Anatomy - lower limb

What movement is this?

Flexion

What movement is this?

Extension

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Adduction

What movement is this?

Abduction

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Lateral rotation

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Medial rotation

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Extension

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Flexion

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Eversion

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Inversion

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Flexion

What movement is this?

Extension

What are the bones of the lower limb?

Innominate, sacrum, femur, patella, tibia, fibula, tarsals, metatarsals, phalanges

What are the bony landmarks of the lower limb?

ASIS, AIIS, pubic tubercle, pubic symphysis, greater trochanter, lesser trochanter, medial epicondyle, lateral epicondyle, tibial tuberosity, subcutaneous border of tibia, medial malleolus, lateral malleolus

What are the muscles of the anterior thigh?

Psoas, illiacus, sartorius, rectus femoris, vastus intermedius, vastus lateralis, vastus medialis

What muscles make up the quadriceps group?

Rectus femoris, vastus lateralis, vastus medialis, vestus intermedius

Where is the psoas muscle?

Flexor of hip joint, attached at lesser trochanter

Where is the iliacus muscle?

Shares attachment with psoas at lesser trochanter

Where is rectus femoris?

Most superficial, in the midline, attaches proximal to hip joint

Where is vastus lateralis?

Lies laterally, partially covered by the ITT

Where is vastus medialis?

Lies medially, distal fibres run horizontally

Where is vastus intermedius?

Lies deep to rectus femoris

Where is sartorial?

Divides anterior and medial compartments of thigh, runs from ASIS to medial tibia

What are the muscles of the medial thigh?

Pectineus, obturator externus, adductor longus, adductor brevis, gracillis, adductor magnus

Where is the adductor longus?

Medial border of femoral triangle

Where is adductor breves?

Small muscle lying deep to adductor longus

Where is adductor Magnus?

Large muscle lying posteriorly, attaches to femur

Where is gracillis?

Most medial muscle of the medial thigh, passes behind the knee joint then anteriorly to attache to the medial tibia along with sartorius and semitendonosus

Where is pectinous?

Forms the medial hand of the floor of the femoral triangle

What movement does the gluteus Maximus do?

Hip extension and lateral rotation of hip

What movement is the gluteus medias involved in?

Hip abduction, steadies pelvis when walking

What movement does the rectus femoris do?

Extends knee

What does the sartorius do?

Flexes the thigh

What movement is the quadriceps group involved in?

Extension of the knee

What are the muscles of the anterior leg?

Tibialis anterior, extensor digitorum longus, extensor hallucis longus

What are the muscles of the lateral leg?

Peroneus longus, peroneus brevis, peroneus tertius

Where is the tibialis anterior?

Adjacent to subcutaneous border of tibia

What does the tibialis anterior do?

Inverts foot

Where is the extensor digitorum longus?

Distally this muscle splits into 4 tendons one to each of the lateral toes

Where is the extensor hallucis longus?

Distally lies between tibialis anterior and extensor digitorum

What does extensor hallucis longus do?

Extends great toe

Where is the peroneus longus?

Superficial to brevis. Passes posterior to the ankle joint, runs under the foot and attaches to the medial aspect of the sole of the foot.

Where is the peroneus brevis?

Deep to longus. Distally attaches to the lateral aspect of the foot.

Where is the peroneus tertius?

Small muscle branching from extensor digitorum, attaches to lateral aspect of foot

What nerves innervate the anterior lower limb?

Nerve to psoas, femoral nerve, obturator nerve

Where is the nerve to psoas?

Small branch passing directly from lumbar plexus to psoas major

Where is the femoral nerve?

Most lateral of the three major structures in the femoral triangle

Where is the obturator nerve?

Passes through obturator foramen before entering the medial compartment of the thigh

What muscle group is responsible for this movement, flexion?

Anterior thigh

What muscle group is responsible for this movement, extension?

Posterior thigh

What muscle group is responsible for this movement, adduction?

Medial thigh

What muscle group is responsible for this movement, abduction?

Superior gluteal

What muscle group is responsible for this movement, lateral rotation?

Deep gluteal

What muscle group is responsible for this movement, medial rotation?

Superior gluteal

What muscle group is responsible for this movement, extension?

Anterior thigh

What muscle group is responsible for this movement, flexion?

Posterior thigh

What muscle group is responsible for this movement, extension?

Anterior leg

What muscle group is responsible for this movement, inversion?

Ant/post leg - tibialis muscles

What muscle group is responsible for this movement, eversion?

Lateral leg

What bony landmarks feature in the posterior lower limb?

Greater trochanter, ischial spine, obturator foramen, ischial tuberosity, lesser trochanter, linea aspera, lateral condyle, medial condyle, head of the fibula, neck of the fibula, medial malleolus, lateral malleolus

What are the muscles of the gluteal region?

Gluteus medius, gluteus maximus, gluteus minimus

Where is the gluteus Maximus?

Largest muscle in the body. Proximally attaches to sacral and sacrotuberous ligament. Passes laterally to blend with fibres of ilioibial tract

Where is gluteus medius?

Deep and anterior to gluteus Maximus, distally attaches to greater trochanter

Where is the gluteus minimus?

Deep to gluteus maximus, smallest and most anterior of gluteal muscles

What are the muscles of the posterior thigh?

Biceps femoris, semitendinosus, semimembranosus

Where is the biceps femoris?

Passes laterally to head of fibula, long head attaches to ischial tuberosity, short head attaches to femur

Where is the semimembranosus?

Proximally has a membrane like tendon, sandwiched between the other two hamstring muscles, distally becomes fatter and attaches to the tibia posteriorly

Where is the semitendinosus?

Distally becomes a long cord like tendon, shares its distal attachment with gracilis and sartorius

What are the muscles of the posterior leg?

Plantaris, gastrocnemius, soleus, flexor digitorum longus, tibialis posterior, flexor hallucis longus

Where is the gastrocnemius?

Proximally medial and lateral heads attach to the medial and lateral femoral condyles. Distally fuses with soleus to form achilles tendon

Where is soleus?

Flattened muscles lying deep to gastrocnemius, tendinous arch in proximal attachment allows structures to pass from popliteal fossa into leg

Where is plantaris?

Small, vestigial muscle with a long tendon, largely non-functional

Where is flexor digitorum longus?

Proximally attaches to the tibia. Runs behind medial malleolus and splits into 4 tendons

Where is tibialis posterior?

Proximally attaches to interosseous membrane, runs to medial aspect of foot

Where is the interosseous membrane?

Between tibia and fibula

Where is flexor hallucis longus?

Proximally attaches to the fibula, passes medially to the big toe

What nerves innervate the posterior lower limb?

Superior gluteal nerve, inferior gluteal nerve, sciatic nerve

Where is the superior gluteal nerve?

Found at superior border of piriformis muscle - supplies gluteus maximus

Where is the inferior gluteal nerve?

Found at inferior border of piriformis muscle - supplies gluteus medius and minimus

Where is the sciatic nerve?

Largest nerve in the body, passes under piriformis and runs down posterior thigh, splits to provide tibial and common peroneal nerves

What is the tibial nerve?

A branch of the sciatic nerve. Passes vertically down through the posterior compartment of the leg and behind the medial malleolus where it terminates as the medial and lateral plantar nerves in the sole of the foot

What muscles are in the deep gluteal region?

Piriformis, gemellus superior, gemellus inferior, obturator internus, quadratus femoris

Where is piriformis?

Pear shaped muscle passing from anterior surface of sacrum to greater trochanter, sciatic nerve emerges from under its inferior edge

Where is obturator internus?

Proximally attaches to internal surface of obturator membrane, passes laterally to greater trochanter

Where are gemellus inferior and superior?

Twin muscles that accompany tendon of obturator internus

Where is quadratus femoris?

Quadrangular muscle passing between ischium and greater trochanter

What are the anatomic features of the hip joint?

Ilium, neck of femur, ischium, pubis, lesser trochanter, greater trochanter, intertrochanteric line

What are the colateral ligaments?

Ligaments on either side of the knee preventing side to side movement

What tendon goes over the patella?

Quadriceps tendon

What are the two menisci?

Lateral and medial

What is the purpose of the menisci?

Increase stability, distribute load, absorb shock, provide lubrication

What do the cruciate ligaments do?

Prevent movement back and forth of the knee

Where are the cruciate ligaments?

Inside the knee joint

What are the intracapsular features of the knee joint?

Posterior and anterior cruciate ligaments, posterior menisco-femoral ligament, medial and lateral menisicus

What are the bones of the foot?

Phalanges, 1-5 metatarsals, talus calceneous, navicular, cuboid, medial cuneiform, middle cuneiform, lateral cuneiform

What bones are in the proximal row of tarsal bones?

Talus calcaneous and navicular

What bones are in the distal row of tarsal bones?

Cuboid, medial cuneiform, middle cuneiform, lateral cuneiform

What are the 3 articulations of the ankle joint?

1. Talocrucial
2. Subtalor
3. Mid-tarsal

What is the site of the adductor longus muscle?

Medial thigh

What is the shape of the adductor longus muscle?

Long triangular