The deep femur ring is limited. Poor Canal

Topographic anatomy It allows you to describe in detail the layer-by-layer structure of the muscular apparatus of the lower extremities, their blood supply and innervation.

Location

The poor canal is placed in the zone of the femoral triangle (its location is limited at the top of the groove bunch, tailoring and long leading muscles, placed on the side and in the middle), is formed on the spot in which femoral hernias are out of the body (protrusion internal organs Fur in the form of folds in the area of \u200b\u200bgroin), passes between a sheet of wide fascia through the arcuate space (ring). On the surface sheet of wide fascia hips is the outer opening. Through it stretches blood vessels (femoral vein and artery), the same way enter the hernias, which are in the area of \u200b\u200bthe location of intra-viable organs.

Topography

Consider the main components of education.

Holes

There are several of them in the channel:

• Deep (femur ring).
• Surface: subcutaneous gap, muscular anomaly. The blood and lymphatic beds pass through it. Located 2 cm below than the groove bunch.

The channel runs through the first pass, is washed by artery and vein passing in this part of the leg.

High Ring

Latin name - Anulus Femoralis. Indicates a place in a triangle, in which there are muscle and vascular lacuna. The first is the iliac femoral muscle and the nerve of the same name, in the second there are large vessels that feed the thigh.

Allocate:

• ring deep femoral (internal);
• surface (subcutaneous femoral slot).

The first, limiting space of a small plate, is directed to the pelvis. It is based on several bundles:

• pahova (front);
• comb (rear);
• medial lacunarnary (runs in the groin area in the medial space);
• Cooper (covering the edge of the Lobakov bone).

From the edge abdominal cavity He has a slight recess (oval fossa), inside there is a lymphatic node.

The second is located below the groin fold and includes sexual, silent veins bringing lymphosovudes, nerve processes.

Walls of the femoral canal

Their three (they form a pyramido-shaped space):

• Front. Created by a corresponding sheet of wide fascia is located in the interphetic bundle near the vertex of the subcutaneous gap.
• Side - formed by a venous thigh vessel.
• Rear - created by a deep fascia sheet wide.

Symptoms of violations

The appearance of space indicates the presence of hanier-like formations, and the appearance of specific symptoms is associated with this.

Characteristic:

• painful sensations in groin;
• swelling, localized in the lower side of the abdomen;
• ricking sounds of the intestinal functioning;
• wave-like moving movement during passing;
• edema and numbness in the leg (observed due to the relocation of the nearest blood vessels).

Problems with urination and defecation may appear. It happens in the event that in the hernia bag urinary Ways and organs.

In case of untimely treatment, there are inflammations, accompanied by increasing the temperature, redness of the skin, the growth of edema and swelling.

Diagnosis of pathologies

It is possible to establish the presence of anomalous education visually, judging by the rounded bulge in the upper part of the hip, at the bottom of the groin.

The external look of the patient is complemented by diagnostic surveys. The patient is assigned:

• Ultrasound of the lower abdomen ( bladder, small pelvis organs);
• irrigocopy ( ultrasound procedure Colon by introducing a contrasting substance into it).

Anomalous general education is important to distinguish from:

• Venous varicose nodes: when pressed, they fall and promptly take the original appearance.
• Tuberculosis (stretches in the course of the iliac-lumbar muscle on the thigh in the pathology of the spinal column in the lower back area; the pain is determined by the palpation method; X-ray zone is prescribed to exclude an anomaly).

The study of the topographic structure of the femoral finite canal allows you to correctly and successfully implement surgical intervention And eliminate the femoral hernia.

Treatment of vessels of the cult.As a rule, amputation is performed under the harness. This makes it possible to cut off all soft tissues. At the end of the operation before removing the harness in a cult, all major vessels are tied up, and the arteries are tied up with two ligatures, the bottom of which should be firmware: one of the ends of the ligature is inserted into the needle, with which the artery walls are flashed. Such an additional fixation insures from the scaling of ligature. As a suture material, many surgeons prefer ketgut, since when using Silka, the formation of a ligature fistula is possible. The ends of ligatures are cut off only after removing the harness. Smaller vessels are tied up with flashing surrounding fabrics.

Operations on the vessels of the lower limb

Puncture of the femoral artery in the Seldgere.Puncture is carried out in order to introduce into the aorta and its branches of the catheter, through which the contrasts of the vessels can be carried out, probe

cut the cavity. Internal diameter of 1.5 mm internal diameter of 1.5 mm is carried out immediately below the groove bunch for the projection of the femoral artery. Through the surveillance of the needle entered in the artery, the conductor is introduced first, then the needle is removed and instead of it on the conductor put on a plastic catheter with an outer diameter of 1.2-1.5 mm. The catheter together with the conductor is promoted by the femoral artery, the iliac arteries in the aorta to the desired level. Then the conductor is removed, and the syringe with a contrasting substance is attached to the catheter.

Operations varicose expansion veins of the shin and hips.For

varicose veins of the lower limb (V. saphena Magna.and v. SAPHENA PARVA)due to the insufficiency of venous valves, blood is stood in the lower shin deposits, as a result of which the tank trophic is disturbed, trophic ulcers are developing. This contributes to the insufficiency of valves of perforant veins, which is why surface veins Blood discharge from deep veins. The purpose of operations is to eliminate blood flow on surface veins (with complete confidence in the passability of deep veins!). The previously used operations on the dressing of a large subcutaneous vein at the place of its imposition to the femoral (in particular, the Trojanov-Trejdelen Burg's operation) were not effective enough. The most radical is the operation of the complete removal of a large subcutaneous vein on Babcon. The principle of the method is to remove the veins using a special flexible rod introduced into it at the end through a small incision under the groin bundle to the level knee Sustava, where, through a small incision, produced inmine. The conductor is removed through this hole, the pin head is replaced with a venextractor (metal cone with sharp edges). Pulling the extractor for the conductor at the upper case, remove the vein from the subcutaneous fiber. In addition, the principle is removed from the distal part of the vein on the legs.

Table of contents of the topic "Front of the thigh. Poor triangle.":
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Surface plate of wide fascia hips. Deep plate of wide hip fascia. Topography of wide fascia. Subcutaneous gap (HIATUS SAPHENUS).

In the field of the femoral triangle wide fascia The inner edge of the tailort muscle is divided into two plates.

Surface plate of wide fascia hips

Surface plate of wide fascia hips Heterogeneous structure: dense in the outer part, in m. Sartorius, it is loosened in the medial part and has a name " grid fascia», fascia Cribrosa. [Hesselbach.|. Here, at a distance of 1-2 cm, the book from the inner third of the groin bundle, it has a hole: subcutaneous gap, hiatus Saphenus., Through which, from subcutaneous fiber in the subfasse-social space passes v. Saphena Magna (see Fig. 4.2). Hiatus Saphenus highlights the outer sick-shaped edge of Margo Falciformis * and its upper and bottom horns, Cornua Superius Et Inferius. The lower horn is easily determined by the V begging through it. Saphena Magna.

Hiatus Saphenus. It is a superficial (subcutaneous) hole of the femoral channel.

Deep plate of wide fascia hips

Deep plate of wide fascia It goes back from m. Sartorius behind the thigh vessels and connects with the fascia of the iliac-lumbar and comb muscle. Under the name Fascia Iliopectinea, a deep plate comes to a long leading muscle, where it is again connected to the surface sheet of wide fascia.

Even deeper, under deep leaf of fascia, the bottom of the femoral triangle, which is called iliac-comb, fossa iliopectinea.. Here outside lies m. Iliopsoas, attached to a small spit, from the inside - m. Pectineus, starting with Pecent Ossis Pubis and also attached to a small spit. Even deeper, there are a short thrust muscle of the thigh and the outer locking muscle.

Table of contents of the topic "Poor Canal (Canalis Femoralis). Hernia of the belly.":
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Poor Canal It is located between the superficial and deep sheets of wide fascia. Poor Canal It has two holes - Deep and superficial, and three walls. The deep hole of the femoral channel is projected on the inner third of the groove bundle. The surface hole of the femoral canal, or subcutaneous gap, HIATUS SAPHENUS, is projected by 1-2 cm Book from this part of the groove bundle.

The leaving of the abdominal cavity of hernia penetrates the channel through deep hole - high Ring, anulus Femoralis.. It is located in the most medial Vascular lacuna and has four edges.

In front high Ring Limits the groove bunch, behind - the comb bunch, Lig. Pectineale, or a bunch of Cooper, located on the crest of the pubic bone (pecent ossis pubis), medial - lacunar bunch, Lig. Lacunare, located in the corner between the groove bunch and the ridge of the pubic bone. From the lateral side it is limited to the femoral vein.

High Ring Added to the pelvis cavity and on the inner surface abdominal wall Covered with transverse fascia, which has a type of thin plate, Septum Femorale. Within the rings there is a deep groove of the lymph node of Pirogov-Rosenmuller.

Superficial ring of the femoral canal (hole) is an subcutaneous gap, hiatus Saphenus., Defect in a surface sheet of wide fascia. Hole is closed with lattice fascia, Fascia Cribrosa (Fig. 4.8).

Femoral canal and femoral hernia.
1 - m. iliacus; 2 - m. Psoas Major,
3 - Spina Iliaca Anterior Superior; 4 - n. femoralis;
5 - Arcus Ilio-Pectineus; 6 - Lig. Inguinale;
7 - Margo Falciformis et Cornu Superior, 8 - a, v. femoralis;
9 - OS Pubis; 10 - Saccus Herniae (Herge Bag);
11 - v. Saphena Magna.

Walls of the femoral canal

Walls of the femoral canal Present a triangular pyramid.

Front wall of the femoral canal Educated with a surface sheet of wide fascia between the groove bunch and the upper horn of the subcutaneous gap - Cornu Superius.

Lateral wall of the femoral canal - Medical semicircle of the femoral vein.

Rear wall of the femoral canal - A deep leaflet of wide fascia, which is also called Fascia Iliopectinea.

Medial wall of the femoral canal No, since the superficial and deep sheet of fascia in the long leading muscle grow together.

Length of the femoral canal (The distance from the groin bundle to the top horns of HIATUS SAPHENUS) ranges from 1 to 3 cm.

The thigh (regio femoris) is the department of the lower limb, in front and from above, filled from the lower departments of the abdomen with a line connecting the front upper iliac (spina iliaca ant. Sup.) With a tuberculum tuberculum (tuberculum pubicum); Behind and from above - from the buttocks of the jagical fold; Below - from the area of \u200b\u200bthe knee joint with a circular line, spent on two transverse fingers above the patella.

Anatomy. The hip skeleton is the femoral bone (FEMUR) (Fig. 1). The diaphone of it is somewhat twisted along the axis and bent the kleon.

Fig. 1. The femoral bone and place of the beginning and attachment of the muscles in front (a) and behind (b): 1 - m. Vastus Medialis; 2 - m. iliopsoas; 3 - m. ARTICULARIS GENUS; 4 - m. Adductor Magnus; b - Capsula Articularis Genus; in - m. Gastrocnemius (Caput Lat.); 7 - m. vastus intermedius; 8 - m. Vastus Lat.; 9 - m. gluteus minimus; 10- m. gluteus medius; 11 - m. Piriformis; 12 - Capsula ARTICULARIS COXAE; 13 - m. Obturator EXT.; 14 - m. Quadratus Femoris; 15 - m. Gluteus Maximus; 16 - m. biceps femoris; 17 - m. Plantaris; 18 - m. Gastrocnemius (Caput Mediale); 19 - m. Adductor Longus; 20 -M. Adductor Brevis; 21 - m. Pectineus; 22 - LIG. Capitis Femoris.

The thigh length is determined by the distance between the large spit (TroChanter Major) and the outer edge of the articular slot of the knee joint. The thighs are divided into the front and rear areas (Regiones Femoris Ant. Et post.), Limited by two vertical lines spent on the thigh supermarkets (Epicondylus med. Et lat.) In the course of the muscle pulling the wide fascia of the thigh, and the gentle muscle (m. Tensor Fasciae Latae, m. Gracilis) to a large spit and symphysu. On the front surface of the hip, two triangles are distinguished - internal and outdoor; The first facing the base up, the second book. Within the inner triangle, a femoral triangle is located on top of the groin bunch (Lig. Inguinale), outside the inner edge of the tailort muscle (m. Sartorius), from the inside the outer edge of the long leading muscle (m. Adductor Longus). On the front-inner surface of the thigh, the furrow is distinguished between the four-headed thigh muscle (m. Quadriceps Femoris) and leading muscles. This groove, well-pronounced from thin people, is a projection of femoral vessels (N. I. Pirogov).

Hip leather is movable, especially on the inner surface. The subcutaneous thigh fiber is separated by two sheets of surface fascia, between which the following nerves are running in front: the femoral branch of the femoral nerve (R. Femoralis N. Genitofemoralis), the lateral skin nerve of the thigh (N. Cutaneus Femoris Lat.), The front skin branches of the femoral nerve ( RR. Cutanei Ant. N. Femoralis). There are also branches of the femoral artery (color. Table, Fig. 3): Superficialis surface (a. Epigastrica superficialis), surface, envelope iliac bone (a. Circumflexa Ilium Superficialis), outdoor (a. Pudenda Externa). Above the surface sheet of wide fascia (color. Table, Fig. 1) Surface inguinal lymphatic nodes are located, and under it - deep inguinal lymphatic nodes (Lymphonodi Inguinales Profundi).

Fig. one. Lymphatic system In the thigh triangle area: 1 - Noduli Lymphatici Inguinales Superficiales; 2 - FORAMEN OVALE; 3 - V. Saphena Magna; 4 - Nodulus Lymphaticus Subinguinalis Superficialis. Fig. 2. Muscular and vascular lacuna: 1 - Lig. Inguinale; 2 - Arcus iliopeectius; 3 - m. iliopsoas; 4 - n. femoralis; 5 - a. femoralis; 6 - v. lemoralis; 7 - Anulus Femoralis; 8 - m. Pectlneus. Fig. 3. Subcutaneous vessels and nerves of the front surface of the hip: 1 - Vasa Circumflexa Ilium Superficialia; 2 - Vasa Epigastrica Superficial; 3 - n. Cutaneus Femoris Lat.; 4 - r. Femoralis N. genitofemoralis; 5 - HIATUS SAPHENUS ET MARGO FALCLFORMLS; 6 - a. femoralis; 7 - v. femoralis; 8 - Vasa Pudenda Ext.; 9 - v. Saphena Magna; 10 - RR. Cutanei Ant. n. Femoralis. Fig. 4. Deep layers of the femoral triangle: 1 - Fascia LATA; 2 - m. Sartorius; 3 - n. femoralis; 4 - a. femoralis; 5 - v. femoralis; 6 - fatty fiber; 7 - m. Pectineus; 8 - a. Circumflexa Formoris Med.; 9 - RAM. Adductores; 10 --n. Obturatorius.

Fig. 5. The front surface of the hip (after the deletion of the fascia): 1 - a. ET V. femoralis; 2 - m. Pectineus; 3 - m. Adductor Longus; 4 - m. Gracilis; 5 - m. Adductor Magnus; 6 - Lamina Vastoadductoria; 7 - a. Genu Descendens; 8 - n. saphenus; 9 - m. Vastus Medialis; 10 - m. Sartorius; 11 - m. Vastus Lat.; 12 - TRACTUS ILIOTIBIALIS; 13 - m. Rectus Femoris; 14 - m. TENSOR FASCIAE LATAE; 15 --n. Femoralis. Fig. 6. Rear thigh surface (after the deletion of fascia): 1 - n. ischiadicus; 2 - Fascia LATA; 3 - Caput Longum m. Bicipitls Femoris; 4 - n. Peroneus Communis; 5 - n. Tibalis; 6 - m. semitendinosus; 7 - m. Semimembranosus. Fig. 7. Cross cut in the middle third of the right hip: 1 - m. Rectus Femoris; 2 - RR. Cutanei Ant. n. femoralis; 3 - m. Vastus Medialis; 4 - n. saphenus; 5 - a. ET V. femoralis; 6 - m. Sartorius; 7 - v. Saphena Magna; 8 - m. Adductor Longus; 9 - m. Adductor Magnus; 10 - m. Gracilis; 11 - m. semimembranosus; 12 - m. semltendinosus; 13 - Caput Longum m. Bicipitis Femoris; 14 --n. ischiadicus; a. ET V. comitans n. ischiadic!; 15 - Caput Breve m. Bicipitis Femoris; 16 - m. Vastus Lat.; 17 - VASA PROFUNDA FEMORIS; 18 - femur; 19 - m. Vastus Intermedius. Fig. 8. Transverse crooked right hip at the level of the lower third: 1 - m. tendo recti femoris; 2 - femur; 3 - m. Vastus Medialis; 4 - a. ET V. femoralis; 5 - n. Saphenus et a. Genu Suprema with its accompanying veins; 6 - m. Adductor Longus; 7 - m. Sartorius; 8 - v. Saphena Magna; 9 - m. Gracilis; 10 - m. semimembranosus; 11 - m. semitendinosus; 12 - Caput Longum m. Bicipitis; 13 - NN. Tibalis etperus Communis with accompanying vessels; 14 - Caput Breve m. Bicipitis Femoris; 15 - m. Vastus Lat.

Three groups of thigh muscles are distinguished: the front - the extensors - the tongue-round muscle of the thigh; The rear - flexors - the two-headed muscles of the thigh, semi-september and semi-drying (MM. Biceps Femoris, Semitendinosus et semimembranosus); Inner - leading muscles: swing, gentle, leading long, short, large and small (mm. Pectineus, Gracilis, Adductores Longus, Brevis, Minimus et Magnus) (Cherno. Table, Fig. 5-8). Each of these muscle groups is located in a separate fascial case. In the front fascial bed, in addition to a four-headed muscle, there are a femoral nerve (N. Femoralis), most of The front home of the femur diaphyse, at the top - a separate fascial space for the iliac-lumbar muscle (m. IliopSoas). In the rear fascial bed, in addition to the flexors, a sedellastic nerve and its feeding arteries are lying (n. Ischiadicus et a. Comitans N. Ischiadici). In the inner fascial bed, leading muscles, locking artery, vein and nerve are located (A., v. Et n. Obturatorii). Between the front and internal fascial legs pass the femoral vessels (a. Et v. Femorales) and nerve (N. SAPHENUS). In addition to the described three fascial spaces, wide fascia (Fascia LATA) forms individual cases for tailoring, delicate muscles and muscles that pulls the wide fascia (m. Tensor Fasciae Latae).

Purulent chapels with complicated thigh wounds apply to the fiber surrounding the vessels, nerves, and by fasc.com. In the front fascial bed between the direct muscle of the hip (M. Rectus Femoris) and the middle wide muscle of the hip (m. Vastus intermedius), as well as between the last muscle and the femoral bone, there is a fiber in which deep chapels can be located. During surgical processing The Front Front Fascial Lodge dissect the longitudinal intermittent section along the overall surface; rear - on the rear surface; Internal - on the front-inner and assholes of the thigh surface (Fig. 2).

Fig. 2. Cuts for opening of fascial spaces: a - front: 1 - extensors; 2 - tailoring muscles; 3 - iliac lumbar muscles; 4 - leading muscles; B - rear: 1 - leading muscles; 2 - flexors; 3 - extensors.

Wide fascia, forming a cortical muscle case, is divided into two sheets: superficial and deep, pronounced in the upper third of the front of the thigh. The surface sheet of this fascia covers the femoral vessels, is attached at the top to the groove bunch, and knutsa moves to the scallop muscle and merges with a deep leaflet of the wide fascia of the thigh. Large subcutaneous vein (v. Saphena Magna) and lymphatic vessels are trying a loose surface sheet (Fascia Cribrosa) and are included in the oval hole (HIATUS SAPHENUS), or an oval fox, limited from the top of the serpent edge (Margo Falciformis). Sometimes there is an additional subcutaneous vein (v. Saphena Accessoria), which is enclosed in a large subcutaneous vein. The space located between the groove bunch, the lannaya and the iliac bones is divided by the arcuate thickening of the iliac fascia (Arcus iliopeectineus) into two departments: internal - vascular lacuna (lacuna vasorum) and outdoor lacuna (lacuna musculorum, color. Table, Fig. 2) . Muscular lacuna contains the iliac-lumbar muscle (m. Iliopsoas), a femoral nerve and an outer skin thigh (n. Cutaneus Femoris Lat.). This lacuna is reported to the front surface of the hip under the rocking fascia, where the cold abscesses can be descended from the pelvis cavity (with tuberculous spondylitis) in the course of the iliac-lumbar muscle. Vascular lacuna contains femur vessels lying in a faschic vagina separated by a partition; The artery is located in the duck, and Vienna - Knutrice. Vascular lacuna is reported to the front surface of the hip in the area of \u200b\u200boval fossa over the swollen fascia, which descends from under the groove bunch of a hernia bag with femoral hernia.

W. healthy man interior department Vascular lacuna made by loose fiber, lymphatic nodes and corresponds to the inner femoral ring (Anulus Femoralis). It is closed by the abdominal cavity of a loose plate of transverse fascia (Septum Femorale). The inner femur ring is limited in front of the groin bond (Lig. Inguinale), backing the scallop (Lig. Pectineale), from the inside lacunar (Lig. Lacunare), and outside the fasal vagina of the femur vein; The width of the ring in women is greater than that of men, which is explained by the large size of the female pelvis. In this regard, the femoral hernias are observed more often in women. The outer femoral ring corresponds to an oval hole.

There is an outlet hole of the locking channel (Canalis Obturatorius), which comes out of the cavity of a small pelvis and containing locking artery, vein and nerve (a., V. Et n.ohturatorii).

In the field of the femoral triangle under the surface sheet of wide fascia, between the iliac-lumbar and swing muscles, in the iliac and massiferous yam (Fossa iliopeectinea) are located femoral artery, Vienna, and the duck from the femoral artery under a deep leaflet of wide fascia is a femoral nerve (color. Table , Fig. 4). The latter at the exit from under the groin ligament is divided into muscle and skin branches; Of these, the longest branch is the subcutaneous nerve (N. SAPHENUS) follows the femoral artery. Muscle branches of the femur nerve innervate the tailoring, four-chapted and scallop muscles.

3-4 cm below the groove bundle from the femoral artery, the largest branch is departed - deep artery of the hip (a. PROFUNDA FEMORIS), providing collateral blood circulation in the peripheral sections of the limb. In this regard, the burning of the femoral artery is above the place of dishelling of the deep artery of the hip is more dangerous than the release of it.

At the top of the femoral triangle, the vessels from the iliac-scallop yams enter the front furrow of the thigh (Sulcus Femoralis Ant.), Limited outside the middle wide muscle of the thigh (m. Vastus Medialis), from the inside the long and large lead, and in front of the tailored muscles. At the same time, the femoral vein begins to deviate the duck and the stop from the artery, and below is located behind it. Femoral vessels The triangular shape canal (canalis addiversity), whose length in an adult is 5-7 cm. The channel is limited in front and inside the Lamina Vastoadductoria and the tailoring muscle, in front and outside the wide inner muscle, an internal intermuscular partition, from the inside and behind the large muscle leading muscle. The femoral vessels, passing through the bottom hole of the channel (Hiatus Tendineus), enter the patented pamm. Through the front channel of the canal, located in Lamina Vastoadductoria, pass the subcutaneous nerve and the branch of the femoral artery - the descending artery of the knee (a. Genu Descendens).

The femoral artery is conditionally divided into three segments: the upper - from the groin bunch to the place of dishellion of the deep artery of the thigh; Middle - from the place of removal of the deep artery of the hip before the femoral artery entry into the canal; Nizhny - throughout Canalis AddUCTORIUS. The projection of the femoral artery is determined along the Quein line, which comes from the middle of the distances between the front top ileum and symphysome to the inner thigh superior. The projection line corresponds to the movement of the femoral artery only in the position of the rotation of the thigh dust and flexion of the limbs in the hip and knee joints.

Within the rear surface of the thigh, the resulting rear muscle muscle is determined, which the duck moves into the groove, separating the wide outdoor muscle of the thigh from the double muscle. Through this groove is carried out operational access To the diaphysia of the hip. The leather of the rear surface of the hip is innervated by the branches of the rear and outer skin nerves of the hip (NN. Cutaneus Femoris Post, et lat.), Female femur and disconnect nerves. Under the wide fascia of the hips are shiny bends. In the furrows formed outside the double-headed, from the inside of semi-dry (m. Semitendinosiis) and semi-sempute (m. Semimembranosus), and in front of a large leading muscle, there is a sedellastic nerve (N. Iscbidicus), which, coming out from under the long head of the double muscle, descends down And it is divided into two branches of the back surface of the hip in the lower third: the tibial nerve (N. Tibalis) and the total mining nerve (N. Perneus Communis). Sometimes there is a high division of the sciatic nerve; In such cases, its branches come out of the above and fod infrapiriforme (ForaMina Supra-et infrapiriforme) with individual trunks separated by a pear-like muscle (m. Piriformis).

The projection of the sedellastic nerve is determined along the line coming from the middle of the distance between the large spit and the sedlicated hill to the middle of the distance between the inner and outer thigh supervisors. The branches of the sedelled nerve innervate the bends and a large leading muscle. In the fiber surrounding the seeded nerve, inflammatory processes are spread to the buttock area and down - into the popliteal fossa.

Of inflammatory processes at soft tissues Hips are observed: furuncul, carbuncoon, abscess, phlegmon (Fig. 3 and 4) and other purulent processes.

Of the tumors of soft tissues of hips, benign - lipoms, fibroma, angiofibrome, hemangioma, neurinoma and malignant - rhadomiomarcoma, fibrosarcoma, etc. benign tumors femoral bone - osteoma, chondroma, osteochondroma, etc. The solitary chondrom of the interstitial department of the femoral bone is distinguished by the tendency to zero-quality. TO malignant tumors The femoral bones belong to Fibrospar, Chondrosarcom and Osteosarcoma. In the femoral bone, metastases of hypernefromes, prostate cancer, breast cancer, etc. can be observed.

Damage. In the injuries of hips, there can be subcutaneous, subfasial, intermushkin and intramuscular hemorrhages. The treatment is conservative, and in the case of the attachment of infection and the formation of abscesses - operational. With excessive tension, oblasts of fascia, muscles and tendons are observed. Muscles are most often damaged: tailoring, straight and straining wide fascia. Sometimes the muscles come off along with the tendon and bone record; With a significant or complete break, the muscles show the operation - stopping bleeding and suturing the muscles.