gluteal region and posterior region of thigh and leg

SDU. SDU. LIZHENHUALIZHENHUA

Gluteal Region and Posterior Region of Thigh and Leg

山东大学医学院解剖教研室李振华


Skin incisions

Make the skin incisions shown in figure and reflect the skin flaps


Gluteal region


The gluteal region

Boundaries: Superiorly: iliac crest Inferiorly: fold of buttock Medially: lateral borders of sacrum and

coccyx Laterally: a line joining anterior superior

iliac spine and great trochanter


Cutaneous nerves

Superior cluneal n.

Medial cluneal n.

Inferior cluneal n.


Muscles of hip

Posterior group 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 Obturator externus 闭孔外肌 Quadratus femoris 股方肌


Muscles of the gluteal region

Gluteus medius 臀中肌

Gluteus minimus 臀小肌

Piriformis 梨状肌

Obturator internus 闭孔内肌

Obturator externus 闭孔外肌

Quadratus femoris 股方肌

Gluteus maximus臀大肌


The gluteal region

suprapiriform foramen

infrapiriform foramen


Structures 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 foramen

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 foramen


Posterior Region of Thigh and Leg


Contents of the posterior osseofascial compartment of the thigh

Muscles Biceps femoris Semitendinosus Semimembranosus

Blood supply Branches of the deep femoral artery

Nerve supply Sciatic nerve


Muscles of posterior region of thigh

Semitendinosus 半腱肌

Semimembranosus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Course: Arises from the sacral plexus Leaves pelvis through infrapiriform foramen to enter glutea

l region Runs inferiorly laterally deep to gluteus maximus Passing midway between the greater trochanter of femur a

nd ischial tuberosity to back of thigh Lying deep to long head of biceps femoris, Normally divided into tibial and common peroneal nerves j

ust above popliteal fossa

Innervates: Semitendinosus Semimembranosus Biceps femoris Hip and knee joints


Relationship of sciatic n. to the piriformis


Popliteal fossa 腘窝Boundaries Superolaterally: Biceps femoris Superomedially: semimembranosus an

d semitendinosus Inferiorly: lateral and medial heads of ga

strocnemius Roof: deep fascia Floor: popliteal surface of the femur, the

posterior capsule of the knee joint, and the fascia covering popliteus


Popliteal fossa 腘窝

Contents Nerves

Tibial nerve 胫神经 common peroneal nerve 腓总神经

Popliteal vein and its tributaries Popliteal artery and its branches Popliteal lympn nodes


Popliteal artery 腘动脉 Course:

Begins at the adductor tendinous opening Here it is continuous with the femoral artery.

Ends at the lower border of the popliteus where it divides into anterior and posterior tibial arteries

Branches: Medial superior genicular a. 膝上内侧动脉 Lateral superior genicular a. 膝上外侧动脉 Medial inferior genicular a. 膝下内侧动脉 Lateral inferior genicular a. 膝下外侧动脉 Middle genicular a. 膝中动脉


Popliteal vein 腘静脉

This is formed by the junction of the anterior and posterior tibial veins near the lower border of the popliteus muscle.


Popliteal lymph nodes 腘淋巴结 There may be one or two nodes just unde

r the deep fascia, close to the popliteal fossa vessels.

They drain the deep tissues of the leg and foot and the knee joint. They also receive superficial lymph vessels from the lateral side of the foot, the heel, and the back of the calf. These drain along the line of the small saphenous vein.


The back of the legThe back of the leg


Superficial veins

Small saphenous v. 小隐静脉 Arises from the lateral part of the dorsal

venous arch of foot Ascends behind lateral malleolus and th

en runs up the midline of the back of the leg

Pierces the deep fascia and enters the popliteal v.

Drains the lateral side of the foot and ankle and the back of the leg.


Cutaneous nerves of the back of the leg

Medial sural cutaneous nerve 腓肠内侧皮神经

Peroneal communicating n. 腓神经交通支

Sural nerve 腓肠神经


Contents of the posterior osseofascial compartment of the leg

Superficial group muscles Gastrocnemius 腓肠肌 Soleus 比目鱼肌 Plantaris 跖肌Deep group muscles Popliteus 腘肌 Flexor digitorum longus

趾长屈肌 Tibialis posterior 胫骨后肌 Flexor hallucis longus

拇长屈肌Blood supply: Posterior tibi

al a.Nerve supply: Tibial nerve


Muscles of posterior crural region

Gastrocnemius腓肠肌 Soleus 比目鱼肌

Plantaris 跖肌

Flexor hallucis longus拇屈伸肌

Popliteus 腘肌

Flexor digitorum longus趾长屈肌

Tibialis posterior 胫骨后肌

Tendo calcaneus跟腱


Posterior tibial artery 胫后动脉

Begin at level of the lower border of the popliteus

Passes downwards deep to gastrocnemius and soleus

Passes behind medial malleolus and terminates by dividing into medial and lateral plantar arteries

Main branches: peroneal a. 腓动脉 medial plantar a. 足底内侧动脉 lateral plantar a. 足底外侧动脉


Tibial nerve 胫神经

Runs inferiorly with posterior tibial vessels and terminates beneath flexor retinaculum by dividing into medial and lateral plantar nerves

Supplies posterior muscles of leg and knee joint


Malleolar canal 踝管Boundaries Formed by medial surface of c

alcaneus, flexor retinaculum and medial malleolus

Structures passing through the malleolar canal Tibialis posterior Flexor digitirum longus Posterior tibial a. v. and n. Flexor hallucis longus

景致动人么


You must identify follow structures ！

Muscles of gluteal region, posterior thigh and leg Gluteus maximus Gluteus medius Gluteus minimus Piriformis Obturator internus Quadratus femoris Biceps femoris Semitendinosus Semimembranosus Gastrocnemius Soleus Tendo calcaneus Flexor digitorum longus Tibialis posterior Flexor hallucis longus

Nerves and vessels Sciatic n. Superior gluteal n. and vessels Inferior gluteal n. and vessels Internal pudendal vessels Pudendal n. Tibial n. Common peroneal n. Popliteal v. Popliteal a. Small saphenous v. Tibial a. and v.

gluteal region and posterior region of thigh and leg

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