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歐陽品教 授 11/25/2015 Lower Limb 1 : Femur and Superficial structures Margin of the lower limb Regions of the lower limb Functions of the lower limb 1. Support the body weight 2. locomotion Bones and joints of the lower limb Nerves of the lower limb Arteries of the lower limb Femur: : the longest bone in the body, being a quarter of the length of an individual 1. proximal end: inclination angle of 125o head neck intertrochanteric line : attachment of iliofemoral ligament lesser 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. 2. body linea aspera 3. distal end medial and lateral condyles intercondylar fossa epicondyle : attachment of medial and lateral ligaments of knee joint patellar surface adductor tubercle Femoral fractures Fascia compartments of thigh and leg : caused by intermuscular septa of the fascia lata Superficial structures of lower limb 1. superficial fascia 2. 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 3. superficial veins great 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 Small saphenous vein and musculovenous pump 4. lymph node: efferent vessels converge to external iliac nodes a. inguinal nodes i. superficial superior horizontal group ii. superficial inferior vertical group lymph vessels accompanying great saphenous vain iii. deep node : within femoral canal b. knee (popliteal) node lymph vessels accompanying small saphenous vein 5. cutaneous nerve : vertral rami of L 1, 2, 3, 4 lateral and posterior cutaneous n. of thigh anterior 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. 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 Femoral triangle : apex 10 cm below inguinal ligament 1. borders inguinal ligament sartorius m. adductor longus m. 2. floor : a trough with sloping medial and lateral walls medial wall: pectinus and adductor longus m. lateral wall: iliopsoas and sartorius m. (innervated by femoral n. ) 3. Contents Femoral 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 Femoral hernia