Lower limb (gluteal region)

Question 1

What are the main arteries supplying the gluteal region?

Answer 1

• Superior gluteal artery
• Inferior gluteal artery

Question 2

What is the course of the superior gluteal artery?

Answer 2

1. The superior gluteal artery originates as a branch of the internal iliac artery.
2. It exits the pelvis through the greater sciatic foraman and passes into the gluteal region superior to piriformis with superior gluteal nerve.
3. It divides into superficial and deep branches.
4. Superficial branches pass deep to gluteus maxius while deep branches pass between gluteus medius and minimus.

Question 3

What is the course of the inferior gluteal artery?

Answer 3

1. The inferior gluteal artery is a branch of the internal iliac artery.
2. It exits the pelvis through the greater sciatic foraman and enters the gluteal region inferior to piriformis.

Question 4

What is the structure of the sacral plexus?

Answer 4

The plexus consists of 2 components:

1. Lumbosacral trunk (anterior primary rami of L4-5)
2. Anterior rami of S1-4

Question 5

How is the sacral plexus formed?

Answer 5

1. Lumbodacral trunk crosses pelvic brim to join anterior rami of S1.
2. These subsequently join anterior rami of S2-4 on piriformis.

Question 6

What are the branches of the sacral plexus passing superior to piriformis?

Answer 6

Superior gluteal nerve

Question 7

What are the branches of the sacral plexus passing inferior to piriformis (lateral to medial)?

Answer 7

• Sciatic nerve
• Nerve to quadratus femoris (posterior to sciatic)
• Inferior gluteal nerve (posterior to sciatic)
• Posterior femoral cutaneous nerve
• Nerve to obturator internus
• Pudendal nerve

Question 8

What is the course of the pudendal nerve?

Answer 8

1. The pudendal nerve exits the pelvis through the greater sciatic foraman.
2. It passes inferior to piriformis.
3. It re-enters the pelvis through the lesser sciatic foraman to supply the structures of the perineum.

Question 9

What are the muscles of the gluteal region?

Answer 9

• Gluteus maximus
• Gluteus medius
• Gluteus minimus

Short lateral rotators:

• Piriformis
• Superior gemilli
• Obturator internus
• Inferior gemeli
• Quadratus femoris