局部解剖学：臀区和股后区

1、Gluteal Region and Back of ThighGluteal Region臀区Gluteal region 臀区 Boundaries: Superiorly: iliac crest Inferiorly: fold of buttockMedially: lateral borders of sacrum and coccyxLaterally: a line joining anterior superior iliac spine and great trochanter1.Skin incisions1.上切口：髂前上棘-髂后上棘，内侧延伸至骶部正中。2.正中切口：

2、至尾骨尖3.下切口：臀沟至臀部外侧4.膝下切口：腘窝下方5.股后纵切口2.Superficial structuresSuperior cluneal n.Medial cluneal n.Inferior cluneal n.Cutaneous nerves3. Muscles of hip 髋肌Posterior groupGluteus maximus 臀大肌Gluteus medius 臀中肌Gluteus minimus 臀小肌Piriformis 梨状肌Gemellus superior 上孖肌 Obturator internus 闭孔内肌Gemellus inferior 下孖

3、肌Obturator externus 闭孔外肌Quadratus femoris 股方肌4. Nerves and vesselssuprapiriform forameninfrapiriform foramenStructures passing through suprapiriform foramen（from lateral to medial side）Superior gluteal n. 臀上神经Superior gluteal a. 臀上动脉Superior gluteal v. 臀上静脉Structures passing through infrapiriform fo

4、ramen (from lateral to medial side) Sciatic n. 坐骨神经Posterior femoral cutaneous n. 股后皮神经 Inferior gluteal n. 臀下神经Inferior gluteal a., v. 臀下动、静脉Internal pudendal v., a. 阴部内动、静脉Pudendal n. 阴部神经 They then curve forwards to enter the perineum through the lesser sciatic foramenStructures passing through l

5、essor sciatic foramen（from lateral to medial side）Internal pudendal a., v. 阴部内动、静脉Pudendal n. 阴部神经Gluteal region 臀区Anastomosis of arteries around hip joint 髋周围动脉网Medial circumflex femoral a. 旋股内侧动脉 Lateral circumflex femoral a. 旋股外侧动脉 Superior gluteal a. 臀上动脉Inferior gluteal a. 臀下动脉First perforating

6、 a. 第一穿动脉Back of ThighContents of the posterior osseofascial compartment of the thighMuscles Biceps femoris 股二头肌Semitendinosus 半腱肌Semimembranosus 半膜肌Blood supplyPerforating arteries the deep femoral arteryNerve supplySciatic nerve 坐骨神经Muscles of posterior region of thighSemitendinosus半腱肌Semimembrano

7、sus半膜肌Long head of biceps femoris 股二头肌长头Short head of biceps femoris 股二头肌短头Sciatic nerve 坐骨神经CourseArises from the sacral plexusLeaves pelvis through infrapiriform foramen to enter gluteal regionRuns inferiorly laterally deep to gluteus maximusPassing midway between the greater trochanter of femur a

8、nd ischial tuberosity to back of thighLying deep to long head of biceps femoris, Normally divided into tibial and common peroneal nerves just above popliteal fossaSciatic nerve 坐骨神经InnervatesSemitendinosus 半腱肌Semimembranosus 半膜肌 Biceps femoris 股二头肌Hip and knee joints 髋关节和膝关节Relationship of sciatic n. to the piriformisYou must identify follow structures！Muscles Gluteus maximus 臀大肌Gluteus medius 臀中肌Gluteus minimus 臀小肌Piriformis 梨状肌Obturator internus 闭孔内肌 Quadratus femoris 股方肌Biceps femoris 股二头肌Semitendinosus 半腱肌Semimembranosus 半膜肌 Nerves and vesselsSciatic n. 坐骨神经Superior gluteal n.