颅骨四肢骨PPT精品课件

1、颅骨的整体观The skull as a whole颅顶面观 The superior aspect of the skull 颅底内面观# The internal aspect of the cranial base颅底外面观 The external aspect of the cranial base颅侧面观 The lateral aspect of the skull 颅前面观 The anterior aspect of the skull 冠状缝 coronal suture矢状缝sagittal suture颅上面观superior aspect of skull颅后面观 t

2、he dorsal aspect of the skull枕外隆突external occipital protuberance矢状缝人字缝颅盖的内面观The internal aspect of the skull cap颗粒小凹上矢状窦沟上矢状窦沟动静脉沟The internal surface of the cranial base颅前窝anterior cranial fossa颅中窝middle cranial fossa颅后窝posterior cranial fossa颅底内面观颅前窝The anterior cranial fossa组成主要结构毗邻与相通额骨的眶板筛骨的筛板蝶

3、骨的体额骨的眶板蝶骨的小翼蝶骨的小翼Cribriform foramina 5组成主要结构毗邻与相通颅前窝The anterior cranial fossae额嵴15盲孔9鸡冠6筛板18筛孔5Frontal crest 15Foramen caecum 9Crista galli 6Cribriform plate 18颅 前 窝组成:由额骨、筛骨和蝶骨组成。主要孔裂：有筛板、筛孔等。通过的血管神经：容纳大脑的额叶。筛孔有嗅神经通过。毗邻：借筛板与鼻腔相邻；借额骨眶部与眶相隔。Anterior cranial fossaAnterior cranial fossa is formed by

4、the frontal bone anteriorly and laterally, the ethmoid bone centrally, and the body and lesser wings of the sphenoid posteriorly.The greater part of the anterior cranial fossa is formed by orbital plates of the frontal bone, which support the frontal lobes of the brain and form the roofs of the orbi

5、ts. The frontal crest is a median bony extension of the frontal bone, and the crista galli (cocks comb) is a median ridge of bone that projects superiorly from the ethmoid. On each side of the crista galli is the cribriform plate of the ethmoid. 颅中窝The middle cranial fossa组成主要结构毗邻与相通颞骨鳞部蝶骨的体颞骨岩部蝶骨的大

6、翼颅中窝The middle cranial fossa组成主要结构毗邻与相通蝶骨体、蝶鞍、垂体窝38、鞍结节45、视神经管34、前床突1、鞍背8、后床突39、颈动脉沟3、眶上裂42、破裂孔10、圆孔13、卵圆孔12、棘孔14、脑膜中动脉沟24、鼓室盖2、三叉神经压迹44 、颈动脉管内口眶上裂42 superior orbital fissure、破裂孔10 foramen lacerum、圆孔13 foramen rotundum、卵圆孔12 foramen ovale、棘孔14 foramen spinosum、脑膜中动脉沟24、鼓室盖2 tympanic tegmen、三叉神经压迹44

7、trigeminal impression 、颈动脉管内口 internal opening carotid canal颅 中 窝组成：由蝶骨、颞骨和顶骨组成。主要孔裂及其通过的血管神经：容纳大脑的颞叶。视神经管，有视神经和眼动脉通过。眶上裂，有动眼神经、滑车神经、三叉神经的眼神经、展神经和眼静脉通过；圆孔，有三叉神经的上颌神经通过；卵圆孔，有三叉神经的下颌神经通过；棘孔，有脑膜中动脉通过。Middle cranial fossaAnterior cranial fossa is formed by the greater wings of the sphenoid, squamous par

8、ts of the temporal bones laterally, and petrous parts of the temporal bones posteriorly. The lateral parts of the middle cranial fossa are posteroinferior to the anterior cranial fossa and support the temporal lobes of the brain.颅后窝The posterior cranial fossa组成主要结构毗邻与相通枕骨鳞部鞍背颞骨岩部枕骨基底部枕骨大孔11、斜坡4、舌下神经

9、管内口27、枕内隆凸29、横窦沟23、乙状窦沟20、颈静脉孔30、内耳门28、岩上窦21、岩下窦19foramen magnum11、 clivus 4 、 internal opening of hypoglossal canal 27 、internal occipital protuberance29、sulcus for transverse sinus 23 、 sulcus for sigmoid sinus20、jugular foramen 30 、 internal acoustic meatus 28 、sulcus for superior petrosal sinus

10、21、 sulcus for inferior petrosal sinus 19枕骨大孔11foramen magnum、斜坡4 clivus、舌下神经管内口27 internal opening of hypoglossal canal、枕内隆凸29internal occipital protuberance、横窦沟23 sulcus for transverse sinus、乙状窦沟20 sulcus for sigmoid sinus 、颈静脉孔30 jugular foramen、内耳门28 internal acoustic meatus、岩上窦sulcus for superi

11、or petrosal sinus 21、岩下窦sulcus for inferior petrosal sinus 19颅 后 窝组成：主要由枕骨和颞骨岩部后面组成。主要孔裂及其通过的血管神经：枕骨大孔，与椎管相通，延髓与脊髓相延续，有椎动脉和副神经的脊髓根通过；舌下神经管，有舌下神经通过；颈静脉孔，有舌咽、迷走、副神经通过，且颈内静脉与乙状窦在此延续；内耳门，通内耳道，有面神经、前庭蜗神经和迷路血管通过。Posterior cranial fossaThe posterior cranial fossa, the largest and deepest of the cranial fos

12、sae, contains the cerebellum, pons and medulla oblongata.The fossa is formed largely by the occipital bones, but parts of the sphenoid and temporal bones make smaller contribution to it.颅底外面观The external aspect of base of skull骨腭、腭中缝28、切牙管16、腭大孔50、鼻后孔、枕髁29、舌下神经管外口15、颈静脉孔20、颈动脉管外口3、茎突46、茎乳孔47、下颌窝23、关

13、节结节2、破裂孔9颅底外面观 The external aspect of base of skull枕髁29 occipital condyle舌下神经管外口15 external opening of hypoglossal canal颈静脉孔20 jugular foramen颈动脉管外口3 external opening of carotid canal茎突46 styloid process茎乳孔47 stylomastoid foramen下颌窝23 mandibular fossa关节结节2 articular tubercle外耳门34乳突18颧弓37、35颞窝颞线33翼点2

14、9External acoustic meatus34Mastoid process18Zagomatic arch37、35Temporal fossaTemporal line33Pterion29 颅外侧面观 The lateral aspect of the skull翼点前支后支脑膜中动脉上颌动脉翼点39pterion颞下窝 infratemporal fossa 翼腭窝 pterygopalatine fossa位置相通颅前面观 The anterior aspect of the skull额区眶 orbit骨性鼻腔 bony nasal cavity鼻旁窦 paranasal

15、sinuses骨性口腔 oral cavity眶上孔5（眶上切迹）视神经管16泪腺窝18泪囊窝4眶上裂23眶下裂10眶下沟17眶下孔9眶的主要结构supraorbital foramen眶上孔5 (supraorbital notch眶上切迹）optic canal视神经管16fossa for the lacrimal gland泪腺窝18fossa for the lacrimal sac泪囊窝4 superior orbital fissure眶上裂23inferior orbital fissure眶下裂10 infraorbital groove眶下沟17 infraorbital

16、foramen眶下孔9 眶的主要结构The nasal median septum鼻中隔筛骨，垂直板犁骨鼻中隔 The nasal median septum犁骨筛骨，垂直板鼻中隔软骨鼻腔外侧壁 The lateral wall of nasal cavity下鼻甲上颌骨，腭突腭骨,水平板筛骨，上鼻甲腭骨, 垂直板筛骨，中鼻甲筛骨，鸡冠筛骨，筛板鼻骨下鼻道中鼻道上鼻道蝶腭孔蝶筛隐窝蝶骨,翼突下鼻道鼻旁窦位置相通特点额窦frontal sinus、蝶窦sphenoidal sinus、筛窦ethmoidal cells、上颌窦maxillary sinusparanasal sinuses鼻旁窦

17、 paranasal sinuses额窦筛窦上颌窦鼻旁窦及鼻泪管的开口The orifices of paranasal sinuses and nasolacrimal canal鼻旁窦 paranasal sinusesparanasal sinuses鼻旁窦鼻旁窦paranasal sinuses鼻旁窦paranasal sinuses新生儿颅骨The skull of a newborn颅囟 Cranial fontanelleMastoid fontanelleSphenoidal fontanelleAnterior fontanelle颅囟 cranial fontanelleP

18、osterior fontanelleAnterior fontanelle四肢骨上肢骨下肢骨上肢带骨自由肢骨下肢带骨自由肢骨第三节 附肢骨骼（322）锁骨肩胛骨肱骨桡骨尺骨腕骨 掌骨指骨上肢带骨上肢骨自由肢骨臂前臂手肘部The shoulder girdle clavicle scapulaThe free parts of the limb humerus radius ulna carpus metacarpus phalanges bones of the upper limb 上肢骨（322）上肢带骨 锁骨1 肩胛骨1 自由肢骨： 肱骨1 桡骨1 尺骨1 腕骨8 掌骨5 指骨14锁骨

19、 clavicle 锁骨全长可在体表扪到，为重要的骨性标志。The clavicle of a living subject can be palpated throughout its entire extent, and is an important bony landmark.锁骨胸骨颈静脉切迹锁骨 clavicle锁骨呈S形，是典型的长骨。The clavicle is a S-shaped and typical long bone.锁骨几乎横置于颈根部的两侧，从胸骨延伸至肩胛骨的肩峰。It lies almost horizontally on each side of the

20、root of the neck, extending from the sternum to the acromion of the scapula.锁骨连接上肢与躯干。It joins the trunk with the upper limb. 锁骨的内侧端（胸骨端）呈圆形，借胸锁关节连于胸骨柄，Its medial (or sternal) end is round, and joints the manubrium by sternoclavicular joint. 锁骨的外侧端（肩峰端）呈扁平形，与肩胛骨的肩峰相关节。Its lateral (or acromial ) end

21、is flat, and articulates with the acromion of the scapula.锁骨 clavicle锁骨干的内侧2/3凸向前，外侧1/3凹向前。The medial two-thirds of its shaft is convex anteriorly, whereas the lateral third is concave anteriorly. 锁骨上面光滑，下面粗糙。Its superior surface is smooth and the inferior surface is rough.肩峰端胸骨端锁骨干锁骨最薄弱的部位在中、外侧1/3交

22、界处。The weakest part of the clavicle is at the junction of its middle and lateral thirds.锁骨的薄弱部位及其临床意义当手或肩着地跌倒时，锁骨骨折相当常见。Fracture of the clavicle is relatively common by falls on the shoulder or hand.肩胛骨 Scapula肩 胛 骨 scapula肩峰肩胛冈冈上窝上角下角外侧角冈下窝关节盂肩胛下窝外侧缘内侧缘上缘肩胛切迹喙突（外侧面）肩胛骨肩峰关节盂外侧缘喙突盂上结节盂下结节肋面后面肩胛骨 scap

23、ula为三角形的扁骨，贴于胸廓后外面。可分为：二面：腹侧面（肋面）和背侧面（后面）；三缘：上缘、内侧缘（脊柱缘）、外侧缘（腋缘）；三个角：上角、下角、外侧角。主要结构：有肩胛下窝、肩胛冈、肩峰、冈上窝、冈下窝、关节盂、喙突等结构。肩胛骨 ScapulaIt lies on the posterolateral aspect of the thorax（胸廓） between the second and seventh ribs（肋）.It is a triangular flat bone.It has two surfaces ( the anterior or costal and po

24、sterior or dorsal surface ), three borders ( the medial, lateral and superior borders), and three angles ( the superior, inferior and lateral angles ).The superior border has the scapular notch（肩胛切迹） and coracoid process（喙突）(which can be palpated in the infraclavicular fossa锁骨下窝).The lateral angle h

25、as a concave articular surface, the glenoid cavity（关节盂） which articulates with the head of the humerus to form the shoulder joint.The superior angle between the medial and superior border is opposite to the second rib.肩胛骨 ScapulaThe inferior angle is opposite to the seventh rib, which is a landmark

26、in the back for determination of the order of the ribs.The costal surface is known as subscapular fossa（肩胛下窝）.The dorsal surface is divided by the spine of scapula（肩胛冈） into the supraspinous fossa（冈上窝） and infraspinous fossa（冈下窝）.The spine of scapula, a thick projecting ridge, continues laterally as

27、 the flat acromion（肩峰） of scapula.The acromion of scapula is the highest point of shoulder joint, and articulates with the acromial end of clavicle.humerus肱骨头解剖颈小结节大结节结节间沟外科颈桡神经沟小结节嵴大结节嵴三角肌粗隆内上髁肱骨滑车外上髁尺神经沟肱骨小头鹰嘴窝外科颈肱 骨humerusHead of humersAnatomical neck Greater tubercleLesser tubercleCrest of great

28、er tubercleCrest of lesser tubercleIntertubercular grooveSurgical neckSulcus for radial nerveSulcus for ulnar nerve 肱骨头解剖颈肱骨大结节肱骨小结节大结节嵴小结节嵴结节间沟外科颈桡神经沟尺神经沟肱 骨肩关节 shoulder joint 肱骨头与肩胛骨的关节盂相关节，构成肩关节。The head of humerus articulates with the glenoid cavity of scapula to form the shoulder joint.肱骨与神经的位置

29、关系及其临床意义肱 骨肱骨为典型的长骨，分为一体两端。肱骨上端：有肱骨头、解剖颈（肱骨头周围的环状浅沟）、小结节、大结节、肱骨外科颈（肱骨上端与体交界稍细之处，较易发生骨折，有腋神经和旋肱前、后血管经过。）等结构。肱骨体：有三角肌粗隆、桡神经沟（肱骨体中部后面的浅沟，有桡神经和肱深血管经过。）等结构。肱骨下端：有内上髁、尺神经沟（内上髁后面的浅沟，有尺神经经过。）、外上髁、肱骨滑车、肱骨小头和鹰嘴窝（在肱骨滑车后面的上方，容纳尺骨的鹰嘴）等结构。肱骨大结节、内上髁、外上髁可在体表触及。肱骨与3条神经紧密相贴：肱骨外科颈有腋神经和旋肱前、后血管经过，外科颈骨折易伤及腋神经。肱骨体中部后面的桡神经

30、沟内有桡神经和肱深血管经过，肱骨体中段骨折易伤及桡神经。内上髁后面的尺神经沟内有同名神经，内上髁骨折易伤及该神经。肱 骨 Humerus（1）The is the longest and largest of the upper limb.It has a body and two end.The upper(proximal) end has the head of humerus, the anatomical neck, the greater tubercle, the lesser tubercle, intertubercular groove, the crest of grea

31、ter and lesser tubercle, and the surgical neck.The head of humerus articulates with the glenoid cavity of scapula at the shoulder joint.The anatomical neck is a groove distal to the head.The surgical neck is a narrow area distal to the greater and lesser tubercles that is a common site of fracture,

32、which is where the humerus narrow to become the body.The shaft of humerus has the deltoid tuberosity laterally and the radial groove for radial nerve and deep artery of arm posteriorly. The lower end has two articular surface, a lateral capitulum for articulation with the head of the radius and a me

33、dial trochlea for articulation with the trochlear notch of ulna. Superior to the trochlea anteriorly is the coronoid fossa to accommodate the coronoid process of the ulna during full flextion of the elbow. Superior to the trochlea posteriorly is the olecranon fossa for the olecranon of the ulna duri

34、ng extension of the elbow .Superior to the capitulum anteriorly is the radial fossa for the edge of the head of the radius when the elbow is flexed. The lateral and medial epicondyle are on each side of the lower end, the latter being very prominent.The ulnar groove lies on the posterior aspect of m

35、edial epicondyle for the ulnar nerve.肱 骨 Humerus（2）Radius桡骨头桡骨粗隆尺切迹桡骨颈关节面环状关节面腕关节面桡骨茎突桡骨骨间缘RadiusHead of radiusNeck of radiusRadial tuberosityRadial styloid processUlnar notch桡骨头桡骨颈桡骨粗隆桡骨茎突尺切迹桡 骨桡 骨为位于前臂外侧的长骨，分为一体两端。其上端有膨大的桡骨头，头上面有关节面，周围有环状关节面；此外有桡骨颈、桡骨粗隆；下端有桡骨茎突、尺切迹及其下面有腕关节面。桡骨茎突比尺骨茎突约低1cm。桡骨茎突和桡骨头

36、可在体表触及。桡 骨 Radius（1）It is the lateral bone of the forearm.It has a shaft and two end.Its proximal end includes a head, a neck and a tuberosity.The superior aspect of the head of radius is a articular facet（关节面） for articulation with the capitulum of the humerus（肱骨小头） at the humero-radial joint.The a

37、rticular circumference（环状关节面） of the head of radius medially articulates with the radial notch of the ulnaThe neck of radius is the narrow part between the head and radial tuberosity（桡骨粗隆）.The radial tuberosity is below the medial part of the neck for the attachment of the biceps brachii.桡 骨 Radius(

38、2)The lower end includes the ulnar notch and styloid process of radiusThe ulnar notch（尺切迹） of radius articulates with the head of ulna to form the distal radial-ulnar joint.The radial styloid（桡骨茎突） process of is much larger than the ulnar styloid process and extends approximately a fingers breath fu

39、rther distally.The dorsal radial tubercle（桡骨背结节） lies between the shallow grooves for passage of the tendons of forearm muscles.Ulna滑车切迹鹰嘴冠突桡切迹尺骨粗隆尺骨茎突尺骨头桡切迹骨间缘尺骨UlnaTrochlear notcholecranonCoronoid processRadial notchUlnar tuberosityHead of ulnaUlnar styloid process滑车切迹鹰嘴冠突桡切迹尺骨粗隆尺骨头尺骨茎突尺 骨肘关节冠状面和X

40、线影像片肘关节矢状面和侧位X线像桡骨茎突与尺骨茎突Radial styloid process尺 骨为位于前臂的内侧的长骨，分为一体两端。其上端粗大，有滑车切迹、鹰嘴、冠突、桡切迹、尺骨粗隆；下端有尺骨头、尺骨茎突。尺骨茎突尺骨茎突比桡骨茎突约高1cm。鹰嘴、尺骨头和茎突可在体表触及。 尺 骨 ulnaIt is the medial bone of the forearm.It is a long bone with a body and two ends.The upper end of ulna has the olecranon（鹰嘴）, the coronoid process（冠突

41、） , the trochlear notch （滑车切迹）, the ulnar tuberosity and the radial notch （桡切迹）.The trochlear notch articulates with the capitulum of humerus to form the humero-ulnar joint.The radial notch articulates with the articular circumference of radius at the proximal radio-ulnar joint.The distal end of uln

42、a has a head and styloid process（茎突）.The head of ulna articulates with the ulnar notch of radius at the distal radio-ulnar joint.手舟骨月骨三角骨豌豆骨大多角骨小多角骨头状骨钩骨手 骨第掌骨掌骨底掌骨体掌骨头手 骨 近节指骨中节指骨远节指骨近节指骨远节指骨指骨底指骨体指骨滑车手 骨Carpal boneScaphoid boneLunate boneTriangular（triquetral) bonePisiformTrapezium boneTrapezoid b

43、oneCapitate boneHamate boneMetacarpal bonePhalangesProximal phalanxMiddle phalanxDistal phalanxBones of the hand腕骨8手舟骨月骨三角骨豌豆骨大多角骨小多角骨 头状骨钩骨掌骨5(, , , ) 指骨14近节指骨中节指骨远节指骨手 骨手 骨手 骨掌骨头 head of metacarpal bone指骨头（滑车）、体、底 base, body and head（trochlear) of phalanx腕 骨 CarpusIt is the skeleton of the wrist.I

44、t is composed of eight carpal bones arranged two of four each.From lateral to medial, the four bones in the proximal row of carpals are the scaphoid（手舟骨）, lunate（月骨）, triquetrum（三角骨）, and pisiform（豌豆骨）.From lateral to medial, the four bones in the distal row of carpals are the trapezium（大多角骨）, trape

45、zoid （小多角骨）, capitate （头状骨）, and hamate （钩骨）.The carpus is markedly convex（凹） from side to side posteriorly and concave（凸） anteriorly.上肢的骨性标志The bony landmark of upper limb（31 2）髋骨股骨髌骨胫骨腓骨跗骨跖骨趾骨二、下肢骨下肢带骨自由肢骨髋大腿膝小腿足二、下肢骨（31 2） bones of lower limb下肢带骨 pelvic girdle 髋骨1 hip bones自由肢骨 Free parts of the

46、limb 股骨1 femur 髌骨1 patella 胫骨1 tibia 腓骨1 fibula 跗骨7 tarsal bones 跖骨5 metatarsal bones 趾骨14 phalanges8个月胎儿的髋骨X线影像片髂骨耻骨坐骨12个月幼儿的髋骨X线影像片髂骨耻骨坐骨成人髋骨X线影像片髂骨耻骨坐骨髋 骨 hip bone髂骨耻骨坐骨髂骨翼耻骨下支坐骨体髂骨体耻骨体坐骨支耻骨上支坐骨结节髋 骨髋骨的内侧面髂嵴髂前上棘髂前下棘弓状线髂窝耻骨梳闭孔耻骨联合面坐骨结节坐骨大切迹坐骨小切迹坐骨棘髂后上棘髂后下棘耳状面臀面髂结节髋骨的背外侧面月状面髋臼切迹髋臼窝髋臼月状面髋臼切迹髋臼窝髋 骨的腹

47、侧面月状面髋臼切迹髋臼窝耻骨结节闭孔耻骨嵴髋臼髋骨 hip boneThe pubis（耻骨） form the anterior part of the acetabulum（髋臼） and the anteromedial part of the hip bone. The pubis has a body and two ramus（支）, superior and inferior ramus.The ischium（坐骨） is the posteroinferior part of the acetabulum and hip bone. The ischium comprises

48、 a body and a ramus.The ilium（髂骨） is the superior part of the acetabulum and hip bone, The ilium consists of a body and a wing or ala（翼）.髋 骨 hip boneThe hip bone of newborn consists of three componnts: a superior ilium（髂骨）, an anteroinferior pubis（耻骨）, and a posteroinferior ischium（坐骨）.Eventually (a

49、bout 16 years old), the three separate bones fuse into one. The area of fusion is a deep, lateral, fossa called the acetabulum（髋臼）. The hip bone forms the bony connection between the trunk and lower limb.Each mature hip bone is formed by the fusion of three bones: ilium, ischium, and pubis.At pubert

50、y these bone are still separated by a triradiate cartilage. The cartilage disappears and the bones begin to fuse at 15 to 17（1318） years of age.髋骨的解剖学位置 When the hip bone in the anatomical positionAnterior superior iliac spine and anterosuperior aspect of the pubis lie in the same vertical plane.Isc

51、hial spine and superior end of the pubic symphysis are approximately in the same plane.Symphyseal surface of the pubis is vertical parallel, and close to the median plane.Internal aspect of the body of the pubis faces almost directly superiorlyAcetabulum faces inferolaterally, with the acetabular no

52、tch directed inferiorly.Obturator foramen lies inferomedial to the acetabulum.髋 骨的体表标志髂嵴髂前上棘股骨股骨头股骨颈大转子小转子转子间线转子间嵴粗线臀肌粗隆内侧髁外侧髁髁间窝外上髁收肌结节内上髁外上髁股骨头凹耻骨肌线髌面Intertrochanteric lineFemur股骨头 股骨颈大转子小转子粗线臀肌粗隆内侧髁外侧髁髁间窝内上髁外上髁收肌结节股 骨Femur head Neck of femurGreater trochanterLesser trochanterLinea asperGluteal tu

53、berosityMedial condyleLateral condyleIntercondylar fossaMedial epicondyleLateral epicondyleAdductor tubercle股 骨是人体最长最结实的长骨，有一体两端。上端有股骨头、股骨头凹、股骨颈、大转子小转子 转子间线、转子间嵴等结构；体有粗线、臀肌粗隆等结构；下端有内侧髁、外侧髁、髁间窝、收肌结节等结构。股 骨 FemurIt is the longest and heaviest bone in the body.It consists of a shaft(body) and two ends,

54、 proximal and distal ends.its proximal end consists of a head, a neck , two trochanters（转子） (greater and lesser), intertrochanteric line（转子间线） and intertrochanteric crest （转子间嵴） (which joint two trochanters anteriorly and posteriorly).The head of femur（股骨头） articulates with the acetabulum （髋臼）to for

55、m the hip join（髋关节）.The linea aspera（粗线） is a prominent double-edge ridge on its posterior aspect.Its distal end has the medial and lateral condyles（内、外侧髁）.成人髋关节X线影像片 髌 骨 patella髌骨底前面髌骨尖关节面髌骨 patellaThe patella (knee cap膝盖) is a large and triangular-shaped sesamoid（籽骨）, and has a base, a apex（尖）, two borders, and two surface (anterior and posterior). The posterior surface of the patella articulates with the patellar surface of