Regionalanatomyofthelowerlimb丁兆習(xí)山東大學(xué)醫(yī)學(xué)院人體解剖學(xué)教研室Office:1205dingzhaoxi@BoundariesanddivisionsofthelowerlimbBoundariesDivisionsGlutealregion:

betweeniliaccrestsuperiorlyandglutealfoldinferiorlyThigh:

betweenhipandkneeKnee:

jointbetweenlegandthighLeg:

betweenkneeandfootAnkleFoot★

SurfaceAnatomy★

LandmarksoflowerlimbGlutealregionandthighiliaccrest髂嵴anteriorsuperioriliacspines髂前上棘anteriorinferioriliacspines

髂前下棘tubercleofiliaccrest

髂結(jié)節(jié)ischial

tuberosity

坐骨結(jié)節(jié)greatertrochanter

大轉(zhuǎn)子pubictubercle

恥骨結(jié)節(jié)pubiccrest

恥骨嵴superiorborderofpubicsymphysis

恥骨聯(lián)合上緣SurfaceAnatomyKneepatellarligament

髕韌帶tuberosityoftibia

脛骨粗隆medialandlateralcondyles

內(nèi)(外)側(cè)髁medialandlateralepicondyles

內(nèi)(外)上髁tendonofbicepsfemoris

股二頭肌腱tendonsofsemitendinosusandsemimembranosus

半腱(半膜)肌腱

SurfaceAnatomyLeganteriorborderoftibia

脛骨前緣headoffibula

腓骨頭neckoffibula

腓骨頸Ankleandfootmedialandlateralmalleolus

內(nèi)(外)踝calcaneal

tuberosity

跟結(jié)節(jié)tuberosityofnavicularbone

舟骨粗隆tuberosityoffifthmetatarsalbone

第五跖骨粗隆Tendo

calcaneous跟腱Mensuration

Rose-Nelaton’sline：Thelinedrawnfromtheanteriorsuperioriliacspinetotheischial

tuberosity.Normally,thislinepassorabovetheapexofgreatertronchanter.Duringdislocationofhipjointorfracturesoftheneckofthefemur,thegreatertronchanterisdisplacedsuperiorly.MensurationKaplan’spointandSchomarker’ssign：Thepatientliessupinewithstretchedlegs.Boththeanteriorsuperioriliacspinesareatthesamehorizontalplane.Joinalinefromtheapexofthegreatertronchantertotheanteriorsuperioriliacspine(Schomakerline).Normally,itsprolongedlinepassthroughorabovetheumblicus.Duringdislocationofhipjointorfracturesoftheneckofthefemur,thelinepassbelowtheumblicusMensurationCoxa

vara

髖內(nèi)翻(abnormallydecreasedangleofinclination,itoccursinfracturesoftheneckofthefemurandslippingofthefemoralepiphysis)<125°Coxa

valga

髖外翻(abnormallyincreasedangleofinclination,incasesofcongenitaldislocationofthehip)>130°Normalangleofinclination1250-1300

頸干角neck-shaftangleNormalalignmentGenu

varum(bowleg)膝內(nèi)翻

Genu

valgum（knockknee

）膝外翻Mensuration膝外翻角Eversionangleofknee1700

>1700<1700SurfaceprojectionsSuperiorgluteala.,v.,n.

臀上動(dòng)、靜脈和神經(jīng)LeaveorenterthepelviccavityatthejunctionofmedialandmiddlethirdsoflinejoiningtheposteriorsuperioriliacspineandgreatertrochanterInferiorgluteala.,v.,n.臀下動(dòng)、靜脈和神經(jīng)Leaveorenterthepelviccavityatthemiddlepointbetweenposteriorsuperioriliacspineandischial

tuberocitySurfaceprojectionsSciaticnerve

坐骨神經(jīng)Leaveorenterthepelviccavityabout2-3cmlateraltothemiddlepointbetweenposteriorsuperioriliacspineandischial

tuberocityThetrunkrunsdownwardthroughthejunctionofmedialandmiddlethirdsoflinejoiningthegreatertrochanterandischial

tuberocity,tothemiddlepointbetweenlateralandmedialcondyleoffemurSurfaceprojectionsFemorala.

股動(dòng)脈Slightflexandadductthethigh,thefemorala.runsfromthemidpointbetweenthesuperioranterioriliacspineandpubicsymphysistotheadductortuberclePopliteala.

腘動(dòng)脈Superiorpart:fromthepoint2.5cmmedialtothejunctionbetweentheinferior1/3circumferenceandposteriormedianlineofthethightothemidpointofthepopliteal

fossaInferiorpart:fromthemidpointofpopliteal

fossatotheinferiorangleofpopliteal

fossa

Anteriortibiala.

脛前動(dòng)脈Fromthemidpointbetweenthefibularheadandtibal

tuberiocitytothemidpointbetweenthemedialandlateralmalleolus

Posterior

tibiala.

脛后動(dòng)脈Fromtheinferiorangleofpopliteal

fossatothemidpointbetweenthemedialmalleolusandmedialmarginoftendo

calcaneus

Dorsala.offood

足背動(dòng)脈Fromthemidpointonthebackofthefootbetweenthemedialandlateralmalleolustothebaseofmetatarsalbonesbetweenthefirstandsecondone.AnteriorandMedialRegionoftheThigh

股前內(nèi)側(cè)區(qū)MainstructuresintheanteriorregionsoflowerlimbGreatsaphenousvein大隱靜脈Lacunamusculorum

肌腔隙Lacunavasorum

血管腔隙Femoraltriangle股三角Femoralsheath股鞘Adductorcanal收肌管Anteriorandlateralosseofascialcompartmentsofthethigh大腿前、內(nèi)側(cè)骨筋膜鞘淺層結(jié)構(gòu)SuperficialstructuresSkinSuperficialfasciaSuperficialA.Superficialepigastrica.Superficialiliaccircumflexa.Externalpudendala.★Greatersaphenousv.SuperficialInguinallymphnodesCutaneousn.lateralfemoralcutaneousn.Anteriorcutaneousbranchesoffemoraln.Cutaneousbranchesofobturatorn.淺層結(jié)構(gòu)Superficialstructures★Greatsaphenousvein大隱靜脈

Thegreatsaphenousveinbeginsatthemedialendofdorsalvenousarchoffood,passesanteriortothemedialmalleolusandascendsonthemedialsideoftheleg,thenpassesbehindthekneeandcurvesforwardaroundthemedialsideofthethigh.Inclinesanteriorlythroughthethightoenterthefemoralvein.Passesthroughthesaphenoushiatusinthedeepfasciaandjointsthefemoralveinabout3~4cmbelowandlateraltothepubictubercleTributaries屬支

股外側(cè)淺靜脈Superficiallateralfemoralv.股內(nèi)側(cè)淺靜脈Superficialmedialfemoralv.腹壁淺靜脈Superficialepigastricv.旋髂淺靜脈Superficialiliaccircumflexv.陰部外靜脈Externalpudendalv.淺層結(jié)構(gòu)Superficialstructures靜脈曲張Varicoseveins淺層結(jié)構(gòu)Superficialstructures★Superficialinguinalln.腹股溝淺淋巴結(jié)Superiorgroup:Liebelowalongtheinguinalligment.Receivelymphvesselsfromanteriorabdominalwallbelowumbilicus,glutealregion,perinealregion,externalgenitalorgansInferiorgroupLiesverticalalongtheterminalgreatsaphenousv.Receivesallsuperficiallymphvesselsoflowerlimb,exceptthosefromtheposterolateralpartofcalfEfferentvesselsdrainintothedeepinguinalln.orexternaliliacln.淺層結(jié)構(gòu)Superficialstructures淺動(dòng)脈Superficialarteries

腹壁淺動(dòng)脈superficialepigastrica.旋髂淺動(dòng)脈superficialiliaccircumflexa.陰部外動(dòng)脈externalpudendala.皮神經(jīng)Cutaneousnerves股外側(cè)皮神經(jīng)

lateralfemoralcutaneousn.股神經(jīng)前皮支

anteriorcutaneousbranchesoffemoraln.股神經(jīng)內(nèi)側(cè)皮支

medialcutaneousbranchesoffemoraln.閉孔神經(jīng)皮支

cutaneousbranchesofobturatorn.淺層結(jié)構(gòu)SuperficialstructuresThelateralfemoralcutaneousn.arisesfromlumbarplexus,entersthethighposteriortotheinguinalligamentneartheanteriorsuperioriliacspineandrunsunderthefascialataanddividedintoanteriorandposteriorbranches5cmbelowtheanteriorsuperioriliacspine.Bothbranchespiercesthedeepfasciadistallytosupplytheskin.深層結(jié)構(gòu)deepstructuresDeepfasciaMusclesSatorius

縫匠肌quadricepsfemoris股四頭肌pectineus

恥骨肌adductorlongus長(zhǎng)收肌Gracilis

股薄肌adductorbrevis

短收肌adductormagnus

大收肌Arteryfemorala.股動(dòng)脈--deepfemorala.股深動(dòng)脈obturatora.閉孔動(dòng)脈Veinfemoralv.股靜脈.deepfemoralv.股深靜脈Nervesfemoraln.股神經(jīng)--saphenousn.隱神經(jīng)obturatorn.閉孔神經(jīng)DeepInguinallymphnodes深層結(jié)構(gòu)deepstructuresLacunamusculorum

肌腔隙Lacunavasorum

血管腔隙Femoral

triangle股三角Femoralsheath股鞘Thefemoralcanal股管Adductorcanal收肌管(Hunter’scanal)Osseo-fibroussheath/osseofascial

compartmentsofthethighAnterior/Medial/PosteriorDeepfascia–fascialata

闊筋膜Iliotibialtract

髂脛束-Tensorfascialata闊筋膜張肌Saphenoushiatus

隱靜脈裂孔falciformmargin鐮狀緣cribriformfascia篩筋膜intermuscularseptumandosseofibroussheathMuscleofanteriomedialregionofthighIliacus

髂肌Psoasmajor腰大肌Sartorius縫匠肌Vastus

intermedius

股中間肌Vastus

lateralis

股外側(cè)肌Rectusfemoris

股直肌Vastus

medialis

股內(nèi)側(cè)肌

Pectineus

恥骨肌

Adductorlongus

長(zhǎng)收肌

Adductorbrevis

短收肌Adductormagnus

大收肌

Gracilis

股薄肌

Adductortendinousopening收肌腱裂孔Iliopsoas髂腰肌Quadricepsfemoris

股四頭肌Contentsoftheanteriorosseofascialcompartmentsofthethigh前骨筋膜鞘Iliopsoas髂腰肌Iliacus

髂肌Psoasmajor腰大肌Sartorius縫匠肌Quadricepsfemoris

股四頭肌Vastus

intermedius

股中間肌Vastus

lateralis

股外側(cè)肌Rectusfemoris

股直肌Vastus

medialis

股內(nèi)側(cè)肌

Anteriorgroupmuscle,femoralAVN,deepinguinalLN.Contentsofthemedialosseofascialcompartmentsofthethigh內(nèi)側(cè)骨筋膜鞘Pectineus

恥骨肌

Adductorlongus

長(zhǎng)收肌

Adductorbrevis

短收肌Adductormagnus

大收肌

Gracilis

股薄肌

Medialgroupmuscles,obturatorAVN.★L(fēng)acunamusculorum肌腔隙BoundaryAnteriorly:lateralportionofinguinallig.Posterolaterally:

iliumMedially:

iliopectinalarchContents:Iliopsoas髂腰肌femoraln.股神經(jīng)lateralfemoralcutaneousn.

股外側(cè)皮神經(jīng)IliopectinalarchFemoraln.IliopsoasLateralfemoralcutaneousn.★

Lacunavasorum

血管腔隙

Boundaryanteriorly:medialportionofinguinallig.Medially:

lacunarligamentPosteromedially:

pectineal

lig.Posterolaterally:

iliopectinalarchFemorala.Femoralv.Femoralring

Contents

femorala.andv.股動(dòng)脈、股靜脈femoralbranchofgenitofemoraln.生殖股神經(jīng)股支femoralsheathandfemoralring股鞘、股環(huán)lymphaticvesselsanddeepinguinallymphnodesIliopectinalarch★

Femoral

triangle股三角★Position

Atriangulardepressedareasituatedintheupperpartofthemedialaspectofthethighjustbelowtheinguinalligament★

Boundaries

Superiorly(base):inguinallig.Laterally:medialborderofsartoriusMedially:medialborderofadductorlongus.Inferiorly(apex):continuedwithadductorcanal.Anteriorwall:fascialataPosteriorwall:

adductorlongus,pectineusandiliopsoasandtheirfascia

(frommedialtolateralside).★

Femoral

triangle股三角★

ContentsofthefemoraltriangleFemoralnerve

Femoralsheath

anditscontent:1.Thefemoralarteryanditsbranches2.Thefemoralveinanditstributaries3.Thefemoralcanalanditscontents:Deepinguinallymphnodes:Threeorfourliealongthemedialsideofthefemoralvein

Thefemoralbloodvesselsandlymphaticareenclosedinfemoralsheath

腹股溝韌帶長(zhǎng)收肌縫匠肌★

Femoral

triangle股三角ThepositionofthefemoralAVNinfemoraltriangleAtthebase:NAV(fromlat.tomed.)Attheapex:NAV(fromant.topost.)Clinicaltips:FemoralvenouspunctureFemoralarterypunctureRegionalanesthesia★

Femoraltriangle股三角★

Femoralsheath股鞘

Itisafunnel-shapedsheath,derivedfromtransversalisfasciaanteriorlyandiliacfasciaposteriorly.Itsurroundsthefemoralbloodvesselsandlymphaticabout2.5cmbellowtheinguinalligament.Itslowerenddisappearsatthelowermarginofthesaphenoushiatuswherethesheathfuseswiththeadventitiaofthevessels.ThreecompartmentsbytwofibrousseptaLateral:femorala.Middle:femoralv.Medial:femoralcanalFemoraltriangle股三角★

Thefemoralcanal股管Themedialcompartmentoffemoralsheath,about1-1.5cmlong,SuperiorlyitcommunicatewithabdominalcavitybyItsupperopening,calledthefemoralring股環(huán),

whichiscoveredbyfemoralseptum股環(huán)隔.

Inferiorlyitisablindendoppositetothesaphenoushiatus.Theboundariesofthefemoralring

are:Anteriorly:inguinalligamentMedially:lacunarligament腔隙韌帶;Posteriorly:pectenofpubisandpectineus

Laterally:femoralveinThefemoralcanalcontainsalittleloosefattytissueanddeepinguinallymphnodes腹股溝韌帶股靜脈股動(dòng)脈股鞘卵圓窩大隱靜脈Femoraltriangle股三角Femoralhernia股疝Ifaloopofintestineisforcedintothefemoralring,itexpandstoformaswellingintheupperpartofthethigh.Suchaconditionisknownasafemoralhernia.Afemoralherniaismorecommoninwomenthaninmen(possiblybecausetheirwiderpelvisandfemoralcanal).股疝:腹腔內(nèi)容物→股環(huán)→股管→隱V裂孔→皮下Femoraltriangle股三角★

Femoralartery股動(dòng)脈Itisthemainarteryofthelowerlimbandisdirectlycontinuouswiththeexternaliliacarteryoftheabdomenbehindtheinguinalligamentatthemid-inguinalpoint.Itcontinueswiththepoplitealarterybypassingthroughtheadductortendinous

opening(adductorhiatus).Femoraltriangle股三角Themainbranchoffemorala.

Deepfemoralartery（股深動(dòng)脈）

arisesfromtheposterolateralsurfaceofthefemoralarteryabout2-5cmbelowtheinguinalligamentandsends：Lateralfemoralcircumflexartery（旋股外側(cè)動(dòng)脈）

isthelargestbranchoftheprofunda

femorisartery.Itarisesfromtheprofundanearitsoriginandrunslaterallyamongthebranchesofthefemoralnerveandthendeeptorectusfemoris.Hereitdividesintoascending,transverse,anddescendingbranches.

Medialfemoralcircumflexartery（旋股內(nèi)側(cè)動(dòng)脈）

ariseseitherfromtheprofundanearitsoriginoroccasionallydirectfromthefemoralartery.

perforatedarteries(穿動(dòng)脈).

Deepfemerala.股深動(dòng)脈Lateralfemoracircumflexa.旋股外側(cè)動(dòng)脈Medialfemoralcircumflexa.旋股內(nèi)側(cè)動(dòng)脈

Perforatingarteries穿動(dòng)脈Femoraltriangle股三角Femoralvein

股靜脈Thisisthedirectcontinuationofthepoplitealvein.Itbeginsattheadductortendinousopening(adductorhiatus)andaccompaniesthefemoralarterytotheinguinalligamentbehindwhichitbecomestheexternaliliacvein.Thefemoralveincontainsseveralvalves.Femoraltriangle股三角★

Femoralnerve股神經(jīng)Itarisesfromthelumbarplexusintheabdomen,andentersthethighposteriortotheinguinalligamentandlateraltothefemoralartery.Itendsbydividingintoanumberofbranches2cmbelowtheinguinalligament.Branches:

Muscularbranches

to:pectineus,sartorius,quadricepsfemoris

ArticularbranchesCutaneousbranchesFemoraltriangle股三角Cutaneousbranches:

Anteriorcutaneousnervesofthefemoralnerve

intermediatefemoralcutaneousnerves.medialfemoralcutaneousnervesSaphenousnerve（隱神經(jīng)）

thelongestbranchofthefemoralnerve.Itaccompaniesthefemoralvesselsintheadductorcanal,thenaccompaniesthegreatsaphenousveintothemedialsideofthelegandfood.Obturatorn.閉孔神經(jīng)Femoraltriangle股三角腹股溝深淋巴結(jié)Thedeepinguinallymphnodes

Threeorfourdeepinguinallymphnodesliealongthemedialsideofthefemoralvein.Receivedeeplymphaticsoflowerlimb,perinealregion,andefferentlymphaticsfromthesuperficialinguinalln.Efferentlymphvesselspassfromthedeepinguinalnodesalongthefemoralvesselstotheexternaliliacnodesontheexternaliliacvesselsintheabdomen.★

Adductorcanal收肌管(Hunter’scanal)Position

Itisanintermuscularcleftsituatedonthemedialaspectofthemiddlethirdofthethigh.Extendsfromapexoffemoraltriangletoadductortendinousopening,about

15~17cmlong.WallsIncrosssection,itistriangularinshape.Theanteromedialwallisformedbyadductorlaminadeeptothesartorius.Theposteriorwallisformedbytheadductorlongusandmagnusmuscles.Thelateralwallisformedbythevastus

medialis.Communication

Itcommunicatesabovewithfemoraltriangleattheapex,belowwithpopliteal

fossaattheadductorhiatus.ContentsThesaphenousnerve,femoralarteryand

femoralveinruninthiscanal.BloodvesselsandnervesofmedialsideofthighObturatorartery閉孔動(dòng)脈

ArisesfrominternaliliacarteryinthelesserpelvispassesthroughtheobturatorcanalwhereitdividesintoanteriorandposteriorbranchesBloodvesselsandnervesofmedialsideofthighObturatorn.

閉孔神經(jīng)Arisesfromthelumbarplexusintheabdomen.Entersthethighthroughtheobturatorcanalwhereitdividesintoanteriorandposteriorbranches.BranchesTheanteriorbranchdescendsinthethighanteriortoadductorbrevis.Theposteriorbranchdescendsbetweenadductorsbrevisandmagnussupplyingboth.Suppliesmedialgroupofmusclesofthigh,obturator

externus,andskinofmedialsideofthigh

Anteriorregionoftheleg小腿前外側(cè)區(qū)SuperficialstructuresSkinSuperficialfasciaGreatersaphenousv.大隱靜脈Saphenousnerve隱神經(jīng)superficialperonealnerve腓淺神經(jīng)

Branchesoflateralcutaneousn.腓腸外側(cè)皮神經(jīng)DeepStructuresDeepfascia伸肌上支持帶Superiorextensorretinaculum伸肌下支持帶

InferiorextensorretinaculuminterrmuscularseptumandosseofibroussheathMuscles脛骨前肌tibialisanterior趾長(zhǎng)伸肌extensordigitorum

longus

拇長(zhǎng)伸肌extensorhallucis

longus腓骨長(zhǎng)肌peroneus

longus腓骨短肌

peroneus

brevisArtery脛前動(dòng)脈anteriortibiala.-足背動(dòng)脈Dorsalis

pedisa.Vein脛前靜脈anteriortibialv.-足背靜脈Dorsalis

pedisv.Nerves腓總神經(jīng)Commonperonealnerve腓淺神經(jīng)superficialperonealn.腓深神經(jīng)deepperonealn.Superficialstructures★Greatsaphenousvein

Drainsthemedialendofdorsalvenousarchoffoodandpassesupwarddirectlyinfrontofthemedialmalleolus.Thenascendsincompanywiththesaphenousn.inthesuperficialfasciaoverthemedialsideofthelegThedorsalvenousarchliesonthedistalpartsofthebodiesofthemetatarsals.Itdrainsthedorsumofthefootandtoes.saphenousnerve(L3,4)

Suppliestheskinontheanteromedialsurfaceofthelegsuperficialperonealnerve

Suppliestheskinofthelowerpartoftheanterolateralsurfaceofthelegmedialandintermediatecutaneousbranchesofthesuperficialperonealnerve.

Supplythedorsumofthefoot.However,thelateralmarginissuppliedbythesuralnervethesuralnerve

supply

lateralmarginthedeepperonealnervesupplythefirstinterdigitalcleftandtheskinimmediatelyproximaltoit.SurroundsthelegandformstwointermuscularseptatobeattachedtothefibulaandDividedthelegintothreeosseofascialcompartments：anterior,lateralandposterior－eachofwhichcontainsagroupofmuscles,thevesselsandthenervesAttheankleitformsthickenedbands(retinacula)whichholdthetendonsclosetothejointandpreventthemfromspringingforwardsindorsiflexionoftheankle.Superiorextensorretinaculum伸肌上支持帶

isabroadbandwhichextendsbetweenthefibulaandtheanteriorborderofthetibia.Inferiorextensorretinaculum伸肌下支持帶

isY-shaped.ThestemoftheYisattachedtotheuppersurfaceoftheanteriorpartofthecalcaneus.Medially,thelimbsoftheYseparate.Theupperisattachedtothemedialmalleolus,thelowerpassestothemedialsideofthefootandfuseswiththefasciaofthesole.★ContentsoftheanteriorosseofascialcompartmentofthelegMusclesTibialisanterior脛骨前肌Extensorhallucis

longus

拇長(zhǎng)伸肌Extensordigitorum

longus

趾長(zhǎng)伸肌Peroneus

tertius

第三腓骨肌Blood

supplyAnteriortibiala.脛前動(dòng)脈Anteriortibialvein

脛前動(dòng)脈Nerve

supply

Deepperonealn.腓深神經(jīng)Muscles脛骨前肌

tibialisanterior趾長(zhǎng)伸肌extensordigitorum

longus

拇長(zhǎng)伸肌

extensorhallucis

longus

Action:

dorsalflextheanklejointanddigitorumtibialisanteriormakethefootenversionContentsoftheanteriorosseofascialcompartmentofthelegContentsoftheanteriorosseofascialcompartmentofthelegBloodvessel脛前動(dòng)脈Anteriortibialartery

Itarisesfromthepoplitealarteryatthelowerborderofpopliteus.Itpassesforwardsabovetheinterosseousmembrane,andturnsdownwardsontheanteriorsurfaceofthatmembranewiththedeepperonealnerve.Itbecomesthedorsalarteryoffoot足背動(dòng)脈midwaybetweenthemalleoli.脛前靜脈Theanteriortibialveinscloselyappliedtotheanteriortibial

artery.ContentsoftheanteriorosseofascialcompartmentofthelegNervesCommonperonealn.

腓總神經(jīng)

PassesoverposterioraspectofheadoffibulaandthenwindsaroundneckoffibulaDeeptoperoneus

longus,whereitdividesintodeepandsuperficialperonealnervesDeepperonealnerve腓深神經(jīng)

Arisesfromthecommonperonealnervebetweentheneckofthefibulaandtheperoneus

longusmuscleDescendsintheanteriorcompartmentofthelegwiththeanteriortibialvesselsSuppliesallthemusclesoftheanteriorcompartmentofthelegandextensordigitorum

brevis★

ContentsofthelateralosseofascialcompartmentofthelegMusclesPeroneus

longus

腓骨長(zhǎng)肌Peroneus

brevis

腓骨短肌

Action:flextheanklejoint

makethefootinversionBloodsupplyBranchesfromtheperoneala.腓動(dòng)脈Nervesupply

Superficialperonealn.腓淺神經(jīng)Anteriortibiala.Dorsala.offootTibialisanterior

Extensorhallucis

longusExtensordigitorum

longusDeepperonealn.Superficialperonealn.InjurytothecommonperonealnerveThecommonfibularnervemaybeseveredduringfractureofthefibulaneckorseverelystretchedwhenthekneejointisinjuredofdislocated.Severanceofthecommonfibularn.resultsinparalysisofallmusclesintheanteriorandlateralcompartmentsoftheleg.Thelossofeversionofthefootanddorsiflexionoftheanklecausesfoot-drop.Thefootdropsandthetoesdragofthefloorwhenwalking.Becauseitisimpossibletomaketheheelstrikethegroundfirst,thepatienthasahighstepping(‘steppage”)gait,raisingthefootashighasnecessarytokeepthetoesfromhittingtheground.Anteriortalocruralregion

anddorsumoffoot踝前區(qū)和足背SperficialstructuresDorsalvenousarch

足背靜脈弓LiesinthesubcutaneoustissueovertheheadsofthemetatarsalbonesDrainsonthemedialsideintothegreatsaphenousv.andonthelateralsideintothesmallsaphenousv.Saphenousn.

隱神經(jīng)SuppliestheskinonthemedialborderoffootSuralnerve

腓腸神經(jīng)Superficialperonealn.

腓淺神經(jīng)SuppliestheskinofdorsumofthefootDeepperonealn.

腓深神經(jīng)SuppliestheskinoftheadjacentsidesofthebigandsecondtoesAnteriortalocruralregion

anddorsumoffoot踝前區(qū)和足背DeepstructuresDeepfascia深筋膜Superiorextensorretinaculum

伸肌上支持帶Inferiorextensorretinaculum

伸肌下支持帶Muscles足背肌Tendonsofextensordigitorum/hallucis

longusExtensordigitorum

brevis/hallucis

brevis

Dorsalis

pedisartery足背動(dòng)脈Deepperonealnerve腓深神經(jīng)Anteriortalocruralregion

anddorsumoffoot踝前區(qū)和足背★

Dorsalis

pedisartery

足背動(dòng)脈Continuationsof