The gluteal region & the back of the lower limbs

Department of human anatomy Guangxi Medical University Yu hongrong

2008.04.07

Objectives
 Describe the superficial structures  Describe the deep structures
Muscles Blood vessel and nerves

 Describe the Specific region

Suprapiriform foramina Infrapiriform foramina Lesser sciatic foramen Popliteal fossa

Gluteal region
Muscles
Gluteus maximus Gluteus medius Gluteus minimus Piriformis
Gemellus superior Obturator internus Gemellus inferior Quadratus femoris

Suprapiriform foramina
Location: Upper border of piriform Structures passed through : superior gluteal N Superior gluteal A,V

Infrapiriform foramina
Location: Below border of piriform Structures passed through : (lateral medial side) Sciatic N post.femoral cutaneous N Inferior gluteal N Inferior gluteal A,V Internal pudendal A,V Pudendal N

Lesser sciatic foramen

Structures passing through Internal pudendal A,V Pudendal N

Pudendal canal (Alcocks canal) Structures passing through

Internal pudendal A,V Pudendal N

Back of the thigh

Superficial fascia Post.femoral cutaneous N Post. group of muscles of thigh (lateral medial side) Biceps femoris Semitendinosus Semimembranosus Nerve Sciatic N

Popliteal fossa Boundaries

Upper lateral Biceps femoris Upper medial Semitendinosus Semimembranosus Lower medial: medial head of gastrocnemius Lower lateral: lateral head of gastrocnemius

Popliteal fossa
Contents:
(super. deep) Tibial N Popliteal V Popliteal A Adipose tissue LN Common peroneal N Medial and lateral sural cutaneous N

Back of the leg

Superficial fascia
Small Saphenous V Medial & lat. sural cutaneous N Sural N

Post. Group of muscle of leg

(Superficial layer)

Triceps surae Gastrocnemius Soleus Tendo calcaneus

(Deep layer)

Flexor digitorum longus Tibialis posterior Flexor hallucis longus

Nerve and vessel

Tibial N Posterior tibial A,V
(lie between superf. and deep group muscles of leg)

Malleolar canal
Composition
Formed by flexor retinaculum , the calcaneum

Contents:
(anterior posterior) Tendon and synovial sheath of tibialis posterior Tendon and synovial sheath of flexor digitorum longus Posterior tibial vessels and tibial nerve Tendon and synovial sheath of flexor hallucis longus

Surface projection of sciatic nerve (1)midway between post. Sup. Iliac spine and ischial tuberosity (2)midway between the greater trochanter and ischial tuberosity (3)midline of the back of the thigh A line connected above three points Safe area for giving intramuscular injection superolateral quadrant of the region Types of the sciatic nerve (1)one cord passed through infrapiriform foramen 60.5% (2)variation 39.5%