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Gluteal Region Anatomy | Key Points to Remembers

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The Gluteal Region is an anatomical area above the thigh region contains arteries, veins, and muscles. The muscle of the gluteal region is studied under the chapter of the lower limb therefore the gluteal region is considered as a part of the Lower Limb.

The Region is largely made up of Gluteal Muscles and the thick layer of superficial fascia.

The Gluteal Region is also known as the Buttock region.


Boundaries:

Superiorly: By Iliac Crest

Inferiorly: By Fold of the buttock

Bones of the Gluteal Region:

Hip Bone:

The ileum, Ischium, and Pubis combine to form the hip bone. The ileum, Ischium and Pubis meets one another at a place known as Acetabulum. The Ileum, Ishium and Pubis combines to make a strong supporting bone, therefore,they can bear the weight of the body at sitting position.

Femur:

The femur is believed as the largest and strongest bone in the present in the human body. It articulates with the hip bone at Acetabulum to form the hip joint. 

On the other hand, it articulates below with tibia and Patella to form the knee joint.

Fracture of neck of the femur is common and causes avascular necrosis of the head of the femur, resulting in severe Excruciating pain in the hip and gluteal region and makes the person unable to walk.

Hip Joint :

Hip Joint is a type of Ball and socket synovial joint it is the articulation between the hemispherical head of the femur and the cup-shaped acetabulum of the hip bone.

Hyaline cartilage covers the articulating surface.

Ligaments of the hip joint:

The hip joint ligaments are divided into two groups the extracapsular which includes the

iliofemoral, pubofemoral and ischiofemoral ligaments and intracapsular the ligament of head of the femur.

Movements:

Flexion – iliopsoas, rectus femoris, pectineus, sartorius

Extension – Gluteus maximus, Semimembraneous, hamstring portion of bicep femoris However other portion of bicep femoris has no role in it.

Abduction – Tensor Fascia latae, gluteus medius, gluteus minimus, piriformis 

Adduction – It involves the  adductors magus, longus and brevis, pectineus and gracilis

Lateral Rotation – gluteus maximus, piriformis, assisted by the obturators, Gemelli and quadratus femoris, biceps femoris However the hamstring portion has no role in lateral rotation

Medial Rotation – tensor fascia latae, anterior fibers of gluteus medius and minimus however other have no role in medial rotation.

Circumduction – It is the combination of all movements together, therefore, all muscles have a role in this movement

Anastomosis around Hip Joint:


Trochanteric Anastomosis:

It provides the major blood supply to the head of the femur because theses arteries pass along the femoral neck beneath the capsule.

Arteries involved in trochanteric anastomosis are:

  • Superior gluteal artery
  • Medial Femoral circumflex artery
  • Inferior gluteal Artery
  • Lateral Femoral circumflex artery

Cruciate Anastomosis:

The cruciate anastomosis is found at the level of the lesser trochanter of the femur, with trochanteric Anastomosis therefore it provides a connection between internal iliac and femoral arteries.

Arteries involved in Cruciate Anastomosis:

  • Inferior gluteal Artery
  • Medial femoral Circumflex artery
  • Lateral femoral circumflex artery
  • 1st perforating artery ( a branch of profunda femoral artery)

Femoral Neck fractures interfere with or completely interrupt the blood supply from the root of the femoral neck to the head. So as a result Avascular necrosis of the femoral head occurs.

The Superior and Inferior Gluteal arteries are the branches of Internal Iliac Artery but most of the blood supply to the femoral head are arising from Medial femoral Circumflex artery.

Ligaments present on Gluteal Region other than hip Joint:

Sacrotuberous ligament: It connects the back of the sacrum with the Ischial Tuberosity, As a result, it strengthens the iliosacral Joint.

Sacrospinous Ligament: It connects the back of the sacrum with Spine of Ischium In conclusion it hold the iliosacral joint

The Functions of these ligaments is to stabilize the sacrum, As a result it prevents it from rotation at the sacroiliac joint by the weight of vertebral column.

Foramina present in Gluteal Region:

Greater Sciatic Foramena:

The greater Sciatic foramen is formed by greater sciatic notch of the hip bone and sacrotuberous, sacrospinous ligaments. The greater sciatic foramen provides an exit from pelvic into the gluteal region therefore it as an important role in the connecting gluteal region with other parts of body.

Structure exits from the foramen include:

  • Piriformis
  • Sciatic Nerve
  • Posterior Cutaneous Nerve of the thigh
  • Superior and Inferior gluteal Nerves
  • Nerves to Obturator Internus and Quadratus Femoris
  • Pudendal Nerve 
  • Superior and Inferior Gluteal Arteries & Veins
  • Internal Pudendal Artery and Vein

Lesser Sciatic Foramen:

The lesser sciatic foramen is formed by the lesser sciatic notch of the hip bone and sacrotuberous and sacrospinous ligaments similarly it provides entrance into perinum.

The Lesser Sciatic foramen provides an entrance into perineum from the gluteal region.

  • Structure passes through foramen includes
  • Tendon of Obturator Internus Muscle 
  • Nerve to Obturator Internus
  • Pudendal Nerve
  • Internal Pudendal artery and Vein

Muscles of Gluteal Region:

Gluteus Maximus:

Gluteus Maximus is the largest muscle in the body and main extensor of the hip joint along with the extension, However it provides an important role in lateral rotation of the hip joint.

It also extends the knee joint and provides help in climbing up to stairs and in standing from sitting position.

Nerve supply of Gluteus maximus

Inferior Gluteal Nerve, In other words from (L5, S1, S2) of spinal cord.

Any Injury to an inferior gluteal nerve causes weakened extension of the hip, In other words, it causes difficulty in rising from a sitting position to standing. 

Read more: Cell Death Process

Gluteus Maximus is ideal for IntraMuscular Injection, therefore, it should be focused that injection should be given on outer lateral quadrant of the buttock to avoid any injury to underlying Sciatic Nerve.

Gluteus Medius and Gluteus Minimus:

Gluteus Medius and Minimus adduct the thigh at the hip joint. These muscles help to tilts pelvis during walking to permit the opposite leg to clear ground i.e stabilizers of the pelvis during walking. Along with adduction these muscles also helps in Medial Rotation of the thigh at hip joint as well.

Nerve Supply to Gluteus Medius and Minimus:

Superior Gluteal Nerve (L5, S1) 

When any injury or damage occurs to superior gluteal nerve the paralysis of Gluteus medius and minimus occurs the patient presentation will be the Waddling Gait. 

Causing the Trenderburg’s Sign positive i.e Patient cannot keep pelvis on a level when he/she is standing on one leg. Also, weakness occurs in Abduction of the hip joint.

Blood Blister: Its Symptoms Causes and Treatment

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What is blister

Any Fluid-filled small vesicle (lymph, serum, plasma, blood, or pus) that is usually formed on the upper layer of skin after it has been ruptured is called blister. There are several types of blisters depending upon their causes and composition.

Blood Blister: We can observe sometimes that on the skin there is a raised piece that contains blood in it. This is known as a blood blister. In some cases, there is water inside the raised piece of skin instead of blood. That blisters are not much different than one that has blood in them.

In most parts where they are present, they are less harmless and without the doctor’s treatment, they will go away within a few weeks. A blood blister is a minor condition of the skin and it is very common. Blood blisters are the fluid-filled sacs and look similar to friction blisters (clear fluid-filled sacs) and they have appeared as a raised piece of skin.

There are two types of blisters:

  • Blood blisters
  • Friction blisters

Blood blister contains red fluid in the raised piece of the skin whereas in friction blisters they contain clear liquid fluid in the raised piece of skin. The blood blisters are firstly light red in color but over time they become darker in color. At the site of the blister, most of the blood blisters cause. The blood blisters may be black, purplish or red in color,

Areas those are most likely to be affected with blood blisters

In different locations on the skin, the blood blisters can form. The most common areas where blood blisters can more commonly develop include:

  • Feet
  • Near joints
  • Hands
  • Mouth
  • Fingers
  • Near the bony part of the body like heal, toe, etc.
  • Eyelids

Read more About: Functions of blood

Signs and Symptoms

In different locations on the skin, the blood blisters are present. The most common signs and symptoms where blood blisters can more commonly develop and shows the symptoms include.

  • Minor irritation in the site of blister
  • Allergic reactions may occur where blister formed
  • Infection
  • Warmth spread from the blister
  • Red lines spreading from the blister 

Causes

Anywhere on the body, a blister is formed where the skin is pinched but does not break open. For a prolonged period of time lifting heavy weights or closing a drawer on a finger can lead to the cause of blood blisters.

Some other causes of blood blisters are:

  • Severe frostbite
  • Pinching of the skin due to wearing poorly fitted shoes 
  • Extra friction that is caused by sweaty feet
  • An object or tool regularly rubbing against the skin
  • Pinching of skin between two objects cause minor trauma
  • Running, dancing or participating in a sport for a longer period of time

Blood Blister in The Mouth

Medically, blood blister mouth is related to a condition which is known as angina bullosa hemorrhagica (ABH). According to the review in the World Journal of Stomatology in the oral cavity angina bullosa hemorrhagica (ABH) is characterized by the formation of blood-filled sac and it is an uncommon oral disorder. These purplish or dark red blood blisters in the mouth spontaneously appeared 

Some causes of blood blisters in the mouth include:

  • Mouth cancer
  • Allergies 
  • Bleeding disorders
  • Nutritional deficiencies
  • Excessive consumption of alcohol
  • Inhaling drugs that are including steroids
  • Eat crunching, hot or hard food
  • Having a disease that is systemic such as diabetes
  • Having an injection of local anesthesia
  • Undergoing through the dental process, such as crown replacement or impressions

Blood Blister in Lip

Blood blisters in lips can make a person appear awful and are usually painful. Depending upon the cause of blood blisters the texture and size of blood blisters are varied on the lips. The reasons for the formation of blisters on the lips are:

  • Physical injuries
  • Cold injuries
  • Exposure to heat
  • Lip biting
  • Insect bites

Blood Blister Symptoms of Lip

Some symptoms of blood blisters in the lip include

  • Burning sensation on lips or itching lip
  • The white or the yellow crust on the lip
  • Difficulties in smiling, speaking and eating
  • Large or tiny soft lump on the lip
  • Inside the lip red blood filled bumps
  • Chapped, scaly, flaked and dry lips
  • With sores crack corner of the lips
  • Oozing sores or fluid-filled bumps on the surface of lip

Blood Blister on Fingers

In different locations on the skin, the blood blisters can form. Blood blisters are also present and formed on the finger. For a prolonged period of time lifting heavy weights or closing a drawer on a finger can lead to the cause of a blood blister finger. Blood blisters in/on finger felt like pinching the finger on a door.

Diagnosis

Usually, blood blisters don’t require proper diagnosis and general examination is sufficient to identify it but sometimes it may cause severe secondary infection and pain at the affected site. As a result, it is necessary to seek a physician help that will find out the route cause of that chronic infection. Some types of skin cancer will also appear similar to that of a blood blister. Therefore a biopsy is required to confirm the type of blister either it is the acute or chronic type of blood blister.

Blood Blister Treatment options:

Naturally, blood blisters will heal on their own within few days i.e 3-7 days and will not require any special medical attention.it is often recommended by the physicians not to rupture the blood blister by yourself and allow it to burst on their own in order to avoid any type of secondary infection at the affected site.

Blood blisters that are formed on toes and feet may require some additional steps in order to ensure that they are healing properly. Once the blood blister is ruptured, don’t peel off the dead skin and allow the liquid inside the blood blister to drain properly. In order to improve the healing process and to prevent infection the Infected site should be covered with a dry and sterile dressing. povidone-iodine preparation and sterile gloves should be used to drain the blister.

 General steps to take include:

  • Applying ice to the blister
  • Covering the blister loosely to help avoid extra friction
  • Avoiding placing pressure on the blister by removing shoes or wearing open-toe footwear.
  • Gently cleansing and protecting a blister that has burst open seeking preventive attention when needed

Home remedies to heal blood blisters:

Certain home remedies are also used to improve the healing process

Aloe vera
aloevera
Aloe vera has analgesic anti-inflammatory and anti-bacterial properties.
Aloe vera gel should be applied daily on blood blister until it heals.

Witch Hazel

witch hazel
Witch hazel contains tannins that have excellent analgesic properties. Blood blister will be dried earlier after its regular application on the affected area.

·Turmeric
   turmeric
Turmeric has an antibacterial and anti-inflammatory property and is also used as a home remedy to treat blood blister. A pinch of turmeric is mixed with honey and should be taken twice a day in order to prevent infection. Alternately you can drink one glass of warm milk mixed with a pinch of turmeric powder. Cucumber is another home remedy widely used to treat blood blister. Mineral silica is present in cucumber that is very useful in strengthening the walls of damaged blood vessels and skin tissues. Applying For a slice of cold cucumber will help in reducing swelling and pain of blood blister. You can also drink one glass of cucumber juice.

Risk factors


Generally, every individual is susceptible to the formation of blood blister but taking certain steps and good care of health and body will decrease the chances of incidence.
Following steps should be taken to reduce the development of blood blister
• Wear gloves during working with tools or lifting heavyweights
• Wear appropriately-sized footwear
• Keep the feet dry

When to consult your physician:

When the following sign and symptoms will appear, you must have to consult the doctor

 

  • If the blister is not clearing up on its own
  • If the blister repeatedly comes back
  • When there is no apparent reason for the blister to have formed
  • If the blister is caused by an allergic reaction
  • Multiple unexplained blisters have formed.
  • When the symptoms of infection, such as red lines or warmth spreading from the blister appeared.
  • Blisters have also formed in the mouth or eyelids
  • The blister is making it difficult for a person to move their hands and walk


A Pharmacist Can help with blisters


Must protect your blister from becoming infected, The pharmacist can recommend a plaster or dressing to cover it while it heals. A hydrocolloid dressing can also help to reduce pain and speed up healing.

 

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