Post on 15-Jan-2020
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Anatomy of the lower limb
1. Bones of the lower limb
Pelvis
Hip bone/Coxal bone
Acetabulum o Acetabular margin o Acetabular fossa o Acetabular notch o Lunate surface
Ischiopubic ramus
Obturator foramen Ilium
Body of ilium
Ala of ilium/Wing of ilium
Arcuate line
Iliac crest
Anterior superior iliac spine
Anterior inferior iliac spine
Posterior superior iliac spine
Posterior inferior iliac spine
Iliac fossa
Gluteal surface
Sacropelvic surface o Auricular surface o Iliac tuberosity
Ischium
Body
Ramus o Ischial tuberosity
Ischial spine
Greater sciatic notch
Lesser sciatic notch Pubis
Body
Superior pubic ramus o Iliopubic ramus o Pecten pubis/Pectineal line
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o Pubic tubercle o Symphysial surface o Obturator crest o Obturator groove o Anterior obturator tubercle o (Posterior obturator tubercle)
Inferior pubic ramus
Pelvis Greater pelvis Lesser pelvis Linea terminalis Pelvic inlet Pelvic cavity Pelvic outlet
Femur Proximal epiphysis
Head
Fovea for ligament of head
Neck
Greater trochanter
Trochanteric fossa
Lesser trochanter
Intertrochanteric line
Intertrochanteric crest Shaft of femur/Diaphysis
Linea aspera
Gluteal tuberosity
Pectineal line Distal epiphysis
Medial and lateral condyles
Medial epicondyle o Adductor tubercle
Lateral epicondyle
Medial supracondylar line
Lateral supracondylar line
Intercondylar fossa
Intercondylar line
Popliteal surface
Patellar surface
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Patella Base of patella
Apex of patella
Articular surface
Anterior surface
Tibia Proximal epiphysis
Medial and lateral condyle
Superior articular surface
Intercondylar eminence
Anterior and posterior intercondylar area
Lateral intercondylar tubercle
Medial intercondylar tubercle
Fibular articular facet
Soleal line
Tibial tuberosity Shaft/ Diaphysis
Anterior border
Medial border
Interosseous border
Medial surface
Lateral surface
Posterior surface Distal epiphysis
Medial malleolus
Articular facet
Malleolar groove
Inferior articular surface
Fibular notch
Fibula Proximal epiphysis
Head
Apex of head
Articular facet
Neck Shaft/ Diaphysis
Interosseous border
Anterior border
Posterior border
Medial surface
Lateral surface
Posterior surface
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Distal epiphysis
Lateral malleolus
Articular facet
Malleolar fossa
Malleolar groove
Bones of foot Talus
Head
Neck
Body
Trochlea of talus
Medial malleolar facet
Lateral malleolar facet
Navicular articular surface
Anterior facet for calcaneus
Middle facet for calcaneus
Posterior calcaneal articular facet
Sulcus tali
Lateral process
Posterior process
Groove for tendon of flexor hallucis longus
Calcaneus Calcaneal tuberosity
o Medial process; Lateral process
Anterior talar articular surface
Middle talar articular surface
Posterior talar articular surface
Calcaneal sulcus Sustentaculum tali
Groove for tendon of flexor hallucis longus
Groove for tendon of fibularis longus
Articular surface for cuboid
Os naviculare Tuberosity
Medial-, Intermediate-, Lateral cuneiform Cuboid
Tuberosity
Groove for tendon of fibularis longus
Metatarsals ; Phalanges
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2. Joints of lower limb
Joints
Name
Articulating surfaces
Type of joint
Movements
Capsule, ligaments
Special components
Ligaments to know
Sacro-iliac joint
Anterior, posterior interosseous sacro-iliac ligaments
Pubic symphysis Superior pubic ligament
Inferior pubic ligament
Ligaments of pelvis Iliolumbar ligament
Sacrospinous ligament
Sacrotuberous ligament
Obturator membrane
Inguinal ligament
Hip joint Ligament of head of femur
Transverse acetabular ligament
Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament
Knee joint Anterior cruciate ligament
Posterior cruciate ligament
Transverse ligament of knee
Tibial collateral ligament
Fibular collateral ligament
Oblique popliteal ligament
Patellar ligament
Medial patellar retinaculum
Lateral patellar retinaculum
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Tibiofibular joint Anterior ligament of fibular head
Posterior ligament of fibular head
Syndesmosis tibiofibularis Interosseous membrane
Anterior ligament of fibular head
Posterior ligament of fibular head
Ankle joint Deltoid ligament
o Tibionavicular part o Tibiocalcaneal part o Anterior tibiotalar part o Posterior tibiotalar part
Lateral ligament o Anterior talofibular ligament o Posterior talofibular ligament o Calcaneofibular ligament
Subtalar joint Lateral talocalcaneal ligament
Medial talocalcaneal ligament
Posterior talocalcaneal ligament
Talocalcaneal interosseous ligament
Talocalcaneonavicular joint Spring ligament = Plantar calcaneonavicular ligament
Talonavicular ligament
Bifurcate ligament
Calcaneocuboid joint Long plantar ligament
Spring ligament = Plantar calcaneonavicular ligament
Bifurcate ligament
Transverse tarsal joint Bifurcate ligament
Tarsometatarsal joint
Dorsal tarsometatarsal ligament
Plantar tarsometatarsal ligament
Interosseous tarsometatarsal ligament
Plantar arches
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3. Muscles of the lower limb
Origin, insertion, function, innervation Muscles of the pelvis
Iliopsoas
Piriformis
Obturator internus
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fasciae latae
Gemelli sup. et inf.
Obturator externus
Quadratus femoris
Fascia lata, iliotibial tract
Extensors of thigh Quadriceps femoris
o Rectus femoris o Vastus medialis o Vastus lateralis o Vastus intermedius
Sartorius
Flexors of thigh Semitendinosus
Semimembranosus
Biceps femoris
Adductors of thigh Pectineus
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Extensors of leg Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
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Flexors of leg
Triceps surae (mm. gastrocnemii, m. soleus, m. plantaris), tendo calcanei
Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior
Fibular muscles of leg Fibularis (Peroneus) longus
Fibularis (Peroneus) brevis
Muscles of back of foot Extensor hallucis brevis
Extensor digitorum brevis
Muscles of the sole Plantar aponeurosis Medial plantar eminence
Abductor hallucis
Flexor hallucis brevis
Adductor hallucis
Lateral plantar eminence Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Intermedial plantar eminence Flexor digitorum brevis
Lumbricals
Quadratus plantae
Planter interossei
Dorsal interossei
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4. Blood supply of lower limb
Internal iliac a. o Superior gluteal a. o Inferior gluteal a. o Internal pudendal a. o Obturator a. - acetabular branch
External iliac a. o Inferior epigastric a. o Deep circumflex iliac a.
Femoral a. o Deep artery of thigh
Medial circumflex femoral a. Lateral circumflex femoral a. Perforating aa.
o Descending genicular a.
Popliteal a. o Superior lateral genicular a. o Superior medial genicular a. o Middle genicular a. o Sural aa. o Inferior lateral genicular a. o Inferior medial genicular a.
Anterior tibial a. o Anterior tibial recurrent a. o Anterior lateral malleolar a. o Anterior medial malleolar a.
Dorsalis pedis a./Dorsal a. of foot o Later tarsal a. o Medial tarsal aa. o Arcuate a. o Dorsal metatarsal aa. o Dorsal digital aa. o Deep plantar a.
Posterior tibial a. o Circumflex fibular branch o Fibular a. o Medial malleolar branches o Calcaneal branches
Medial plantar a. o Deep branch o Superficial branch
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Lateral plantar a. o Deep plantar arch o Plantar metatarsal aa. o Common plantar digital aa. o Plantar digital arteries proper
External iliac v. Femoral v. Popliteal v. Great saphenous v. Small saphenous v. Dorsal venous arch of foot
Theoretical question
Lymph drainage of lower limb Pulse points on lower limb Anastomoses of deep – superficial veins of lower limb.
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5. Nerves of lower limb
Lumbar plexus
Iliohypogastric n.
Ilio-inguinal n. Genitofemoral n. Lateral cutaneous nerve of thigh Femoral n.
o Muscular branches
o Anterior femoral cutaneous n. o Saphenous n.
Obturator n. o Anterior br. o Posterior br.
Lumbosacral trunk
Sacral plexus Superior gluteal n. Inferior gluteal n. Posterior cutaneous n. of thigh Sciatic n.
o Tibial n. Med. sural cutaneous n. → sural n. →lateral dorsal cutaneous nerve of foot Medial calcaneal branches
Medial plantar n.
Common plantar digital nerves→Proper plantar digital nerves Lateral plantar n.
Deep br.
Superficial br. Common plantar digital nerves → Proper plantar digital nerves
o Fibular n.
Lateral sural cutaneous n. Superficial fibular n.
Medial dorsal cutaneous nerve of foot Intemediate dorsal cutaneous nerve of foot
Deep fibular n. Pudendal n.
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Theoretical questions Skin innervation of lower limb Parts of lower limb innervated by branches of the lumbar plexus.
Topography Suprapiriform hiatus - contents Infrapiriform hiatus - contents Subinguinal hiatus Femoral canal Adductor canal Popliteal fossa Obturator canal Medial malleolar region Lateral malleolar region Femoral trigone