局解绪论和下肢-ty-20111103PPT.ppt

局部解剖学Regional Anatomy ;;绪 论;系统解剖学：以人体的功能系统为基础。 局部解剖学：以人体各个局部区域的结构及其位置关系为基础。境界、层次、内容、毗邻、临床意义 ; ;The essence of good dissection is to display each structure fully, clearly, and cleanly. 完全、清晰、干净地显露每一个结构;下 肢LOWER LIMB;概述;;分区解剖：;下肢前区的浅静脉和皮神经Superficial vein and cutaneous nerve of the anterior lower limb;;髋肌 Muscles of Hip ;大隐静脉Great Saphenous Vein;大隐静脉;五条主要属支 ;静脉瓣防止血液返流 ;GSV (Great Saphenous Vein) graft;腹股沟浅淋巴结Superficial Inguinal Lymph Nodes;股前部皮神经;In a presurgical patient, the great saphenous vein is cannulated 插管 in the vicinity of 在附近 the ankle. During the procedure, the patient experiences severe pain that radiates along the medial border of the foot. Which one of the following nerves was accidentally included in a ligature 结扎 during this procedure? a. Medial femoral cutaneous nerve b. Saphenous nerve c. Superficial fibular nerve d. Sural cutaneous nerve e. Tibial nerve ;第一部分股前、内侧区Anterior Medial Region of the Thigh;大腿肌——前群;耻骨肌 Pectineus  长收肌 Adductor longus 短收肌 Adductor brevis 大收肌 Adductor magnus  股薄肌 Gracilis;主要内容;隐静脉裂孔 Saphenous opening ;股三角 Femoral Triangle;股三角 Femoral Triangle;股动脉及其主要分支：股深动脉（旋股内侧动脉、旋股外侧动脉、穿动脉）;Branches of the femoral nerve;Femoral Triangle;收肌管是位于缝匠肌中1/3段深面的肌筋膜腔隙。 股动脉和股静脉自股三角尖端穿出后，穿经收肌管至大腿下部内侧，终于收肌腱裂孔。 ;境界:前界: 缝匠肌和收肌腱板Sartorius adductor lamina后界：长收肌和大收肌Adductor longus magnus外侧界: 股内侧肌Vastus medialis;腹股沟韧带;肌腔隙 Lacuna Musculorum ;境界:前—— 腹股沟韧带 Inguinal lig. 后—— 耻骨梳韧带 Pectineal lig. 外—— 髂耻弓 Iliopectineal arch 内——陷窝韧带 Lacunar lig. 穿经结构:股血管 Femoral vessels股管 Femoral canal （含淋巴管和淋巴结）;股鞘 Femoral Sheath;股环 Femoral Ring ;股环 Femoral Ring ;股疝 Femoral Hernia ;闭孔动脉 Obturator a.;闭孔神经来自腰丛 Obturator nerve, a branch from lumbar plexus;Branches of the obturator nerve;腰丛Lumbar plexus;1, 回顾阔筋膜fascia lata和隐静脉裂孔saphenous opening ，保留髂胫束iliotibial band。 2, 显露和解剖股三角femoral triangle和收肌管 adductor canal。 3, 修洁此区肌肉、血管和神经。;A third year medical student on cardiology service receives a transfer patient from the ED. The 52-year-old woman i