SUPRAPIRIFORMAL HOLE(foramen suprapiriforme) - a slit-shaped hole between top edge piriformis muscle and greater sciatic notch. The superior gluteal vessels and nerve pass through it.
SUBPIRA-SHAPED HOLE(foramen infraperiforme) - a slit-like opening between the lower edge of the piriformis muscle and the sacrospinous ligament. The foramen passes through the sciatic nerve, the inferior gluteal vessels and nerve, the posterior cutaneous nerve of the thigh, the internal genital vessels and the pudendal nerve.
OBSTORATE CANAL(canalis obturatorius) is a bone-fibrous canal formed above by the obturator groove of the pubic bone, below by the obturator membrane and the external and internal obturator muscles. Contains vessels and nerve of the same name.
MUSCLE GAP(lacuna musculorum) - the outer part of the space under the inguinal ligament, bounded by the anterior inguinal ligament, posteriorly and lateral iliac bone, medially by the iliopectineal arch. Contains: iliopsoas muscle, femoral nerve and in some cases the lateral cutaneous nerve of the thigh.
iliopectineal arch(arcus iliopectineus) - a compacted area of fascia covering the iliopsoas muscle, and passing from the inguinal ligament to the iliopubic eminence of the pelvic bone.
VASCULAR GAP(lacuna vasorum) - the internal part of the space between the inguinal ligament and the pelvic bone. Anteriorly bounded by the inguinal ligament, posteriorly by the pectineal ligament (tendon of the pectineus muscle, attached to the upper surface upper branch pubic bone), laterally - the iliopectineal arch, medially - the lacunar (Gimbernate) ligament (fibers of the inguinal ligament wrapped downwards). Contains: femoral artery and vein, femoral branch of the femoral-genital nerve, fiber, Rosenmuller-Pirogov lymph node. Exit site for typical femoral hernias.
FEMORAL TRIANGLE(trigonum femorale, Scarpa's triangle) - part of the anterior region of the thigh, bounded above by the inguinal ligament, laterally by the inner edge of the sartorius muscle, medially by the outer edge of the adductor longus muscle. The bottom of the triangle is the iliopsoas muscle, pectineus muscle, longus and adductor magnus muscles.
iliopectineal groove(sulcus iliopectineus) is an intermuscular groove in the upper part of the femoral triangle, limited on the medial side by the pectineus muscle, on the lateral side by the iliopsoas muscle. Contains the femoral artery and vein.
ANTERIOR FEMORAL GROOVE(sulcus femoralis anterior) - continuation of the iliopectineal groove in the lower part of the femoral triangle. It is limited on the medial side by the long and large adductors, on the lateral side by the vastus medialis muscle. Contains the femoral artery and vein and the saphenous nerve.
FEMORAL CHANNEL(canalis femoralis) is a narrow triangular interfascial gap in the superomedial part of the femoral triangle. The walls of the canal are: in front - the upper horn of the crescent-shaped edge of the superficial leaf of the proper fascia of the thigh, behind - the pectineal fascia, laterally - the fascial sheath of the femoral vein. The canal has an internal opening (femoral ring) and an external one ( subcutaneous ring). In healthy individuals, it is filled with fiber and lymphatic vessels. Anatomical route of exit of a femoral hernia.
FEMOR RING(annulus femoralis) - the internal opening of the femoral canal, occupying the most medial section vascular lacuna. Its boundaries: in front - inguinal ligament, posteriorly – pectineal ligament, lateral-fascial sheath of the femoral vein, medially – lacunar ligament. When a femoral hernia forms, it is its hernial orifice.
SUBCUTANEOUS RING(hiatus saphenus PNA, fossa ovalis BNA; sinus oval fossa) - the external opening of the femoral canal, limited laterally by the falciform edge, above and below, respectively, by the upper and lower horns of the falciform edge, medial pectineal fascia.
DRIVING CHANNEL(canalis adductorius, Gunter's canal, syn. femoral-popliteal canal) - an interfascial space connecting the anterior region of the thigh and the popliteal fossa. It has three walls (medial, lateral and anterior) and three openings (superior, inferior and anterior). The medial wall is formed by the adductor magnus muscle, the lateral wall by the vastus medialis muscle, the anterior wall by the fibrous lamina vastoadductoria, which spreads between these muscles. The superior foramen enters the femoral artery and saphenous nerve and exits femoral vein. The popliteal vein enters the inferior opening and exits femoral artery. From the anterior opening in the lamina vastoadductoria, the saphenous nerve and the descending artery of the knee emerge from the canal, and the descending vein of the knee enters.
POPELLETIUM FOSSA(fossa poplitea) - a diamond-shaped depression in the posterior region of the knee filled with fiber and bounded above and laterally by the biceps femoris muscle, above and medially by the semitendinosus and semimembranosus muscles, below laterally and medially by the heads of the gastrocnemius muscle. Contains popliteal The lymph nodes, tibial nerve (lies most superficially), popliteal vein and artery (lies most deeply) (“NEVA”). The bottom of the fossa forms the posterior surface of the distal epiphysis femur, knee joint capsule, popliteus muscle.
Ankle-popliteal canal(canalis cruropopliteus, Gruber's canal) is an intermuscular canal in the posterior region of the leg, originating in the lower corner of the popliteal fossa and ending at the medial edge of the soleus muscle at the origin of its tendon (lower third of the leg). Bounded: anteriorly by the tibialis posterior muscle, posteriorly by the deep layer of the fascia of the leg and soleus muscle, laterally by the flexor hallucis longus muscle, medially by the flexor digitorum longus muscle. Contains the posterior tibial artery and veins, the tibial nerve. Through the anterior opening in the interosseous membrane of the leg, the canal leaves the anterior tibial artery.
LOWER MUSCULORFIBULAR CANAL(canalis musculoperoneus inferior) – a branch of the ankle-popliteal canal, limited fibula and flexor hallucis longus. Contains the peroneal artery and vein.
SUPERIOR MUSCULORFIBULAR CANAL(canalis musculoperoneus superior) is an independent muscle-bone canal in the lateral osteo-fibrous bed of the leg, limited by the neck of the fibula and the peroneus longus muscle. The channel carries a common peroneal nerve, which is also divided into the superficial and deep peroneal nerves.
MEDIAL PLANTAR GURROUS(sulcus plantaris medialis) - intermuscular groove limited by the short flexor of the fingers and the abductor big toe muscle. Contains the medial plantar artery and vein, medial plantar nerve.
LATERAL PLANTAR GROOVE(sulcus plantaris lateralis) is an intermuscular groove bounded by the flexor digitorum brevis and the abductor of the little finger muscle. Contains the lateral plantar artery and vein, the lateral plantar nerve.
SPLANCHNOLOGY
Pear-shaped hole
1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First health care. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet encyclopedia. - 1982-1984.
See what a “Pear-shaped hole” is in other dictionaries:
See Pear-shaped aperture... Large medical dictionary
APERTURA- (lat.), anat. a term denoting an opening; a channel or cavity opens to the eye. In this sense, the word foramen is sometimes used in anatomy. Example: A. piriformis pear-shaped opening; A. sinus sphenoidalis sinus opening... ...
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- (apertura piriformis, PNA, BNA, JNA; synonym piriform aperture) anterior bony opening of the nasal cavity, limited by the nasal notches of the upper jaws and the anterior edges of the nasal bones ... Medical encyclopedia
I Muscles (musculi; synonym muscles) Functionally, involuntary and voluntary muscles are distinguished. Involuntary muscles are formed by smooth (non-striated) muscle tissue. It forms the muscular membranes of hollow organs, the walls of blood vessels... Medical encyclopedia
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Topography of neurovascular formations of the gluteal region. Superior gluteal neurovascular bundle. Genital neurovascular bundle. Olcock channel.
All arteries and nerves of the gluteal region exit the pelvic cavity through the greater sciatic foramen, through the supra- and infrapiriform openings (see Fig. 4.11, 4.12).
From the supragiriform foramen(between the lower edge of the gluteus medius muscle and the upper edge of the piriformis) comes out superior gluteal neurovascular bundle.
Superior gluteal artery, a. glutea superior, arises from the posterior trunk of the internal iliac artery in the pelvic cavity. After exiting the supragiriformis foramen, it supplies blood to the piriformis muscle, gluteus maximus, gluteus medius and minimus. The veins of the same name, forming a plexus, cover the superior gluteal artery, and the superior gluteal nerve, gluteus superior, is located downward and outward in relation to the vessels and innervates the muscles listed above.
Through the infrapiriform opening(between the lower edge of the piriformis muscle and the superior gemellus muscle) the sciatic nerve, inferior gluteal and genital neurovascular bundles enter the subgluteal space.
Most laterally in this hole is located n. ischiadicus, the largest nerve human body. The sciatic nerve is the most prominent nerve, so it can be considered an internal landmark for locating the infrapiriformis foramen and other neurovascular bundles. Medially from sciatic nerve there are the posterior cutaneous nerve of the thigh, n. cutaneus femoris posterior, and the artery accompanying the sciatic nerve, a. comitans n. ischiadici, arising from the inferior gluteal artery.
Next is the sciatic nerve is directed downwards, while in front of it from top to bottom are the superior gemellus muscle, the obturator internus tendon, the inferior gemellus muscle and the quadratus femoris muscle. Posterior to the nerve lies the gluteus maximus muscle. Coming out from under the lower edge of the gluteus maximus muscle, the sciatic nerve is located superficially and is covered only by the fascia lata.
Here, at the point of intersection of the gluteal fold and the contour of the lower edge of the gluteus maximus, conduction anesthesia of the sciatic nerve can be performed. To find the needle insertion point, you can also use the projection of the nerve onto the skin presented above.
Inferior gluteal artery, a. glutea inferior, thinner than the superior gluteal artery by 2-3 times. The artery is surrounded by veins of the same name and branches of the inferior gluteal nerve, gluteus inferior. In the infrapiriform foramen, this bundle lies medially to the sciatic nerve and the posterior cutaneous nerve of the thigh. Upon exiting the infrapiriformis foramen, the artery and nerve divide into branches that penetrate into the thickness of the gluteus maximus muscle and into the piriformis muscle, where the inferior and superior gluteal arteries anastomose.
Genital neurovascular bundle
Genital neurovascular bundle(a. et v. pudendae internae and n. pudendus) is located in the infrapiriform foramen most medially. Upon exiting the infrapiriform foramen, the genital neurovascular bundle lies on the sacrospinous ligament, lig. sacrospinal, and the spine of the ischium, forming the upper edge of the lesser sciatic foramen (see Fig. 4.11). Then the bundle passes through the lesser sciatic foramen under the sacrotuberous ligament, lig. sacrotuberale, on the inner surface of the ischial tuberosity. The latter is part of the lateral wall of the ischioanal fossa and is covered by the obturator internus muscle and its fascia. The splitting of this fascia forms the so-called Olkok canal, in which the genital neurovascular bundle passes. N. pudendus in it is located downward and medial from the vessels.
The nasal cavity, cavum nasi, opens in front with a pear-shaped opening, apertura piriformis; in the back, paired openings, choanae, connect it with the pharyngeal cavity. By means of the bony nasal septum, septum nasi osseum, the nasal cavity is divided into two not entirely symmetrical halves, since in most cases the septum is not strictly sagittal, but deviates to the side. Each half of the nasal cavity has 5 walls: upper, lower, lateral, medial and posterior.
The lateral wall has the most complex structure: it includes (going from front to back) the following bones: the nasal bone, the nasal surface of the body and the frontal process upper jaw, lacrimal bone, labyrinth of the ethmoid bone, inferior concha, perpendicular plate of the palatine bone and medial plate of the pterygoid process of the sphenoid bone.
Nasal septum, septum nasi osseum is like the medial wall of each half of the nasal cavity. It is formed by the perpendicular plate of the ethmoid bone, the vomer, above the spina nasales of the frontal bone, crista sphenoidalis, below the crista nasales of the upper jaw and palatine bone.
Top wall formed by a small part of the frontal bone, the lamina cribrosa of the ethmoid bone and partly by the sphenoid bone.
The composition of the lower wall, or bottom, includes palatine process the maxilla and the horizontal plate of the palatine bone, constituting the palatum osseum; in its anterior section the opening of the incisive canal, canalis incisivus, is noticeable.
On the lateral wall of the nasal cavity, three nasal conchae hang inward, which separate the three nasal passages from each other: upper, middle and lower.
The pear-shaped opening of the nose, apertura piriformis nasi, is located below and partly between the eye sockets. At the lower edge of the pyriform opening in the midline, the anterior nasal spine, spina nasalis anterior, protrudes forward, which continues posteriorly into the bony septum of the nose.
1.22. Nose: cavity, paranasal sinuses, their function, communication of the paranasal sinuses with the nasal cavity, variants and anomalies.
The composition of cavi nas includes the nasal cavity itself and paranasal sinuses: sinus frontales, cellulae ethmoidales, labyrinti ethmoidales, sinus maxillares, sinus sphenoidales. The nasal cavity opens apertura piriformis in front and choanae in the back. The nasal cavity is divided into two halves, septum nasi osseum, into which the paranasal sinuses and ethmoidal labyrinths open.
Apertura periformis is limited: spina nasalis anterior (bottom); incissurae nasales of the upper jaw (from the sides); free edges of the noses. bones (top). The septum nasi ossum forms the lamina perpendicularis above and the vomer (below and behind). Choanae – oval-shaped hole, section. ass cr. opener
Three nasal conchae hang inward from the lateral wall, which are divided. nasal passages between each other. Shells: conona nasolis superior, conona nasolis media, conona nasolis inferior. Moves: meatus nasi superior, media, inferior. In the first section of the upper section, the cellula ethmoidales posterius opens. In the recessus sphenoethmoidalis, which is located in the nasal concha, the sinus sphenoidalis opens. The sinus maxillaris opens in the middle meatus. The opening of the last sinus is divided by the processus incinatus into sections: anterioinferior and posterosuperior. The latter is hiatus semilunaris, i.e. entrance to the cavity maxillary sinus. Top part This cleft (infundibulum ethmoidale) connects the middle meatus with the sinus frontalis. Near the lower nasal passage is the canalis nasolacrimalis, through which the tear fluid enters the nasal cavity. Through the nose connection. move. Wed lane relit cells k.-b. the frontal sinus becomes inflamed. process of a runny nose in the frontal sinus (fractitis).
These anatomical connections explain the transition inflammatory process with a runny nose in the frontal sinus (frontal sinusitis). The lower nasal passage, meatus nasi inferior, passes between the inferior concha and the bottom of the nasal cavity; in its anterior section, the nasolacrimal canal opens, through which lacrimal fluid enters the nasal cavity. This explains that when crying, nasal discharge increases and, conversely, when you have a runny nose, your eyes become watery.
For normal activity of the nasal sinuses, the outlet openings are constantly open. Due to edema, the outlet openings close - ed. violation gas exchange is limited and then the flow of air into the sinus is completely stopped, hence the thickening. tears. membranes, accumulation of secretion products, activation. viruses and bacterial flora and development. initial stage aseptic inflammatory process. The paranasal sinuses are a protective barrier between the cavities of the throat and nose. The most common diseases of the nose and paranasal sinuses are: sinusitis, vasomotor rhinitis (considered as pre-asthma), allergic rhinitis.
In newborns there is no pneumatization of the air-bearing bones, from 1 year to x-ray you can see the frontal sinus, then it gradually increases, but its complete absence is possible; cells of the ethmoid bone note. in the first years of life. The goymore's sinus reaches full development during the period of tooth change and is characterized by significant variability.
Variants and anomalies of development (genesis) of the paranasal sinuses.
1. Hypogenesis of the natural openings of the paranasal sinuses, leading to disruption of their aeration.
2. Hypergenesis of the paranasal sinuses.
3. Various number(5-17) cells of the ethmoid bone.
4. Dysgenesis of the paranasal sinuses, characterized by a violation of the shape of the nose and its structures.
5. Absence of the frontal sinus.
6. Development of various nasal formations in unusual places (dystopia).
7. Agenesis of the sinuses and nasal structures.
8. Hypergenesis of the ethmoidal bulla.
These openings are formed along the edges of the greater sciatic foramen as the piriformis muscle passes through it (Fig. 28)
Rice. 28. Suprapyriform (A) and infrapiriform (B) foramina (highlighted by dotted lines)
1 – piriformis muscle, 2 – sacrotuberous ligament, 3 – sacrospinous ligament, 4 – obturator internus muscle, 5 – gluteus medius muscle, 6 – gluteus minimus muscle
Suprapiriform foramen (A) limited to:
Superior edge of the piriformis muscle
The superior edge of the greater sciatic foramen;
Infrapiriform foramen (B) limited to:
Inferior border of the piriformis muscle
The lower edge of the greater sciatic foramen
5. Bed of the sciatic nerve
WITH 
strictly speaking, such an object is included in the nomenclature of topographic-anatomical formations lower limb Excluded. However, this cellular space should be highlighted for orientation in the topography of the largest nerve of the human body. It is located in the gluteal region and in the posterior thigh (Fig. 29).
In the gluteal region, the bed of the sciatic nerve is limited:
Posteriorly – the gluteus maximus muscle;
In front – pelvic muscles:
Piriformis muscle
Obturator internus muscle
Quadratus femoris muscle
Rice. 29. Bed of the sciatic nerve. The course of the nerve is indicated by a dotted line.
1 – gluteus maximus (opened), 2 – piriformis, 3 – obturator internus, 4 – quadratus femoris, 5 – ischial tuberosity, 6 – adductor magnus, 7 – vastus lateralis, 8 – short head of the biceps femoris , 9 – long head of the biceps femoris muscle (cut off), 10 – semimembranosus muscle, 11 – semitendinosus muscle (cut off), 12 – popliteal fossa
In the posterior region of the thigh, the bed of the sciatic nerve is limited:
In front – the adductor magnus muscle;
Medially – semimembranosus muscle;
Laterally – biceps femoris muscle.
Below, the bed of the sciatic nerve communicates with popliteal fossa.
6. Popliteal fossa
Popliteal fossa, fossa poplitea, located posterior to the knee joint, has a diamond shape and is limited by the following structures:
The popliteal fossa communicates:
Above – with the adductor canal (through the adductor cleft) and with the bed of the sciatic nerve;
Below - with the ankle-popliteal canal.
