局部解剖学课件：3-臀区和股后区

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1、Gluteal Region and Back of Thigh山东大学医学院山东大学医学院 解剖教研室解剖教研室Gluteal Region臀区臀区Gluteal region 臀区臀区 Boundaries:nSuperiorly:iliac crest nInferiorly:fold of buttocknMedially:lateral borders of sacrum and coccyxnLaterally:a line joining anterior superior iliac spine and great trochanter1.Skin incisionsn1.上切

2、口：髂前上棘-髂后上棘，内侧延伸至骶部正中。n2.正中切口：至尾骨尖n3.下切口：臀沟至臀部外侧n4.膝下切口：腘窝下方n5.股后纵切口2.Superficial structuresSuperior cluneal n.Medial cluneal n.Inferior cluneal n.Cutaneous nerves3.Muscles of hip 髋肌髋肌nPosterior groupqGluteus maximus 臀大肌臀大肌qGluteus medius 臀中肌臀中肌qGluteus minimus 臀小肌臀小肌qPiriformis 梨状肌梨状肌qGemellus supe

3、rior 上孖肌上孖肌 qObturator internus 闭孔内肌闭孔内肌qGemellus inferior 下孖肌下孖肌qObturator externus 闭孔外肌闭孔外肌qQuadratus femoris 股方肌股方肌4.Nerves and vesselssuprapiriform forameninfrapiriform foramennStructures passing through suprapiriform foramen（from lateral to medial side）qSuperior gluteal n.臀上神经臀上神经qSuperior glut

4、eal a.臀上动脉臀上动脉qSuperior gluteal v.臀上静脉臀上静脉nStructures passing through infrapiriform foramen(from lateral to medial side)qSciatic n.坐骨神经坐骨神经qPosterior femoral cutaneous n.股后皮神经股后皮神经 qInferior gluteal n.臀下神经臀下神经qInferior gluteal a.,v.臀下动、静脉臀下动、静脉qInternal pudendal v.,a.阴部内动、静脉阴部内动、静脉qPudendal n.阴部神经阴部

5、神经 They then curve forwards to enter the perineum through the lesser sciatic foramennStructures passing through lessor sciatic foramen（from lateral to medial side）qInternal pudendal a.,v.阴部内动、静脉阴部内动、静脉qPudendal n.阴部神经阴部神经Gluteal region 臀区臀区nAnastomosis of arteries around hip joint 髋周围动脉网髋周围动脉网qMedia

6、l circumflex femoral a.旋股内侧动脉旋股内侧动脉 qLateral circumflex femoral a.旋股外侧动脉旋股外侧动脉 qSuperior gluteal a.臀上动脉臀上动脉qInferior gluteal a.臀下动脉臀下动脉qFirst perforating a.第一穿动脉第一穿动脉Back of ThighContents of the posterior osseofascial compartment of the thighnMuscles qBiceps femoris 股二头肌股二头肌qSemitendinosus 半腱肌半腱肌qSe

7、mimembranosus 半膜肌半膜肌nBlood supplyqPerforating arteries the deep femoral arterynNerve supplyqSciatic nerve 坐骨神经坐骨神经Muscles of posterior region of thighSemitendinosus半腱肌半腱肌Semimembranosus半膜肌半膜肌Long head of biceps femoris 股二头肌长头股二头肌长头Short head of biceps femoris 股二头肌短头股二头肌短头Sciatic nerve 坐骨神经坐骨神经nCours

8、eqArises from the sacral plexusqLeaves pelvis through infrapiriform foramen to enter gluteal regionqRuns inferiorly laterally deep to gluteus maximusqPassing midway between the greater trochanter of femur and ischial tuberosity to back of thighqLying deep to long head of biceps femoris,qNormally div

9、ided into tibial and common peroneal nerves just above popliteal fossaSciatic nerve 坐骨神经坐骨神经nInnervatesqSemitendinosus 半腱肌半腱肌qSemimembranosus 半膜肌半膜肌 qBiceps femoris 股二头肌股二头肌qHip and knee joints 髋关节和膝关节髋关节和膝关节Relationship of sciatic n.to the piriformisYou must identify follow structures！Muscles nGlut

10、eus maximus 臀大肌臀大肌nGluteus medius 臀中肌臀中肌nGluteus minimus 臀小肌臀小肌nPiriformis 梨状肌梨状肌nObturator internus 闭孔内肌闭孔内肌 nQuadratus femoris 股方肌股方肌nBiceps femoris 股二头肌股二头肌nSemitendinosus 半腱肌半腱肌nSemimembranosus 半膜肌半膜肌 Nerves and vesselsnSciatic n.坐骨神经坐骨神经nSuperior gluteal n.and vessels 臀上神经及血管臀上神经及血管nInferior gluteal n.and vessels 臀下神经及血管臀下神经及血管nInternal pudendal vessels 阴部阴部内血管内血管nPudendal n.阴部神经阴部神经nTibial n.胫神经胫神经nCommon peroneal n.腓总神经腓总神经下节课n腘窝、小腿后区、踝管腘窝、小腿后区、踝管