AnatoMemory

Nerve

Sacral plexus

Lumbosacral fibers gathered on the pelvic surface of piriformis

PelvisNervous system

High-yield

The lumbosacral trunk contributes L4–L5. The sciatic nerve usually contains L4–S3 fibers, whereas the pudendal nerve contains S2–S4.

Overview

The sacral plexus combines the lumbosacral trunk with sacral anterior rami on the posterior pelvic wall. Its major branches carry motor and sensory fibers to the buttock, posterior thigh, leg, foot and perineum.

Reference facts

Origin
Anterior rami S1–S4 join the L4–L5 lumbosacral trunk.
Root value
Overall L4–S4; superior gluteal L4–S1, inferior gluteal L5–S2, sciatic L4–S3, posterior femoral cutaneous S1–S3 and pudendal S2–S4.
Course
Lies anterior to piriformis and behind the internal iliac vessels; major limb branches leave through the greater sciatic foramen.
Motor
Supplies gluteal and posterior-thigh muscles, leg and foot muscles, and perineal/pelvic-floor muscles through its branches.
Sensory
Serves much of the buttock, posterior thigh, leg and foot, together with perineal and external-genital skin.

Mnemonic

Follow the posterior pelvic wall: piriformis lies behind the plexus, and the sciatic route leads toward the limb.

Clinical correlation

Pelvic trauma, tumors or compression during childbirth can involve multiple branches at once. A plexus lesion may therefore cause weakness and sensory loss spanning more than one peripheral nerve territory.

Frequently asked questions

What are the roots of the sacral plexus?

Overall L4–S4; superior gluteal L4–S1, inferior gluteal L5–S2, sciatic L4–S3, posterior femoral cutaneous S1–S3 and pudendal S2–S4.

What muscles does the sacral plexus supply?

Supplies gluteal and posterior-thigh muscles, leg and foot muscles, and perineal/pelvic-floor muscles through its branches.

What is the sensory distribution of the sacral plexus?

The sacral plexus carries sensation from the serves much of the buttock, posterior thigh, leg and foot, together with perineal and external-genital skin.

What is the course of the sacral plexus?

Lies anterior to piriformis and behind the internal iliac vessels; major limb branches leave through the greater sciatic foramen.