6. Musculoskeletal System: Lower Extremity

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lower extremity bones

  • pelvic girdle

    • 2 pelvic bones

    • sacrum + coccyx (axial skeleton)

  • thigh

    • femur

  • lower leg

    • tibia

    • fibula

  • ankle + foot

    • tarsals

    • metatarsals

    • phalanges


<ul><li><p>pelvic girdle</p><ul><li><p>2 pelvic bones</p></li><li><p>sacrum + coccyx (axial skeleton)</p></li></ul></li><li><p>thigh</p><ul><li><p>femur</p></li></ul></li><li><p>lower leg</p><ul><li><p>tibia</p></li><li><p>fibula</p></li></ul></li><li><p>ankle + foot</p><ul><li><p>tarsals</p></li><li><p>metatarsals</p></li><li><p>phalanges</p></li></ul></li></ul><p></p>
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pelvic bone

3 bones fused together to lateral acetabulum + obturator foramen

  • ilium

  • ischium

  • pubis


<p>3 bones fused together to lateral acetabulum + obturator foramen </p><ul><li><p>ilium</p></li><li><p>ischium</p></li><li><p>pubis</p></li></ul><p></p>
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ilium

part of pelvic bone

  • has

    • anterior → iliac fossa

    • posterior → gluteal surface

    • anterior superior iliac spine (ASIS)

    • anterior inferior iliac spine (AIIS)


<p>part of pelvic bone</p><ul><li><p>has</p><ul><li><p>anterior → iliac fossa </p></li><li><p>posterior → gluteal surface </p></li><li><p>anterior superior iliac spine (ASIS)</p></li><li><p>anterior inferior iliac spine (AIIS)</p></li></ul></li></ul><p></p>
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ischium

part of pelvic bone

  • features ischium tuberosity


<p>part of pelvic bone</p><ul><li><p>features ischium tuberosity </p></li></ul><p></p>
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pubis

part of pelvic bone

<p>part of pelvic bone</p>
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pelvic girdle joints

  • sacroiliac joint

    • plane joint

    • fibrous joint components

  • sacrococcygeal joint

    • plane joint

  • pubic symphysis

    • symphysis

  • pelvic joint

    • ball-and-socket joint


<ul><li><p>sacroiliac joint</p><ul><li><p>plane joint </p></li><li><p>fibrous joint components</p></li></ul></li><li><p>sacrococcygeal joint</p><ul><li><p>plane joint</p></li></ul></li><li><p>pubic symphysis</p><ul><li><p>symphysis</p></li></ul></li><li><p>pelvic joint</p><ul><li><p>ball-and-socket joint</p></li></ul></li></ul><p></p>
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hip joint

articulation b/w femoral head + acetabulum of pelvic bone

  • triaxial ball-and-socket joint

  • movements

    • flexion + extension

    • abduction + adduction

    • internal medial + external lateral rotation


<p>articulation b/w femoral head + acetabulum of pelvic bone</p><ul><li><p>triaxial ball-and-socket joint</p></li><li><p>movements</p><ul><li><p>flexion + extension</p></li><li><p>abduction + adduction</p></li><li><p>internal medial + external lateral rotation</p></li></ul></li></ul><p></p>
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hip joint muscles

  • anterior

    • iliopsoas = iliacus + psoas major

      • flexion

  • posterior

    • gluteus maximus

      • extension

    • gluteus medius

      • abduction

    • gluteus minimus

      • abduction

    • deep lateral rotators

      • piriformis

      • obturators internus + externus

      • superior + inferior gemelli

      • quadratus femoris

        • lateral rotation at hip joint


<ul><li><p>anterior</p><ul><li><p>iliopsoas = iliacus + psoas major</p><ul><li><p>flexion </p></li></ul></li></ul></li><li><p>posterior</p><ul><li><p>gluteus maximus</p><ul><li><p>extension</p></li></ul></li><li><p>gluteus medius</p><ul><li><p>abduction</p></li></ul></li><li><p>gluteus minimus </p><ul><li><p>abduction </p></li></ul></li><li><p>deep lateral rotators </p><ul><li><p>piriformis</p></li><li><p>obturators internus + externus </p></li><li><p>superior + inferior gemelli</p></li><li><p>quadratus femoris </p><ul><li><p>lateral rotation at hip joint </p></li></ul></li></ul></li></ul></li></ul><p></p>
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iliopsoas

acts on hip joint → flexion at hip joint

  • formed by iliacus + psoas major

  • origin

    • sides of lumbar vertebral bodies + iliac fossa

  • passes deep to inguinal ligament

  • insertion

    • lesser trochanter of femur


<p>acts on hip joint → flexion at hip joint</p><ul><li><p>formed by iliacus + psoas major </p></li></ul><ul><li><p>origin</p><ul><li><p>sides of lumbar vertebral bodies + iliac fossa </p></li></ul></li><li><p>passes deep to inguinal ligament</p></li><li><p>insertion</p><ul><li><p>lesser trochanter of femur</p></li></ul></li></ul><p></p>
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gluteus maximus

acts on hip joint → extension at hip joint

  • origin

    • ilium

    • sacrum

  • insertion

    • gluteal tuberosity of femur

    • iliotibial tract


<p>acts on hip joint → extension at hip joint</p><ul><li><p>origin</p><ul><li><p>ilium </p></li><li><p>sacrum</p></li></ul></li><li><p>insertion </p><ul><li><p>gluteal tuberosity of femur </p></li><li><p>iliotibial tract</p></li></ul></li></ul><p></p>
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gluteus medius and minimus

acts on hip joint → abduction at hip joint

  • origin

    • posterior ilium (gluteal surface)

  • insertion

    • greater trochanter of femur


<p>acts on hip joint → abduction at hip joint</p><ul><li><p>origin </p><ul><li><p>posterior ilium (gluteal surface)</p></li></ul></li><li><p>insertion</p><ul><li><p>greater trochanter of femur </p></li></ul></li></ul><p></p>
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deep lateral rotators

act on hip joint → lateral rotation at hip joint

  • muscles

    • piriformis

    • obturators internus + externus

    • superior + inferior gemelli

    • quadratus femoris

  • origin

    • anterior sacrum

    • posterior ischium

    • obturator foramen

  • runs posterior to hip joint

  • insertion

    • greater trochanter of femur


<p>act on hip joint → lateral rotation at hip joint</p><ul><li><p>muscles</p><ul><li><p>piriformis</p></li><li><p>obturators internus + externus</p></li><li><p>superior + inferior gemelli</p></li><li><p>quadratus femoris </p></li></ul></li><li><p>origin</p><ul><li><p>anterior sacrum</p></li><li><p>posterior ischium</p></li><li><p>obturator foramen</p></li></ul></li><li><p>runs posterior to hip joint</p></li><li><p>insertion</p><ul><li><p>greater trochanter of femur</p></li></ul></li></ul><p></p>
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proximal lower limb arteries

  • aorta

  • common iliac artery

    • internal iliac artery

      • pelvic organs

      • gluteal muscles

    • external iliac artery

      • lower limb

        • femoral artery

        • profunda femoris artery

        • popliteal artery


<ul><li><p>aorta</p></li><li><p>common iliac artery</p><ul><li><p>internal iliac artery</p><ul><li><p>pelvic organs</p></li><li><p>gluteal muscles</p></li></ul></li><li><p>external iliac artery</p><ul><li><p>lower limb</p><ul><li><p>femoral artery </p></li><li><p>profunda femoris artery</p></li><li><p>popliteal artery</p></li></ul></li></ul></li></ul></li></ul><p></p>
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proximal lower limb veins

  • deep veins

    • share names w/ associate arteries

  • superficial veins

    • dorsal venous arch

    • great saphenous vein → medial

      • drains into femoral vein

    • small saphenous vein → lateral

      • drains into popliteal vein

  • blood from lower limb veins drain to external iliac vein → drain into inferior vena cava


<ul><li><p>deep veins</p><ul><li><p>share names w/ associate arteries </p></li></ul></li><li><p>superficial veins</p><ul><li><p>dorsal venous arch</p></li><li><p>great saphenous vein → medial</p><ul><li><p>drains into femoral vein</p></li></ul></li><li><p>small saphenous vein → lateral</p><ul><li><p>drains into popliteal vein</p></li></ul></li></ul></li><li><p>blood from lower limb veins drain to external iliac vein → drain into inferior vena cava</p></li></ul><p></p>
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lower limb innervation

  • lumbar plexus = L1-L4

    • major nerves

      • femoral nerve

        • anterior thigh compartment

      • obturator nerve

        • medial thigh compartment

    • connects to sacral plexus via lumbosacral trunk = L4-L5

  • lumbosacral plexus = lumbosacral trunk + S1-S4

    • major nerve

      • sciatic nerve + branches

        • posterior thigh compartment

        • compartments of lower leg + foot


<ul><li><p>lumbar plexus = L1-L4</p><ul><li><p>major nerves </p><ul><li><p>femoral nerve</p><ul><li><p>anterior thigh compartment</p></li></ul></li><li><p>obturator nerve</p><ul><li><p>medial thigh compartment</p></li></ul></li></ul></li><li><p>connects to sacral plexus via lumbosacral trunk = L4-L5</p></li></ul></li><li><p>lumbosacral plexus = lumbosacral trunk + S1-S4</p><ul><li><p>major nerve</p><ul><li><p>sciatic nerve + branches</p><ul><li><p>posterior thigh compartment</p></li><li><p>compartments of lower leg + foot</p></li></ul></li></ul></li></ul></li></ul><p></p>
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knee joint

biaxial modified hinge joint

  • consists of

    • femoral condyles articulate w/ tibial plateau

    • medial + lateral collateral ligaments

    • anterior + posterior cruciate ligaments (ACL + PCL)

    • medial + lateral menisci (fibrocartilage)

      • optimize joint congruency

      • shock absorption

        • sits on tibial plateau + acts as cushion

  • movements

    • flexion + extension

    • slight medial + lateral rotation

      • locking + unlocking of knee


<p>biaxial modified hinge joint </p><ul><li><p>consists of </p><ul><li><p>femoral condyles articulate w/ tibial plateau</p></li><li><p>medial + lateral collateral ligaments </p></li><li><p>anterior + posterior cruciate ligaments (ACL + PCL)</p></li><li><p>medial + lateral menisci (fibrocartilage)</p><ul><li><p>optimize joint congruency</p></li><li><p>shock absorption </p><ul><li><p>sits on tibial plateau + acts as cushion</p></li></ul></li></ul></li></ul></li></ul><ul><li><p>movements</p><ul><li><p>flexion + extension</p></li><li><p>slight medial + lateral rotation</p><ul><li><p>locking + unlocking of knee</p></li></ul></li></ul></li></ul><p></p>
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knee locking

  • knee moves into extension

    • slight medial rotation of femur

      • tightening of collateral ligaments

  • full extension = reinforces extended state + prevents buckling


<ul><li><p>knee moves into extension </p><ul><li><p>slight medial rotation of femur </p><ul><li><p><em>tightening </em>of collateral ligaments</p></li></ul></li></ul></li><li><p>full extension = reinforces extended state + prevents buckling</p></li></ul><p></p>
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knee unlocking

  • flex knee from extended position

    • popliteus contracts

      • slight lateral rotation of femur on tibia

        • knee ligaments loosened


<ul><li><p>flex knee from extended position</p><ul><li><p>popliteus contracts</p><ul><li><p>slight lateral rotation of femur on tibia</p><ul><li><p>knee ligaments loosened</p></li></ul></li></ul></li></ul></li></ul><p></p>
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popliteus

deep muscle posterior to joint

  • attachments to distal femur + proximal tibia

  • action

    • unlocks knee

      • contraction → slight rotation of femur on tibia

        • loosens knee ligaments


<p>deep muscle posterior to joint </p><ul><li><p>attachments to distal femur + proximal tibia</p></li><li><p>action</p><ul><li><p>unlocks knee</p><ul><li><p>contraction → slight rotation of femur on tibia </p><ul><li><p>loosens knee ligaments</p></li></ul></li></ul></li></ul></li></ul><p></p>
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cruciate ligaments

  • attach to sides of intercondylar fossa + tibial plateau

  • action

    • limit rotational movement at knee joint

  • 2 structures

    • anterior cruciate ligament (ACL)

    • posterior cruciate ligament (PCL)


<ul><li><p>attach to sides of intercondylar fossa + tibial plateau</p></li><li><p>action</p><ul><li><p>limit rotational movement at knee joint</p></li></ul></li><li><p>2 structures</p><ul><li><p>anterior cruciate ligament (ACL)</p></li><li><p>posterior cruciate ligament (PCL)</p></li></ul></li></ul><p></p>
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anterior cruciate ligament (ACL)

  • attach to sides of intercondylar fossa + tibial plateau

  • action

    • limit rotational movement at knee joint

      • restraint against anterior translation of tibia compared to femur

        • prevents tibia from moving too far anteriorly


<ul><li><p>attach to sides of intercondylar fossa + tibial plateau</p></li><li><p>action</p><ul><li><p>limit rotational movement at knee joint</p><ul><li><p>restraint against <em>anterior translation</em> of tibia compared to femur</p><ul><li><p>prevents tibia from moving too far anteriorly</p></li></ul></li></ul></li></ul></li></ul><p></p>
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posterior cruciate ligament (PCL)

  • attach to sides of intercondylar fossa + tibial plateau

  • action

    • limit rotational movement at knee joint

      • restraint against posterior translation of tibia compared to femur

        • prevents tibia from moving too far posteriorly


<ul><li><p>attach to sides of intercondylar fossa + tibial plateau</p></li><li><p>action</p><ul><li><p>limit rotational movement at knee joint</p><ul><li><p>restraint against <em>posterior translation </em>of tibia compared to femur </p><ul><li><p>prevents tibia from moving too far posteriorly</p></li></ul></li></ul></li></ul></li></ul><p></p>
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anterior thigh compartment

  • muscles

    • sartorius

    • quadriceps femoris

      • rectus femoris

      • vastus lateralis, intermedius, medialis

  • action

    • sartorius → flexion at hip and knee

    • quadriceps femoris → extension at knee joint

  • innervation

    • femoral nerve


<ul><li><p>muscles</p><ul><li><p>sartorius</p></li><li><p>quadriceps femoris</p><ul><li><p>rectus femoris</p></li><li><p>vastus lateralis, intermedius, medialis</p></li></ul></li></ul></li><li><p>action</p><ul><li><p>sartorius → flexion at hip and knee</p></li><li><p>quadriceps femoris → extension at knee joint</p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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quadriceps femoris

part of anterior thigh compartment → flexion at knee joint

  • 4 muscles

    • rectus femoris

    • vastus lateralis

    • vastus intermedius

    • vastus medialis

  • origin

    • RF → anterior superior iliac spine

    • others → proximal anterior femur

  • insertion

    • tibial tuberosity via patella + patellar ligament

  • innervation

    • femoral nerve


<p>part of anterior thigh compartment → flexion at knee joint</p><ul><li><p>4 muscles</p><ul><li><p>rectus femoris </p></li><li><p>vastus lateralis</p></li><li><p>vastus intermedius</p></li><li><p>vastus medialis </p></li></ul></li></ul><ul><li><p>origin</p><ul><li><p>RF → anterior superior iliac spine </p></li><li><p>others → proximal anterior femur</p></li></ul></li><li><p>insertion</p><ul><li><p>tibial tuberosity via patella + patellar ligament</p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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sartorius

part of anterior thigh compartment → flexion at hip and knee

  • origin

    • anterior superior iliac spine (ASIS)

  • insertion

    • medial proximal tibia

  • innervation

    • femoral nerve


<p>part of anterior thigh compartment → flexion at hip and knee</p><ul><li><p>origin</p><ul><li><p>anterior superior iliac spine (ASIS)</p></li></ul></li><li><p>insertion</p><ul><li><p>medial proximal tibia</p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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hamstrings

part of posterior thigh compartment → flexion at knee joint

  • 3 muscles

    • biceps femoris (BF)

      • long + short heads

    • semitendinosus (ST)

    • semimembranosus (SM)

  • origin

    • ischial tuberosity

  • insertion

    • BF → lateral tibial condyle/head of fibula

    • ST + SM → medial tibial condyle

  • innervation

    • sciatic nerve


<p>part of posterior thigh compartment → flexion at knee joint</p><ul><li><p>3 muscles</p><ul><li><p>biceps femoris (BF)</p><ul><li><p>long + short heads</p></li></ul></li><li><p>semitendinosus (ST)</p></li><li><p>semimembranosus (SM)</p></li></ul></li><li><p>origin</p><ul><li><p>ischial tuberosity</p></li></ul></li><li><p>insertion</p><ul><li><p>BF → lateral tibial condyle/head of fibula</p></li><li><p>ST + SM → medial tibial condyle</p></li></ul></li><li><p>innervation</p><ul><li><p>sciatic nerve</p></li></ul></li></ul><p></p>
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adductors

part of medial thigh compartment → adduction at hip joint

  • 4 muscles

    • pectineus

    • adductor longus

    • adductor brevis

    • adductor magnus

  • origin

    • pubis

  • insertion

    • linea aspera of femur

    • adductor magnus → adductor tubercle

  • innervation

    • obturator nerve


<p>part of medial thigh compartment → adduction at hip joint</p><ul><li><p>4 muscles</p><ul><li><p>pectineus</p></li><li><p>adductor longus</p></li><li><p>adductor brevis</p></li><li><p>adductor magnus</p></li></ul></li><li><p>origin</p><ul><li><p>pubis</p></li></ul></li><li><p>insertion</p><ul><li><p>linea aspera of femur</p></li><li><p>adductor magnus → adductor tubercle</p></li></ul></li><li><p>innervation</p><ul><li><p>obturator nerve</p></li></ul></li></ul><p></p>
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adductor hiatus

hole in adductor magnus for passage of popliteal artery + vein to posterior knee

<p>hole in adductor magnus for passage of popliteal artery + vein to posterior knee</p>
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gracilis

part of medial thigh compartment → adduction at hip joint

  • part of adductors

  • origin

    • pubis

  • insertion

    • medial proximal tibia

  • innervation

    • obturator nerve


<p>part of medial thigh compartment → adduction at hip joint</p><ul><li><p>part of adductors</p></li><li><p>origin</p><ul><li><p>pubis</p></li></ul></li><li><p>insertion</p><ul><li><p>medial proximal tibia</p></li></ul></li><li><p>innervation</p><ul><li><p>obturator nerve</p></li></ul></li></ul><p></p>
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sciatic nerve

  • innervates

    • posterior thigh compartment

    • muscles of lower leg + foot

  • exits pelvis via greater sciatic foramen

  • descends b/w medial + posterior compartments

  • divides into tibial + common peroneal (fibular) branches at popliteal fossa


<ul><li><p>innervates</p><ul><li><p>posterior thigh compartment</p></li><li><p>muscles of lower leg + foot</p></li></ul></li><li><p>exits pelvis via greater sciatic foramen</p></li><li><p>descends b/w medial + posterior compartments</p></li><li><p>divides into tibial + common peroneal (fibular) branches at popliteal fossa</p></li></ul><p></p>
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femoral artery

  • external iliac artery passes deep to inguinal ligament + enters thigh → becomes _____ artery

  • major branch = profunda femoris artery

    • runs deep + parallel

  • descends b/w anterior + medial compartments of thigh

  • passes through adductor hiatus to enter posterior knee → becomes popliteal artery


<ul><li><p>external iliac artery passes deep to inguinal ligament + enters thigh → becomes _____ artery</p></li><li><p>major branch = profunda femoris artery </p><ul><li><p>runs deep + parallel</p></li></ul></li><li><p>descends b/w anterior + medial compartments of thigh</p></li><li><p>passes through adductor hiatus to enter posterior knee → becomes popliteal artery</p></li></ul><p></p>
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popliteal fossa

superficial landmark behind knee

  • boundaries

    • superior border

      • biceps femoris

      • semitendonosus

      • semimembranosus

    • inferior border

      • gastrocnemius

  • contents

    • popliteal artery + vein

    • tibial + common peroneal (fibular) nerves → derived from sciatic nerve


<p>superficial landmark behind knee</p><ul><li><p>boundaries</p><ul><li><p>superior border</p><ul><li><p>biceps femoris </p></li><li><p>semitendonosus </p></li><li><p>semimembranosus </p></li></ul></li><li><p>inferior border</p><ul><li><p>gastrocnemius</p></li></ul></li></ul></li><li><p>contents</p><ul><li><p>popliteal artery + vein</p></li><li><p>tibial + common peroneal (fibular) nerves → derived from sciatic nerve </p></li></ul></li></ul><p></p>
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ankle joint

articulation b/w distal tibia + fibula, some talus bone

  • uniaxial hinge joint

  • supported by collateral ligaments, tendons running distally into foot

  • movements

    • dorsiflexion

    • plantarflexion


<p>articulation b/w distal tibia + fibula, some talus bone</p><ul><li><p>uniaxial hinge joint</p></li><li><p>supported by collateral ligaments, tendons running distally into foot</p></li><li><p>movements</p><ul><li><p>dorsiflexion </p></li><li><p>plantarflexion</p></li></ul></li></ul><p></p>
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anterior lower leg compartment

  • muscles

    • tibialis anterior (TA)

      • right against shin bone

    • extensor digitorum longus (EDL)

    • extensor hallucis longus (EHL) → big toe

  • origin

    • anterior tibia

    • fibula

    • interosseous membrane

  • insertion

    • distal to ankle joint

    • EDL + EHL tendons out to respective digits

  • action

    • dorsiflexion at ankle joint

    • EDL + EHL → extension of digits

  • innervation

    • deep peroneal nerve


<ul><li><p>muscles</p><ul><li><p>tibialis anterior (TA) </p><ul><li><p>right against shin bone </p></li></ul></li><li><p>extensor digitorum longus (EDL)</p></li><li><p>extensor hallucis longus (EHL) → big toe</p></li></ul></li><li><p>origin</p><ul><li><p>anterior tibia</p></li><li><p>fibula</p></li><li><p>interosseous membrane</p></li></ul></li><li><p>insertion</p><ul><li><p>distal to ankle joint</p></li><li><p>EDL + EHL tendons out to respective digits</p></li></ul></li><li><p>action</p><ul><li><p>dorsiflexion at ankle joint</p></li><li><p>EDL + EHL → extension of digits </p></li></ul></li><li><p>innervation </p><ul><li><p>deep peroneal nerve</p></li></ul></li></ul><p></p>
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superficial posterior lower leg compartment

  • muscles

    • gastrocnemius

    • soleus

  • action

    • plantar flexion at ankle joint

  • innervation

    • tibial nerve


<ul><li><p>muscles</p><ul><li><p>gastrocnemius </p></li><li><p>soleus </p></li></ul></li><li><p>action</p><ul><li><p>plantar flexion at ankle joint</p></li></ul></li><li><p>innervation</p><ul><li><p>tibial nerve</p></li></ul></li></ul><p></p>
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gastrocnemius

part of superficial posterior lower leg compartment → plantar flexion at ankle joint

  • origin

    • medial + lateral femoral condyles

  • insertion

    • calcaneus via calcaneal (Achilles) tendon

  • innervation

    • tibial nerve


<p>part of superficial posterior lower leg compartment → plantar flexion at ankle joint</p><ul><li><p>origin</p><ul><li><p>medial + lateral femoral condyles</p></li></ul></li><li><p>insertion</p><ul><li><p>calcaneus via calcaneal (Achilles) tendon</p></li></ul></li><li><p>innervation</p><ul><li><p>tibial nerve</p></li></ul></li></ul><p></p>
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soleus

part of superficial posterior lower leg compartment → plantar flexion at ankle joint

  • origin

    • posterior proximal tibia + fibula

  • insertion

    • calcaneus via calcaneal (Achilles) tendon

  • innervation

    • tibial nerve


<p>part of superficial posterior lower leg compartment → plantar flexion at ankle joint</p><ul><li><p>origin</p><ul><li><p>posterior proximal tibia + fibula</p></li></ul></li><li><p>insertion</p><ul><li><p>calcaneus via calcaneal (Achilles) tendon</p></li></ul></li><li><p>innervation</p><ul><li><p>tibial nerve</p></li></ul></li></ul><p></p>
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medial thigh compartment

  • muscles

    • adductors

      • pectineus

      • adductor longus, brevis, magnus

    • gracilis

  • action

    • adduction at hip joint

  • innervation

    • obturator nerve


<ul><li><p>muscles</p><ul><li><p>adductors</p><ul><li><p>pectineus</p></li><li><p>adductor longus, brevis, magnus</p></li></ul></li><li><p>gracilis</p></li></ul></li><li><p>action</p><ul><li><p>adduction at hip joint</p></li></ul></li><li><p>innervation</p><ul><li><p>obturator nerve</p></li></ul></li></ul><p></p>
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posterior thigh compartment

  • muscles

    • hamstrings

      • biceps femoris

      • semitendinosus

      • semimembranosus

  • action

    • flexion at knee joint

  • innervation

    • sciatic nerve


<ul><li><p>muscles</p><ul><li><p>hamstrings</p><ul><li><p>biceps femoris</p></li><li><p>semitendinosus</p></li><li><p>semimembranosus</p></li></ul></li></ul></li><li><p>action</p><ul><li><p>flexion at knee joint</p></li></ul></li><li><p>innervation</p><ul><li><p>sciatic nerve</p></li></ul></li></ul><p></p>
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deep posterior lower leg compartment

  • muscles

    • tibialis posterior (TP)

    • flexor digitorum longus (FDL)

    • flexor hallucis longus (FHL)

  • origin

    • posterior tibia + fibula

    • interosseous membrane

  • tendons pass posterior to medial malleolus

  • insertion

    • distal to ankle joint

    • FDL + FHL → respective digits

  • action

    • plantar flexion at ankle joint

    • FDL + FHL only → flexion of digits

  • innervation

    • tibial nerve


<ul><li><p>muscles</p><ul><li><p>tibialis posterior (TP)</p></li><li><p>flexor digitorum longus (FDL)</p></li><li><p>flexor hallucis longus (FHL)</p></li></ul></li><li><p>origin</p><ul><li><p>posterior tibia + fibula</p></li><li><p>interosseous membrane</p></li></ul></li><li><p>tendons pass posterior to medial malleolus</p></li><li><p>insertion</p><ul><li><p>distal to ankle joint</p></li><li><p>FDL + FHL → respective digits</p></li></ul></li><li><p>action</p><ul><li><p>plantar flexion at ankle joint</p></li><li><p>FDL + FHL only → flexion of digits</p></li></ul></li><li><p>innervation</p><ul><li><p>tibial nerve</p></li></ul></li></ul><p></p>
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lateral lower leg compartment

  • muscles

    • fibularis (peroneus) longus

    • fibularis (peroneus) brevis

  • origin

    • along length of fibula

  • pass posterior to lateral malleolus

  • insertion

    • longus → onto 1st metatarsal

    • brevis → onto 5th metatarsal

  • action

    • plantar flexion at ankle joint

    • eversion of foot → movement at subtalar joint

      • support arches of foot

  • innervation

    • superficial peroneal nerve


<ul><li><p>muscles</p><ul><li><p>fibularis (peroneus) longus</p></li><li><p>fibularis (peroneus) brevis</p></li></ul></li><li><p>origin</p><ul><li><p>along length of fibula</p></li></ul></li><li><p>pass posterior to lateral malleolus</p></li><li><p>insertion</p><ul><li><p>longus → onto 1st metatarsal </p></li><li><p>brevis → onto 5th metatarsal</p></li></ul></li><li><p>action</p><ul><li><p>plantar flexion at ankle joint</p></li><li><p>eversion of foot → movement at subtalar joint</p><ul><li><p>support arches of foot</p></li></ul></li></ul></li><li><p>innervation</p><ul><li><p>superficial peroneal nerve</p></li></ul></li></ul><p></p>
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sciatic nerve branches

2 branches

  1. tibial nerve

    1. superficial + deep layers of posterior compartment of lower leg

  2. common peroneal (fibular) nerve

    1. superficial peroneal (fibular) nerve

      1. lateral compartment of lower leg

    2. deep peroneal (fibular) nerve

      1. anterior compartment of lower leg


<p>2 branches</p><ol><li><p>tibial nerve</p><ol><li><p>superficial + deep layers of posterior compartment of lower leg </p></li></ol></li><li><p>common peroneal (fibular) nerve</p><ol><li><p>superficial peroneal (fibular) nerve</p><ol><li><p>lateral compartment of lower leg</p></li></ol></li><li><p>deep peroneal (fibular) nerve</p><ol><li><p>anterior compartment of lower leg</p></li></ol></li></ol></li></ol><p></p>
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popliteal artery

2 branches

  1. anterior tibial artery

    1. moves anteriorly through proximal hiatus in interosseous membrane

      1. supplies anterior compartment of lower leg

  2. posterior tibial artery

    1. moves distally b/w superficial + deep layers of posterior compartment of lower leg

      1. supplies posterior compartment of lower leg


<p>2 branches</p><ol><li><p>anterior tibial artery</p><ol><li><p>moves <em>anteriorly </em>through proximal hiatus in interosseous membrane</p><ol><li><p>supplies <em>anterior </em>compartment of lower leg</p></li></ol></li></ol></li><li><p>posterior tibial artery</p><ol><li><p>moves <em>distally </em>b/w superficial + deep layers of posterior compartment of lower leg </p><ol><li><p>supplies <em>posterior </em>compartment of lower leg</p></li></ol></li></ol></li></ol><p></p>
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piriformis

deep lateral rotator muscle → lateral rotation at hip

<p>deep lateral rotator muscle → lateral rotation at hip </p>
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obturators internus and externus

deep lateral rotator muscle → lateral rotation at hip

<p>deep lateral rotator muscle → lateral rotation at hip </p>
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superior and inferior gemelli

deep lateral rotator muscle → lateral rotation at hip

<p>deep lateral rotator muscle → lateral rotation at hip </p>
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quadratus femoris

deep lateral rotator muscle → lateral rotation at hip

<p>deep lateral rotator muscle → lateral rotation at hip </p>
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important bony landmarks

knowt flashcard image
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rectus femoris

anterior compartment of thigh → extension at knee joint

  • part of quadriceps femoris

  • origin

    • anterior superior iliac spine (ASIS)

  • insertion

    • tibial tuberosity via patella + patellar ligament

  • innervation

    • femoral nerve


<p>anterior compartment of thigh → extension at knee joint </p><ul><li><p>part of quadriceps femoris </p></li><li><p>origin</p><ul><li><p>anterior superior iliac spine (ASIS)</p></li></ul></li><li><p>insertion </p><ul><li><p>tibial tuberosity via patella + patellar ligament </p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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vastus lateralis

anterior compartment of thigh → extension at knee joint

  • part of quadriceps femoris

  • origin

    • proximal anterior femur

  • insertion

    • tibial tuberosity via patella + patellar ligament

  • innervation

    • femoral nerve


<p>anterior compartment of thigh → extension at knee joint </p><ul><li><p>part of quadriceps femoris </p></li><li><p>origin</p><ul><li><p>proximal anterior femur</p></li></ul></li><li><p>insertion </p><ul><li><p>tibial tuberosity via patella + patellar ligament </p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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vastus intermedius

anterior compartment of thigh → extension at knee joint

  • part of quadriceps femoris

  • origin

    • proximal anterior femur

  • insertion

    • tibial tuberosity via patella + patellar ligament

  • innervation

    • femoral nerve


<p>anterior compartment of thigh → extension at knee joint </p><ul><li><p>part of quadriceps femoris </p></li><li><p>origin</p><ul><li><p>proximal anterior femur</p></li></ul></li><li><p>insertion </p><ul><li><p>tibial tuberosity via patella + patellar ligament </p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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vastus medialis

anterior compartment of thigh → extension at knee joint

  • part of quadriceps femoris

  • origin

    • proximal anterior femur

  • insertion

    • tibial tuberosity via patella + patellar ligament

  • innervation

    • femoral nerve


<p>anterior compartment of thigh → extension at knee joint </p><ul><li><p>part of quadriceps femoris </p></li><li><p>origin</p><ul><li><p>proximal anterior femur</p></li></ul></li><li><p>insertion </p><ul><li><p>tibial tuberosity via patella + patellar ligament </p></li></ul></li><li><p>innervation</p><ul><li><p>femoral nerve</p></li></ul></li></ul><p></p>
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biceps femoris

posterior compartment of thigh → flexion at knee joint

  • part of hamstrings

  • origin

    • ischial tuberosity

  • insertion

    • lateral tibial condyle/head of fibula

  • innervation

    • sciatic nerve


<p>posterior compartment of thigh → flexion at knee joint </p><ul><li><p>part of hamstrings</p></li><li><p>origin </p><ul><li><p>ischial tuberosity </p></li></ul></li><li><p>insertion </p><ul><li><p>lateral tibial condyle/head of fibula</p></li></ul></li><li><p>innervation</p><ul><li><p>sciatic nerve </p></li></ul></li></ul><p></p>
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semimembranosus

posterior compartment of thigh → flexion at knee joint

  • part of hamstrings

  • origin

    • ischial tuberosity

  • insertion

    • medial tibial condyle

  • innervation

    • sciatic nerve


<p>posterior compartment of thigh → flexion at knee joint </p><ul><li><p>part of hamstrings</p></li><li><p>origin </p><ul><li><p>ischial tuberosity </p></li></ul></li><li><p>insertion </p><ul><li><p>medial tibial condyle </p></li></ul></li><li><p>innervation</p><ul><li><p>sciatic nerve </p></li></ul></li></ul><p></p>
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semitendinosus

posterior compartment of thigh → flexion at knee joint

  • part of hamstrings

  • origin

    • ischial tuberosity

  • insertion

    • medial tibial condyle

  • innervation

    • sciatic nerve


<p>posterior compartment of thigh → flexion at knee joint </p><ul><li><p>part of hamstrings</p></li><li><p>origin </p><ul><li><p>ischial tuberosity </p></li></ul></li><li><p>insertion </p><ul><li><p>medial tibial condyle</p></li></ul></li><li><p>innervation</p><ul><li><p>sciatic nerve </p></li></ul></li></ul><p></p>
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pectineus

medial compartment of thigh → adduction at hip joint

  • part of adductors

  • origin

    • pubis

  • insertion

    • linea aspera of femur

  • innervation

    • obturator nerve


<p>medial compartment of thigh → adduction at hip joint </p><ul><li><p>part of adductors </p></li><li><p>origin</p><ul><li><p>pubis</p></li></ul></li><li><p>insertion </p><ul><li><p>linea aspera of femur </p></li></ul></li><li><p>innervation </p><ul><li><p>obturator nerve </p></li></ul></li></ul><p></p>
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adductor longus

medial compartment of thigh → adduction at hip joint

  • part of adductors

  • origin

    • pubis

  • insertion

    • linea aspera of femur

  • innervation

    • obturator nerve


<p>medial compartment of thigh → adduction at hip joint </p><ul><li><p>part of adductors </p></li><li><p>origin</p><ul><li><p>pubis</p></li></ul></li><li><p>insertion </p><ul><li><p>linea aspera of femur </p></li></ul></li><li><p>innervation </p><ul><li><p>obturator nerve </p></li></ul></li></ul><p></p>
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adductor brevis

medial compartment of thigh → adduction at hip joint

  • part of adductors

  • origin

    • pubis

  • insertion

    • linea aspera of femur

  • innervation

    • obturator nerve


<p>medial compartment of thigh → adduction at hip joint </p><ul><li><p>part of adductors </p></li><li><p>origin</p><ul><li><p>pubis</p></li></ul></li><li><p>insertion </p><ul><li><p>linea aspera of femur </p></li></ul></li><li><p>innervation </p><ul><li><p>obturator nerve </p></li></ul></li></ul><p></p>
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adductor magnus

medial compartment of thigh → adduction at hip joint

  • part of adductors

  • origin

    • pubis

  • insertion

    • adductor tubercle

  • innervation

    • obturator nerve


<p>medial compartment of thigh → adduction at hip joint</p><ul><li><p>part of adductors</p></li><li><p>origin</p><ul><li><p>pubis</p></li></ul></li><li><p>insertion</p><ul><li><p>adductor tubercle</p></li></ul></li><li><p>innervation</p><ul><li><p>obturator nerve</p></li></ul></li></ul><p></p>
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tibialis anterior

anterior compartment of lower leg → dorsiflexion at ankle joint

  • origin

    • anterior tibia (lateral condyle)

    • interosseous membrane

  • insertion

    • distal to ankle joint

  • innervation

    • deep peroneal nerve


<p>anterior compartment of lower leg → dorsiflexion at ankle joint </p><ul><li><p>origin</p><ul><li><p>anterior tibia (lateral condyle)</p></li><li><p>interosseous membrane </p></li></ul></li><li><p>insertion </p><ul><li><p>distal to ankle joint</p></li></ul></li><li><p>innervation</p><ul><li><p>deep peroneal nerve</p></li></ul></li></ul><p></p>
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extensor digitorum longus (EDL)

anterior compartment of lower leg → dorsiflexion at ankle joint + extension of digits

  • origin

    • anterior tibia (lateral condyle)

    • fibula

    • interosseous membrane

  • insertion

    • tendons out to respective digits (2-5)

  • innervation

    • deep peroneal nerve


<p>anterior compartment of lower leg → dorsiflexion at ankle joint + extension of digits</p><ul><li><p>origin</p><ul><li><p>anterior tibia (lateral condyle)</p></li><li><p>fibula </p></li><li><p>interosseous membrane </p></li></ul></li><li><p>insertion </p><ul><li><p>tendons out to respective digits (2-5)</p></li></ul></li><li><p>innervation</p><ul><li><p>deep peroneal nerve </p></li></ul></li></ul><p></p>
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extensor hallucis longus (EHL)

anterior compartment of lower leg → dorsiflexion at ankle joint + extension of digits

  • origin

    • fibula

    • interosseous membrane

  • insertion

    • tendons out to respective digit (1)

  • innervation

    • deep peroneal nerve


<p>anterior compartment of lower leg → dorsiflexion at ankle joint + extension of digits</p><ul><li><p>origin</p><ul><li><p>fibula </p></li><li><p>interosseous membrane </p></li></ul></li><li><p>insertion </p><ul><li><p>tendons out to respective digit (1)</p></li></ul></li><li><p>innervation</p><ul><li><p>deep peroneal nerve </p></li></ul></li></ul><p></p>
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tibialis posterior

posterior compartment of lower leg → plantarflexion at ankle joint

  • origin

    • posterior tibia + fibula

    • interosseous membrane

  • insertion

    • distal to ankle joint

  • innervation

    • tibial nerve


<p>posterior compartment of lower leg → plantarflexion at ankle joint</p><ul><li><p>origin </p><ul><li><p>posterior tibia + fibula </p></li><li><p>interosseous membrane </p></li></ul></li><li><p>insertion </p><ul><li><p>distal to ankle joint </p></li></ul></li><li><p>innervation </p><ul><li><p>tibial nerve </p></li></ul></li></ul><p></p>
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flexor digitorum longus

posterior compartment of lower leg → plantarflexion at ankle joint + flexion of digits

  • origin

    • posterior tibia + fibula

  • insertion

    • tendons to respective digits (2-5)

  • innervation

    • tibial nerve


<p>posterior compartment of lower leg → plantarflexion at ankle joint + flexion of digits</p><ul><li><p>origin </p><ul><li><p>posterior tibia + fibula </p></li></ul></li><li><p>insertion </p><ul><li><p>tendons to respective digits (2-5)</p></li></ul></li><li><p>innervation </p><ul><li><p>tibial nerve </p></li></ul></li></ul><p></p>
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flexor hallucis longus

posterior compartment of lower leg → plantarflexion at ankle joint + flexion of digits

  • origin

    • posterior tibia + fibula

  • insertion

    • tendons to respective digit (1)

  • innervation

    • tibial nerve


<p>posterior compartment of lower leg → plantarflexion at ankle joint + flexion of digits</p><ul><li><p>origin </p><ul><li><p>posterior tibia + fibula </p></li></ul></li><li><p>insertion </p><ul><li><p>tendons to respective digit (1)</p></li></ul></li><li><p>innervation </p><ul><li><p>tibial nerve </p></li></ul></li></ul><p></p>
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fibularis longus (peroneus longus)

lateral compartment of lower leg → plantarflexion at ankle joint + eversion of foot (at subtalar joint)

  • origin

    • along fibula

  • insertion

    • onto 1st metatarsal

  • innervation

    • superficial peroneal nerve


<p>lateral compartment of lower leg → plantarflexion at ankle joint + eversion of foot (at subtalar joint)</p><ul><li><p>origin </p><ul><li><p>along fibula </p></li></ul></li><li><p>insertion </p><ul><li><p>onto 1st metatarsal </p></li></ul></li><li><p>innervation </p><ul><li><p>superficial peroneal nerve </p></li></ul></li></ul><p></p>
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fibularis brevis (peroneus brevis)

lateral compartment of lower leg → plantarflexion at ankle joint + eversion of foot (at subtalar joint)

  • origin

    • along fibula

  • insertion

    • onto 5th metatarsal

  • innervation

    • superficial peroneal nerve


<p>lateral compartment of lower leg → plantarflexion at ankle joint + eversion of foot (at subtalar joint)</p><ul><li><p>origin </p><ul><li><p>along fibula </p></li></ul></li><li><p>insertion </p><ul><li><p>onto 5th metatarsal </p></li></ul></li><li><p>innervation </p><ul><li><p>superficial peroneal nerve </p></li></ul></li></ul><p></p>
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ilium

(1)

<p>(1)</p>
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sacrum

(2)

<p>(2)</p>
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ilium

(1)

<p>(1)</p>
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sacrum

(2)

<p>(2)</p>
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pubis

(1)

<p>(1)</p>
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femoral head

(2)

<p>(2)</p>
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femoral neck

(3)

<p>(3)</p>
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greater trochanter

(4)

<p>(4)</p>
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ischium

(5)

<p>(5)</p>
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femur

(1)

<p>(1)</p>
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lesser trochanter

(2)

<p>(2)</p>
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inferior ramus of pubis

(3)

<p>(3)</p>
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greater trochanter

(1)

<p>(1)</p>
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acetabulum

(2)

<p>(2)</p>
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ilium

(3)

<p>(3)</p>
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femoral head

(4)

<p>(4)</p>
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acetabulum

(1)

<p>(1)</p>
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femoral head

(2)

<p>(2)</p>
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ilium

(3)

<p>(3)</p>
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ischial tuberosity

(4)

<p>(4)</p>
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psoas

(1)

<p>(1)</p>
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iliacus

(2)

<p>(2)</p>
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iliopsoas

(1)

<p>(1)</p>
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femoral head

(2)

<p>(2)</p>
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ilium

(3)

<p>(3)</p>
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gluteus minimus

(1)

<p>(1)</p>
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gluteus maximus

(2)

<p>(2)</p>
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gluteus medius

(3)

<p>(3)</p>
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iliopsoas

(4)

<p>(4)</p>
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gluteus medius

(1)

<p>(1)</p>
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gluteus maximus

(2)

<p>(2)</p>
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lesser trochanter

(3)

<p>(3)</p>
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acetabulum

(4)

<p>(4)</p>