As soon as these nerves are found, or the student
thinks he has expended enough time and patience on
the search, the superficial fascia must be taken ofif in
one piece, and the gluteus maximus exposed. It is a
large coarse muscle, and very difficult to clean ; in
fact, it is only possible to clean it by taking the fascia



Chap. IV.] Dissection of Buttock. 83

off each fibre separately. When it is cleaned the
gluteus medius will be seen appearing from beneath
its front margin covered with a dense fascia prolonged
from the fascia lata of the leg. Beginnisig from where
it touches the gluteus medius, the maximus must be
cut through about three-quarters of an inch from
its origin, and reflected downwards and outwards
towards the great trochanter.
The gluteal vessels and nerves (inferior gluteal
from lesser sciatic) which enter it on its deep
surface must be cut away close to the muscle to
facilitate the process of reflection, and its insertion
into the fascia lata made out.
The gluteus medius should next be cleaned and
reflected partially from its origin, like the gluteus
maximus.
The principal structures in the gluteal region will
then be exposed.
The student will be able to verify the surface mark-
ings of the ischial tuberosities and great trochanter
which he felt through the skin.
The hamstring muscles will be seen arising from
the ischial tuberosity; their exact positions will be
made out later on.
A little above the tuberosity, and emerging from
under the gluteus maximus, will be seen a muscle
(pyriformis) which may be said to form the key to
this region.
