局部解剖学(三) 下肢后区解剖与操作
局部解剖学（三） 下肢后区解剖与操作
下肢后区解剖 Postenor cervical region back of lower limb 臀部 gluteal region Lumbar oox Antenor region of forearm 股后区 back of thigh 膝后区 popliteal fossa Palm Palmar region] 小腿后区 back of leg Postenor rog on of thigh 踝后区 back of ankle Postenor region of knee 足底 sole of foot Antenor region of lee
下肢后区解剖 back of lower limb • 臀部 gluteal region • 股后区 back of thigh • 膝后区 popliteal fossa • 小腿后区 back of leg • 踝后区 back of ankle • 足底 sole of foot
臀部 Gluteal Region 境界 Boundary 表面标志 Surface landmarks 浅层结构 Superficial structures 深层结构 Deep structures
一、臀 部 Gluteal Region • 境 界 Boundary • 表面标志 Surface Landmarks • 浅层结构 Superficial structures • 深层结构 Deep structures
lliac crest Anterior superior iliac spine Posterior superior iliac spine Median sacral crest Superior gluteal nerve spine s (Suprapiriform foramen Posterior inferior iliac spine (Infrapiriform foramen) Greater sciatic foramen Sciatic nerve- nferior gluteal nerve Piriformis Sacrospinous ligament Greater trochanter Lesser sciatic foramen Posterior cutaneous nerve of thigh Ischial tuberosity [posterior femoral cutaneous nerve Sacrotuberous ligament schaal tuberosity Fig. 1337 Projection of skeleton and sciatic nerve onto the surface of the gluteal region posterior aspect. 髂嵴Ⅲ iac crest,髂后上棘 Posterior superior iliac spine 髂前上棘 Anterior superior iliac spine, 坐骨结节 Ischial tuberosity大转子 Greater trochanter
髂嵴 Iliac crest, 髂后上棘Posterior superior iliac spine 髂前上棘Anterior superior iliac spine , 坐骨结节Ischial tuberosity, 大转子Greater trochanter
Superior clunial nerves(L1-L3) Lateral cutaneous branch (iliohypogastric nerve [iliopubic nerve)) Middle clunial nerves(S1-S3) Gluteal fold Lateral cutaneous nerve of thigh of thigh [posterior femoral cutaneous nerve] s [lateral femoral cutaneous nerve 皮肤skin 浅层结构浅筋膜 superficial fascia 皮神经 cutaneous nerve
皮 肤 skin 浅筋膜 superficial fascia 皮神经 cutaneous nerve 浅层结构
Middle clunial nerves(S1-S3) ( Gluteal fascia)一 o Gluteus maximus Inferior clunial nerves, posterior cutaneous nerve of thigh Posterior femoral cutaneous nerve Posterior cutaneous nerve of thigh osterior femoral cutaneous nerve ● Perforating arter 深层结构:臀筋膜 Fascia of buttock、 臀肌、臀肌间隙、血管神经
深层结构：臀筋膜 Fascia of buttock、 臀肌、臀肌间隙、血管神经
Latissimus dorsi Iliac crest Deep branches● (iliohypogastric nerve [iliopubic nerve) (superior gluteal artery and vein External oblique Iliac crest o Gluteus medius o Gluteus minimus Inferior gluteal nerve o Gluteus medius nferior gluteal artery and vein e o Gluteus maximus Gluteus maximus c Posterior cutaneous nerve of thigh [posterior femoral cutaneous nerve Sciatic nerve e Gemellus superior [superior gemellus o Obturator internus Internal pudendal artery and vein. o Gemellus inferior [inferior gemellus Sacrotuberous ligament e Obturator externus o Quadratus femoris Deep branches(medial circumflex femoral artery)o o Adductor ma Fig. 1341 Blood vessels and nerves of right gluteal region; gluteus maximus and medius sectioned and partially removed; sciatic nerve after passage through 深层结构:臀筋膜 Fascia of buttock、 臀肌、臀肌间隙、血管神经
深层结构：臀筋膜 Fascia of buttock、 臀肌、臀肌间隙、血管神经
Iliolumbar ligament Posterior sacro-iliac ligaments osterior sacro-iliac ligaments nterosseous sacro-iliac Postenor sacro-iliac ligaments 坐骨大孔 Greater sciatic foramen 骶结节韧带 Sacrotuberous lig Hip joint, joint capsule articular capsule Greater trochanter 骶棘韧带 坐骨小孔 Deep posterior sacrococcygeal Sacrospinous lig. Lesser sciatic foramen pubic Fig. 1176 Joints of pelvic girdle and lumbosacral joint in the female; posterior aspect (30%)
坐骨大孔 Greater sciatic foramen 坐骨小孔 Lesser sciatic foramen 骶棘韧带 Sacrospinous lig. 骶结节韧带 Sacrotuberous lig
Posterior superior iliac spine lliac crest Anterior superior iliac spine s Posterior superior iliac spine Median sacral crest Superior gluteal nerve spine s (Suprapiriform foramen) Greater Posterior inferior iliac spine sciatic (Infrapiriform foramen) Greater sciatic foramen Sciatic nerve nferior gluteal nerve Piriformis Pudendal nerve一 Sacrospinous ligament Greater trochanter Lesser sciatic foramen Posterior cutaneous nerve of thigh Ischial tuberosity [posterior femoral cutaneous nerve Sacrotuberous ligament schaal tuberosity Fig. 1337 Projection of skeleton and sciatic nerve onto the surface of the gluteal region posterior aspect. 梨状肌上、下孔 Suprapiriform and Infrapiriform Foramen
梨状肌上、下孔 Suprapiriform and Infrapiriform Foramen 梨状肌 Piriformis 梨状肌上孔 梨状肌下孔
(supe 髂后上棘 臀上动、静脉及 臀上神经 Inferior glute 臀下动、静脉及 臀下神经 Posterior cutan 阴部内动脉 Posterior femora 阴部神经 梨状肌 ellus 阴部内静脉 Internal pudenda 大转子 股后皮神经 股方肌 ranches坐骨神经 穿行梨状肌上、下孔的血管和神经 Vessels and nerves which passing through the suprapiriform and infrapiriform foramen
穿行梨状肌上、下孔的血管和神经 Vessels and nerves which passing through the suprapiriform and infrapiriform foramen