Which structure passes above the piriformis muscle?

The superior gluteal vessels, which include the superior gluteal artery and vein, are responsible for supplying blood to the gluteal region. They emerge from the pelvic cavity and exit the pelvis through the greater sciatic foramen, situated above the piriformis muscle. This anatomical pathway is significant because the superior gluteal vessels travel in a superior and lateral direction in relation to the piriformis.

In contrast, the inferior gluteal vessels exit below the piriformis muscle, while the sciatic nerve typically passes below this muscle as well, which is relevant in clinical considerations, such as during sciatic nerve injury assessments. The pudendal nerve, though crucial for innervation in the pelvic floor and genital region, also exits the pelvis through the greater sciatic foramen but travels below the piriformis. Therefore, understanding the anatomical relationships of these structures in relation to the piriformis is essential for surgical practice and diagnosing conditions affecting the gluteal and pelvic regions.