Corse Outline

Extent of Lower Limb

Bone, Joints, Muscles, Blood
Vessels, Nerves and
Movements Possible at Lower
Limb
 Learning OBJECTIVES
Recognize different parts of lower limb
Define different land marks in different
regions of lower limb
Describe regions of lower limb
Enumerate the bones and joints of lower
limb
Describe the vessels and nerves of lower
limb
Discuss movements possible at lower
limb
Extent Segments of the Lower
Limb
 Limb Girdle
 pelvic girdle (gluteal)
• Free limb
- thigh
- leg
- foot
 Lower Limb- outline
 Skeleton
 Muscles—anterior and posterior
compartments
 Nerves sciatic, femoral
 Vessels
 Surface anatomy
 REGIONS OF
LOWER LIMB

 Gluteal region
 Thigh
 Leg
 Foot
 SKELETON
Functions:
Locomotion
Carry weight of entire erect body
Support
Provides muscular attachments
Bones of the Lower Limb
 Components:
 Gluteal Region
 Hip bone
 Thigh
 Hip bone
 Femur
 Knee
 Patella
 Leg
 Tibia (medial)
 Fibula (lateral)
 Foot
 Tarsals (7)
 Metatarsals (5)
 Phalanges (14)
Thigh

 Femur
 Largest, longest,
strongest bone in the
body
 Stress bearer
 Femur: Posterior
Head of Femur
Pelvis
Greater Trochanter

Lesser Trochanter Shaft of Femur

Linea Aspera

Lateral Condyle
Medial Condyle

Tibia
Fibula

Right, Posterior View

 Leg: Anterior
Patella (knee cap)
Femur
Medial condyle of femur
Lateral condyle of femur
Medial condyle of tibia

Lateral condyle of tibia

Tibial tuberosity

Fibula
Tibia

Lateral malleolus Medial malleolus

Talus (tarsal bone)

Right Leg, Anterior View

Leg: Posterior
 TIBIA
 Receives the weight of
body from femur and
transmits to foot
 Second to femur in size
and weight

 FIBULA
 Does NOT bear weight
 NOT a part of knee joint
 Stabilizes ankle joint
Patella
 Triangular sesamoid
bone
 Protects knee joint
 Improves leverage of
thigh muscles acting
across the knee
 Contained within
patellar ligament
Foot

Function:
 Supports weight
 Acts as lever when walking
 Tarsals
 Talus = ankle
 Between tibia + fibula

 Calcaneus = heel
 Carries talus

_ Navicular

_ Cuboid

_ Medial, lateral and

intermediate cuneiforms

 Metatarsals

 Phalanges - Smaller, less

nimble
 Mnemonic for Learning Tarsal
Bones
Tiger Cubs Need MILC
Talus Navicular Medial
A boat
It sails on the Cs
cuneiform (1)
Intermediate
cuneiform (2)
Lateral
cuneiform (3)
Calcaneus Cuboid
Joints of Lower Limb
 Hip (femur + acetabulum)
 Ball + socket

 Multiaxial

 Synovial

 Knee (femur + tibia)

 Hinge (modified)

 Biaxial

 Synovial

 Contains menisci, bursa, many

ligaments

 Knee (femur + patella)

 Plane

 Gliding of patella

 Synovial
Joints of Lower Limb
 Joints of Lower
Limb
 Proximal Tibia + Fibula
 Plane, Gliding
 Synovial

 Distal Tibia + Fibula

 Slight “give” (synarthrosis)
 Fibrous (syndesmosis)

 Ankle (Tibia/Fibula + Talus)

 Hinge, Uniaxial
 Synovial

 Intertarsal & Tarsal-metatarsal

 Plane, synovial

 Metatarsal-phalanges
 Condyloid, synovial

 Interphalangeal _ Hinge, uniaxial

 Ankle

 Tarsus--forms ankle
joint
 Calcaneus--forms
heel
Muscles of
Lower Limb
Muscle Groups acting at Hip
 Flexors: (Iliopsoas)
 Extensors (Gluteus Maximus)
 Abductors (Gluteus Medius & minimus)
 Adductors (Groin muscles)
Muscles of Hip and Thigh
 Gluteals
 Posterior pelvis
 Extend thigh
 Rotate thigh
 Abducts thigh
 Anterior Compartment
Thigh
 Flexes thigh at hip
 Extends leg at knee
 Medial/Adductor
Compartment
 Adducts thigh
 Medially rotates thigh
 Posterior Compartment
Thigh
 Extends thigh
 Flexes leg
 Compartments of the thigh

 Anterior ( quadriceps, extensors of knee)

– femoral nerve.
 Posterior (hamstrings, flexors of knee) -
sciatic nerve.
 Medial (hip adductors) – Obturator nerve.
 Anterior Compartment Thigh-
Extensors of knee

 Quadriceps femoris
 Rectus femoris

 Vastus lateralis

 Vastus medialis

 Vastus intermedius

 Sartorius
 Iliopsoas

All above innervated by the femoral nerve!!!

 Medial Compartment
of Thigh- Adductors of
thigh

 Adductor longus
 Adductor brevis
 Adductor magnus
 Pectineus
 Gracilis

Innervation – Obturator nerve

Posterior Compartment – Hamstrings

 Biceps femoris
– 2 heads- short and
long
 Semitendinosus
 Semimembranosus

Sciatic nerve innervates all of the above muscles!!!

Hamstrings (extensors of
thigh and flexors of knee)
 Muscle Compartments of the leg
 Posterior
Superficial and deep layers
Action: Plantarflex foot, flex toes
Innervation: Tibial nerve

 Anterior
Action: Dorsiflex ankle, invert foot, extend toes
Innervation: Deep fibular nerve

 Lateral
Action: Plantarflex, evert foot
Innervation: Superficial Fibular nerve
 Muscle
Compartmen
ts of the leg
 Anterior
Compartment
Dorsiflex ankle, invert
foot, extend toes

 Tibialis anterior

 Extensor digitorum
longus

 Extensor hallucis
longus

All innervated by deep fibular nerve

 Lateral
Compartment
 Fibularis (peroneus)
longus

 Fibularis (peroneus)
brevis

All innervated by the superficial fibular nerve

 Superficial
Posterior
Compartment

 Triceps surae
 Gastrocnemius (2 heads)
 Soleus

 Plantaris (variable)

All innervated by the tibial nerve

 Deep Posterior
Compartment
 Popliteus

 Flexor digitorum longus

 Flexor hallucis longus

 Tibialis posterior

All innervated by the tibial nerve

Plexuses of the Lower Limb
 “Lumbosacral plexus”

 Lumbar Plexus
 Arises from L1-L4
 Lies within the psoas
major muscle
 Mostly anterior structures

 Sacral Plexus
 Arises from spinal nerve
L4-S4
 Lies caudal to the lumbar
plexus
 Mostly posterior
structures
  Sacral plexus
(sciatic nerve)

With leg out to

side like
quadruped,
lumbar-anterior,
sacral-posterior
makes sense

 Lumbar plexus
(femoral nerve)
Dermatomes show twisting of
leg in development
Vasculature of
Lower Limb
Arteries
 Common iliac (from
aorta) branches into:

 Internal iliac
 Supplies pelvic organs

 External iliac
 Supplies lower limb
Arteries
 Internal iliac branches
into:
 Cranial and Caudal
Gluteals
(Superior and Inferior)
 Gluteals
 Internal Pudendal
 Perineum, external
genitalia
 Obturator
 Adductor muscles
 Other branches supply
rectum, bladder, uterus,
vagina, male
reproductive glands
 External iliac becomes…….
 Femoral

 Once passes the inguinal ligament

 Lower limb

 Branches into Deep femoral

 Adductors, hamstrings, quadriceps

 Branches into Medial/lateral

femoral circumflex
 Head and neck of femur

 Femoral becomes……
 Popliteal (continuation of femoral)

 Branches into:

 Geniculars

 Knee

 Splits into:

 Anterior Tibial

 Anterior leg muscles, branches

to feet
 Posterior Tibial

 Flexor muscles, plantar arch,

branches to toes
Veins  Deep Veins: Mostly share
names of arteries
 Ultimately empty into Inferior
Vena Cava
 Plantar
 Tibial
 Fibular
 Popliteal
 Femoral
 External/internal iliac
 Common iliac

 Superficial Veins
 Dorsal venous arch (foot)
 Great saphenous (empties into
femoral)
 Small saphenous (empties into
popliteal)
 Surface
Anatomy of
Lower Limb
Anterior thigh and leg
Palpate
 Patella

 Condyles of femur

 Femoral Triangle
 Boundaries:

 Sartorius (lateral)

 Adductor longus

(medial)
 Inguinal ligament

(superior)

 Contents:
 Femoral artery,

vein and nerve,

lymph nodes
 Posterior leg
 Popliteal fossa
 Diamond-shape fossa
behind knee

 Boundaries
 Biceps femoris (superior-
lateral)
 Semitendinosis and
semimembranosis
(superior-medial)
 Gastrocnemius heads
(inferior)

 Contents
 Popliteal artery and vein
 Calcaneal (Achilles)
tendon
Gluteal region / posterior pelvis
 Iliac crest
 Gluteus maximus
 Cheeks
 Natal/gluteal cleft
 Vertical midline;
“Crack”
 Gluteal folds
 Bottom of cheek;
“prominence”