Exploration of gluteal region and hip

Contents of greater sciatic foramen

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Image #180-5

Exploration of gluteal region and hip

Contents of greater sciatic foramen

The tendon of the piriformis (9) has been divided near its insertion to allow the muscle (1) to be reflected upward. The sacrotuberous ligament (24) has also been divided and its upper part reflected medially. The sacral plexus is partially exposed.

1. Piriform muscle
2. Sacral plexus
3. Superior gluteal artery and vein
4. Right pointer: Inferior gluteal nerve Left pointer: Posterior femoral cutaneous nerve
5. Superior gluteal nerve
6. Gluteus minimus muscle
7. Body of ischium (covered by periosteum)
8. Sciatic nerve
9. Piriform muscle (tendon of insertion, cut off)
10. Greater trochanter (covered by tendon of Gluteus medius muscle)
11. Obturator internus muscle (tendon of insertion)
12. Upper pointer: Obturator externus muscle Lower pointer: Medial femoral circumflex artery
13. Sacral bone
14. Inferior gluteal artery
15. Inferior cluneal nerve (medial)
16. Internal pudendal vein (cut off)
17. Lymph node
18. Perforating cutaneous nerve
19. Nerve to obturator internus
20. Inferior rectal nerve
21. Upper pointer: Sacrospinal ligament Lower pointer: Pudendal nerve (slightly elevated)
22. Internal pudendal artery and vein
23. Levator ani muscle
24. Sacrotuberous ligament (divided and retracted)
25. Deep transverse perineal muscle
26. Ischial tuberosity
27. Gemelli muscles
28. Artery supplying sciatic nerve
29. Quadratus femoris muscle