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歐陽品教 授 11/25/2015 Lower Limb 1 : Femur and Superficial structures Margin of the lower limb

歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

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Page 1: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

歐陽品教授 11/25/2015

Lower Limb 1 : Femur and Superficial structures Margin of the lower limb

Page 2: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Regions of the lower limb

Page 3: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Functions of the lower limb

1. Support the body weight2. locomotion

Page 4: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Bones and joints of the lower limb

Page 5: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Nerves of the lower limb

Page 6: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Arteries of the lower limb

Page 7: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Femur: : the longest bone in the body, being a quarter of the length of an individual

1. proximal end: inclination angle of 125o

headneckintertrochanteric line : attachment of iliofemoral ligamentlesser trochanter : attachment of iliopsoas m.greater trochanter : 10 cm below the tubercle on the iliac crest

insertion of five muscles : gluteus minimus, gluteus medius, piriformis, obturator internus, gemelli

quadrate tubercle: insertion of quadratus femoris m.trochanteric fossa: insertion of obturator externus m.gluteal tuberosity: insertion of gluteus maximus m.

Page 8: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

2. bodylinea aspera

3. distal endmedial and lateral condylesintercondylar fossaepicondyle : attachment of medialand lateral  ligaments of knee joint 

patellar surfaceadductor tubercle

Page 9: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Femoral fractures

Page 10: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Fascia compartments of thigh and leg : caused by intermuscular septa of the fascia lata

Page 11: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Superficial structures of lower limb

1. superficial fascia2. deep fascia (fascial lata)

iliotibial tract : conjoint aponeurosis of tensor of the fasciae latae m. and gluteus maximus m., extending from iliac tubercle to anterolateral tibial tubercle

Page 12: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

3. superficial veinsgreat saphenous vein : join femoral vein 4 cm inferolateral to the pubic tubercle,

anastomose with small saphenous vein inferior to the knee, receive superficial veins, e.g. external pudendal v, superficial epigastricl v. and superficial circumflex iliac v.

small saphenous vein

Page 13: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Small saphenous vein and musculovenous pump

Page 14: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

4. lymph node: efferent vessels converge to external iliac nodesa. inguinal nodes

i. superficial superior horizontal groupii. superficial inferior vertical group lymph vessels    

accompanying great saphenous vainiii. deep node : within femoral canal

b. knee (popliteal) node lymph vessels accompanyingsmall saphenous vein

Page 15: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

5. cutaneous nerve : vertral rami of L 1, 2, 3, 4lateral and posterior cutaneous n. of thighanterior cutaneous br. of femoral n.saphenous nerve. (br. of femoral nerve)sural n. (br. of tibial n.)lateral sural cutaneous n. (br. of common fibular n.)innervation for skin inferior to inguinal ligament: ilioinguinal n, femoral br. of       

genitofemoral n. and obturator n.

Page 16: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

6. saphenous opening : oval shape hitus in the fascia lata through which the great    saphenous v. passes to join the femoral v., which lies within the femoral sheath

Falciform margin

Page 17: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Femoral triangle : apex 10 cm below inguinal ligament1. borders

inguinal ligamentsartorius m.adductor longus m.

Page 18: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

2. floor : a trough with sloping medial and lateral wallsmedial wall: pectinus and adductor longus m.lateral wall: iliopsoas and sartorius m. (innervated by femoral n. )

Page 19: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

3. ContentsFemoral n. and its br.femoral sheath : prolongation of the extraperitoneal areolar 

tissue that envelops the  external iliac vessels in the abdomen, contains; 

a. femoral artery (lateral compartment)b. femoral vein (intermediate compartment)c. femoral canal (medial compartment); occupied by deep     node

femoral ring: boundaries are femoral vein (lateral), pectineus m. (posterior),  lacunar ligament (medial) and inguinal ligament (anterior) femoral hernia

Page 20: 歐陽品教授 11/25/2015 Lower Limb 1 Femur and structuresanatomy.cgu.edu.tw/ezfiles/71/1071/img/1609/G37.pdf · 歐陽品教授11/25/2015 Lower Limb 1 : Femur and Superficial structures

Femoral hernia