7 8 9 Mirjalili, S. Ali (2015-01-01), Tubbs, R. Shane; Rizk, Elias; Shoja, Mohammadali M.; Loukas, Marios (eds.), "Chapter 46 - Anatomy of the Sacral Plexus L4-S4", Nerves and Nerve Injuries, San Diego: Academic Press, pp. 619–626, doi:10.1016/b978-0-12-410390-0.00048-2, ISBN   978-0-12-410390-0 , retrieved 2021-02-28
  2. 1 2 3 Thieme Atlas of Anatomy (2006), p 476
  3. 1 2 David, William S.; Sadjadi, Reza (2019-01-01), Levin, Kerry H.; Chauvel, Patrick (eds.), "Chapter 13 - Clinical neurophysiology of lower extremity focal neuropathies", Handbook of Clinical Neurology, Clinical Neurophysiology: Diseases and Disorders, Elsevier, 161: 207–216, doi:10.1016/b978-0-444-64142-7.00050-3, ISBN   9780444641427, PMID   31307602, S2CID   196812589 , retrieved 2021-02-28
  4. Moore, Keith L.; Dalley, Arthur F.; Agur, Anne M. R. (2017). Essential Clinical Anatomy. Lippincott Williams & Wilkins. p. 586. ISBN   978-1496347213.
  5. 1 2 3 4 5 6 7 Moore, Keith L.; Dalley, Arthur F.; Agur, Anne M. R. (2018). Clinically Oriented Anatomy (8th ed.). Wolters Kluwer. p. 733. ISBN   978-1-4963-4721-3.
  6. Platzer (2004), p 420
  7. Iwanaga J; Eid S; Simonds E; Schumacher M; Loukas M; Tubbs RS (2019). "The Majority of Piriformis Muscles are Innervated by the Superior Gluteal Nerve". Clinical Anatomy. 32 (2): 282–286. doi:10.1002/ca.23311. PMID   30408241. S2CID   53238082.

Bibliography