Several neurovascular structures leave the pelvis through the greater sciatic foramen. Which structure exits ABOVE the piriformis muscle?

• A Superior gluteal nerve and vessels ✓
• B Nerve to obturator internus
• C Sciatic nerve
• D Pudendal nerve and internal pudendal vessels

Explanation

The superior gluteal nerve and vessels are the only major neurovascular structures that leave the pelvis through the greater sciatic foramen above the piriformis, entering the plane between gluteus medius and minimus. All other listed structures emerge below piriformis: the sciatic nerve, pudendal nerve, internal pudendal vessels, and nerves to obturator internus and quadratus femoris. This arrangement explains why superior gluteal nerve palsy follows injections given too low and medial in the buttock.

Reference: Snell's Clinical Anatomy by Regions, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.