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The aim of our study was to provide quantitative data on pudendal motor neuron cell bodies and axons in the female rat. To confirm earlier studies, fluorescent retrograde tracers were used to label the motor neurons for correlation with myelinated axon counts along the length of the motor pudendal nerve. The external urethral sphincter of female rats was injected with diamidino yellow and the external anal sphincter with fast blue. The L(6) spinal cord revealed labeled motor neurons. Those in the dorsolateral column (60.8 +/- 10.6) had nuclei labeled yellow from the external urethral sphincter and those in the dorsomedial column (31.7 +/- 8.5) had cytoplasm labeled blue from the external anal sphincter. Double labeling was not present, suggesting that pudendal motor neurons in each column innervate separate sphincters. The motor pudendal nerve in the ischiorectal fossa was also characterized by light microscopy. The mean myelinated axon count (151.4 +/- 17.0) was highly correlated (r = 0.995) in the proximal fascicles and the sum of distal fascicles. This indicated that myelinated axons do not branch at the point where the main motor pudendal nerve branches into separate fascicles. Axon counts between sides were not as well correlated (r = 0.883). The ratio of motor neurons to myelinated axons is 56%, suggesting that some myelinated axons either innervate other muscles or are sensory. This reproducible characterization of the normal pudendal nerve anatomy provides an excellent basis for experimental studies associated with pudendal nerve denervation as a model for neurogenic incontinence., (Copyright 2002 Wiley-Liss, Inc.)

The manner of innervation of the obturator internus, superior and inferior gemelli, and the quadratus femoris in humans (101 pelvic halves) and in rhesus monkeys (Macaca mulatta: 8 pelvic halves) were investigated. In most specimens, the inferior gemellus originated from the lateral surface of the ischial tuberosity and also from the medial surface (intrapelvic origin) just beneath the obturator internus and was covered by the falciform process of the sacrotuberous ligament. The superior gemellus was frequently innervated by the nerve to the obturator internus and the nerve to the quadratus femoris (60.4%), and the inferior gemellus was innervated by the obturator internus nerve in two specimens. The quadratus femoris nerve originated from more cranial segments than the obturator internus nerve, however these nerves had various communication patterns inside and outside the muscles. According to the intramuscular nerve distribution, in some specimens the branches to the superior gemellus from the quadratus femoris nerve extended to the inferior gemellus, and the branches to the inferior gemellus were distributed to the obturator internus. The present findings revealed that the positional relationships among the branches to the obturator internus and gemelli muscles are relatively constant, although the branching patterns and innervation patterns were varied. The various patterns and routes are considered to reflect the variability of the differentiation patterns of the anlage of the muscles. A possible schematic model of the positional relationships between the muscles and the nerves is proposed.

Background: The manner of innervation of the muscles of the inferior limb, pelvic outlet, and tail in rhesus monkey (Macaca mulatta) was investigated in detail in 11 pelvic halves of four males and two females., Results: The origins of the pudendal nerve were widespread and overlapped the sacral plexus. After removal of the bone structures, detailed dissection revealed the origin of the pudendal nerve to ventrocaudally overlap the sacral plexus. This dorsoventral branching pattern between the sacral plexus and the pudendal nerve is similar to that in Urodela (Akita, 1992b), Lacertilia (Akita, 1992a) and Aves (Akita et al., 1992a), and is a basis for morphological understanding of the muscles of the pelvic outlet., Conclusions: The muscles of the pelvic outlet consist of the levator, sphincter, and tail muscle groups, based on the stratification of the supplying nerves the former two groups likely derive from the ventral muscles of the inferior limb, and the latter group from the ventral caudal (trunk) muscles.

In order to examine the relationships between the positional arrangement and supplying nerves of the glutei medius and minimus and the piriformis, we investigated 49 pelvic halves of 28 cadavers. The superior gluteal nerve ran on the ventral surface of the piriformis in 44 cases (89.8%) (Type A), and some branches of the nerve perforated the piriformis in five cases (10.2%) (Type B). Based on the detailed findings of the innervation of the three muscles, the piriformis is chiefly composed of the caudal element of the gluteus medius (Type A) and in some cases the caudal element of the gluteus minimus as well (Type B).

In order to comprehend more completely the morphology of the nerves to the piriformis, it is necessary to obtain a detailed understanding of the relationship of the origin and the course of these nerves from the dorsal division of the sacral plexus, with reference to the superior and inferior gluteal nerves. Twelve of seven human pelvic halves were carefully dissected in order to examine the origins of the nerves from the dorsal division of the sacral plexus. Six of these pelvic halves were further dissected under a stereomicroscope to examine the nerves to the piriformis. 1. The origin of the superior gluteal nerve was more proximal and dorsal in the sacral plexus than that of the inferior gluteal nerve. 2. The superior gluteal nerve consisted of a thick cranial part and a thin caudal part; the former continued as the inferior branch of the nerve, and the latter, the superior branch. The cranial and caudal parts crossed before reaching the glutei medius and minimus. 3. The nerves to the piriformis arose from three main nerves from the dorsal division of the sacral plexus: 1) the caudalmost root of the superior gluteal nerve, 2) the caudal roots of the inferior gluteal nerve and 3) the common peroneal nerve. Considering the stratificational relationship among the main nerves from the dorsal division of the sacral plexus, the piriformis appears to be composed of parts from different muscle layers.