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LOWER LIMB

The pelvic bone (os coxae) in adults looks like a whole bone. Up to 16 years old, it consists of three separate bones: the iliac, sciatic and pubic. The bodies of these bones on the outer surface form the acetabulum, which serves as the junction of the pelvic bone with the femur (Fig. 46).

Fig. 46.

Pelvic bone, right

:

A - view from the lateral side: 1 - iliac crest; 2 - inner lip; 3 - an intermediate line; 4 - outer lip; 5 - upper anterior iliac spine; b — lower anterior iliac spine; 7 - oververt-pit groove; 8 - the body of the ilium; 9 - the edge of the acetabulum; 10 - semilunar surface; 11 - fossa of the acetabulum; 12 - excision of the acetabulum; 13 - acetabulum; 14 - a locking hole; 15 - ischial tubercle; 16 - ischial spine; 17 — back gluteal line; 18 - lower posterior iliac spine; 19 - upper posterior iliac spine; 20 - ilium; 21 - lower gluteal line; 22 — gluteal surface; 23 - the ilium wing; 24 - front gluteal line; 25 - ileal tubercle; B - view from the medial side: 1 - iliac crest; 2 - upper posterior iliac spine; 3 - sacro-pelvic surface; 4 - iliac tuberosity; 5 - lower posterior iliac spine; 6 - an ear-shaped surface; 7 — locking hole; 8 - arcuate line; 9 - the lower anterior iliac spine; 10 - the body of the ilium; 11 - the ilium; 12 - upper anterior iliac spine; 13 - iliac fossa; 14 - the wing of the ilium; 15 - inner lip

The ilium (os ilium) is the largest, occupying the upper-posterior parts of the pelvic bone.
It consists of two sections - the body and the ilium wing. The upper curved edge of the wing is called the iliac crest. In front of the iliac crest there are two protrusions - the upper and lower anterior iliac spines, and below - the large sciatic notch. The inner concave surface of the wing forms the iliac fossa, and the outer convex - gluteal surface. On the inner surface of the wing are the ear-shaped surface - the place where the pelvic bone and the sacrum join.

The ischium (os ischii) consists of a body and a branch. Here are the sciatic tubercle and sciatic spine, as well as large and small sciatic notches. The ischium branch, fused in front with the lower branch of the pubic bone, closes the obstructive opening of the pelvic bone in this way.

The pubic bone (os pubis) has a body, upper and lower branches. At the junction of the bodies of the pubic and iliac bones is the iliac-pubic elevation. And at the junction of the upper branch to the lower, in the area of ​​the medial surface, there is a symphysial surface - the junction of the pelvic bones in front.

The acetabulum is formed by the fused bodies of the ilium, sciatic and pubic bones. Its articular semilunar surface occupies the peripheral part of the cavity.
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LOWER LIMB

  1. UPPER EXTREMITY BELT
    The shoulder blade (scapula) is a flat bone of a triangular shape, located behind the rib cage at the level of II – VIII ribs (Fig. 36, 37). {foto37} In the scapula, the costal and dorsal surfaces, the upper, lower and lateral angles, as well as the upper, lateral (lateral) and medial (inner) edges are distinguished. The dorsal (posterior) surface of the scapula with the spine of the scapula divided into supraspinatus and supraspinatus
  2. MUSCLES AND FACTS OF THE LOWER EXTREMITY
    Depending on the location and functions performed, the muscles of the lower limb are divided into the muscles of the pelvic girdle and the free part of the lower limb — the thigh, lower leg, and foot (Fig. 74). The muscles of the pelvis. They are divided into two groups - internal and external. They originate from the bones of the pelvis and spine, cover the hip joint and attach to the upper thigh. The internal group of the muscles of the pelvis.
  3. Blockade of nerves of the lower extremity
    For regional anesthesia during operations on the lower extremities, spinal and epidural anesthesia are most often used (see Chapter 16). Nevertheless, blockade of the somatic branches of the lumbar plexus and sciatic nerve during interventions on the lower extremities also provides adequate anesthesia. Blockade of nerves of the lower extremity is performed at the level of the hip, knee and ankle
  4. CONDUCTIVE ANALGESIS FOR OPERATIONS IN THE LOWER EXTREMITY
    When determining blocked nerves for performing an operative measure on the lower limb, the following are taken into account: 1. Dermal innervation zones (Fig. 40) (the femoral nerve innervates the anterior surface of the thigh, the anterolateral surface of the lower leg and rear of the foot, the sciatic - the rear and lateral surface of the lower leg, the plantar surface of the foot and its outer edge, and at the same time the posterior cutaneous blocking with it
  5. FACTS OF THE LOWER EXTREMITY
    Since a number of muscles of the lower extremities begin from the spine and pelvic bones, the fascia that covers them is closely related to the fascia lining the walls of the abdominal cavity and pelvis. The lumbar fascia is part of the intra-abdominal fascia, covers the large lumbar muscle in front, attaches to the bodies of the vertebrae and the upper part of the sacrum, and also connects to the fascia of the square muscle of the lower back.
  6. LOWER EXTREMITY BONES
    BONES BELOW
  7. TOPOGRAPHY OF THE LOWER EXTREMITY
    In the area of ​​the large sciatic foramen there are supra-pear-shaped and sub-piriform-shaped holes through which large vessels and nerves go from the pelvic cavity. In the area of ​​the obturator foramen there is an obturator channel through which obturator vessels and nerve exit from the pelvic cavity to the adductors of the thigh. On the anterior surface of the thigh below the inguinal ligament, a femoral triangle is distinguished
  8. MUSCLES OF THE FREE LOWER EXTREMITY
    The thigh muscles encompass the femur and form three groups: the anterior (hip flexors), the medial (adducting femur) and the posterior (hip extensors). The front muscle group of the thigh. The quadriceps femoris (m. Quadriceps femoris) has four heads: rectus, lateral, medial and intermediate. The rectus femoris originates from the lower anterior spine and from the ilium over
  9. LOWER EXTREMITY BONE COMPOUNDS
    The sacroiliac joint (articulatio sacroiliaca) is a paired flat joint, inactive, formed by the auricular articular surfaces of the ilium and sacrum. In addition to a strong capsule, the joint is well strengthened by the anterior, posterior sacroiliac and interosseous sacroiliac ligaments. The latter have special strength and grow together with the capsule of the joint. From transverse
  10. SKELETON OF THE FREE LOWER EXTREMITY
    The femur is the largest and longest tubular bone in the human body (Fig. 47). It consists of a body and two epiphyses. The upper pineal gland ends with a rounded head of the femur, which connects to the pelvic bone. The body of the femur connects to its head with the help of the narrowed part of the neck. On the border of the neck of the femur and body are two powerful bone protrusions:
  11. Game exercises in depth to the waist
    This set of exercises is aimed at developing courage and confidence in water, introduces the child to such properties of water as viscosity, resistance, exercises are performed at a depth to the waist. The child learns to move along the bottom, dive headlong into the water and navigate underwater, breathe correctly in the water. Particular attention is recommended to be paid to immersion under water and prolonged exhalations in
  12. Dislocation of the lower jaw
    Dislocation of the lower jaw (dislocation of the temporomandibular joint) can occur with deep yawning, vomiting, tooth extraction, etc. Dislocation can be unilateral and bilateral. With a unilateral dislocation, the jaw is shifted to the healthy side. With a dislocation, the head of the joint often slides anterior to the articular tubercle and is fixed by the masticatory muscles. The position of the lower jaw is forced, the mouth is not
  13. Anesthesia in the lower third of the leg
    Anatomy. In the middle third of the tibia, the peroneal nerves leave the bed between the peroneal muscles: the superficial goes to the subcutaneous fat, and the deep moves to the front surface of the interosseous membrane. The tibial nerve, on the contrary, somewhat departs from the interosseous membrane and is located under the calcaneal tendon closer to its medial edge. In subcutaneous fat, in addition to
  14. ELIMINATION OF POINT DAMAGE TO THE LOWER CAVIA
    METHODOLOGY: 1 The surgeon often encounters small rounded defects in the wall of the inferior vena cava above the bifurcation. They are formed upon separation from the wall of the vein of small venous branches that go to the paracaval lymph nodes and are removed with them. The formation of a defect is accompanied by immediate profuse bleeding. The surgeon’s first action to stop the bleeding is to press the spot
  15. LIMB SKELETON
    In the process of human development, the skeleton of the limbs has changed significantly. The upper limbs acquired greater mobility, began to fulfill the function of the organs of labor, perform complex and extensive movements, and the lower limbs - the function of movement and support, holding the human body upright. In the skeleton of the upper and lower extremities of a person, a belt and a free part are distinguished. Belt top
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