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Lower Limb

  • Skeleton (homologous with upper limb)
  • Muscles--anterior, posterior compartments
  • Nerves--sciatic, femoral
  • Surface anatomy

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Upper-Lower Limb Comparison

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See Table M&M, Table 8.1

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Tibia/fibula

  • Tibia--big toe side
  • Fibula--little toe side

(no pronation/supination)

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Ankle

  • Tarsus--forms ankle joint
  • Calcaneus--forms heel

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Foot

  • Function:
    • Support weight
    • Act as lever when walking
  • Tarsals
    • Talus = ankle
      • Between tibia + fibula
      • Articulates w/both
    • Calcaneus = heel
      • Attachment for Calcaneal tendon
      • Carries talus
  • Metatarsals
    • Homologous to metacarpals
  • Phalanges
    • Smaller, less nimble

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Frolich, Human Anatomy, 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

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Frolich, Human Anatomy, 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

​

pg 218

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Lower Limb Movements

  • Hip
    • Flexion/extension
    • Abduction/adduction
    • Lateral/medial rotation
  • Knee
    • Flexion/extension
  • Ankle
    • Dorsiflexion/plantarflexion
    • Inversion/eversion
  • Toes
    • Flexion/extension
  • Bending on posterior side is flexion (except hip)
  • Bending on anterior sided is extension (except hip)

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Anterior/Posterior compartments

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Sciatic n.

(sacral plexus)

Femoral n.

(lumbar plexus)

NERVES

Hamstrings

Gastrocs

Quads

Shin

MUSCLES

Flexion

Extension

MOVEMENT

POSTERIOR COMPARTMENT

ANTERIOR COMPARTMENT

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Thigh movements by compartment

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Posterior Thigh

  • Gluts (gluteal nn.)
    • Maximus—extensor of thigh
    • Medius--pelvic tilt
  • Lateral rotators (spinal nn.)
    • Piriformis syndrome
  • Hamstrings (sciatic n.)
    • Biceps femoris
    • Semimembranous
    • Semitendinous

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Anterior thigh (femoral n.)

  • Sartorius (Tailor’s muscle)
  • Quads (four)
    • Rectus femoris (crosses hip)
    • 3 vastus mm. (vast--big)

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Medial compartment (obturator n.)

  • Adductor muscles
    • Gracilis
    • Adductor
      • Magnus
      • Longus
      • brevis

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

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Anterior Leg (deep fibular n.)

  • Fibularis (peroneus) longus
  • Extensor digitorum longus
  • Extensor hallicus longus
  • Tibialis anteriorus

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Lateral Leg (superficial fibular n.)

  • Fibularis brevis/longus

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Posterior Leg (tibial n.)

  • Gastrocs and soleus
  • Flexor digitorum longus
  • Flexor hallucus longus

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Intrinsics of foot

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  • Lumbar plexus (femoral nerve)
  • Sacral plexus (sciatic nerve)

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With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense

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Dermatomes show twisting of leg in development

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Blood supply to lower limb

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  • Internal Iliac
    • Cranial + Caudal Gluteals= gluteals
    • Internal Pudendal = perineum, external genitalia
    • Obturator = adductor muscles

​

  • External Iliac
    • Femoral = lower limb
      • Deep femoral = adductors, hamstrings, quadriceps
    • Popliteal (continuation of femoral)
      • Geniculars = knee
      • Anterior Tibial = ant. leg muscles, further branches to feet
      • Posterior Tibial = flexor muscles, plantar arch, branches to toes

​

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Surface Anatomy: Posterior Pelvis

  • Iliac crest
  • Gluteus maximus = cheeks
  • Natal/gluteal cleft = crack
  • Gluteal folds = bottom of cheek

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pg 789

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Surface Anatomy: Anterior Thigh + Leg

  • Palpate
    • Patella
    • Condyles of femur
  • Femoral Triangle
    • Sartorius (lateral)
    • Adductor longus (medial)
    • Inguinal ligament (superior)
    • Femoral a + v, lymph nodes

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pg 785

pg 792

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Surface Anatomy: Posterior Leg

  • Popliteal fossa
    • Diamond-shape fossa behind knee
  • Boundaries
    • Biceps femoris (sup-lat)
    • Semitendinosis + semimembranosis (sup-med)
    • Gastrocnemius heads (inf)
  • Contents
    • Popliteal a + v

​

  • Calcaneal (Achilles) tendon

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pg 793