THE GLUTEAL REGION. 237 



limits, in front, the anterior superior spine of the ilium, 

 and the margin of the tensor vaginae femoris; superiorly 

 the crest ; posteriorly the posterior superior spine of the 

 ilium, the sacrum, and the middle line of the body ; 

 below the tuberosity of the ischium, and fold of the nates. 



Dissection. On removing the skin, there is a consid- 

 erable amount of fat, particularly over the tuberosity of 

 the ischium, in which lie a number of cutaneous nerves, 

 supplying the integument ; the fascia lata, which is thin 

 over the gluteus maximus, and very thick in front over 

 the gluteus medius, to which it gives origin; next, the 

 gluteus maximus, and the anterior and superior portion 

 of the medius. 



Parts beneath the Gluteus Maximus. Beneath the 

 gluteus maximus lie, first of all, a fibro-cellular layer, 

 continuous with the subperitoneal cellular tissue through 

 the great sacro-sciatic notch, a portion of the gluteus 

 medius, sacro-sciatic ligaments, pyriformis muscle, with 

 the sciatic vessels and nerves emerging below its inferior 

 border; the obturator internus, with its satellite muscles, 

 the gemelli ; the internal pudic vessels and nerve with 

 the nerve to the obturator internus, the quadratus femoris, 

 the tuberosity of the ischium with the origin of the ham- 

 string muscles, the great trochanter covered by a large 

 bursa mucosa, which separates it from the gluteus maxi- 

 mus, and part of the origin of the vastus internus, the 

 superficial gluteal vessels, and the anastomoses of the 

 external circumflex with the gluteal vessels, the gluteus 

 minimus muscle, the posterior part of the articulation of 

 the hip-joint ; and beneath the quadratus femoris, the 

 obturator externus and the anastomosing branch of the 

 internal circumflex. 



The gluteal artery, generally the larger terminal branch 



