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Edit Comment Close Premium member Presentation Transcript ANATOMY OF LOWER LIMB : ANATOMY OF LOWER LIMB By Dr: Mohammed Faez MSU Lower limb : Lower limb The limb of the body extending from the gluteal region to the foot. It is specialized for weight-bearing and locomotion Lower limb : Lower limb The lower limb is divided into the gluteal region, thigh, leg, and foot on the basis of major joints, component bones, and superficial landmarks Parts And Regions Of The Lower Limb : Parts And Regions Of The Lower Limb Gluteal region－between iliac crest superiorly and gluteal fold inferiorly Thigh－between hip and knee knee－joint between leg and thigh Leg－between knee and foot Ankle Foot Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Gluteal region and thigh anterior superior and inferior iliac spines tubercle of iliac crest ischial tuberosity greater trochanter pubic tubercle pubic crest superior border of pubic symphysis Knee patella ligament tuberosity of tibia medial and lateral condyles and epicondyles tendon of biceps femoris tendons of semitendinosus and semimembranosus head of fibula Leg anterior border of tibia neck of fibula Ankle and foot medial and lateral malleolus calcaneal tuberosity tuberosity of navicular bone tuberosity of fifth metatarsal bone Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Gluteus maximus muscle Gluteus medius muscle Gluteal cleft Gluteal fold Ischeal tuberosity Greater trochanter Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Surface features of the Thigh Sartorius muscle Quadriceps femoris muscle Adductor longus muscle Hamstring muscles Femoral triange Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Femoral Triangle Boundaries: Sartorius (lateral) Adductor longus (medial) Inguinal ligament (superior) Contents: Femoral artery, vein and nerve, lymph nodes Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Surface Anatomy of the Knee Patella Patellar ligament Medial condyle of femur Medial condyle of thigh Lateral condyle of femur Lateral condyle of thigh Popliteal fossa Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Popliteal fossa Diamond-shape fossa behind knee Boundaries Biceps femoris (superior-lateral) Semitendinosis and semimembranosis (superior-medial) Gastrocnemius heads (inferior) Contents Popliteal artery and vein Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Surface features of the Leg, Ankle & Foot Tibial tuberosity Tibialis anterior muscle Tibia Peroneus longus muscle Gastrocnemius muscle soleus muscle Surface Anatomy Of Lower Limb : Surface Anatomy Of Lower Limb Achilles (Calcaneal) tendon Lateral malleolus of fibula Medial malleolus of tibia Dorsal venous arch Tendons of extensor digitorum longus muscle Slide 15: 15 Slide 16: 16 Slide 17: 17 Slide 18: 18 Slide 19: 19 Slide 20: 20 Lower limb bones : Lower limb bones Pelvis Femur Tibia, fibula Patella Tarsals Digits Metatarsals Phalanges Lower limb bones : Lower limb bones Joints of Lower Limb : Joints of Lower Limb Hip (femur + acetabulum) Ball + socket Multiaxial Synovial Knee (femur + patella) Plane Gliding of patella Synovial Knee (femur + tibia) Hinge Biaxial Synovial Joints of Lower Limb : Joints of Lower Limb Proximal Tibia + Fibula Plane Gliding Synovial Distal Tibia + Fibula Slight “give” Fibrous Ankle (Tibia/Fibula + Talus) Hinge Uniaxial Synovial Joints of Lower Limb : Joints of Lower Limb Lower Limb Movements : Lower Limb Movements Hip Flexion/extension Abduction/adduction Lateral/medial rotation Knee Flexion/extension Ankle Dorsiflexion/plantarflexion Inversion/eversion Toes Flexion/extension Lower Limb Movements : Lower Limb Movements Bending on posterior side is flexion (except hip) Bending on anterior sided is extension (except hip) Bones of the Lower Limb : Bones of the Lower Limb Function: Locomotion Carry weight of entire erect body Support Points for muscular attachments Components: Thigh Femur Knee Patella Leg Tibia (medial) Fibula (lateral) Foot Tarsals (7) Metatarsals (5) Phalanges (14) Thigh : Thigh Femur The femur is the longest and largest bone. There are four eminences, or protuberances, in the femur: the head, the greater trochanter, the lesser trochanter, and the lower extremity. The shaft of femur is cylindrical with a rough line on its posterior surface (linea aspera). Knee : Knee Patella Triangular sesamoid bone Protects knee joint Improves leverage of thigh muscles acting across the knee Contained within patellar ligament Leg : Leg Tibia Receives the weight of body from femur and transmits to foot Second to femur in size and weight Articulates with fibula proximally and distally Interosseous membrane Fibula Does NOT bear weight Muscle attachment Not part of knee joint Stabilize ankle joint Foot : Foot Function: Supports the weight of the body Act as a lever to propel the body forward Parts: Tarsals Talus = ankle Between tibia and fibula Articulates with both Calcaneus = heel Attachment for Calcaneal tendon Carries talus Navicular Cuboid Medial, lateral and intermediate cuneiforms Metatarsals Phalanges Foot : Foot 3 arches Medial Lateral Transverse Has tendons that run inferior to foot bones Help support arches of foot Function Recoil after stepping Longitudinal Femur: Posterior : Femur: Posterior Tibia Fibula Femur Right, Posterior View Lateral condyle Medial condyle Linea aspera Greater trochanter Lesser trochanter Pelvis Head of femur Lower Leg : Lower Leg Femur Tibia Fibula Tibial tuberosity Talus (tarsal bone) Medial malleolus Lateral malleolus Medial condyle of tibia Lateral condyle of tibia Right Leg, Anterior View Lateral condyle of femur Medial condyle of femur Knee cap Mnemonic for Learning Tarsal Bones: : Mnemonic for Learning Tarsal Bones: Medial cuneiform (1) Intermediate cuneiform (2) Lateral cuneiform (3) Navicular A boat It sails on the Cs Talus Calcaneus Cuboid Tiger Cubs Need M I L C Foot Quiz : Foot Quiz Right, Superior View Slide 38: Right, Superior View Vascular of Lower Limb : Vascular of Lower Limb Main arteries Common iliac External iliac Femoral (+ superficial/deep branches) Profunda femoris Anastomosis around knee (genicular arteries, branch of lat femoral circumflex) Popliteal Anterior/posterior tibial Peroneal Medial/lateral plantar Plantar arch Dorsalis pedis Vascular of Lower Limb : Vascular of Lower Limb Vascular of Lower Limb : Vascular of Lower Limb Vascular of Lower Limb : Vascular of Lower Limb Vascular of Lower Limb : Vascular of Lower Limb Vascular of Lower Limb : Vascular of Lower Limb Venous anatomy divided into 3 groups: Superficial (dermis > Muscular Fascia) Deep (deep to muscular fascia) Perforating veins Vascular of Lower Limb : Vascular of Lower Limb Deep veins Thigh Common femoral vein Femoral vein Deep femoral vein Deep femoral communicating veins Medial circumflex femoral vein Lateral circumflex femoral vein Sciatic vein Vascular of Lower Limb : Vascular of Lower Limb Deep veins KNEE Popliteal vein Genicular venous plexus Deep Veins of Lower limb Posterior tibial veins peroneal Veins Anterior Tibial veins Vascular of Lower Limb : Vascular of Lower Limb Superficial veins Great (long) saphenous vein Sapheno-femoral Junction Posterior lower leg Small (short) saphenous vein Sapheno-popliteal junction Lower Leg perforators Vascular of Lower Limb : Vascular of Lower Limb Great (long) saphenous vein Small (short) saphenous vein Sapheno-popliteal junction Veins of Lower Limb : Veins of Lower Limb Vascular of Lower Limb : Vascular of Lower Limb Lymphatic Drainage Of Lower Limb : Lymphatic Drainage Of Lower Limb Three main groups Superficial inguinal lymph nodes Deep inguinal lymph nodes Popliteal lymph nodes Lymphatic Drainage Of Lower Limb : Lymphatic Drainage Of Lower Limb The superficial inguinal lymph nodes form a chain immediately below the inguinal ligament. They receive as afferents lymphatic vessels from the following: integument of the penis Scrotum Perineum Buttock abdominal wall below the level of the umbilicus Vulva anus (below the pectinate line) the lower extremity (foot, leg and thigh) Lymphatic Drainage Of Lower Limb : Lymphatic Drainage Of Lower Limb The deep inguinal lymph nodes are located medial to the femoral vein and under the cribriform fascia. There are approximately 3 to 5 deep nodes. The superior-most node is located under the inguinal ligament and is called Cloquet's node. The deep inguinal lymph nodes drain superiorly to the external iliac lymph nodes, then to the pelvic lymph nodes and on to the paraaortic lymph nodes. Lymphatic Drainage Of Lower Limb : Lymphatic Drainage Of Lower Limb The popliteal lymph nodes, small in size and some six or seven in number, are imbedded in the fat contained in the popliteal fossa. They receive lymph from: knee joint Deep lymph vessels from leg along anterior & posterior tibial arteries Some superficial lymph vessels from leg & foot along small saphenous vein Their efferents drain into deep inguinal lymph nodes Innervations' of the lower limb : Innervations' of the lower limb Plexuses of the Lower Limb : Plexuses of the Lower Limb “Lumbosacral plexus” Lumbar Plexus Arises from L1-L4 Lies within the psoas major muscle Mostly anterior structures Sacral Plexus Arises from spinal nerve L4-S4 Lies caudal to the lumbar plexus Mostly posterior structures Plexuses of the Lower Limb : Plexuses of the Lower Limb The lumbar plexus : formed by L1-L4 nerves the main branches innervate the anterior thigh via the femoral nerve. Medial thigh and adductor muscles are innervated by the obturator nerve. Plexuses of the Lower Limb : Plexuses of the Lower Limb Lumbar Plexus : Lumbar Plexus Femoral nerve Cutaneous branches Thigh, leg, foot (e.g. saphenous nerve) Motor branches Anterior thigh muscles (e.g. quadriceps, sartorius, iliopsoas) Obturator nerve Sensory Skin medial thigh; hip, knee joints Motor Adductor muscles Lateral femoral cutaneous Sensory Skin lateral thigh Genitofemoral Sensory Skin scrotum, labia major, anterior thigh Motor Cremaster muscle Lumbar Plexus : Lumbar Plexus Femoral n. Sciatic n. Plexuses of the Lower Limb : Plexuses of the Lower Limb The sacral plexus : formed by L4-S4 nerves, its many branches innervate the buttock, lower limb, pelvis, and perineum. The largest branch is the sciatic nerve that supplies lateral and posterior limb regions. It branches into the tibial and fibial nerve. Sacral Plexus : Sacral Plexus Sacral Plexus : Sacral Plexus Sciatic Motor: Hamstring Branches into: Tibial nerve Cutaneous Posterior leg and sole of foot Motor Posterior leg, foot Common fibular (peroneal) nerve Cutaneous Anterior and lateral leg, dorsum foot Motor Lateral compartment, tibialis anterior, toe extensors Superior gluteal nerve Motor Gluteus medius and minimus, tensor fasciae latae Sacral Plexus (continued) : Sacral Plexus (continued) Inferior gluteal nerve Motor Gluteus maximus Posterior femoral cutaneous nerve Sensory Inferior buttocks, posterior thigh, popliteal fossa Pudendal nerve Sensory External genitalia, anus Motor Muscles of perineum Slide 66: lumbarplexus(L1-L4) Slide 67: Lower Limb Dermatomes : Lower Limb Dermatomes Lower Limb Dermatomes : Lower Limb Dermatomes Key dermatomes* of the Lower Limb umbilicus - T10 hip crease - L1 great toe - L4 5th toe - S1 You do not have the permission to view this presentation. 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