下肢2011.pptVIP

体表标志 1． 股前部：髂前上棘、耻骨联合上缘、耻骨结节。 2． 膝部：髌骨、髌韧带、胫骨粗隆、股骨内、外侧髁 小腿部:胫骨、腓骨、内外踝 胫骨内、外侧髁、腓骨小头、收肌结节、胫骨前缘，足内、外踝。 Nelaton线：侧卧，髋关节屈90～120度，自坐骨结节至髂前上棘的连线称为Nelaton线，正常时该线恰通过股骨大转子尖，当髋关节脱位或股骨颈折时，大转子尖可移位于此线上方。 Relationship of sciatic n. to the piriformis 髋关节韧带髋关节动脉网 髋关节的韧带 及髋关节动脉网 第三节 股部 Deep fascia – fascia lata 阔筋膜 Iliotibial tract 髂胫束 Saphenous hiatus 隐静脉裂孔 falciform margin 镰状缘 cribriform fascia 筛筋膜 Lacuna musculorum 肌腔隙 Bounded by lateral portion of inguinal ligament anteriorly, ilium posterolaterally, iliopectinal arch medially Contents: iliopsoas, femoral n. and lateral femoral cutaneous n. Lacuna vasorum 血管腔隙 Bounded by medial portion of inguinal ligament anteriorly, pectineal ligament posteromedially, lacunar ligament medially, and iliopectinal arch posterolaterally Contents: femoral sheath, femoral a. and v., genital branch of genitofemoral n. and lymphatic vessels, femoral ring Femoral triangle Femoral sheath Femoral hernia The deep inguinal lymph nodes Cutaneous nerves Popliteal artery 三、膝关节韧带及膝关节动脉网 Front of the leg Superficial veins great saphenous vein Cutaneous nerves The upper two-thirds of the front of the leg is supllied by the saphenous nerve (L3,4) medially, and the lateral cutaneous nerve of the calf laterally. The lower third is supplied by the superficial peroneal and saphenous nerves. （二）深层结构 Deep fascia The deep fascia of the leg is very strong. Superior extensor retinaculum伸肌上支持带 Inferior extensor retinaculum伸肌下支持带 Anterior tibial artery The anterior tibial veins Deep peroneal nerve The back of the leg Find the small saphenous vein Find the Sural nerve and Peroneal communicating nerve 第六节踝与足部 一、踝前区与足背 （一）浅层结构 1.足背静脉弓，足背静脉弓（或网）每个趾的内、外侧各有一条趾背静脉，向后行至足背互相吻合形成足背静脉弓（或网），其内侧端移行为大隐静脉，外侧端移行为小隐静脉。  大、小隐静脉 2.皮神经 （1）隐神经：足内侧缘的皮肤 （2）腓浅神经 足背内侧皮神经分布于足背的内侧部、拇趾内侧缘及第2、3趾相对缘的皮肤。 足背中间皮神经分布于足背中部和第3－5趾相对缘的皮肤。 （3）腓深神经发自腓总神经，于第1、2跖骨间穿出深筋膜，分布于第1、2趾相对缘的皮肤。 （4）足背外侧皮神经 是腓肠神经的终支，经外踝后方转至足背外侧，分布于足背和小趾外侧缘的皮肤。  （二）深层结构 1.伸肌上支持带（小腿横韧带），在小腿下端的前面，附