Sacral Plexus

Formation
1. Lumbosacral trunk (L4,5)
2. Ventral rami of S1, 2, 3
3. Upper part of S4

Each of these nerve roots divides into anterior and posterior divisions

Site and Relations

1. Lies on the posterior pelvic wall in front of piriformis muscle and behind internal iliac
vessels
2. Coming out through greater sciatic foramen

Branches
1. Branches from the roots:
a. Nerve to Piriformis (S1, 2)
b. Perforating cutaneous nerve of thigh (S2, 3)
c. Pelvic splancnic nerve (parasympathetic), S2, 3, 4
d. Pudendal nerve (S2, 3, 4)
e. Perineal branch of 4th sacral nerve
2. Branches from posterior divisions:
a. Superior gluteal nerve (L4, 5, S1)
b. Inferior gluteal nerve (L5, S1, 2)
3. Branches from anterior divisions:
a. Nerve to quadratus femoris (L4, 5, S1)
b. Nerve to obturator internus (L5, S1, 2)
4. Branches from both anterior and posterior divisions
a. Sciatic nerve
i. Common peroneal part (posterior division of L4, 5, S1, 2)
ii. Tibial part (anterior division L4, 5, S1, 2, 3)
b. Posterior cutaneous of thigh
i. posterior divisions of S1, 2
ii. anterior divisions of S2, 3
Individual Branches
1. Perforating cutaneous nerve of thigh (S2, 3)
a. Skin of lower and medial part of gluteus maximus
2. Posterior cutaneous of thigh
a. Gluteal branches → skin over inferolateral part of gluteus maximus
b. Perineal branches → skin of the perineum
c. Branches to the skin of the back of the thigh, popliteal fossa and upper ½ the back
of the leg
3. Nerve to quadratus femoris (L4, 5, S1)
a. Quadratus femoris
b. Inferior gemellus
c. Hip joint
4. Nerve to obturator internus (L5, S1, 2)
a. Obturator internus muscle
5. Superior gluteal nerve (L4, 5, S1)
a. Upper branch → gluteus medius
b. Lower branch → gluteus minimus and tensor fascia lata
6. Inferior gluteal nerve (L5, S1, 2)
a. Gluteus maximus muscle
7. Pelvic splancnic nerve (parasympathetic), S2, 3, 4
a. To pelvis viscera
8. Sciatic nerve
a. Articular branches → hip joint
b. Muscular branches
i. Tibial part
1. ischial head of adductor magnus
2. semitendinosus
3. semimembranosus
4. long head of biceps
ii. Common peroneal part
1. short head of biceps