Antero-medial compartments of the thigh, antero-lateral compartment of leg, dorsum of the foot

Functions of lower limbs

• Support the weight of the body

• Produce locomotion

• are very stable and bear weight of the body

• General arrangement of the bones very similar to that of UE

hip bone

Two irregularly shaped bones that form part of the pelvic girdle

• Ilium

• ischium

• Pubis

3 skeletal elements

Pubis - Acetabulum

where the head of the femur articulates

os coxae (hip bone)

• is topographically and functionally the equivalent of the upper limb clavicle and scapula. It forms the lower limb girdle that attaches the limb to the vertebral column

• These bones meet one another at the acetabulum

  • articulate with the sacrum at the sacroiliac joints and form the anterolateral walls of the pelvis

  • articulate with one another anteriorly at the symphysis pubis

ilium

Is the widest and largest located superiorly - acetabular roof

• which is the upper flattened part of the bone, possesses the iliac crest.

• This can be felt through the skin along its entire length. It ends in front at the anterosuperior iliac spine and behind at the posterosuperior iliac spine

• The ilium possesses a large notch, the greater sciatic notch.

ischium

• Forms the posteroinferior part of the hip bone composed of a body, an inferior ramus and superior ramus

• also called as Sitting bone

True

The ischium is L shaped, possessing an upper thicker part, the body, and a lower thinner part, the ramus.

ischial spine

projects from the posterior border of the ischium and intervenes between the greater and lesser sciatic notches.

ischial tuberosity

is the large roughened area that forms the posterior aspect of the lower part of the body of the bone.

Pubis

Is the most anterior
It consists of a body, superior ramus and inferior ramus

symphisis pubis

makakapa sa may puson na area

True

• The pubis is divided into a body, a superior ramus, and an inferior ramus.

• The bodies of the two pubic bones articulate with each other in the midline anteriorly at the symphysis pubis.

superior ramus

joins the ilium and ischium at the acetabulum

inferior ramus

joins the ischial ramus below the obturator foramen.

hip joint

knee joint

femur

hip joint

is a ball and socket joint

circumduction, lateral and medial rotation, extension of thigh

Movements na meron sa ball and socket joint

True

hip join

• Joins the middle hip joint through your head of the femur. Compared to humerus, mas mahaba ang length ng femur.

  • From the greater to lesser trochanter anterior surface (color green), is called the intertrochanteric line. Pag posterior, it is called intertrochanteric crest.

hip joint; knee joint

The femur articulates above with the acetabulum to form the blank and below with the tibia and the patella to form the blank

upper end femur

head, neck, greater and lesser trochanters

articular surface

The anterior surfaces of the condyles are joined by an blank for the patella

fovea capitis

In the center of the head is a small depression, called the blank, for the attachment of the ligament of the head

head

articulates with the acetabulum of the os coxae to form the hip joint

neck

connects the head and shaft

True

The greater and lesser trochanters are large eminences situated at the junction of the neck and the shaft.

intertrochanteric line

The blank, which connects the trochanters anteriorly, is where the iliofemoral ligament attaches.

intertrochanteric crest

The blank connects the trochanters posteriorly

shaft

of the femur is smooth and rounded on its anterior surface but posteriorly has a ridge, the linea aspera, to which are attached muscles and intermuscular septa seen. The margins of the linea aspera diverge above and below.

True

The lower end of the femur has lateral and medial condyles - The two condyles take part in the formation of the knee joint.

Patella

• Kneecap

• -  Largest sesamoid bone

• -  Triangular

• -  Apex - lies inferiorly

apex

is connected to the tuberosity of the tibia by the ligamentum patellae (patellar ligament).

• -  Leg extension - enhances the leverage that the quadriceps tendon can exert on the femur, increasing efficiency of the muscle.

• -  Protection - protects the anterior aspect of the knee joining from physical trauma.

functions of patella

thigh

• -  Proximal segment of the lower limb proper, from the hip to the knee (proximal segments of lower extremity).

• -  The femur is the bony core of the thigh

• -  Sartorius

• -  Iliopsoas

• -  Pectineus

• -  Quadriceps femoris

muscles

femoral artery

blood supply of muscles

True

Arterial supply of these 4 is femoral artery

• Anterior compartment = femoral artery at ang nerve supply nila ay femoral nerve

Sartorius

O - ant superior illiac spine

I - Upper med surface of shaft of tibia (pes anserinus)

A - flex, abduct, lateral rot of thigh, flexes and medial rotate leg at knee joint

Nerve - femoral

True

• Pag thigh, ang legs abduct, lateral rotate; pero medial rotate sa leg

• Flexes, abducts, and laterally rotates the thigh, pero nagfflex at medially rotate ng leg

• External rotation = naka-de kwatro (cross legs)

Iliacus

O - Iliac fossa

I - With psoas into lesser trochanter

A - Flexes thigh on trunk

N - Femoral nerve

True

Iliacus

• Origin ng psoas muscle is the lateral border of lumbar vertebra. Galing sa likod, pababa, magjo-join siya with your iliacus muscle galing sa iliac fossa ng ilium na magiging iliopsoas

Psoas

O - Transverse processes, bodies and IVD of the 12th thoracic vertebra and 5 lumbar vertebras

I - With Iliacus into lesser trochanter

A- Flexes thigh on trunk

N - Lumbar plexus (siya lang iba)

Pectineus

O - Superior ramus of pubis

I - Upper end of linea aspera of shaft of femur

A- Flexes and adducts thigh

N - Femoral nerve (sometimes Obturator nerve)

True

• NERVE SUPPLY! ANTERIOR PART: FEMORAL NERVE AGAD PAG DI ALAM ANG SAGOT

• Sa apat na quadriceps si rectus femoris lang ang nakakapag flex (thigh) because of its origin, lahat sila ang action is extension (knee)

rectus femoris

vastus lateralis

vastus medialis

vastus intermedius

quadriceps femoris

rectus femoris

O - ant infer iliac spine

I - quadriceps tendon → patellar ligament → tubercle of tibia

A - extension of knee; flexes thigh

N - femoral

vastus lateralis

O - Upper end shaft of femur

I - Quadriceps tendon -> Patellar ligament -> Tubercle of

tibia

A - Extension of knee

N - Femoral nerve

Vastus medialis

O - Extension of knee Femoral nerve

I - Quadriceps tendon -> Patellar ligament -> Tubercle of tibia

A - Extension of knee ; stabilizes patella

N - Femoral nerve

Vastus intermedius

O - ant and lat surfaces of shaft and femur

I - Quadriceps tendon -> Patellar ligament -> Tubercle of tibia

A - Extension of knee NERVE

N - Femoral nerve

femoral triangle

situated in the upper part, of the medial aspect of the thigh just below the inguinal ligament

Superiorly: Inguinal ligament
Laterally: Sartorius muscle
Medially: Adductor longus muscle
Floor: Iliopsoas, pectineus, adductor longus

Roof: Skin and fasciae of the thigh

triangular depression

• ●  Femoral nerve and its terminal branches

• ●  Femoral sheath

• ●  Femoral artery and its branches

• ●  Femoral vein and its tributaries

• ●  Deep inguinal lymph nodes
  

• VAN; Vein, Artery, Nerve tapos nababalutan ng sheath,

  tandaan lagi ganan ang arrangement!

major content of triangular depression

adductor canal

• an intermuscular cleft situated on the medial aspect of the middle third of the thigh deep to the sartorius muscle

• Begins - apex of femoral triangle

• Ends – below at the opening in the adductor magnus (adductor hiatus)

• “Hunter’s Canal” (Subsartorial Canal)

• Located at the middle 3rd of thigh

• Passage for neurovascular structures

  • Terminal part of the femoral artery, Femoral vein, Deep lymph vessels, Saphenous nerve, nerve to vastus medialis, terminal part of the obturator nerve

triangular walls

Anteromedial - sartorius muscles

Posterior - adductor longus magnus

Lateral - vastus medialis

femoral sheath

• Downward protrusion of the fascial lining of the abdominal walls into the thigh

• Surround the femoral vessels and lymphatics

• -  Gracilis

• -  Adductor longus

• -  Adductor brevis

• -  Adductor magnus

• -  Obturator externus

muscles of medial fascial compartment

Profunda femoris artery and obturator artery

medial fascial compartment blood supply

obturator nerve

medial fascial compartment nerve supply

Gracilis

O - inferior ramus of pubis

I - Upper part of shaft of tibia on medial surface (pes anserinus)

A - adducts thigh at hip joint; flexes leg at knee joint

N - obturator nerve

adductor longus

O - body of pubis

I - Posterior of surface of shaft of femur

A- Adducts thigh at hip joint; Assist in medial rotation

N - Obturator nerve

adductor brevis

O - Inferior ramus of pubis

I - Posterior of surface of shaft of femur

Posterior of surface of shaft of femur

A - Adducts thigh at hip joint

N - Obturator nerve

adductor magnus

O - Inferior ramus of pubis, ramus of ischium, ischial tuberosity

I - Posterior surface of shaft of femur, adductor tubercle of femur

A - Adducts thigh at hip joint; assists in medial rotation

N - Adductor portion: Obturator nerve

Hamstring portion: Sciatic nerve

obturator externus

O - outer surface of obturator membrane

I - Medial surface of greater trochanter

A - laterally rotates thigh at hip oint

N - obturator nerve

leg

• Middle part of the lower limb

• Between knee and ankle

tibia

Largest weight-bearing medial bone of the leg

Articulates:

• -  Condyles of femur and head of fibula

• -  Talus and distal end of fibula

Ang articulation ng fibula ay nasa proximal head ng Tibia. No connection with femur. Tibia, distally, is connected to the talus and distal end of fibula.

fibula

• Slender lateral bone of the leg

• -  Knee joint – no part in articulation

• -  Ankle joint – participates

• -  No part in transmission of body weight

Provides attachment for muscles. The lower end of the fibula forms the triangular lateral malleolus, which is subcutaneous.

• Distal end of fibula (Lateral malleolus) yung nakakapa na malaking bone sa ankle.

• -  Tibialis anterior

• -  Extensor digitorum longus

• -  Fibularis tertius

• -  Extensor hallucis longus

muscles of anterior fascial compartment of leg

Anterior tibial artery

muscles of anterior fascial compartment of leg blood supply

Deep fibular (peroneal) nerve

muscles of anterior fascial compartment of leg nerve supply

tibialis anterior

O - lat surface of shaft of tibia

I- Medial cuneiform and base of 1st metatarsal bone

A - Extends foot at ankle joint; inverts foot at subtalar joint

N - Deep fibular nerve

Extension of foot - plantarflexion

extensor hallucis longus

O - Anterior surface of shaft of fibula

I - Base of digital phalanx of great toe

A - Extends big toe ;extends foot at ankle joint

N - Deep fibular nerve

extensor digitorum longus

O - Anterior surface of shaft of fibula

I - Extensor expansion of lateral four toes E

A- Extends toes ; extends foot at ankle joint

N - Deep fibular nerve

• -  Fibularis longus

• -  Fibularis brevis

muscles of lateral fascial compartment of leg

Branches from fibular artery

muscles of lateral fascial compartment of leg blood supply

Branches from fibular artery

muscles of lateral fascial compartment of leg nerve supply

fibularis longus

O - Lateral surface of shaft of fibula

I - Base of 5th metatarsal and medial cuneiform

A - Plantarflexes foot ; everts foot

N - Superficial fibular nerve

This is the long muscle
Plantarflex - papuntang talampakan ; Evert: palabas

fibularis brevis

O - Lateral surface of shaft of fibula

I - Base of 5th metatarsal

A - Plantarflexes foot ; everts foot

N - Superficial fibular nerve

This is the short muscle that supports Fibularis Longu

Ankle retinacula

Keep the long tendons around the ankle in position

SUPERIOR EXTENSOR RETINACULUM

Attached to distal ends of the anterior borders of fibula and tibia

INFERIOR EXTENSOR RETINACULUM

Y- shaped band located in front of the ankle joint

True

• The retinacula are thickenings of the deep fascia that keep the long tendons around the ankle joint in position, prevent the long tendons from bowstringing, and act as pulleys.

• Holds in place structures like nerves, tendons, blood vessels

• 52 bones (26 each)

• Tarsal bones (7) "Tiger Cubs Need MILC" Medial to Lateral

  • Talus: connection towards fibula and tibia

  • Calcaneus: largest ; heel/sakong

  • Navicular

  • Medial Cuneiform

  • Intermediate Cuneiform

  • Lateral Cuneiform

  • Cuboid

• Metatarsal (5)

• Phalanges (14)

foot bones

dorsum muscle

● Sole intrinsic muscle on the dorsum of the foot

extensor digitorum brevis

O - Anterior part of upper surface of the calcaneum

I - By four tendons into proximal phalanx of big toe

A - Extends toe

N - Deep fibular nerve

Short muscle for the phalanges

great saphenous vein (superficial veins)

• Drains the medial end of the dorsal venous arch of the foot and passes upward directly in front of the medial malleolus

• Drains into Femoral
  

• Most commonly used for graft i.e. angioplasty, injured blood vesse

lesser saphenous vein

drains into popliteal

• Neck

• Intertrochanteric (bet. Greater and lesser trochanter)

• Subtrochanteric

• Management: Screws, nails, plates

• Fraction (first aid) > Immobilize > Hip replacement (worst case)

femur fractures

lateral, rotation, flexion, abduction

thigh movement

middle rotation at flexion

leg movement

brevis

mas superior, brevis or longus

longus

mas superficial, brevis or longus

sesamoid bone

Anong klaseng bone ang patella

sartorius

illiacus

psoas

pectineus

quadriceps femoris

muscles of anterior fascial compartments of thigh

quadriceps femoris

rectus femoris

vastus lateralis

vastus medialis

vastus intermedius

1. Gracilis

2. Adductor Longus

3. Adductor Brevis

4. Adductor Magnus

5. Obturator Externus

MUSCLES OF MEDIAL FASCIAL COMPARTMENTS OF THIGH

1. Tibialis Anterior

2. Extensor Hallucis Longus

3. Extensor Digitorum Longus

MUSCLES OF ANTERIOR FASCIAL COMPONENTS OF LEG

1. Fibularis Longus

2. Fibularis Brevis

MUSCLES OF LATERAL FASCIAL COMPARTMENT OF LEG