216 INFERIOR EXTREMITY 



maximus ; (and after this has been reflected). 

 Three bursse mucosrc. 

 The glutaens medius and minimus. 



The two gemelli muscles and the tendon of the obturator internus. 

 Tendon of the obturator externus. 

 Proximal border of the adductor magnus. 

 The origin of the hamstrings from the tuber ischiadicum. 

 The proximal part of the vastus lateralis. 

 5. The iigamentum sacro-tuberosum. (O.T. great sciatic lig. ). 



(The superior glutreal artery. 

 The inferior glutseal artery (O.T. sciatic). 



| The internal pudendal artery. 



I nil ' 1 <-l . 



The medial circumflex artery. 

 'Superior glutrcal. 

 Sciatic. 



Posterior femoral cutaneous. 

 7. Nerves . . [ Pudendal. 



Nerve to m. obturator internus. 

 Nerve to m. quadratus femoris. 

 Inferior glutreal. 



Supposing that two days are allowed for the above dissection, the first 

 day's work should consist (i) in the dissection of the parts superficial to 

 the glutrcus maximus ; (2) in the cleaning and reflecting of this muscle ; (3) 

 in tracing and defining the various nerves and blood-vessels which enter its 

 deep surface. On the second day the parts which are exposed by the 

 reflection of the gluteus maximus should be dissected. 



Surface Anatomy. Before the skin is reflected the surface 

 markings of the gluteal region require examination. On each 

 side the prominence of the nates forms a round, smooth 

 elevation. Inferiorly the nates are separated, in the middle 

 line, by a deep fissure the natal cleft. This cleft, if traced 

 upwards, almost disappears over the prominence formed 

 by the coccyx and lower part of the sacrum. The crest 

 of the ilium can be felt along its whole length, and in the 

 well-formed male its position is indicated by a groove the 

 iliac furrow. Traced anteriorly the crest terminates in 

 the anterior superior spine of the ilium; traced posteriorly 

 it ends in the posterior superior spine of the ilium. The 

 position of the latter is indicated by a faint depression or 

 dimple which lies on a level with the second spine of the 

 sacrum, and it corresponds with the middle of the sacro- 

 iliac articulation. The prominence of the nates is chiefly 

 formed by the glutasus maximus muscle, covered by a thick 

 layer of fat. A deep transverse groove, produced by a fold 

 of skin and fascia, limits the gluteal elevation below. This is 

 called the gluteal sulcus, and is sometimes said to correspond 

 with the distal border of the glut?eus maximus muscle. It 



