Lower limb (LL) – skeleton, joints, muscles, arterial blood supply, venous
and lymphatic drainage, innervation, regional anatomy
Skeleton of LL
Pelvic girdle: hip bone (2x)
dorsally sacrum and coccyx
Free LL: on thigh – femur, patella
on leg – tibia, fibula
on foot:
1/ tarsal bones: talus, calcaneus, navicular bone, cuboid bone,
cuneiforme bones (medial, intermediate and lateral)
2/ metatarsal bones
3/ phalanges
Joints of LL
Muscles (mm.) of LL
Hip muscles: 1/ anterior hip mm.: psoas major, (psoas minor), iliacus
2/ posterior hip mm.:
superficial: gluteus maximus, medius, minimus, tensor fasciae latae
deep: piriformis, gemelli (superior et inferior), obturatorius internus,
quadratus femoris
Mm. of the thigh: 1/ anterior group: extensors – sartorius (flexor), quadriceps femoris
2/ medial group: adductors – pectineus, adductor longus, brevis et
magnus, gracilis, obturator externus
3/posterior group: flexors – biceps femoris, semitendinosus,
semimembranosus
Mm. of the leg: 1/ anterior group: extensors - tibialis anterior, extensor digitorum
longus, extensor hallucis longus
2/ lateral group: pronators – peroneus (fibularis) longus, peroneus
(fibularis) brevis
3/ posterior group: flexors – triceps surae (gastrocnemius + soleus),
plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor
hallucis longus
Mm. of the foot: 1/ dorsal (posterior) group: extensors – extensor digitorum brevis,
extensor hallucis brevis, dorsal interossei (4)
2/ plantar group:
a/ middle group: flexor digitorum brevis, quadratus plantae,
lumbricales, plantar interossei (3)
b/ mm. of big toe: abductor hallucis, adductor hallucis, flexor hallucis
brevis
c/ mm. of little toe: m. abductor digiti minimi, m. flexor digiti minimi,
opponens digiti minimi
Femoral a.: it is a continuation of external iliac artery, it ends in the popliteal fossa
Branches:
superficial: superficial epigastric a., superficial circumflex iliac a.,
external pudendal aa.
deep: deep femoral a., descending genicular a.
Region of supply: part of the abdominal wall, thigh, hip joint, knee
joint
Anterior tibial a.: runs above the interosseus membrane, between the muscles of the leg
(anterior group), continues on the dorsum of the foot as dorsalis pedis
a. (dorsal a. of the foot).
Region of supply: leg, knee joint, ankle joint, dorsum of the foot
Posterior tibial a.: is situated deep between the muscles of the leg (posterior group or calf
mm.), on the medial side, at the end divides into two branches
Branches:
peroneal (fibular) a.
Division of posterior tibial a.:
1/ medial plantar a.
2/ lateral plantar a.
Region of supply: gluteal region, hip joint, medial group of thigh mm.
Venous drainage of LL
Lymphatic drainage of LL
The lymph of LL runs through superficial and deep lymph vessels and nodes.
superficial lymph nodes: superficial inguinal lymph nodes
deep lymph nodes: deep inguinal lymph nodes – Cloquetti (Rosenmülleri) node
popliteal lymph nodes
Innervation of LL
2/ sacral plexus It gives off short direct muscular branches for deep gluteal mm., first
L4 -L5, S1-S5, Co
Regional anatomy of LL
Borders of LL
against the trunk: inguinal sulcus, iliac crest, genitofemoral sulcus
Gluteal region
Superficial structures: sensory nerves (superior, middle, inferior cluneal nn.)
Deep structures: Suprapiriform foramen:
superior gluteal a.+ v., superior gluteal n.
Infrapiriform foramen:
sciatic nerve
posterior femoral cutaneous nerve
inferior gluteal a. + v.
pudendal nerve
internal pudendal a.+ v.
Vessels and nerves: medial plantar a. + vv., medial plantar n. (+ their branches)
lateral plantar a. + vv., lateral plantar n. (+ their branches)