Gluteal region: structures, relations and applied anatomy
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Gluteal region: overlies the back and side of the lateral half of the pelvis, from iliac crest above to gluteal fold below; topographically trunk, functionally part of the lower limb.
Surface Anatomy and Fascia
Medial limit: mid-dorsal line and natal cleft; lateral limit: line from ASIS to tip of greater trochanter. Posterior bulge is the buttock, anterolateral part the hip.
Palpable landmarks: ASIS; PSIS, in a skin dimple at S2 level; ischial tuberosity, about 5 cm above the gluteal fold; tip of greater trochanter; iliac crest; coccyx.
Nelaton's line joins the ASIS and the most prominent point of the ischial tuberosity, and normally crosses the tip of the greater trochanter.
Bryant's triangle, patient supine: a vertical line from ASIS to the bed, the spinotrochanteric line from ASIS to the trochanter tip, and a vertical line up from the tip to the first line.
Superficial fascia is thick with abundant fat, especially in adult females, producing the buttock's round contour.
Deep fascia splits from the iliac crest to enclose tensor fasciae latae and, more medially, gluteus maximus; between the two lies the gluteal aponeurosis, covering gluteus medius.
Deep fascia is traced laterally as continuous with the iliotibial tract.
Gluteus maximus is the most fasciculated muscle in the body; fibrous septa through it create discrete fasciculi.