. Regional anesthesia : its technic and clinical application . d) Pudic Nerve.—The pudic nerve originates, like the visceralbranches of the pudendal plexus, from S^, S^, and S*. It leaves thepelvis through the great sacrosciatic foramen, passes over the spineof the ischitmi, and enters the ischiorectal fossa through the small sacro-sciatic foramen. It gives off the inferior hemorrhoidal nerve and runsforward in the obturator fascia along the ischiopubic ramus bf theinnominate bone, and, on approaching the base of the triangular ligament,divides into its terminal branches, the perineal nerve an
. Regional anesthesia : its technic and clinical application . d) Pudic Nerve.—The pudic nerve originates, like the visceralbranches of the pudendal plexus, from S^, S^, and S*. It leaves thepelvis through the great sacrosciatic foramen, passes over the spineof the ischitmi, and enters the ischiorectal fossa through the small sacro-sciatic foramen. It gives off the inferior hemorrhoidal nerve and runsforward in the obturator fascia along the ischiopubic ramus bf theinnominate bone, and, on approaching the base of the triangular ligament,divides into its terminal branches, the perineal nerve and the dorsal 17 2S8 REGIONAL ANESTHESIA nerve of the penis or clitoris, which communicate with the inferiorpudendal nerve, branch of the small sciatic nerve. The pudic nervesupplies the external anal sphincter and the integument of the analregion, the perineum and upper inner aspect of the thigh, the integumentof the scrotum or labium majus, the muscles of the perineum, the urethra,and the penis in its anterior two-thirds (Figs. 196 and 197). lr\f pudendal. 1 Fig. 197.—Female pe Inf he-n-Uj-cehoudaL , showing (listril)uti<in of thebranch of the small sciatic. Sacrococcygeal Plexus.—The sacrococcygeal plexus is derived fromthe fifth sacral and the coccygeal nerve, with a contribution from thefourth sacral nerve. Its branches, which are tiny filaments, are dis-tributed to the integument of the coccygeal region, occasionally to thecoccygeus -and gluteus maximus muscles. Great Sciatic Nerve.—The great sciatic nerve, the largest trunk inthe body, leaves the pelvis through the great sacrosciatic foramen,below the pyriformis muscle, turns downward between the greattrochanter and the tuberosity of the ischium (Fig. 215), and enters the BLOCKING OF SPINAL NERVES 259 thigh beneath the lower margin of the gluteus maximus muscle (page286). The foregoing description of the sacrum and sacral plexus, con-ceived and worded from an essentially practical point of view, brings outthe f
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