superior gluteal nerve
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The superior gluteal nerve is a
nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
that originates in the
pelvis The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The ...
. It supplies the
gluteus medius muscle 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. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeuros ...
, the
gluteus minimus muscle The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius. Structure It is fan-shaped, arising from the outer surface of the ilium, between the anterior and infe ...
, the
tensor fasciae latae muscle The tensor fasciae latae (or tensor fasciæ latæ or, formerly, tensor vaginae femoris) 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 ...
, and the
piriformis muscle 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. The piriformis muscle has its origin upon the front surface of the sacrum, and inse ...
.


Structure

The superior gluteal nerve originates in the
sacral 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 vertebr ...
. It arises from the posterior divisions of L4, L5 and S1. It leaves the pelvis through the
greater sciatic foramen The greater sciatic foramen is an opening (foramen) in the posterior human pelvis. It is formed by the sacrotuberous and sacrospinous ligaments. The piriformis muscle passes through the foramen and occupies most of its volume. The greater sciati ...
above the
piriformis muscle 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. The piriformis muscle has its origin upon the front surface of the sacrum, and inse ...
. It is accompanied by the
superior gluteal artery The superior gluteal artery is the largest and final branch of the internal iliac artery. It is the continuation of the posterior division of that vessel. It is a short artery which runs backward between the lumbosacral trunk and the first sacral ...
and the
superior gluteal vein The superior gluteal veins (gluteal veins) are venæ comitantes of the superior gluteal artery; they receive tributaries from the buttock corresponding with the branches of the artery, and enter the pelvis through the greater sciatic foramen, abo ...
.''Thieme Atlas of Anatomy'' (2006), p 476 It then accompanies the upper branch of the deep division of the
superior gluteal artery The superior gluteal artery is the largest and final branch of the internal iliac artery. It is the continuation of the posterior division of that vessel. It is a short artery which runs backward between the lumbosacral trunk and the first sacral ...
. It ends in the
gluteus minimus muscle The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius. Structure It is fan-shaped, arising from the outer surface of the ilium, between the anterior and infe ...
and
tensor fasciae latae muscle The tensor fasciae latae (or tensor fasciæ latæ or, formerly, tensor vaginae femoris) 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 ...
.


Function

The superior nerve supplies: *
tensor fasciae latae muscle The tensor fasciae latae (or tensor fasciæ latæ or, formerly, tensor vaginae femoris) 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 ...
.Platzer (2004), p 420 *
gluteus minimus muscle The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius. Structure It is fan-shaped, arising from the outer surface of the ilium, between the anterior and infe ...
. *
gluteus medius muscle 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. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeuros ...
. *
piriformis muscle 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. The piriformis muscle has its origin upon the front surface of the sacrum, and inse ...
. The superior gluteal nerve also has a cutaneous branch.


Clinical significance


Gait

In normal gait, the small gluteal muscles on the stance side can stabilize the pelvis in the
coronal plane The coronal plane (also known as the frontal plane) is an anatomical plane that divides the body into dorsal and ventral sections. It is perpendicular to the sagittal and transverse planes. Details The coronal plane is an example of a longitud ...
. 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 Gait deviations are nominally referred to as any variation of standard human gait, typically manifesting as a coping mechanism in response to an anatomical impairment. Lower-limb amputees are unable to maintain the characteristic walking pattern ...
is known as
Trendelenburg gait 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. Gandbhir and Rayi point out that the biomechanical action ...
. In a positive
Trendelenburg's sign 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 Tr ...
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 Myopathic gait (or waddling gait) is a form of gait abnormality. The "waddling" is due to the weakness of the proximal muscles of the pelvic girdle. The patient uses circumduction to compensate for gluteal weakness. Conditions associated with a ...
.


Iatrogenic damage

The superior gluteal nerve may be damaged by intramuscular injections and
nephrectomy A nephrectomy is the surgical removal of a kidney, performed to treat a number of kidney diseases including kidney cancer. It is also done to remove a normal healthy kidney from a living or deceased donor, which is part of a kidney transplant pro ...
.


See also

*
Inferior gluteal nerve 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 thi ...
*
Trendelenburg's sign 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 Tr ...


References


Bibliography

* *


External links

* {{Authority control Nerves of the lower limb and lower torso pl:Nerw sromowy