Gluteal muscles

The superficial gluteal muscles lie within the gluteal region posterolateral to the bony pelvis and proximal femur. From superficial to deep lie the gluteus maximus, medius and minimus. The gluteus maximus is an important inmuscle for hip extension and lateral rotation. Gluteus medius and minimus are hip abductors and medial rotators.

Summary

• origin
  • gluteus maximus: ilium, lumbar fascia, sacrum and sacrotuberous ligament
  • gluteus medius and minimus: gluteal surface of the ilium
• insertion
  • gluteus maximus: gluteal tuberosity of femur, iliotibial tract
  • gluteus medius and minimus: greater trochanter of femur
• innervation
  • superior (L4-S1) and inferior gluteal nerves (L5-S2)
• action
  • gluteus maximus: hip extension, lateral rotation
  • gluteal medius and minimus: hip abduction, medial rotation

Gross anatomy

Gluteus maximus is a thick flat sheet of muscle sloping from the pelvis down across the buttock at 45°. Gluteus medius is a fan shaped muscle with its posterior third lying deep to the gluteus maximus. Gluteus minimus is the smallest and deepest of the muscles, lying under the cover of the gluteus medius with their anterior borders lying edge to edge from origin to insertion.

Origin 

• gluteus maximus arises from the gluteal surface of the ilium, behind the posterior gluteal line, and the lumbar fascia, lateral mass of sacrum and sacrotuberous ligament
• gluteus medius arises from the gluteal surface of the ilium between the posterior and anterior gluteal line
• gluteus minimus arises from the gluteal surface of the ilium between the anterior and inferior gluteal lines

Insertion

• gluteus maximus inserts onto the gluteal tuberosity of the femur and iliotibial tract
• gluteus medius inserts onto the posterolateral surface of the greater trochanter
• gluteus minimus inserts into the anterior surface of the greater trochanter

Relations

• anterior and medial: ilium
• deep and inferior: sciatic nerve

Blood supply

• arterial supply: superior and inferior gluteal arteries, branches of the internal iliac arteries
• venous drainage: superior and inferior gluteal veins

Innervation

• gluteus maximus: inferior gluteal nerve (L5-S2)
• gluteus medius and minimus: superior gluteal nerve (L4-S1)

Action 

• gluteus maximus extends the flexed thigh at the hip joint. Also stabilises the knee and hip joint via its attachment at the iliotibial tract.
• gluteus medius and minimus abduct the hip joint. Anterior fibres medially rotate the thigh.

Variant anatomy

• gluteus quartus is a rare muscle arising between gluteus medius and minimus
• fusion of the gluteus maximus and tensor fascia lata