局部解剖學(xué)課件：2-小腿前區(qū)和足

1、Anterior crural region 小腿前區(qū) 山東大學(xué)醫(yī)學(xué)院解剖教研室切口：（1）內(nèi)外踝水平切口（2）足趾根部，趾蹼背側(cè)做一橫行切口到足背內(nèi)、外側(cè)緣（3）取橫切口中點(diǎn)做縱行切口1. skin2. Superficial structuresGreat saphenous v. 大隱靜脈Drains the medial end of dorsal venous arch of food and passes upward directly in front of the medial malleolus.Then ascends in company with the sapheno

2、us n. in the superficial fascia over the medial side of the leg2. Superficial structuresVaricose veinsCutaneous nervesBranches of lateral cutaneous n. 腓腸外側(cè)皮神經(jīng)Supplies the skin on the upper part of the anterolateral surface of the legSuperficial peroneal n. 腓淺神經(jīng) Supplies the skin of the lower part of

3、 the anterolateral surface of the leg Saphenous n. 隱神經(jīng)Supplies the skin on the anteromedial surface of the leg 3. Deep fascia 深筋膜Surrounds the leg and forms two intermuscular septa to be attached to the fibula Divided the leg into three compartments：anterior, lateral and posterioreach of which conta

4、ins a group of muscles, the vessels and the nerves4. Contents of the anterior fascial compartment of the legMusclesTibialis anterior 脛骨前肌Extensor hallucis longus 拇長(zhǎng)伸肌Extensor digitorum longus 趾長(zhǎng)伸肌Peroneus tertius 第三腓骨肌Blood supplyAnterior tibial a. 脛前動(dòng)脈Nerve supply Deep peroneal n. 腓深神經(jīng)Contents of t

5、he anterior fascial compartment of the legAnterior tibial artery 脛前動(dòng)脈Beginning: Arises from the popliteai artery at the lower border of popliteus. It passes forwards above the interosseous membrane, and turns downwards on the anterior surface of that membrane with the deep peroneal nerve. Ending: In

6、 front of ankle joint becomes the dorsalis pedis a. 足背動(dòng)脈The anterior tibial veins 脛前靜脈 Closely applied to the arteryContents of the anterior fascial compartment of the legCommon peroneal n. 腓總神經(jīng) Passes over posterior aspect of head of fibula and then winds around neck of fibulaDeep to peroneus longu

7、s, where it divides into deep and superficial peroneal nervesDeep peroneal nerve 腓深神經(jīng) Arises from the common peroneal nerve between the neck of the fibula and the peroneus longus muscle Descends in the anterior compartment of the leg with the anterior tibial vesselsSupplies all the muscles of the an

8、terior compartment of the leg and extensor digitorum brevisContents of the lateral fascial compartment of the legMusclesPeroneus longus 腓骨長(zhǎng)肌Peroneus brevis 腓骨短肌Blood supplyBranches from the peroneal a. 腓動(dòng)脈 Nerve supply Superficial peroneal n. 腓淺神經(jīng)supplies peroneus longus and brevis and skin on anter

9、ior surface of leg and dorsum of footAnterior tibial a.Dorsal a. of footTibialis anterior Extensor hallucis longusExtensor digitorum longusDeep peroneal n.Superficial peroneal n.Injury to the common peroneal nerveThe common fibular nerve may be severed during fracture of the fibula neck or severely

10、stretched when the knee joint is injured of dislocated. Severance of the common fibular n. results in paralysis of all muscles in the anterior and lateral compartments of the leg. The loss of eversion of the foot and dorsiflexion of the ankle causes foot-drop. The foot drops and the toes drag of the

11、 floor when walking. Because it is impossible to make the heel strike the ground first, the patient has a high stepping (steppage”) gait, raising the foot as high as necessary to keep the toes from hitting the ground.Anterior talocrural region and dorsum of foot 踝前區(qū)和足背Sperficial structuresDorsal ven

12、ous arch 足背靜脈弓Lies in the subcutaneous tissue over the heads of the metatarsal bones Drains on the medial side into the great saphenous v. and on the lateral side into the small saphenous v. Superficial peroneal n. 腓淺神經(jīng)Supplies the skin of dorsum of the foot Saphenous n. 隱神經(jīng)Supplies the skin on the

13、medial border of foot Deep peroneal n. 腓深神經(jīng)Supplies the skin of the adjacent sides of the big and second toesAnterior talocrural region and dorsum of foot 踝前區(qū)和足背Deep structuresSuperior extensor retinaculum 伸肌上支持帶Inferior extensor retinaculum 伸肌下支持帶 Dorsalis pedis artery 足背動(dòng)脈Continuations of anterior

14、 tibial a. at ankle joint, passes beneath extensor retinaculum Runs with the deep peroneal nerve between the tendons of extensor hallucis longus and extensor digitorum longusBranchesMedial and lateral tarsal aa. Arcuate a. First dorsal metatarsal a. Deep branch of plantar a.Anterior talocrural region and dorsum of foot 踝前區(qū)和足背Deep peroneal n. 腓深神經(jīng)Supplies muscles on dorsum of foot Supplies skin of the adjacent sides of the big and second toesYou must identify follow structures！Patellar ligament 髕韌帶M