Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 5: Supplementary Volume
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit36060/194/
124? 
PELVIS. 
great sacro-sciatic ligament (e), I think merits 
the name of the inferior or short superficial 
posterior sacro-iliac ligament. This ligament 
has been hitherto apparently confounded with 
the great sacro-sciatic, which is attached to 
its lower border by a thin fibrous extension. 
Fig. 81. 
Posterior view of the ligaments of the pelvis. 
a, oblique posterior sacro-iliac ligament ; b, infe¬ 
rior posterior superficial sacro-iliac ligament; c, 
great sacro-sciatic ligament ; d, lesser sacro-sciatic 
ligament ; e, membranous expansion over the pyri- 
formis muscle. 
The ligaments which may be considered as 
accessory to this articulation are three in 
number — the ilio-lumbar ligament above, and 
the greater and lesser sacro-sciatic ligaments 
below. 
The ilio-lumbar ligament {fig. 80. c) is a 
triangular fascicular ligament, thickest at 
the etlges, and passing from the tip of the 
last lumbar transverse process, to which its 
apex is attached, horizontally outwards, and a 
little backwards to the posterior filth of the 
inner lip of the crest of the ilium, along which 
its fibres spread as far forward as the inner 
projecting point of the posterior curve. To 
the outer side and behind this ligament is 
attached the quadratus lumborum muscle 
with the tendon of the transversalis abdo¬ 
minis, and to its front the psoas magnus 
muscle. Meckel describes this ligament as 
sometimes reaching as high as the transverse 
process of the fourth lumbar vertebra. He 
also describes a second ligament lower than 
the preceding, but arising from the iliac crest 
a little behind it. They are called by him, 
respectively, the upper and lower anterior 
pelvic ligaments, the latter corresponding to 
the sacro-vertebral ligament before described. 
The great sacro-sciatic ligament (ligamentum 
pelvis posticum magnum, fig. 81. c) is attached 
behind, to the posterior inferior spine of the 
ilium by a membranous expansion (e) ; to the 
superficial posterior sacro-iliac ligaments with 
which its fibres are blended; to the posterior 
surface and borders of the two last pieces of 
the sacrum; and to the posterior sacro-coccy- 
gean ligament and borders of the two or three 
upper coccygeal bones. From this broad at¬ 
tachment its fibres pass downwards, forwards, 
and outwards to be implanted into the whole 
length of the raised inner border of the great 
tuberosity of the ischium. The fibres of this 
ligament are arranged in fasciculi, which cross 
each other in an X-like manner, so as to 
present, at the extremities, an expanded 
appearance, and in the centre a thick con¬ 
tracted rounded outline. The fibres which 
are placed superiorly in one extremity of 
insertion cross at the contracted part to 
become inferior at the other extremity, while 
those which are internal cross in the opposite 
direction to become external. Its superior 
border, consequently, is directed outwards 
and forwards, and its inferior border inwards, 
and both present a curvilinear outline. At its 
insertion into the sciatic tuberosity, the fibres 
of the lower border present a falciform margin 
having the concavity directed upwards along 
the inner edge of the tuberosity, where it is 
united to the fascia covering the obturator in¬ 
ternus muscle. Its superficial or external 
fibres are continued over the tuberosity in- 
feriorly into the tendons of the biceps flexor 
cruris, and semi-tendinosus muscles. Near the 
posterior extremity, this ligament is almost 
invariably perforated by a small hole, through 
which passes the coccygeal branch of the 
ischiadic artery. To the whole length of its 
external or posterior surface is attached the 
great gluteus muscle, which causes it when 
dissected to be very rough and flocculent. At 
the posterior half of its inner surface it is 
blended intimately with the lesser sacro-sciatic 
ligament, anterior to which it is smooth, and 
forms part of the boundary of the ischio¬ 
rectal fossa. 
The lesser or internal sacro-sciatic ligament 
(ligamentum pelvis posticum parvum, fig. 81. 
d) lies internal to the last, in common with 
which it is attached posteriorly to the side of 
the two last pieces of the sacrum and of the 
two upper pieces of the coccyx. At its an¬ 
terior extremity it is contracted into a pointed 
insertion into the spine of the ischium. The 
direction of this ligament is horizontally for¬ 
wards and outwards,and its shape is triangular, 
so that its anterior contracted portion diverges 
from the great sacro-sciatic ligament, leaving 
a triangular opening between them through 
which pass the obturator muscle out of, and 
the pudic vessels and nerves into the pelvis 
This ligament, thus passing from the sacrum 
across to the ischium, converts the sacro- 
sciatic notch into a triangular or oval foramen 
through which pass the pyramidalis muscle, 
the gluteal, ischiadic and pudic vessels, and the 
superior gluteal and great and lesser sciatic 
and pudic nerves out of the pelvis. With its
        

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