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Gluteal Region.docx

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Northeastern University
Physical Therapy
PT 5131
L Day

Gluteal Region Gluteal Region • Area between iliac crest, ASIS, greater trochanter, and gluteal folds • Superficial fascial layer contains several fat deposits • Underneath Superficial Fascial layer is the Deep Fascial layer called the Fascia Lata o Fascia containing a lot of collagen fibers that helps compress the thigh and gluteal region like a compression stocking  Compression prevents bulging of muscles so force is transmitted over joint  Compression helps with venous return o Continuous with inguinal ligament, pubic and membranous layer in inferior abdomen o Becomes thicker on lateral side of thigh, with a lot of collagen fibers  This is known as the Iliotibial Tract (IT Band) • Distal Attachment: Gerdy’s tubercle on lateral tibia • Cutaneous Nerves o Superiorly: Superior Cluneal Nerves (DPR L1-L3) o Medially: Medial Cluneal Nerves (DPR S1-S3) o Inferiorly (over gluteal fold): Posterior Femoral Cutaneous Nerve (S2-S3) Gluteus Maximus • Proximal Attachment: posterior gluteal line, posterior sacrum, coccyx, sacrotuberous ligament • 2 Distal Attachments: o Upper Fibers: IT band to Gerdy’s tubercle in tibia o Inferior Fibers: gluteal tuberosity of femur • Action: extension and external rotation of thigh o Has more force extending thigh when thigh is in flexed position (ex: getting out of chair) • Nerve Innervation: Inferior gluteal nerve (L5-S2) Gluteal Bursas • Bursa: fluid filled sac that decreases friction between 2 places • Ischial Bursa: separates gluteus maximus from ischial tuberosity o Necessary when lying supine, as ischial tuberosity pushes into gluteus maximus when thigh extended • Trochanteric Bursa: located between Iliotibial Tract, where gluteus maximus attaches into it, and the greater trochanter o Often inflamed in people with hip bursitis • Gluteofemoral Bursa: sits between IT band and gluteus maximus Gluteus Medius • Proximal Attachment: external surface of ilium, between anterior and posterior gluteal lines • Distal Attachment: lateral surface of greater trochanter of femur • Action: hip abduction o Anterior Fibers: internally rotate thigh, when thigh is normally extended o Posterior Fibers: externally rotate thigh • Nerve Innervation: Superior Gluteal Nerve (L4-S1) Gluteus Minimus • Proximal Attachment: external surface of ilium, between anterior and inferior gluteal lines • Distal Attachment: anterior surface greater trochanter • Action: hip abduction and internal rotation o Works with gluteus medius • Nerve Innervation: Superior Gluteal Nerve (L4-S1) Trendelenburg Sign/Gait • Hip abductors play major role in gait • Hip abductors play major role in keeping hip level o When you pick your left foot off the ground, it’s the right abductors that keep
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