Transcript Lower Limb
بسم هللا الرحمن الرحیم Frolich, Human Anatomy, Lower LImb Anatomy of lower limb Shirin Kamalgharibi Master degree of physiotherapy Frolich, Human Anatomy, Lower LImb pg 792 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 Surface Anatomy: Posterior Leg Popliteal fossa Boundaries Biceps femoris (sup-lat) Semitendinosis + semimembranosis (supmed) Gastrocnemius heads (inf) Contents Diamond-shape fossa behind knee Popliteal a + v Calcaneal (Achilles) tendon شرمگاه ( عانه ) دانشکده فنی دکتر شریعتی Frolich, Human Anatomy, Lower LImb Bony structure of the pelvis MAIN STRUCTURES Hip bone (innominate, os coxae)--fusion of Ilium (“hips”) Ischium (“rear”) Pubis (anterior midline) Sacrum and coccyx Acetabulum Femur--head, neck, greater trochanter Frolich, Human Anatomy, Lower LImb HOLES False and true pelvis (major, minor pelvis) Pelvic inlet, pelvic outlet Sacrotuberous ligament Sacrospinous ligament Greater, lesser sciatic foramen Obturator foramen Female Cavity is broad, shallow Pelvic inlet oval + outlet round Bones are lighter, thinner Pubic angle larger Coccyx more flexible, straighter Ischial tuberosities shorter, more everted Frolich, Human Anatomy, Lower LImb Male Cavity is narrow, deep Smaller inlet + outlet Bones heavier, thicker Pubic angle more acute Coccyx less flexible, more curved Ischial tuberosities longer, face more medially استخوان ران Tibia/fibula Tibia--big toe side Fibula--little toe side (no pronation/supination) Frolich, Human Anatomy, Lower LImb Ankle Talus--forms ankle joint Calcaneus--forms heel Frolich, Human Anatomy, Lower LImb Muscles that flex thigh at hip Originate from vertebral column and pelvis and pass anterior to hip joint Sartorius Iliopsoas Tensor fasciae lata Rectus femoris (only quad with origin on pelvis) Pectineus (medial compartment) Muscles that flex thigh at hip: individually ( Iliopsoas Pectineus Tensor fascia lata Sartorius Rectus femoris Inserts on tibial tuberosity via patellar tendon http://www.rad.washington.edu/academics/academic-sections/msk/muscle-atlas high extensors posterior) Gluteus maximus Hamstrings (cross hip and knee joints: extend thigh & flex knee) Biceps femoris Semitendinosus Semimembranosus _______ Hamstrings Biceps femoris cross hip and knee joints: extend thigh and flex knee long head Biceps femoris short head Semitendinosus Semimembranosus Abductors of thigh Buttocks muscles that lie lateral to hip joint Gluteus medius Gluteus minimus (under medius) Tensor fascia lata igh abductors Buttocks muscles that lie lateral to the hip joint Gluteus medius Gluteus minimus Lateral rotators Piriformis Also shown are other rotators and the gluteus muscles Piriformis laterally rotates hip; also helps abduct hip if it is flexed Adduction of thigh Muscles originate medial to hip joint Gracilis Adductor magnus Adductor longus Adductor brevis Pectineus Adductor magnus Thigh adductors (originate medial to hip joint) Pectineus Adductor brevis Gracilis Adductor longus Medial thigh (obturator n.) Adductor muscles Gracilis Adductor • Magnus • Longus • brevis Frolich, Human Anatomy, Lower LImb Knee extensors Quadraceps femoris – the only extensors of the leg (lower leg) at the knee Rectus femoris (only quad with origin on pelvis) Rectus femoris Vastus lateralis Vastus intermedius Vastus medialis Antagonized by hamstrings Rectus femoris (only quad with origin on the pelvis) Quadriceps Vastus lateralis, intermedius, and medialis Insert: tibial tuberosity via _________ Anterior thigh (femoral n.) Sartorius (Tailor’s muscle) Quads (four) Rectus femoris (crosses hip) 3 vastus mm. (vast--big) Frolich, Human Anatomy, Lower LImb Posterior compartment of leg Superficial: these plantarflex foot Gastrocnemius Soleus Plantaris Plantaris Posterior leg Soleus Gastrocnemius Posterior leg continued Deep Popliteus Flexor digitorum longus Flexor hallucis longus Tibilialis posterior Deep posterior leg Popliteus Flexor digitorum longus Flexor hallucis longus Tibialis posterior Posterior Leg (tibial n.) Flexors (plantarflexors) Gastrocs and soleus Flexor digitorum longus Flexor hallucus longus Anterior leg extensors Mainly extend toes and dorsiflex foot Tibialis anterior Extensor digitorum longus Extensor hallucis longus More pics Tibialis anterior Extensor digitorum longus Extensor hallucis longus Anterior Leg (deep fibular n.) Extensors (dorsiflexors) Fibularis (peroneus) longus Extensor digitorum longus Extensor hallicus longus Tibialis anteriorus Lateral compartment of leg Fibularis (peroneus) longus: to first metatarsal and cuneiform Fibularis (peroneus) brevis: to fifth metatarsal 38 39 40 Intrinsics of foot Lumbar and sacral plexus Lumbar plexus forms femoral n.—anterior Sacral plexus forms sciatic n.--posterior Femoral n. Sciatic n. Frolich, Human Anatomy, Lower LImb Anterior Thigh External iliac artery Inguinal ligament Common femoral artery Profunda femoris artery Superficial femoral artery 477 44 Blood supply to lower limb ernal Iliac Cranial + Caudal Gluteals= gluteals Internal Pudendal = perineum, external genitalia Obturator = adductor muscles ernal 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 Frolich, Human Anatomy, Lower LImb Medial Anterior Ankle Anterior tibial artery Dorsalis pedis artry 485 With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense Lumbar plexus (femoral nerve) Sacral plexus (sciatic nerve)