Muscles and fascia of the thigh. Fascia of the lower limb. iliotibial band stretch at home

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Proximal attachment. The superior anterior iliac spine and adjacent portion of the iliac crest.

Distal attachment. Iliotibial tract of the fascia lata, attaching to the lateral condyle tibia.

Function. Strains the IT band, helping to strengthen knee joint in an extended position; helps flex, abduct and internally rotate the hip; Helps the gluteus medius and minimus muscles stabilize the pelvis when walking.

The greater trochanter of the femur is a bony protrusion on the lateral surface of the thigh, located approximately a hand's length below the iliac crest; lies on the same horizontal line with the pubic ridge.

The iliotibial tract of the fascia lata is a long fascial plate lying on the outer surface hips. Is the thickened part of the fascia surrounding the thigh; the distal part is attached to the lateral condyle of the tibia. The condyle insertion is palpated anterior to the insertion of the biceps femoris tendon. The iliotibial tract is palpated in sitting position With bent knee and the heel raised above the floor.

To identify the tensor fascia lata muscle, have the patient lie on their back and rotate the thigh inward against gentle resistance—the tensor fascia lata muscle will be easily palpated in this position. Using flat finger palpation, trace the course of the fibers from the superior anterior iliac spine to the connection with the iliotibial tract of the fascia lata on the lateral surface of the thigh. The tensor fascia lata muscle lies anterior to the greater trochanter of the femur.

Walking or running on uneven surfaces; long-term immobilization of the limb; unexpected excess load.
Satellite trigger points. Anterior bundles of small gluteal muscle, rectus femoris, iliopsoas and sartorius muscles.

Affected organ system. Genitourinary system.

Associated zones, meridians and points.

Lateral zone. Shao-yang gallbladder foot meridian. GB 29.31.

2. Maintain your balance by leaning on a wall or table. Cross your legs so that the affected leg is behind you. Grab the knee of your uninjured leg and squat down on it so that the injured leg slides along the floor in the opposite direction, trying to press your shin to the floor. Fix the pose until the count is 10-15.

Strengthening exercise. Take a knee-elbow position. Shift your body weight to the knee on the uninjured side so that the thigh and lower leg of the other side can move freely. Keeping the knee of the affected side bent, move that leg to the side until the inner thigh is in a horizontal position. Return to the starting position. Repeat 5-10 times.

D. Finando, C. Finando

Muscles and fascia of the belt lower limb. Muscles and fascia of the thigh. Topography: muscular and vascular lacunae, femoral and adductor canals.

There are muscles of the pelvic girdle and the free part of the lower limb - thigh, lower leg and foot.

Pelvic muscles:

There are two groups: the internal iliopsoas muscle, the internal obturator and piriformis muscles; gluteus maximus, gluteus medius and minimus, tensor fasciae lata, quadratus femoris and obturator externus.

Internal pelvic muscle group:

1. Iliopsoas muscle (m. iliopsoas) - consists of two muscles - the psoas major and the iliacus.

Psoas major muscle (m. psoas major) - from the lateral surface of the bodies and transverse processes of the 12th thoracic and all lumbar vertebrae, crosses the boundary line of the pelvis and connects with the iliacus muscle.

Iliacus muscle (m. iliacus) from the upper two-thirds of the iliac fossa, the inner lip of the iliac crest, exits through the muscular lacuna and attaches to the lesser trochanter of the femur.

Functions:

Flexes the thigh at the hip joint;

With a fixed lower limb, it bends the lumbar part of the spine and tilts the pelvis along with the torso forward.

2. Psoas minor muscle (m. psoas minor) - fickle.

It starts from the intervertebral disc of the 12th thoracic and 1st lumbar vertebrae.

Attached to the arcuate line of the ilium and to the iliopubic eminence.

Function: stretches the fascia iliaca.

3. Internal obturator muscle (m. obturatorius internus) - from the edges obturator foramen(except for the obturator groove), the pelvic surface of the ilium, the muscle exits the pelvic cavity through the lesser sciatic foramen and is attached to the medial surface of the greater trochanter. Upon exiting the foramen, the muscle is joined by the superior and inferior gemellus muscles, which are also attached to the greater trochanter.

4. Superior gemellus muscle (m. gemellus superior)- from the ischium, and 5. inferior gemellus muscle (m. gemellus inferior) - from the ischial tuberosity.

Function: rotates the hip outward.

6.Piriformis muscle (m. piriformis) - from the pelvic surfaces of the sacrum (2-4 sacral vertebrae), exits the pelvic cavity through the greater sciatic foramen, and is attached to the apex of the greater trochanter.

Function: rotates the hip outward with slight abduction.

External pelvic muscle group:

Located in the gluteal region and on the lateral surface of the pelvis. They form three layers: superficial (gluteus maximus and tensor fasciae lata), middle (gluteus medius, quadratus femoris), deep (gluteus minimus and obturator externus).

1.Gluteus major (m. gluteus maximus) - from the iliac crest, the tendon part of the erector spinae muscle, the dorsal surfaces of the sacrum and coccyx, the sacrotuberous ligament.

Attached to the gluteal tuberosity of the femur, some of the bundles are woven into the fascia lata. Between the muscle tendon and the greater trochanter there is trochanteric bursa of the gluteus maximus muscle (bursa trochanterica m. glutei maximi).

Functions:

Extends the thigh when the muscle contracts with its entire mass;

Abduct the thigh, help keep the knee in an extended state while contracting the anterior superior muscle bundles;

Adduction of the thigh and at the same time rotating it outward with contraction of the posteroinferior muscle bundles;

With a fixed limb, the muscle extends the pelvis, and with it the torso, holding it in an upright position.

2. Gluteus medius muscle (m. gluteus medius)-from the gluteal surface of the ilium, fascia lata, attached to the apex and outer surface of the greater trochanter. Between the gluteus medius tendon and the greater trochanter there is a bursa.

Functions:

Abducts the hip;

The anterior bundles rotate the thigh inward, the posterior bundles outward;

The fixed limb holds the pelvis and torso in an upright position.

3. Gluteus minimus (m. gluteus minimus) - located under the gluteus medius muscle. It begins on the outer surface of the ilium wing, the edge of the greater sciatic notch.

Attached to the anterolateral surface of the greater trochanter, some of the bundles are woven into the capsule of the hip joint. Between the muscle tendon and the greater trochanter there is trochanteric bursa of the gluteus minimus muscle (bursa trochanterica m. glutei minimi).

Functions:

Abducts the hip;

The anterior bundles are involved in turning the hip inward, the posterior bundles outward.

4. Tensor fasciae latae (m. tensor fasciae latae) - from the superior anterior iliac spine. The muscle is enclosed between the plates of the fascia lata. At the level between the upper and middle thirds of the thigh it becomes iliotibial tract (tractus iliotibialis) fascia lata of the thigh, which continues down and attaches to the lateral condyle of the tibia.

Functions:

Strains the tract, helping to strengthen the knee in an extended state;

Flexes the hip.

5. Quadratus femoris (m. quadratus femoris)– from the ischial tuberosity, attached to the upper part of the intertrochanteric ridge. Between the anterior surface of the muscle and the greater trochanter there is a synovial bursa.

Function: rotates the hip outward.

6. External obturator muscle (m. obturatorius externus) - from the outer surface of the pubic bone and the branch of the ischium, the obturator membrane. The bundles pass behind the femoral joint and are attached to the trochanteric fossa of the femur and the joint capsule.

Function: rotates the hip outward.

Muscles of the free part of the lower limb:

They are divided into three groups: anterior (flexors), posterior (extensors) and medial (hip adductors).

Anterior thigh muscle group:

1. Sartorius muscle (m. sartorius) - from the superior anterior iliac spine to the tibial tuberosity and the fascia of the leg. At the point of attachment, the muscle tendon fuses with the tendon of the gracilis and semitendinosus muscles and forms a fibrous plate - the superficial pes anserine, under which is located houndstooth bag (bursa anserina).

Functions:

Flexes the thigh and lower leg;

Participates in external rotation of the hip.

2. Quadriceps muscle (m. quadriceps femoris) - consists of 4 muscles that form its heads: the rectus muscle, the vastus lateralis, the vastus medialis and the vastus intermedius, which are adjacent to the femur. In the distal third of the femur, all heads form a common tendon, which is attached to the tibial tuberosity and to the apex of the patella; distal from the apex, the middle part of the tendon continues into the patellar ligament.

A) Rectus femoris muscle (m. rectus femoris) - from the inferior anterior iliac spine and the ilium above the acetabulum. Between the bone and the beginning of the muscle there is a synovial bursa. The muscle passes in front of the femoral joint and is attached to the base of the patella.

B) Lateral vastus muscle thighs (m. vastus lateralis) - from the intertrochanteric line, the lower part of the greater trochanter, the gluteal roughness, the rough line of the femur. Attaches to the tendon of the rectus femoris muscle, the superolateral part of the patella and the tibial tuberosity.

B) Vastus medialis muscle (m. vastus medialis) - from the lower half of the intertrochanteric line, the medial lip of the linea aspera. Attaches to the upper edge of the base of the patella and the medial condyle of the tibia.

D) Vastus intermedius (m. vastus intermedius)-from the upper two-thirds of the anterior and lateral surfaces of the body of the femur, the lateral lip of the linea aspera. It is attached to the base of the patella and, together with the tendons of the vastus muscles, participates in the formation of the common tendon of the quadriceps femoris muscle.

Functions:

Extends the lower leg at the knee joint;

The rectus femoris muscle flexes the hip.

Posterior thigh muscle group:

1.Biceps femoris muscle (m. biceps femoris) - has two heads.

Long head starts from the ischial tuberosity and the sacrotuberous ligament, at the level of the lower third of the thigh it connects with the short head and they pass into the flat tendon.

Short head starts from the lateral lip of the linea aspera, the lateral epicondyle, attaches to the head of the fibula and the outer surface of the lateral condyle of the tibia. Between the muscle tendon and the tibial collateral ligament there is a lower subtendinous bursa of the biceps femoris muscle (bursa subtendinea m. bicipitis femoris inferior).

Functions:

Extends the hip;

Flexes the lower leg at the knee joint;

With the knee bent, the shin turns outward.

2. Semitendinosus muscle (m. semitendinosus) - from the ischial tuberosity, passes into a long tendon and is attached to the medial surface of the tibia.

Functions:

With the knee bent, the shin rotates inwards.

3. Semimembranosus muscle (m. semimembranosus) - from the ischial tuberosity, with three bundles attached to the posterolateral surface of the medial condyle of the tibia. These bundles form a deep crow's foot. One bundle is attached to the tibial collateral ligament, the second to the popliteal fascia and on the line of the soleus muscle on the tibia, the third to back surface lateral femoral condyle.

Functions:

Extends the thigh, flexes the lower leg;

With the knee bent, the shin rotates inwards;

Retracts the knee joint capsule;

Medial thigh muscle group:

1. Thin muscle (m. gracilis) - from the lower half of the pubic symphysis and the lower ramus of the pubis. Attaches to the medial surface of the tibia and participates in the formation of the superficial pes anserine.

Functions:

Adducts the hip;

Bends the shin, rotates it medially.

2. Pectineus muscle (m. pectineus) - from the crest and superior ramus of the pubis. Attached to the area located between the posterior surface of the lesser trochanter and the rough line of the femur.

Function: adducts and flexes the hip.

3. Long adductor muscle (m. adductor longus) - begins between the pubic crest and the symphysis. Attached to the medial lip of the linea aspera of the femur.

Function: adducts the hip, flexes and rotates it outward.

4. Short adductor muscle (m. adductor brevis) - from the outer surface of the body and the lower branch of the pubic bone. Attached to the rough line of the thigh.

Function: adducts the hip, flexes the hip.

5. Large adductor muscle (m. adductor magnus) - from the ischial tuberosity, ramus of the ischium and inferior ramus of the pubis. Attached along the entire length of the medial lip of the linea aspera.

Along the line of attachment of the adductor magnus muscle there is a series of osteofibrous foramina, the upper four foramina are small, they serve for the passage of three perforating arteries and the terminal branch of the deep femoral artery, the lower foramen is larger and is called tendon gap (hiatus adductorius), a vascular bundle passes through it from the adductor canal of the femur to the popliteal fossa.

Functions:

The strongest adductor muscle of the thigh;

Participates in hip extension.

Synovial bursae:

1) subcutaneous trochanteric bursa (bursa subcutanea trochanterica) - between the skin and the tendon of the gluteus maximus muscle at the level of the greater trochanter;

2) the trochanteric bursa of the gluteus maximus muscle (bursa trochanterica m. glutei maximi) separates the muscle tendon from the greater trochanter;

3) trochanteric bursae of the gluteus medius muscle (bursae trochantericae m. glitei medii), one of them is located between the muscle tendon and the greater trochanter, the other separates the gluteus medius muscle from the piriformis muscle;

4) the trochanteric bursa of the gluteus minimus muscle (bursa trochanterica m. glutei minimi) is located between the muscle tendon and the greater trochanter;

5) bag piriformis muscle(bursa m. piriformis) is located between the muscle tendon and the greater trochanter;

6) the ischial bursa of the internal obturator muscle (bursa ischiadica m. obturatorii interni) lies between the tendon of the muscle and the edge of the lesser sciatic notch;

7) the subtendinous bursa of the internal obturator muscle (bursa subtendinea m. obturatorii interni) is located under the tendon of the muscle at the place of its attachment to the trochanteric fossa;

8) intermuscular bursae of the gluteal muscles (bursae intermusculares musculorum gluteorum) - two or three bursae located under the tendon of the gluteus maximus muscle;

9) the ischial bursa of the gluteus maximus muscle (bursa ischiadica m. glutei maximi) is located between the ischial tuberosity and the gluteus maximus muscle.

Fascia of the lower limb:

Superficial fascia of the lower extremity is represented by a fibrofatty plate; it has differences associated with the areas.

Deep fascia of the lower limb is well developed, enclosing the muscles of the lower limb in a fibrous sheath like an elastic stocking. At the top, it is attached along the upper border of the thigh area: to the posterior surface of the sacrum and coccyx, to the iliac crest, to the inguinal ligament, to the superior branch, body and inferior branch of the pubic bone, to the branch and tubercle of the ischium, to the sacrotuberous ligament. In the gluteal region, the deep fascia is called the gluteal fascia (fascia glutea), on the thigh - the wide fascia (fascia lata), on the lower leg - the fascia of the leg (fascia cruris), on the foot - the fascia of the foot (fascia pedis).

Fascia of the gluteal region.

The superficial fascia is a continuation of the superficial fascia of the back and contains a variable amount of fatty tissue.

Gluteal fascia (fascia glutea) is a continuation of the thoracolumbar fascia. It begins on the dorsal surface of the sacrum and on the outer lip of the iliac crest. Above the gluteus maximus, it is thin and sends out processes into the depths of the muscle, dividing it into large bundles. In the anterior section of the gluteus medius muscle, the fascia thickens and forms gluteal aponeurosis (aponeurosis glutea). Continuing anteriorly, it splits and covers the muscle that strains the fascia lata (m. tensor fasciae latae) on both sides. Inferiorly, the gluteal fascia continues into the fascia lata of the thigh.

Fascia of the internal muscles of the pelvic girdle are derivatives of the intra-abdominal and pelvic fascia. The iliopsoas fascia (fascia iliopsoas), covering the muscle of the same name, is part of the intra-abdominal fascia (fascia endoabdominalis). The iliopsoas fascia is divided into two parts: lumbar (pars psoatica) and iliac (pars iliaca). Lumbar part covers the psoas major muscle in front, on the lateral side it connects with the fascia covering the quadratus lumborum muscle. Downwards, the lumbar part continues into the iliac part. The section of fascia that spreads from the transverse process of the 2nd lumbar vertebra to the body of the 1st lumbar vertebra forms the medial arcuate ligament of the diaphragm.

Iliac part attaches to the inner lip of the iliac crest and to the arcuate line of the ilium, here the tendon of the psoas minor muscle joins it. Laterally, the part is tightly fused with the posterior edge of the inguinal ligament, on the medial side it spreads through the inguinal ligament to the iliopubic eminence and forms the iliopectineal arch (arcus iliopectineus), which separates the vascular and muscular lacunae.

Fascia of the pelvis consists of visceral and parietal fascia.

Parietal fascia (fascia pelvis parietalis) lines the inner surface of the pelvic walls. It is distinguished obturator fascia (fascia obturatoria), piriformis fascia (fascia musculi piriformis), presacral fascia (fascia presacralis), covering the corresponding muscles and the anterior surface of the sacrum. The obturator fascia forms a thickening - the tendinous arch of the fascia of the pelvis or white line of the parietal fascia of the pelvis (arcus tendineus fasciae pelvis), which should not be confused with the tendinous arch of the levator ani muscle located above. Derivatives of the parietal fascia of the pelvis are also the upper and lower fascia of the pelvic diaphragm.

Visceral fascia of the pelvis (fascia pelvis visceralis)- these are compactions of connective tissue around the pelvic organs, it starts from the upper fascia of the pelvic diaphragm and attaches to the organs, forming their own fascia (fascia propria organi) and septa (rectovesical in men and rectovaginal in women, both septa have their own name - Denonvilliers aponeurosis).

The seal at the junction of the visceral and parietal fascia of the pelvis is called intrapelvic fascia (fascia endopelvina), which serves conductor of blood vessels and nerves, in some places acquires fibrous in nature, forms thickenings and ligaments:

Fascia of the thigh.

Fascia lata of the thigh (fascia lata) covers the thigh muscles on all sides. Attaches to the iliac crest, inguinal ligament, pubic symphysis and ischium. On the posterior surface of the lower limb it connects to the gluteal fascia. In the upper third of the anterior region of the thigh, the fascia consists of plates.

Deep lamina or iliopectineal fascia-covers the pectineus and iliopsoas muscles; at the point of their contact, a pectineal groove is formed, in which the femoral artery and vein pass.

Superficial plate below the inguinal ligament has an oval-thinned area or subcutaneous fissure (hiatus saphenus), through which the great saphenous vein passes. The subcutaneous fissure is covered cribriform fascia (fascia cribrosa) with numerous openings for blood vessels and nerves.

Between the laminae of the fascia lata there is cellular space of the femoral triangle, which contains the femoral blood and lymphatic vessels, the femoral nerve and its branches. It communicates along the course of vessels and nerves with the subcutaneous tissue, with the outer area of ​​the hip joint, with the bed of the adductor muscles, with the adductor canal and popliteal fossa, with the posterior bed of the thigh through the perforating arteries, with the subperitoneal floor of the pelvis through the vascular lacuna.

On the lateral surface of the thigh, the fascia lata thickens and forms a strong strip - iliotibial tract (tractus iliotibialis)), which is attached above to the iliac crest, below - to the anterolateral surface of the lateral condyle of the tibia. In the upper part, the iliotibial tract splits into two layers, forming a fascial sheath for the tensor fascia lata muscle, and deep layer merges with the capsule of the hip joint. Part of the bundles of the gluteus maximus muscle is attached to the posterior edge of the iliotibial tract.

Dense plates extend from the fascia lata deep to the femur, limiting the muscle groups of the thigh - the lateral and medial intermuscular septa of the thigh. They serve as a receptacle for the corresponding muscle groups.

Lateral intermuscular septum of the thigh (septum intermusculare femoris laterale) - separates the quadriceps femoris muscle from the posterior thigh muscle group.

Medial intermuscular septum of the thigh (septum intermusculare femoris mediale) separates the quadriceps femoris from the hip adductors

Sometimes isolated posterior intermuscular septum of the thigh (septum intermusculare femoris posterius) it separates the muscles of the medial group from the posterior one.

As a result, three fascial beds: the anterior one is for the extensor muscles, the posterior one is for the flexor muscles, the medial one is for the adductor muscles.

Topography of the lower limb:

Obturator canal (canalis obturatorius) connects the pelvic cavity with the medial fascial bed of the thigh.

Channel limited:

Cat the top– obturator groove, from below– the upper edges of the obturator membrane, the internal and external obturator muscles. The external opening of the canal is hidden under the pectineus muscle.

The obturator neurovascular bundle passes through the canal from the pelvic cavity to the adductor muscles of the thigh. Sometimes hernias can come out through the canal.

Suprapiriform and infrapiriform foramen (foramen suprapiriforme, foramen infrapiriforme).

The piriformis muscle, emerging from the pelvic cavity through the greater sciatic foramen, fills only its central part; openings are formed above and below the muscle - suppiriformis and infrapiriformes, through which blood vessels and nerves pass from the pelvic cavity to the thigh.

The superior gluteal neurovascular bundle emerges through the supragiriform foramen.

Through the infrapiriform foramen exit: the sciatic nerve (lies most laterally), the inferior gluteal neurovascular bundle (located more medially sciatic nerve), genital neurovascular bundle (occupies the most medial position).

Lesser sciatic foramen (foramen ischiadicun minus) located on the posterolateral wall of the pelvis, it is limited by the lesser sciatic notch, sacrotuberous and sacrospinous ligaments. The lesser sciatic foramen is located below the diaphragm, and therefore connects the gluteal region with the perineum:

The obturator internus tendon passes from the pelvic cavity to the gluteal region through the lesser sciatic foramen;

The genital neurovascular bundle (n. pudendus, a. et v. pudendae internae) passes from the pelvic cavity to the gluteal region through the infrapiriform foramen, from there it penetrates the perineum through the lesser sciatic foramen.

Behind the inguinal ligament there are muscular and vascular lacunae, which are separated by the iliopectineal arch.

Muscle lacuna (lacuna musculorum)-located lateral to the iliopectineal arch.

Limited front and top inguinal ligament, laterally and posteriorly- ilium, medially– iliopectineal arch. Through the muscle lacuna, the iliopsoas muscle, femoral nerve, lateral cutaneous nerve hips.

Purulent leaks can spread through the muscle lacuna to the thigh; very rarely, femoral hernias can appear here.

Vascular lacuna (lacuna vasorum)-located medially from the arch.

Limited to four links:

1) in front – inguinal (pupart) ligament (lig. inguinale);

2) medially – lacunar (Gimbernate) ligament (lig. lacunare);

3) behind – pectineal (Cooper) ligament (lig. pectineale);

4) laterally – by the iliopectineal arch (arcus iliopectineus).

The vascular lacuna contains: the femoral artery (laterally), the femoral vein (medially), lymphatic vessels, and the Pirogov-Rosenmüller lymph node.

On the anterior surface of the thigh there is femoral triangle-Scarpa's triangle (trigonum femorale): limited by the superior inguinal ligament, the lateral sartorius muscle, and the medial long adductor muscle. Within the triangle, under the superficial layer of the fascia lata, the pectineal groove is clearly visible (the femoral nerve, artery and vein pass through), which continues distally into the femoral groove. At the top, at the apex of the triangle, the groove passes into the adductor canal (Gunter's canal).

Adductor canal or Gunter's canal (canalis adductorius) connects the anterior region of the thigh with the popliteal fossa. Channel walls:

-Medial: adductor magnus;

-Lateral: vastus medialis;

-Front: fibrous plate that spreads between the named muscles.

The channel has three holes:

1) Upper (input) - limited by the upper edge of the fibrous plate, adductor magnus, vastus medialis; the opening is covered by the sartorius muscle.

2) Lower (output) - called the tendon gap of the adductor magnus muscle (hiatus adductorius, seu tendineus).

3) Front-located in the fibrous plate; the descending artery of the knee and the saphenous nerve of the leg (n. saphenus) pass through it.

Femoral canal (canalis femoralis) is formed in the area of ​​the femoral triangle during the development of a femoral hernia.

Internal (inlet) opening, or femoral ring (anulus femoralis), facing the abdominal cavity, it is located in the medial part of the vascular lacuna;

Limited behind pectineal ligament, front– inguinal ligament, medially– lacunar ligament, laterally-femoral vein. Normally, this hole on the side of the thigh is closed by the Pirogov-Rosenmüller lymph node. From the outside abdominal cavity it is covered by the peritoneum and transverse fascia, which is loosened here and is called the femoral septum (septum femorale); on the posterior surface of the anterior abdominal wall it corresponds to the femoral fossa (fossa femoralis). The femoral ring area is weak point anterior abdominal wall.

Outdoor (weekend) the opening of the femoral canal corresponds to the subcutaneous fissure (hiatus saphenus).

It's limited from the lateral side crescent-shaped edge above– the upper horn of the falciform edge, from below– lower horn of the falcate edge, medially– pectineal fascia.

The subcutaneous fissure, closed by the cribriform fascia, is a weak point of the fascia lata of the thigh.

The femoral canal has a conical shape and three walls.

Front wall formed by the inguinal ligament and the superior horn of the falciform edge of the fascia lata;

Rear– a deep layer of fascia lata covering the pectineus muscle;

Lateral- femoral vein.

The length of the canal is 1.2 cm in men, 1.8 cm in women.

In the case of protrusion of the peritoneum at the site of the femoral ring and the release of the viscera, femoral hernias are formed. The path that the hernia creates is called the femoral canal.

Subcutaneous (hidden) fissure (hiatus saphenus).

The superficial plate of the fascia lata in the region of the femoral triangle is heterogeneous; there is an opening in it - the subcutaneous fissure (hiatus saphenus), located slightly below the medial end of the inguinal ligament, through which the great saphenous vein of the leg (v. saphena magna) passes (lies above the deep fascia) in front flowing into the femoral vein (v. femoralis) (lies under the deep fascia).

The subcutaneous fissure is limited by a crescent-shaped edge (margo falciformis), which has an upper and lower horn (cornu superius et cornu inferius).

The upper horn grows into the inguinal ligament, the lower horn passes into a deep plate covering the pectineus muscle.

The great saphenous vein bends through the inferior horn. In front, the subcutaneous fissure is closed by the cribriform fascia (fascia cribrosa), formed by the deep plate of the superficial fascia of the thigh.

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Proximal attachment. The superior anterior iliac spine and adjacent portion of the iliac crest.

Distal attachment. The iliotibial tract of the fascia lata attaches to the lateral condyle of the tibia.

Function. Strains the iliotibial tract, helping to strengthen the knee joint in an extended position; helps flex, abduct and internally rotate the hip; Helps the gluteus medius and minimus muscles stabilize the pelvis when walking.

The greater trochanter of the femur is a bony protrusion on the lateral surface of the thigh, located approximately a hand's length below the iliac crest; lies on the same horizontal line with the pubic ridge.

The iliotibial tract of the fascia lata is a long fascial plate lying on the outer surface of the thigh. Is the thickened part of the fascia surrounding the thigh; the distal part is attached to the lateral condyle of the tibia. The condyle insertion is palpated anterior to the insertion of the biceps femoris tendon. The iliotibial tract is palpated in a sitting position with the knee bent and the heel raised off the floor.

To identify the tensor fascia lata muscle, have the patient lie on their back and rotate the thigh inward against gentle resistance—the tensor fascia lata muscle will be easily palpated in this position. Using flat finger palpation, trace the course of the fibers from the superior anterior iliac spine to the connection with the iliotibial tract of the fascia lata on the lateral surface of the thigh. The tensor fascia lata muscle lies anterior to the greater trochanter of the femur.

Walking or running on uneven surfaces; long-term immobilization of the limb; unexpected excess load.
Satellite trigger points. The anterior bundles of the gluteus minimus, rectus femoris, iliopsoas and sartorius muscles.

Affected organ system. Genitourinary system.

Associated zones, meridians and points.

Lateral zone. Shao-yang gallbladder foot meridian. GB 29.31.

2. Maintain your balance by leaning on a wall or table. Cross your legs so that the affected leg is behind you. Grab the knee of your uninjured leg and squat down on it so that the injured leg slides along the floor in the opposite direction, trying to press your shin to the floor. Fix the pose until the count is 10-15.

Strengthening exercise. Take a knee-elbow position. Shift your body weight to the knee on the uninjured side so that the thigh and lower leg of the other side can move freely. Keeping the knee of the affected side bent, move that leg to the side until the inner thigh is in a horizontal position. Return to the starting position. Repeat 5-10 times.

D. Finando, C. Finando

Tensor fascia lata- Tensor fascia lata, m. tensor fasciae latae, a flat, slightly elongated muscle, lies on the anterolateral surface of the pelvis; its distal end is woven into the fascia lata of the thigh. The muscle begins on the outer lip of the iliacus... ... Atlas of Human Anatomy

tensor fasciae lata- (m. tensor fasciae latae) a muscle located on the lateral surface of the thigh in the split of the fascia lata. It starts from the superior anterior iliac spine and inserts into the iliotibial tract. The function pulls... ... Glossary of terms and concepts on human anatomy

Muscles and fascia of the thigh, right- Front view. anterior superior iliac spine; inguinal ligament; spermatic cord; great saphenous vein of the leg; adductor muscles; sartorius; rectus femoris muscle; fascia lata (hips); vastus medialis; patella and subcutaneous... Atlas of Human Anatomy

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Thigh muscles, right- Front view. iliac pectineal arch; inguinal ligament; pectineus muscle; adductor longus; thin muscle; sartorius; adductor magnus; vastus medialis; medial suspensory ligament of the patella; ... ... Atlas of Human Anatomy

Muscles of the lower limb - … Atlas of Human Anatomy

PELVIC LIMB- Rice. 1. Muscles of the croup and pelvic limb of cattle (lateral surface). Rice. 1. Muscles of the croup and pelvic limb of cattle (lateral surface): 1 gluteus medius; 24 gluteal… … Veterinary encyclopedic dictionary

Spinal nerves- The number of pairs of spinal nerves and their localization correspond to the segments spinal cord: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal pair. All of them depart from the spinal cord with the posterior sensory and anterior motor... ... Atlas of Human Anatomy