In this article we will consider in more detail the topography of the lower extremities. We will find out the structure of areas and fascial lodges, touch the gaps, channels and spaces.
Topography concept
"Topography" is a term that translates from Greek as "description of the locality." Largely due to the research and activities of the famous 19th-century surgeon Nikolai Pirogov, this concept took on a different meaning and smoothly migrated from the field of geography to the doctrine of the physique of a person. This teaching soon gained worldwide fame and was called the “Topographic Anatomy”.
The concept of medical topography is known to every first-year student with a medical profile. This discipline studies not only the location of parts of the human body and internal organs, but their interaction with each other.
Topographic anatomy is aimed at studying the shape and structure of the parts that make up the body, which underwent a number of changes as a result of various pathologies. By systematizing the scientific data on their displacements as a result of not quite natural conditions, it allows them to be used in surgery and therapy.
The difference between topographic anatomy and anatomy
That is, there is a rather significant difference between the concepts of topography (topographic anatomy) and simple anatomy. First of all, according to the principle of the approach in describing the structure of man. Topography involves the study of the relative position of organs in the context of the areas to which they relate. Anatomy, however, involves the study of systems in which organs are enclosed: the respiratory or circulatory systems, for example.
Another main difference from anatomy is that topography, among other things, is interested in studying various changes in tissues and organs that occur as a result of a certain pathology. A striking example - topography made it possible to determine the level of influence of various inflammatory processes on the nature and shape of organs.
First of all, topography as a discipline is widely used in surgical medicine. The knowledge of this branch of science that studies fascia and topography of the muscles of the lower extremities gives the surgeon the opportunity to have an idea about the exact location of human organs and systems without direct visual observation. Such knowledge allows a comparison of organs in their normal and pathological conditions. It is worth agreeing that during any surgical operations such knowledge is simply necessary.
Topographic Aspects
Topography belongs to applied disciplines, and it is engaged in a detailed study of the structure of each area of the human body; considers it in various planes. In addition, this science studies the following aspects:
- Blood circulation (refers to the topography of the vessels of the lower limb).
- The projection of the organs of the body on the skin and the location thereof in relation to the human skeleton.
- Ways of supplying body tissues with nerve cells (topography of nerves of the lower extremities).
- The outflow of lymph from body tissues, both under normal conditions and in pathological conditions.
- Features of the human body. Including sexual, constitutional.
Surgical topography is conventionally divided into the following anatomical areas:
- Head.
- Neck.
- Torso.
- Limbs.
Topography of the lower and upper extremities
One of the areas of study of science is the topography of the muscles of the lower extremities. Separately, the topology of the upper and the topology of the lower extremities of a person are distinguished.
The skeleton of the supporting limbs of a person includes the pelvic bones and the free part of the limb. It, in turn, consists of paired femurs, patella, bones of the foot and lower leg. In this case, the belt of the lower extremities is formed by the pelvic bone and consists of three bones: the sciatic, pubic and iliac. In combination with the coccyx and sacrum, the bone base of the pelvis.
Topography Areas
Conventionally, the topography of the lower limb includes such areas as:
- The areas of the fingers are divided into the plantar region and the dorsal region.
- Heel area.
- Foot area: plantar and back.
- Shin area: this includes the anterior region of the lower leg, the posterior, anterior region of the ankle joint, and the posterior region.
- Knee: front and back of the knee.
- Hip: front and back of the thigh.
- Gluteal region.
Topography of the lower extremities
The gluteal region is one of the regions of the lower extremity, which is bounded from above by the iliac crest, and the lower border is the gluteal sulcus, with the median-median and lateral line that connects parts such as the superior ilium and the greater trochanter.
Thigh area. Allocate front and back. Areas of the lower extremities, which are limited in front of the proximal inguinal fold and posteriorly, the gluteal groove. It is also distally limited by the circle line, which is drawn over the patella by two fingers. They are divided among themselves by vertical lines: between the lateral adder and the greater trochanter on the lateral side; between the medial epicondyle and the medial side of the lower branch of the pubic bone.
The femoral triangle is a section of the anterior femoral region, which is limited outside by the edge of the tailor muscle, inside by the long adductor muscle, and above it by the inguinal ligament. Here is the topography of the main arteries of the lower extremities.
Knee, lower leg, foot, heel
Knee area. The anterior and posterior regions of the lower limb are distinguished, which are proximally bounded by a circular line. Held above the patella base by 2 fingers. The distal circular line limits the area according to the tuberosity of the tibia. The anterior and posterior areas of the knee are separated by vertical lines running along the posterior edge of the femoral condyles.
Shin area. Anterior and posterior - proximally limited to a circular circumference along the tuberous level of the tibia with a distal circular line that runs at the base of the ankles. Medially divided among themselves along the edge of the tibia (inner) and along the groove that separates the soleus and fibula muscles - laterally.
What else is included in the topography of the lower extremities?
Ankle joint - an area that is bounded by a circular line at the level of the ankles - proximal; at the level of the tips of the ankles - distally. Conventionally, this area is divided into the following departments: lateral and medial; rear and front.
The area of the foot, including the back and plantar area. The area limited by the line at the level of the tips of the ankles of the small and large tibia is proximal, and distally with the bases of the fingers. Separated from each other by a line from the middle of the calcaneus to the middle of the head of the metatarsal bone - along the lateral edge, and by a line connecting the middle of the calcaneus and along the medial edge of the middle of the metatarsal bone.
Heel area. The area that is separated by a vertical stirrup line from the upper border of the feet.
Fascial bed of the lower limb
Includes:
- The thigh area is conditionally divided into the posterior, anterior and medial fascial bed.
- Shin area: front, back and lateral bed.
- Foot area: median, deep, medial and lateral bed.
Fascias and topography of the lower extremities
The anterior fascial bed of the thigh is considered a bed of bone-fibrous nature. It is located on the front of the thigh and is limited to the wide fascia of the thigh in front; the medial and lateral intermuscular septa are separated on its sides; the periosteum of the femur is behind. Includes quadriceps.
The medial fascial bed of the thigh will be the bed, which is medially limited by the wide fascia of the thigh, on the back side - by the posterior intermuscular septum, in front of it is limited by the medial muscular septum. Includes a group of muscles of the lower limb. Topography features are unique.
The posterior femoral bed is the bed of the posterior femoral region of a bone-fibrous nature. The back is limited by the wide fascia of the thigh, on the sides and in front of it are separated the posterior muscular walls and the lateral, periosteum of the posterior surface of the thigh. Includes a group of back muscles.
The anterior bed of the lower leg - has a bone-fibrous character. The front is limited by the fascia of the tibia, the periosteum of the tibia medially and the anterior intermuscular septum of the tibia laterally. The back side is limited by the periosteum of the tibia and the interosseous membrane. The anterior fascial bed of the lower leg contains the anterior tibial veins and arteries, the peroneal nerve, and lower leg muscles, which are related to the topography of the arteries of the lower limb.
A lateral fascial bed is called a bed, which has a bone-fibrous character. It is medially limited by the fascia of the tibia, the periosteum of the tibia limits laterally, in the anterior and posterior regions, respectively, the anterior and posterior intermuscular septa. Includes peroneal muscles (short and long), as well as nerve (superficial peroneal).
Posterior tibia bed - the fascia of the tibia limits the posterior fascial bed of the tibia from the sides and back; the interosseous membrane, the periosteum of the tibia, the posterior muscular septum of the tibia - in front. It includes the tibial nerve, the posterior tibial veins and arteries, the fibular artery, as well as the posterior tibial muscle group. This is the topography of the veins of the lower extremities.
Sole bed
The medial fascial bed of the sole is the bed, which is separated from the middle by the medial muscular septum. It is characterized by a short finger flexor, which regulates the long flexor tendon.
The middle fascial bed of the sole is called the bed, which is located in the gap between the plantar interosseous fascia and plantar aponeurosis. Includes tendons of the long flexor, muscle of the sole (square).
The lateral fascial bed of the sole will be the bed, which is limited from the middle by the lateral muscle septum and contains the flexor and the opposing muscle of the fifth finger, as well as the abducent muscle. Further, what else relates to the topography of the muscles of the lower limb?
The deep fascial bed of the sole - from the middle bed is limited by the lateral muscular septum. The deep fascial bed of the sole contains the abducting and opposing muscles of the fifth finger, as well as the flexor.
Deep fascial bed of the sole - contains interosseous muscles, and is located under the deep fascia.
Canals, slots and cell spaces
Consider the areas of the lower extremities and the cellular spaces, channels and slots contained in them:
- The gluteal region includes the subgluteal and intergluteal spaces.
- The anterior thigh region is conditionally divided into superficial muscular-fascial, deep intermuscular and periosteal spaces. In the perineal space are located: vascular and muscle lacunae; obturator, femoral and addural canals.
- Popliteal fossa.
- Channels: ankle-popliteal, muscular-fibular, ankle.
- Cellular space is the rear subfascial.
- The cellular spaces of the sole are superficial and deep.
Conclusion
Topographic anatomy, or, more simply, topography of the lower extremities, faces a number of important tasks. These include, first of all, an accurate description of the location of human organs. Moreover, as noted earlier, topography describes organs not only in their natural and normal state, but also in the state of pathology or in the state after the pathology. The results of studies of topography and topographic anatomy constitute the basis of knowledge for a wide and active application in the field of diagnosis of diseases, but most importantly - in the field of surgery.