Frolich, Human Anatomy, Lower LImb

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Frolich, Human Anatomy, Lower LImb

Anatomy of lower limb

Shirin Kamalgharibi

Master degree of physiotherapy

Surface Anatomy: Anterior Thigh + Leg

Palpate Patella Condyles of femur

Femoral Triangle Sartorius (lateral) Adductor longus (medial) Inguinal ligament

(superior) Femoral a + v, lymph

nodes

pg 792

Surface Anatomy: Posterior Leg

Popliteal fossa Diamond-shape fossa

behind knee Boundaries

Biceps femoris (sup-lat) Semitendinosis +

semimembranosis (sup-med)

Gastrocnemius heads (inf) Contents

Popliteal a + v

Calcaneal (Achilles) tendon

عانه ) ( شرمگاه

دکتر فنی دانشکده شریعتی

Frolich, Human Anatomy, Lower LImb

Frolich, Human Anatomy, Lower LImb

Bony structure of the pelvis

MAIN STRUCTURES Hip bone (innominate,

os coxae)--fusion of Ilium (“hips”) Ischium (“rear”) Pubis (anterior midline)

Sacrum and coccyx Acetabulum Femur--head, neck,

greater trochanter

HOLES False and true pelvis

(major, minor pelvis) Pelvic inlet, pelvic outlet Sacrotuberous ligament Sacrospinous ligament Greater, lesser sciatic

foramen Obturator foramen

Frolich, Human Anatomy, Lower LImb

Female Male

Cavity is broad, shallow Pelvic inlet oval + outlet round Bones are lighter, thinner Pubic angle larger Coccyx more flexible, straighter Ischial tuberosities shorter,

more everted

Cavity is narrow, deep Smaller inlet + outlet Bones heavier, thicker Pubic angle more acute Coccyx less flexible, more curved Ischial tuberosities longer, face

more medially

ران استخوان

Frolich, Human Anatomy, Lower LImb

Tibia/fibula

Tibia--big toe side Fibula--little toe side

(no pronation/supination)

Frolich, Human Anatomy, Lower LImb

Ankle

Talus--forms ankle joint

Calcaneus--forms heel

Muscles that flex thigh at hip

Sartorius Iliopsoas Tensor fasciae lata Rectus femoris

(only quad with origin on pelvis)

Pectineus (medial compartment)

Originate from vertebral column and pelvis and pass anterior to hip joint

Muscles that flex thigh at hip: individually(

Tensor fascia lataIliopsoas

Sartorius Rectus femoris

Pectineus

Inserts on tibial tuberosity via patellar tendon

http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas

Thigh extensors (posterior)

Gluteus maximus Hamstrings (cross hip

and knee joints: extend thigh & flex knee) Biceps femoris Semitendinosus Semimembranosus

_______

HamstringsBiceps femoris long head

Biceps femoris short head

Semitendinosus Semimembranosus

cross hip and knee joints:extend thigh and flex knee

Abductors of thigh

Buttocks muscles that lie lateral to hip joint

Gluteus medius

Gluteus minimus (under medius)

Tensor fascia lata

Thigh abductors

Gluteus medius

Gluteus minimus

Buttocks muscles that lie lateral to the hip joint

Lateral rotators Piriformis Also shown are other

rotators and the gluteus muscles

Piriformis laterally rotates hip; also helps abduct hip if

it is flexed

Adduction of thigh

Muscles originatemedial to hip joint

Gracilis Adductor magnus Adductor longus Adductor brevis Pectineus

Thigh adductors(originate medial to hip joint)Adductor magnus

Adductor longus

PectineusAdductor brevisGracilis

Frolich, Human Anatomy, Lower LImb

Medial thigh (obturator n.)

Adductor muscles Gracilis Adductor

• Magnus• Longus• brevis

Knee extensors Quadraceps femoris – the only extensors of the leg (lower leg) at the knee

Rectus femoris (only quad with origin on pelvis)

Vastus lateralis Vastus intermedius Vastus medialis

Antagonized by hamstrings

Rectus femoris

Vastus lateralis, intermedius, and medialis

Rectus femoris(only quad with origin on the pelvis)

Quadriceps

_________Insert: tibial tuberosity via patellar ligament

Frolich, Human Anatomy, Lower LImb

Anterior thigh (femoral n.)

Sartorius (Tailor’s muscle)

Quads (four) Rectus femoris

(crosses hip) 3 vastus mm.

(vast--big)

Posterior compartment of leg

Superficial: these plantarflex foot

Gastrocnemius

Soleus

Plantaris

Posterior leg

Soleus

Gastrocnemius

Plantaris

Posterior leg continued

Deep

Popliteus

Flexor digitorum longus

Flexor hallucis longus

Tibilialis posterior

Flexor hallucis longus

Flexor digitorum longus

Tibialis posterior

Popliteus Deep posterior leg

Posterior Leg (tibial n.)

Flexors (plantarflexors) Gastrocs and

soleus Flexor digitorum

longus Flexor hallucus

longus

Anterior leg extensorsMainly extend toes

and dorsiflex foot

Tibialis anterior

Extensor digitorum longus

Extensor hallucis longus

More pics

Tibialis anterior

Extensor digitorum longus

Extensor hallucis longus

Anterior Leg (deep fibular n.)

Extensors (dorsiflexors) Fibularis (peroneus)

longus Extensor digitorum

longus Extensor hallicus longus Tibialis anteriorus

Lateral compartment of leg Fibularis (peroneus)

longus: to first metatarsal

and cuneiform Fibularis (peroneus)

brevis: to fifth metatarsal

38

39

40

Intrinsics of foot

Frolich, Human Anatomy, Lower LImb

Lumbar and sacral plexus

Lumbar plexus forms femoral n.—anterior

Sacral plexus forms sciatic n.--posterior

Femoral n.

Sciatic n.

External iliac artery

Inguinal ligament

Common femoral artery

Profunda femoris artery

Superficial femoral artery

477

Anterior Thigh

44

Frolich, Human Anatomy, Lower LImb

Blood supply to lower limb

Internal Iliac Cranial + Caudal Gluteals= gluteals Internal Pudendal = perineum, external

genitalia Obturator = adductor muscles

External Iliac Femoral = lower limb

• Deep femoral = adductors, hamstrings, quadriceps

Popliteal (continuation of femoral) • Geniculars = knee• Anterior Tibial = ant. leg muscles, further

branches to feet• Posterior Tibial = flexor muscles, plantar arch,

branches to toes

Anterior Ankle

Anterior tibial artery

Dorsalis pedis artry

485

Medial

Lumbar plexus (femoral nerve)

Sacral plexus (sciatic nerve)

With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense