复旦大学：《局部解剖学 Regional Anatomy》教学课件（英文）Part 9 – lower limb（Part 2）Posterior region of lower limb

is Regional Anatomy Part 9-lower limb(Part 2) Posterior region of lower limb INTERNATIONAL EDITION Hongqi zhang(张红旗) Dissector Dept of Anatomy, Histoembryology CEmail:zhanghg58@126.com

1 Regional Anatomy Part 9 – lower limb (Part 2) Posterior region of lower limb Hongqi Zhang (张红旗 ) Dept. of Anatomy,Histoembryology Email: zhanghq58@126.com

Posterior region of lower limbs

Posterior region of lower limbs

Cutaneous nn of posterior superior cluneal n. regions of gluteal and thigh 臀内侧皮神经 L medial cluneal. I Dissection of the sup. fascia gluteus maximus Cutaneous nn. in gluteal region 臀下皮神经1 inferior cluneal n Sup. cluneal n(L posterior femoral Mid cluneal n (S1-3) gracilIs Inf cluneal n biceps femoris 半膜肌 mimembranosus from post femoral cutaneous n. 大隐静脉 Post femoral cutaneous n great saphenous v 胫神经 半膜肌 If don' t find it or them&msst.m肠肌内侧头 腓肠外侧皮神 lateral sural cutaneous n medial head of. 腓总神经经 Deep fascia-thick and strong 腓肠肌外侧头 ateral head of

Dissection of the sup.fascia Cutaneous nn. in gluteal region Sup.cluneal n. (L1-3 ) Mid.cluneal n.(S1-3 ) Inf.cluneal n. ( from post.femoral cutaneous n.) Post. femoral cutaneous n. If don’t find it or them & miss it. Deep fascia - thick and strong. Cutaneous nn of posterior regions of gluteal and thigh

gastric nerve Sup. cluneal n tanto Cutaneous nof obturator Med. cluneal n Inf cluneal n Lat sural rve of thigh Post femoral cutaneous n nerve ous Saphenous n cutaneous n Cutaneous n of obturator n ura Lat sural cutaneous n cutaneous nerve (sciatic nerve

Sup.cluneal n. Med.cluneal n. Inf.cluneal n. Post.femoral cutaneous. n. Saphenous n. Lat.sural cutaneous n. Saphenous n. Lat.sural cutaneous n. Sural n. Cutaneous n.of obturator n. Cutaneous n.of obturator n

Posterior group of hip muscle 1-Gluteus maximus 2-Gluteus medius 3-Gluteus minimus 4-Poriformis 5-Obturator internus 2 6 Gemellus sup. 7 Gemellus inf 6 3 5 7 obt 5 Quadriceps femoris

1-Gluteus maximus 2-Gluteus medius 3-Gluteus minimus 4-Poriformis 5-Obturator internus 1 2 3 4 5 5 Posterior group of hip muscle 6 Gemellus sup. 7 Gemellus inf. 6 7 Quadriceps femiris

Dissection of gluteus maximus and post gluteal cutaneous n Cut open deep fascia from the juncture between gluteus maximus and biceps femoris to popliteal fossa and find the post cutaneous femoral n Clean up the sup inf. border of gluteus maximus. Cut down it at its origin reflect it laterally Cut the gluteus medius at the mid point observe the Bcecs tm gluteus minimus. find sup inf. gluteal blood vessels and nn. At suprapiriformis foramen infrapiriformis foramen Post femoral cutanesou n

Dissection of gluteus maximus and post. gluteal cutaneous n. Cut open deep fascia from the juncture between gluteus maximus and biceps femoris to popliteal fossa and find the post.cutaneous femoral n. Clean up the sup & inf. border of gluteus maximus. Cut down it at its origin & reflect it laterally. Cut the gluteus medius at the mid.point ,observe the gluteus minimus. find sup. & inf. gluteal blood vessels and nn. At suprapiriformis foramen & infrapiriformis foramen. Post.femoral cutanesou n

Blood vessels of gluteal region Observe the sciatic n 匈腰筋膜 thoracolumbar fascia 臀大肌 gluteus maximus 臀上动脉深上支 deep superior branch of 臀中肌 gluteus medius 臀上动脉深下支 臀小肌 deep inferior branch of gluteus mir superior gluteal a 梨状肌 臀上神经 piriformis rior gluteal 阴部神经 坐骨神纟 sciatic n Infrapiriformis Structures pudendal n 闭孔内肌驶 From lat to med.: 阴部内动脉 nternal pudendal a. tendon of obturator 后皮神经 股方肌 1. Sciatic n quadratus femoris cutaneous n 会阴支 co m peroneal n 2. Post. cutaneous femoral n peroneal branck tibial n 3. Infrapiriformis bv&n 大收肌 股二头肌长头 adductor magn long hesd of biceps femoris 4. Pudental bv& nn Cut gluteus magnus

Infrapiriformis Structures From lat.to med.： 1. Sciatic n. 2. Post. cutaneous femoral n. 3. Infrapiriformis BV & n. 4. Pudental BV & nn. Cut gluteus magnus Blood vessels of gluteal region Observe the sciatic n

Main branches of sacral plexus ◆1-Sup. gluteal n ◆2-nf. gluteal n ◆3- Pudendal n ◆4- Post femora cutaneous n ◆5- Sciatic n 5

Main branches of sacral plexus 1-Sup. gluteal n. 2-Inf.gluteal n. 3- Pudendal n. 4-Post.femoral cutaneous n. 5 -Sciatic n. 1 2 3 4 5

Intramuscular injection of hip Intramuscular injection of shoulder Safe Area upper outer quadrant buttock sciatic ner ve

Intramuscular injection of hip Intramuscular injection of shoulder buttock

Posterior group of thigh m Gluteus medius 愿愿 Gracilis Adductor magnus Iliotibial band Vastus lateralis Hamstring group Semimembranosus Biceps femoris Biceps femoris semitendinosus (Long head)(Short head) semimembranosus They are the main extensors of the thigh and flexors of the leg When the knee joints is semi-flexed, they can also rotate the leg

Biceps femoris (Long head) semitendinosus semimembranosus Biceps femoris (Short head) Posterior group of thigh m. They are the main extensors of the thigh and flexors of the leg. When the knee joints is semi-flexed, they can also rotate the leg