The gluteal muscles are divided into a superficial layer and a deep layer.

SUPERFICIAL LAYER

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     Gluteus maximus muscle

Origin	Fascia that covers gluteus medius, ilium posterior to posterior gluteal line, fascia of erector spinae, dorsal surface of sacrum, lateral margin of coccyx, sacrotuberous ligament
Insertion	Iliotibial tract of fascia lata (which inserts into lateral condyle of tibia) and gluteal tuberosity of proximal femur
Innervation	Inferior gluteal nerve
Artery	Inferior gluteal artery, superior gluteal artery, first perforating branch of profunda femoris artery
Action	Extends femur at hip joint, especially from flexed position; laterally stabilizes hip joint and knee joint; laterally rotates and abducts thigh

     Gluteus medius muscle

Origin	External surface of ilium, between anterior and posterior gluteal lines
Insertion	Lateral surface of greater trochanter of femur
Innervation	Superior gluteal nerve
Artery	Superior gluteal artery
Action	Abducts and medially rotates femur at hip joint; during walking, keeps the pelvis stable over the stance leg, which prevents the pelvis from dropping on the swing side

     Gluteus minimus muscle

Origin	External surface of ilium, between anterior and posterior gluteal lines
Insertion	Anterior surface of greater trochanter of femur
Innervation	Superior gluteal nerve
Artery	Superior gluteal artery
Action	Abducts and medially rotates femur at hip joint; during walking, keeps the pelvis stable over the stance leg, which prevents the pelvis from dropping on the swing side

     Tensor fascia latae muscle

Origin	Anterior superior iliac spine; anterior part of iliac crest
Insertion	Iliotibial tract
Innervation	Superior gluteal nerve
Artery	Superior gluteal artery, lateral circumflex femoral artery
Action	Abducts and medially rotates the thigh; assists in flexing thigh; stabilizes the knee in extension

DEEP LAYER

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     Piriformis muscle

Origin	Anterior surface of sacrum between anterior sacral foramina
Insertion	Medial side of superior border of greater trochanter of femur
Innervation	Nerve to piriformis muscle (S1,S2)
Artery	Superior gluteal artery; inferior gluteal artery; internal pudendal artery
Action	Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

     Obturator internus muscle

Origin	Deep surface of obturator membrane and surrounding bone
Insertion	Medial side of greater trochanter of femur
Innervation	Nerve to obturator internus
Artery	Internal pudendal artery; superior gluteal artery; inferior gluteal artery
Action	Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

     Superior gemellus muscle

Origin	Ischial spine
Insertion	Superior surface of the obturator internus tendon; medial side of greater trochanter of femur with obturator internus tendon
Innervation	Nerve to obturator internus
Artery	Inferior gluteal artery
Action	Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

     Inferior gemellus muscle

Origin	Ischial tuberosity
Insertion	Inferior surface of the obturator internus tendon; medial side of greater trochanter of femur with obturator internus tendon
Innervation	Nerve to quadratus femoris
Artery	Inferior gluteal artery
Action	Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

     Quadratus femoris muscle

Origin	Lateral border of ischial tuberosity
Insertion	Quadrate tubercle on the intertrochanteric crest of femur
Innervation	Nerve to quadratus femoris
Artery	Medial circumflex femoral artery; inferior gluteal artery
Action	Laterally rotates femur at hip joint

Nerves

1. Branches of Lumbar and Sacral Plexuses
   1. Obturator nerve (L2-L4)
      1. Anterior branch: innervates adductor longus and brevis, gracilis, and pectineus muscles
      2. Posterior branch: innervates obturator externus muscle, adductor magnus (adductor part)
   2. Femoral nerve (L2-L4)
   3. Nerve to piriformis (S1-S2)
   4. Nerve to quadratus femoris (L4-S1)
   5. Nerve to obturator internus (L5-S2)
   6. Superior gluteal nerve (L4-S1)
      1. Innervates gluteus medius, gluteus minimus, and ensor fascia latae
   7. Inferior gluteal nerve (L5-S2)
      1. Innervates gluteus maximus muscle
   8. Posterior femoral cutaneous nerve (S1-S3)
   9. Sciatic nerve (L4-S3)

Arteries

1. Abdominal aorta branches into common iliac arteries
2. Each common iliac artery branches into an internal iliac artery and external iliac artery
3. External iliac artery
   1. Becomes femoral artery, which supplies the thigh
4. Internal iliac artery
   1. Gives rise to superior gluteal artery and inferior gluteal artery, which travel with the superior and inferior gluteal nerves through the greater sciatic foramen
      1. Superior gluteal artery
         1. Travels with superior gluteal nerve
         2. Passes ABOVE the piriformis muscle
         3. Supplies obturator internus muscle, piriformis muscle, gluteal muscles, and tensor fascia latae muscle
      2. Inferior gluteal artery
         1. Travels with inferior gluteal nerve
         2. Passes BELOW the piriformis muscle
         3. Supplies muscles in gluteal region and hip joint

Quiz