GLUTEAL REGION 291 



Bursae Mucosse under cover of the Glutseus Maximus. 

 Three bursae lie under cover of the glutaeus maximus : one 

 between its inferior margin and the ischial tuberosity, and 

 two under cover of the aponeurotic part of its insertion, one 

 between the aponeurosis and the trochanter major, and the 

 other between the aponeurosis and the proximal part of the 

 vastus lateralis. 



The bursa between the ischial tuberosity and the glutaeus 

 maximus is frequently multilocular, being divided into several 

 compartments by fibrous septa which pass from the bone to 

 the deep surface of the muscle. The other two bursae are 

 unilocular, and not infrequently they communicate with one 

 another. 



On the second day after the body is turned on its face 

 the dissector must examine the muscles, vessels, and nerves 

 which lie directly subjacent to the glutaeus maximus, as well 

 as other structures situated in a deeper plane. 



Before the work is commenced a pelvis with the ligaments 

 in situ should be obtained and the skeletal peculiarities of 

 the region should be studied. The interval between the 

 posterior part of the hip bone and the margins of the sacrum 

 and coccyx is divided into two foramina, the greater and 

 lesser sciatic foramina, by two ligaments, the sacro-tuberous 

 and the sacro-spinous. The sacro-tuberous ligament is the 

 more superficial. It extends from the posterior part of the 

 ilium and the margins of the lower part of the sacrum and 

 the coccyx to the tuberosity of the ischium. The sacro- 

 spinous ligament is partly covered by the sacro-tuberous 

 ligament. It passes from the margin of the lower part of 

 the sacrum and the margin of the coccyx to the spine of the 

 ischium. The large foramen above the sacro-spinous ligament 

 is the greater sciatic foramen. It lies below and behind 

 the lower part of the ilium, and behind the upper part of 

 the ischium. The foramen bounded above by the sacro-spinous 

 and below by the sacro-tuberous ligament is the small sciatic 

 foramen. It lies behind the lower part of the ischium. 

 Through both foramina important structures pass to or from 

 the gluteal region. 



Emerging through the greater sciatic, foramen are the 



piriformis muscle, the superior gluteal vessels and nerves, 



the inferior gluteal vessels and nerve, the posterior cutaneous 



nerve of the thigh, the sciatic nerve, the internal pudendal 



i 19 a 



