Pudendal Nerve - Anatomy

Anatomy

The pudendal nerve originates in the sacral plexus; it derives its fibers from the ventral rami of the second, third, and fourth sacral nerves (S2, S3, S4).

It passes between the piriformis and coccygeus muscles and leaves the pelvis through the lower part of the greater sciatic foramen.

It crosses the spine of the ischium, and reenters the pelvis through the lesser sciatic foramen.

It accompanies the internal pudendal vessels upward and forward along the lateral wall of the ischiorectal fossa, being contained in a sheath of the obturator fascia termed the pudendal canal.

The pudendal nerve gives off the inferior rectal nerves. It soon divides into two terminal branches: the perineal nerve, and the dorsal nerve of the penis (in males) or the dorsal nerve of the clitoris (in females).

Branch Description
Inferior anal nerves given off shortly after passing through the Greater sciatic foramen.
Perineal nerve more superficial terminal branch
Dorsal nerve of penis/Dorsal nerve of clitoris deeper terminal branch, traveling into the deep perineal pouch
Posterior scrotal nerves/Posterior labial nerves Posterior scrotum/Posterior labia
Remember, anterior scrotal nerve/anterior labial nerve is a branch of Illioinguinal nerve.

Research shows that variations in pudendal nerve origin are possible. For example, the pudendal nerve may actually originate off of the Sciatic nerve. Consequently, damage to the sciatic nerve can affect the pudendal nerve as well.

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