Lower Limb 2

Lower LimbSkeleton (homologous with upper limb)Muscles--anterior, posterior compartmentsNerves--sciatic, femoralSurface anatomy

Upper-Lower Limb ComparisonSee Table M&M, Table 8.1

Tibia/fibulaTibia--big toe sideFibula--little toe side(no pronation/supination)

AnkleTarsus--forms ankle jointCalcaneus--forms heel

FootFunction:Support weightAct as lever when walkingTarsalsTalus = ankleBetween tibia + fibulaArticulates w/bothCalcaneus = heelAttachment for Calcaneal tendonCarries talusMetatarsalsHomologous to metacarpalsPhalangesSmaller, less nimble

Joints of Lower LimbHip (femur + acetabulum)Ball + socketMultiaxialSynovialKnee (femur + patella)Plane Gliding of patellaSynovialKnee (femur + tibia)HingeBiaxialSynovial

Joints of Lower LimbProximal Tibia + FibulaPlaneGlidingSynovialDistal Tibia + FibulaSlight giveFibrousAnkle (Tibia/Fibula + Talus)HingeUniaxialSynovial

pg 218

Lower Limb MovementsBending on posterior side is flexion (except hip)Bending on anterior sided is extension (except hip)HipFlexion/extensionAbduction/adductionLateral/medial rotationKneeFlexion/extensionAnkleDorsiflexion/plantarflexionInversion/eversionToesFlexion/extension

Anterior/Posterior compartments

Thigh movements by compartment

Posterior ThighGluts (gluteal nn.)Maximusextensor of thighMedius--pelvic tiltLateral rotators (spinal nn.)Piriformis syndromeHamstrings (sciatic n.)Biceps femorisSemimembranousSemitendinous

Anterior thigh (femoral n.)Sartorius (Tailors muscle)Quads (four)Rectus femoris (crosses hip)3 vastus mm. (vast--big)

Medial compartment (obturator n.)Adductor musclesGracilisAdductorMagnusLongusbrevis

Leg movements by compartment (in leg all nn are branches of sciatic)

Anterior Leg (deep fibular n.)Fibularis (peroneus) longusExtensor digitorum longusExtensor hallicus longusTibialis anteriorus

Lateral Leg (superficial fibular n.)Fibularis brevis/longus

Posterior Leg (tibial n.)Gastrocs and soleusFlexor digitorum longusFlexor hallucus longus

Intrinsics of foot

Lumbar plexus (femoral nerve)Sacral plexus (sciatic nerve)With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense

Dermatomes show twisting of leg in development

Blood supply to lower limbInternal IliacCranial + Caudal Gluteals= glutealsInternal Pudendal = perineum, external genitaliaObturator = adductor muscles

External IliacFemoral = lower limbDeep femoral = adductors, hamstrings, quadricepsPopliteal (continuation of femoral) Geniculars = kneeAnterior Tibial = ant. leg muscles, further branches to feetPosterior Tibial = flexor muscles, plantar arch, branches to toes

Surface Anatomy: Posterior PelvisIliac crestGluteus maximus = cheeksNatal/gluteal cleft = crackGluteal folds = bottom of cheekpg 789

Surface Anatomy: Anterior Thigh + LegPalpatePatellaCondyles of femurFemoral TriangleSartorius (lateral)Adductor longus (medial)Inguinal ligament (superior)Femoral a + v, lymph nodespg 785pg 792

Surface Anatomy: Posterior LegPopliteal fossaDiamond-shape fossa behind kneeBoundariesBiceps femoris (sup-lat)Semitendinosis + semimembranosis (sup-med)Gastrocnemius heads (inf)ContentsPopliteal a + v

Calcaneal (Achilles) tendonpg 793