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Sacrospinous and sacrotuberous ligaments

The sacrospinous and sacrotuberous ligaments do not have direct contact with the hip joint. However, they are important in maintaining pelvic integrity and serving as landmarks when studying relations in the pelvis and gluteal region. Together with the greater and lesser sciatic notches they form the greater and lesser sciatic foramen.

Greater sciatic foramen

The sacrospinous ligament extends from the ischial spine and the lower sacrum and coccyx, converting the greater sciatic notch into the greater sciatic foramen. The greater sciatic foramen is a conduit from the pelvis to the buttock and is divided in half by the piriformis muscle (click muscles to see its course), which exits the pelvis through the foramen.

  • Superior to the piriformis, the superior gluteal vessels and nerve exit.
  • Inferior to the piriformis, the sciatic nerve, inferior gluteal nerves and vessels, posterior femoral cutaneous nerve, and pudendal nerves and vessels exit.

Lesser sciatic foramen

The sacrotuberous ligament extends from the sacrum to the ischial tuberosity, converting the lesser sciatic notch into the lesser sciatic foramen. The obturator internus muscle passes through the lesser sciatic foramen on its way from the inside of the pelvis to the femur (click muscles to see its course). The lesser sciatic foramen is also a conduit to the perineum from the buttock for the pudendal nerves and vessels.



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