Учебники / Atlas_anatomii_cheloveka_Frenk_Netter_6-oe_izdanie_Chast3

Muscles of Hip and Thigh: Lateral View

See also Plate 468

Iliac crest

Gluteal aponeurosis

over gluteus medius muscle

Gluteus maximus muscle

Vastus lateralis muscle

Iliotibial tract

Long head

Biceps femoris muscle

Short head

Semimembranosus muscle

Fibular collateral ligament

Plantaris muscle

Gastrocnemius muscle (lateral head)

Head of fibula

Fibularis (peroneus) longus muscle

External oblique muscle

Anterior superior iliac spine

Sartorius muscle

Tensor fasciae latae muscle

Rectus femoris muscle

Lateral condyle of tibia and Gerdy’s tubercle

Lateral patellar retinaculum

Patella

Extensor digitorum longus muscle

Patellar ligament

Tibialis anterior muscle

Plate 481

Hip and Thigh

	Muscles of Hip and Thigh: Posterior Views		7
		See also Plates 338, 339, 488
Superficial dissection		Deeper dissection

Iliac crest

Gluteal aponeurosis over

Gluteus medius muscle

Gluteus minimus muscle

Gluteus maximus muscle

Piriformis muscle

Sciatic nerve

Sacrospinous ligament

Superior gemellus muscle

Obturator internus muscle

Inferior gemellus muscle

Sacrotuberous ligament

Quadratus femoris muscle

Ischial tuberosity

Semitendinosus muscle

Greater trochanter

Biceps femoris muscle (long head)

Adductor minimus part of

Adductor magnus muscle

Semimembranosus muscle

Iliotibial tract

Gracilis muscle

Biceps femoris muscle

Short head

Long head

Semimembranosus muscle

Semitendinosus muscle

Popliteal vessels and tibial nerve

Common fibular (peroneal) nerve

Plantaris muscle

Gastrocnemius muscle

Medial head

Lateral head

Sartorius muscle

Popliteus muscle

Arch of

Soleus muscle

Plantaris tendon (cut)

Hip and Thigh	Plate 482

Psoas and Iliacus Muscles

See also Plates 253, 258, 262

Subcostal nerve

12th rib

Quadratus lumborum muscle

Transversus abdominis muscle (cut)

Iliohypogastric nerve

Ilio-inguinal nerve

Psoas minor muscle

Psoas major muscle

Genitofemoral nerve

Lateral femoral cutaneous nerve

Iliacus muscle

Femoral nerve

Obturator nerve

Superior and inferior pubic rami

Greater trochanter of femur

Iliacus and psoas muscles pass backward to insert on lesser

trochanter (iliopsoas)

Abductors (gluteus medius and

minimus muscles)

T12

L1

L2

L3

L4

L5

Origin of psoas major muscle from vertebral bodies, transverse processes, and intervertebral discs (T12–L4) and origin of psoas minor muscle from vertebral bodies (T12, L1)

Lumbar plexus (L1–4)

Lumbosacral trunk (L4, 5)

Iliac crest

Anterior superior iliac spine

Iliopectineal bursa

Iliofemoral ligament of hip joint (Y ligament of Bigelow)

Note: Arrows indicate direction of action of muscles (iliacus/psoas superiorly, iliopsoas inferiorly).

Adductors

Plate 483

Hip and Thigh

Intercostal nerve (T11)

Subcostal nerve (T12)

Iliohypogastric nerve (T12, L1)

Ilio-inguinal nerve (L1)

To psoas major and psoas minor muscles

Genitofemoral nerve (L1, 2)

Lateral femoral cutaneous nerve (L2, 3)

Genital branch (L1) and Femoral branch (L2)

of genitofemoral nerve

To psoas major and iliacus muscles

Anterior branches and

Lateral branches of subcostal and

iliohypogastric nerves

Lumbosacral trunk

Nerve to quadratus femoris (and inferior gemellus) (L4, 5, S1)

Nerve to obturator internus (and superior gemellus) (L5, S1, 2)

Superior gluteal nerve (L4, 5, S1)

Nerve to piriformis (S1, 2)

Obturator nerve (L2, 3, 4)

Accessory obturator nerve (L3, 4) (inconstant)

Inferior gluteal nerve (L5, S1, 2)

Femoral nerve (L2, 3, 4)

Sciatic nerve

Posterior femoral cutaneous nerve (S1, 2, 3)

Pudendal nerve (S2, 3, 4)

Common fibular

(peroneal) nerve Sciatic (L4, 5, S1, 2) nerve

Tibial nerve (L4, 5, S1, 2, 3)

Lumbosacral and Coccygeal Plexuses				7
		See also Plate 262
			Anterior division
T12			Posterior division

Sympathetic trunk

Rami	L1
communicantes
	L2
		Lumbar plexus
	L3
	L4
	L5
	S1	Sacral plexus
	S2
	S3

S4

	S5	Coccygeal plexus
	Co
		Pelvic splanchnic
		nerves (parasympathetics)
		Perforating cutaneous
		nerve (S2, 3)
		Nerve to levator ani
		and coccygeus (S3, 4)
		Perineal branch of
		4th sacral nerve
		Anococcygeal nerves
		Obturator nerve
		Inferior anal
		(rectal) nerve
Posterior femoral		Dorsal nerve of penis/clitoris
cutaneous nerve	Perineal nerve and Posterior scrotal/labial branches

Hip and Thigh	Plate 484

Lumbar Plexus

See also Plate 262

Schema

Subcostal nerve (T12)

White and gray rami communicantes

Iliohypogastric nerve

Ilio-inguinal nerve

Genitofemoral nerve

Lateral femoral cutaneous nerve

Gray rami communicantes

Muscular branches

to psoas and iliacus muscles

Femoral nerve

Accessory obturator nerve (often absent)

	Obturator nerve
	Lumbosacral trunk
Diaphragm (cut)
Subcostal nerve (T12)
Sympathetic trunk	L1	L1
Iliohypogastric nerve		L2
	L2
Ilio-inguinal nerve		L3
	L3
Genitofemoral nerve (cut)
	L4	L4

Lateral femoral

cutaneous nerve

L5

Femoral nerve

Obturator nerve

Psoas major muscle (cut)

Lumbosacral trunks

Inguinal ligament (Poupart’s)

T12

L1

L2

	Ventral rami of
	lumbar plexus
L3	spinal nerves

L4

L5

Anterior division

Posterior division

White and gray

rami communicantes

Subcostal nerve (T12)

Iliohypogastric nerve (T12, L1)

Ilio-inguinal nerve (L1)

Transversus abdominis muscle

Quadratus lumborum muscle

Psoas major muscle

Gray rami communicantes

Genitofemoral nerve (L1, 2)

Iliacus muscle

Lateral femoral cutaneous nerve (L2, 3)

Femoral nerve (L2–4)

Genital branch (L1) and

Femoral branch (L2) of genitofemoral nerve

Obturator nerve (L2–4)

Plate 485

Hip and Thigh

Schema

Anterior division

Posterior division

Superior gluteal nerve

Inferior gluteal nerve

Nerve to piriformis

Common fibular (peroneal) nerve (L4, 5, S1, 2)

Sciatic nerve

Tibial nerve (L4, 5, S1, 2, 3)

Nerve to quadratus femoris (and inferior gemellus)

Nerve to obturator internus (and superior gemellus)

Lumbosacral trunk

Psoas major muscle

Superior gluteal artery and nerve

Obturator nerve

Iliacus muscle

Inferior gluteal artery

Nerve to quadratus femoris

Internal pudendal artery

Nerve to obturator internus

Pudendal nerve

Obturator internus muscle

Superior pubic ramus

Piriformis muscle

Coccygeus (ischiococcygeus) muscle

Nerve to levator ani muscle

Levator ani muscle

Topography: medial and slightly anterior view of hemisected pelvis

Sacral and Coccygeal Plexuses		7
	See also Plate 262

L4	Lumbosacral trunk

L5

Gray rami communicantes

S1

Pelvic splanchnic nerves S2 (parasympathetic to

inferior hypogastric [pelvic] plexus [S2, 3, 4])

S3

S4

S5

Coccygeal nerve

Anococcygeal nerve

Perineal branch of 4th sacral nerve

Nerve to levator ani and

coccygeus (ischiococcygeus) muscles

Pudendal nerve

Perforating cutaneous nerve

Posterior femoral cutaneous nerve

	Sympathetic trunk
	Gray rami communicantes
L5	Pelvic splanchnic
L4	nerves (cut)
	(parasympathetic
S1	to inferior
	hypogastric

S2	[pelvic] plexus)
	S3
	S4
	S5
	Co

Sacral

splanchnic nerves (cut)

(sympathetic to inferior hypogastric [pelvic] plexus)

Hip and Thigh	Plate 486

Arteries and Nerves of Thigh: Anterior Views

See also Plate 525

Anterior superior iliac spine	Superficial dissections
Lateral femoral cutaneous nerve
Inguinal ligament	Tensor fasciae latae
Iliopsoas muscle	muscle (retracted)
Superficial circumflex	Gluteus
iliac vessels	minimus
	and medius
Superficial	muscles
epigastric vessels

Superficial and Deep external pudendal vessels

Lateral circumflex femoral artery

Rectus femoris muscle

Vastus lateralis muscle

Vastus medialis muscle

Femoral sheath (cut)

Femoral nerve, artery, and vein

Pectineus muscle

Profunda femoris (deep femoral) artery

Gracilis muscle

Adductor longus muscle

Sartorius muscle

Vastus medialis muscle

Fascia lata (cut)

Rectus femoris muscle

Vastus lateralis muscle

Tensor fasciae latae muscle

Saphenous nerve and saphenous branch of descending genicular artery

Articular branch of descending genicular artery (emerges from vastus medialis muscle)

Patellar anastomosis

Infrapatellar branch of Saphenous nerve

Lateral femoral cutaneous nerve (cut)

Sartorius muscle (cut)

Iliopsoas muscle

Femoral nerve, artery, and vein

Pectineus muscle

Profunda femoris (deep femoral) artery

Adductor longus muscle

Adductor canal (opened by removal of sartorius muscle)

Saphenous nerve

Nerve to vastus medialis muscle

Adductor magnus muscle

Anteromedial intermuscular septum covers entrance of femoral vessels

to popliteal fossa (adductor hiatus)

Sartorius muscle (cut)

Superior medial genicular artery (from popliteal artery)

Inferior medial genicular artery (from popliteal artery)

Plate 487

Hip and Thigh

Arteries and Nerves of Thigh: Anterior Views (continued) 7

See also Plates 525, 526

Deep dissection

Deep circumflex iliac artery

Lateral femoral cutaneous nerve

Sartorius muscle (cut)

Iliopsoas muscle

Tensor fasciae latae muscle (retracted)

Gluteus medius and minimus muscles

Femoral nerve

Rectus femoris muscle (cut)

Ascending, transverse, and descending branches of

Lateral circumflex femoral artery

Medial circumflex femoral artery

Pectineus muscle (cut)

Profunda femoris (deep femoral) artery

Perforating branches

Adductor longus muscle (cut)

Vastus lateralis muscle

Vastus intermedius tendon

Rectus femoris muscle (cut)

Saphenous nerve

Anteromedial intermuscular septum (opened)

Vastus medialis muscle

Quadriceps femoris tendon

Patella and patellar anastomosis

Medial patellar retinaculum

Patellar ligament

External iliac artery and vein

Inguinal ligament (Poupart’s)

Femoral artery and vein (cut)

Pectineus muscle (cut)

Obturator canal

Obturator externus muscle

Adductor longus muscle (cut)

Anterior branch and Posterior branch of obturator nerve

Quadratus femoris muscle

Adductor brevis muscle

Branches of posterior branch of obturator nerve

Adductor magnus muscle

Gracilis muscle

Cutaneous branch of obturator nerve

Femoral artery and vein (cut)

Descending genicular artery

Articular branch

Saphenous branch

Adductor hiatus

Sartorius muscle (cut)

Adductor magnus tendon

Adductor tubercle on medial epicondyle of femur

Superior medial genicular artery (from popliteal artery)

Infrapatellar branch of

Saphenous nerve

Inferior medial genicular artery (from popliteal artery)

Hip and Thigh	Plate 488

Arteries and Nerves of Thigh: Posterior View

See also Plate 527

Deep dissection

Superior clunial nerves (L1, 2, 3)

Gluteus maximus muscle (cut)

Medial clunial nerves (S1, 2, 3)

Inferior gluteal artery and nerve

Pudendal nerve

Nerve to obturator internus (and superior gemellus)

Posterior femoral cutaneous nerve

Sacrotuberous ligament

Ischial tuberosity

Inferior clunial nerves (S2, 3) (cut)

Adductor magnus muscle

Gracilis muscle

Sciatic nerve Muscular branches of sciatic nerve Semitendinosus muscle (retracted)

Semimembranosus muscle

Sciatic nerve

Articular branch

Adductor hiatus

Popliteal vein and artery

Superior medial genicular artery

Medial epicondyle of femur

Tibial nerve

Gastrocnemius muscle (medial head)

Medial sural cutaneous nerve

Small saphenous vein

Iliac crest

Gluteal aponeurosis and gluteus medius muscle (cut)

Superior gluteal artery and nerve

Gluteus minimus muscle

Tensor fasciae latae muscle

Piriformis muscle

Gluteus medius muscle (cut)

Superior gemellus muscle

Greater trochanter of femur

Obturator internus muscle

Inferior gemellus muscle

Gluteus maximus muscle (cut)

Quadratus femoris muscle

Medial circumflex femoral artery

Vastus lateralis muscle deep to iliotibial tract

Adductor minimus part of adductor magnus muscle

1st perforating artery (from profunda femoris artery)

Adductor magnus muscle

2nd and 3rd perforating arteries (from profunda femoris artery)

4th perforating artery (from profunda femoris artery)

Long head (retracted)	Biceps femoris
Short head	muscle

Superior lateral genicular artery

Common fibular (peroneal) nerve

Plantaris muscle

Gastrocnemius muscle (lateral head)

Lateral sural cutaneous nerve

Plate 489

Hip and Thigh

Gluteus maximus muscle (cut)

Superior gluteal nerve

Sciatic nerve (cut)

Inferior gluteal nerve

Posterior femoral cutaneous nerve (cut)

Nerve to obturator internus (and superior gemellus)

Pudendal nerve

Ischial spine

Sacrospinous ligament

Perforating cutaneous nerve

Sacrotuberous ligament

Inferior anal (rectal) nerve

Dorsal nerve of penis

Perineal nerve

Posterior scrotal nerve

Perineal branches of posterior femoral cutaneous nerve

Ischial tuberosity

Semitendinosus muscle

Biceps femoris muscle (long head) (covers semimembranosus muscle)

Nerves of Hip and Buttock 7

See also Plate 333

Iliac crest

Gluteus medius muscle (cut)

Gluteus minimus muscle

Piriformis muscle

Superior gemellus muscle

Tensor fasciae latae muscle

Gluteus medius muscle (cut)

Obturator internus muscle

Nerve to quadratus femoris (and inferior

gemellus) supplying articular branch to hip joint

Greater trochanter of femur

Intertrochanteric crest

Inferior gemellus muscle

Quadratus femoris muscle

Gluteus maximus muscle (cut)

Sciatic nerve (cut)

Posterior femoral cutaneous nerve (cut)

Inferior clunial nerves

Hip and Thigh	Plate 490