局解小腿Lower-limb獲獎課件

LowerlimbGeneralintroductionThelowerlimbisdividedintofourparts:GlutealregionThighLegFootFunctionSupportthebodyweightLocomotionGlutealregionMusclesSuperficialgroupGluteusmaximusGluteusmediusGluteusminimusTensorfasciaelataeDeepgroupPiriformisObturatorinternusGemellussuperiorandinferiorQuadratusfemorisGlutealregion(continue)NervesandvesselsGreatersciaticforamenabovepiriformisSuperiorglutealnerve,arteryandveinGreatersciaticforamenbelowpiriformisSciaticnervePosteriorcutaneousnerveofthethighInferiorglutealnerveandarteryPudendalnerveandinternalpudendalarteryPassthroughthelessersciaticforamentoentertheperineumThigh---anteriorandmedialregion(1)SuperficialfasciaArteries:SuperficialepigastricarterySuperficialiliaccircumflexarteryExternalpudendalarteryGreatsaphenousveinSuperficialinguinallymphnodesCutaneousnervesIlioinguinalnerveFemoralbranchofthegenitofemoralnerveLateralfemoralcutaneousnerveAnteriorcutaneousbranchesofthefemoralnerveThigh---anteriorandmedialregion(2)DeepstructuresFascialata:thickandstronglaterallyMuscles:Anteriorgroup:quadricepsfemorisandthesartoriusMedialgroup:PectineusAdductorlongusGracilisAdductorbrevisAdductormagnusThigh---anteriorandmedialregion(2)DeepstructuresGapbetweentheinguinalligamentandthehipbone(dividedintotwopartsbyiliopectinealarch)Lacunamusculorum:laterallyIliopsoas,femoralnerve,lateralfemoralcutaneousnerveLacunavasorum:mediallyFemoralartery,femoralvein,femoralcanal.FemoraltriangleBoundariesContents:femoralnerve,artery,vein,canal(fromlateraltomedial)Thigh---anteriorandmedialregion(2)DeepstructuresContentsofthefemoraltriangleFemoralnerve:Muscularbranch:anteriorgroupofthethighCutaneousbranch:AnteriorfemoralcutaneousnerveSaphenousnerve(accompaniesthefemoralarteryatthigh,andaccompaniesthegreatsaphenousveinatleg)Femoralartery:MuscularbranchesDeepfemoralartery:lateralandmedialfemoralcircumflexa.Perforatingarteries:3or4arteriesThigh---anteriorandmedialregion(2)DeepstructuresContentsofthefemoraltriangleFemoralsheathandfemoralcanalFemoralcanalisthemedialcompartmentofthefemoralsheath,containsdeeplymphnodesandfattissue.Itssuperioropeningcalledfemoralring.Boundaries:Laterally:femoralveinMedially:lacunarligamentAnteriorly:inguinalligamentPosteriorly:pectinealligament(ofCooper)Femoralhernia:contentsofabdomenprotrudethroughthefemoralringintothefemoralcanalThigh---anteriorandmedialregion(2)DeepstructuresAdductorcanal(ofhunter):deepfurrowonthemedialsideofthethighBoundaries:Anterior:sartoriusandtheadductorlaminaLateral:vastusmedialisPosterior:adductorlongusandadductormagnusContents:fromsuperficialtodeepSaphenousnerveFemoralarteryFemoralveinObturatorvesselsandnerve:supplythemedialcompartmentofthethigh.Thigh---posteriorregion(3)Superficialstructures:posteriorcutaneousnerveofthethigh.Deepstructures:Muscles:Bicepsfemoris:lateralsideSemitendinosusSemimembranosusNerve:sciaticnerveArteries:perforatingbranchesofthedeepfemoralartery.Thigh---posteriorregion(3)PoplitealfossaBoundariesUpperlateral:tendonofthebicepsfemorisUppermedial:semitendinosusandsemimembranosusLowerlateralandlowermedial:gastrocnemiusContents:Tibialnerveandcommonfibular(peroneal)nervePoplitealveinPoplitealarteryLeg---anteriorandlateralregionSuperficialstructuresSuperficialvein:greatsaphenousveinCutaneousnerve:saphenousnervemediallyandthesuperficialfibularnervelaterallyDeepstructuresDeepfasciaSuperiorandinferiorextensorretinaculumSuperiorandInferiorperonealretinaculumLeg---anteriorandlateralregionDeepstructuresMusclesofanteriorgroupTibialisanteriorExtensorhallucislongusExtensordigitorumlongusMusclesoflateralgroupFibularislongusFibularisbrevisNervesandvesselsDeepfibularnerveandtheanteriortibialvesselsSuperficialfibularnerveLeg---posteriorregionSuperficialstructureSmallsaphenousveinCutaneousnervesMedialsuralcutaneousnerve:fromtibialnerveLateralsuralcutaneousnerve:fromcommonfibularnerveSuralnerveLeg---posteriorregionDeepstructuresDeepfascia:flexorretinaculumMuscles:SuperficialgroupGastrocnemiusPlantarisSoleusDeepgroupPopliteusFlexordigitorumlongusTibialisposteriorFlexorhallucislongusTibialnerveandtheposteriortibialarteryTarsaltunnelIsformedby:TarsalbonesFlexorretinaculumContentsfromanteriortoposterior:TendonoftibialisposteriorTendonofflexordigitorumlongusPosteriortibialarteryandthetibialnerveTendonofflexorhallucislongusThefloorofthefootSkinandsuperficialfasciaPlanteraponeurosisMuscles:Abductorhallucis,flexordigitorumbrevis,abductordigitiminimiTendonofflexordigitorumlo