Bones of the Lower Limb

and their landmarks

Sacrum

sacroiliac joint surfaces

Hip bone

sacroiliac surfaces lunate surfaces

asis attachments

aiis attachments

psis attachments

piis attachments

ischial spine attachments

ischial tuberosity attachments

gluteal surface attachments

iliac fossa attachments

iliac crest attachments

lesser sciatic notch role greater sciatic notch role obturator foramen role

pubic tubercle attachments

acetebulum role

Femur

fovea capitis role

neck of femur attachments

head of femur role

greater trochanter attachments

lesser trochanter attachments

intertrochanteric line role

intertrochanteric crest role

linea aspera attachments

epicondyles of the distal femur role articulates with

Patella

attachments associated bursa articulates with femur

Tibia

tibial tuberosity add more??? medial malleolus talotibial joint

Fibula

superior and inferior TF joints serves roles ig lateral malleolus talofibular joint malleolar fossa

Talus

talocrural surface talonavicular surface talocalcaneal surface

Calcaneus

sustaneculum tali calcanocuboid calcaneonavicular

Cuboid

Cuneiforms

Metatarsals

Phalanges

Ligaments of the lower limb

by joint

anterior iliosacral ligament posterior iliosacral ligament interosseus iliosacral ligament

sacrospinous ligament sacrotuberous ligament

inguinal ligament

anterior pubic ligament posterior pubic ligament superior pubic ligament posterior pubic ligament

capsule of the hip ligament of the head of the artery capsular ligaments iliofemoral pubofemoral ischiofemoral

acl pcl lcl mcl popliteal tendon patellar ligament

Deltoid ligament anterior posterior tibiotalar tibio navicular tibiocalcaneal

plantar calcaneonavicular ligament

calcaneofibular ligament anterior and posterior talofibular ligaments

Muscles of the lower limb

Hip

Flexors Iliacus (Originates at: iliac fossa Inserts at: L trochanter) Psoas major (Originates at: lumbar vertebrae Inserts at: L trochanter ) Rectus femoris (Originates at: just above the acetabulum Inserts at: tibial tuberosity) Sartorius (Originates at: ASIS Inserts at: medial to the tibial tuberosity, running behine the knee)

Abductors gluteus medialis (Originates at: gluteal surface rim Inserts at: posterior superior G trochanter) Produces internal rotation too gluteus minimus (Originates at: just above the hip joint on the gluteal surface Inserts at: anterior superior G trochanter) tensor fascia latae (Originates at: Inserts at: Iliotibial tract)

Iliotibial tract goes from ilium to the tibia

External rotators piriformis (originates from the sacrum inserts medial of the g trochanter) gemellus superior (Ori. just inferior to the ischial spine ins. Med G Trochanter) obturator internus (originates at the internal obturator foramen inserts medially to the G trochanter) gemellus interior (Ori. just inferior to Gem. Sup. inserts med G trochanter) obturator externus(originates at the external obturator foramen inserts medially to the G trochanter) quadratus femoris (originates anterior ischiopubic ramus just at the bottom inserts intertrochanteric crest)

Adductors pectineus (Originates at: pectineal line Inserts at: just before adductor brevis) adductor brevis (Originates at: pubis Inserts at: ~1/2 half of the linea aspera) adductor longus (Originates at: pubis Inserts at: 4rd 6th of the linea aspera) adductor magnus (Originates at: outer border of the ischiopubic rim Inserts all along the linea aspera with a break at adductor hiatus) gracilis (Originates at: pubic body Inserts at: just medially of the tibial tuberosity) but goes around the back so helps with flexion of the knee

Extensors gluteus maximus (Originates at: posteriot gluteal surface of ilium sacrum and sacrotuberous ligament Inserts at: upper 3/4 attaches to ITB bottom quater attaches to the gluteal tuberosity) semitendonosis (Originates at: Ischial tuberosity Inserts at: medial tibia (pes anserius )) // posterior to semi m Semimembranosis (Originates at: I tuberosity Inserts at: posterior medial epicondyle of tibia) biceps femoris (Originates at: I tuberosity long head shorthead linea aspera Inserts at: fibular head)

Knee

Extensors Vastus medialis (Originates at: broadly anterior femur Inserts at: medial patella) Vastus intermedius (Originates at: medial edge of ilea aspera and goes around anteriorly at the proximal head Inserts at: Tibial tuberosity) Vastus lateralis (Originates at: lateral edge of the linea aspera Inserts at: lateral patella) R femoris again (Originates at: Hip bone Inserts at: Tibial tuberosity)

Flexors Hamstrings Gracilis Sartorius

Popliteus originates medial posterior tibia insertion at the lateral epicondylar rim Gastrocnemius originates from 2 heads from the posterior epicondyles of the femur insets at the calcaneus through the popliteal tendon Plantaris originates lateral epicondyle of the femur

Rotators Internal stt sm External Biceps femoris

Ankle

dorsiflexion tibialis anterior originates from the upper anterior tibia and interosseus membrane inserts medially to metatarsal and cuneiform also a

Plantarflexion Gastrocnemius posterior epicondyles of the femur to the calcaneal tendon Soleus originates from the rear of the tibia to the rear of the head of the tibialis posterior plantaris?

Foot extensor/dorsiflexor extensor hallucis longus (Originates from: middle of the interosseous membrane Inserts at: hallux) extensor digitorum longus (Originates from: adjacent to the EHL Inserts at: toes)

Tibialis posterior (Originates from: upper half of the middle back of the tibia and fibula Inserts at: navicular tubercle and medial cuneiform) Flexor hallucis longus (Originates from: back of tibia Inserts at: bottom of toes) Flexor digitorum longus (Originates from: back of the tibia Inserts at: underside of toes)

fibularis longus (Originates from: head and proximal 2.3rds of the fibula Inserts at: laterally base of the 1st metatarsal) fibularis brevis (Originates from: bottom half of fibula laterally Inserts at: base of the 5th metatarsal)

Nerves and vasculature of the lower limb

Femoral (posterior division supplies leg) anterior compartment of the thigh and pectineus

obturator (posterior division supplies leg) medial compartment of the thigh

Superior gluteal nerve

  • gluteus medius
  • gluteus minimus
  • TFL

inferior gluteal nerve

  • gluteus maximus

sciatic nerve

  • Tibial (?medial and lateral plantar?) posterior leg and posterior thigh

  • Common fibular (perineal) supplies short head of biceps femoris

deep fibular nerve anterior compartment of leg

superficial fibular nerve lateral compartment of leg

Compartments of the lower limb

Thigh

Anterior (Femoral nerve) + pectineus sartorius quadriceps femoris iliopsoas Posterior hamstrings Medial (Obturator nerve) adductors (tibial nerve supplies part of adductor magnus) gracilis pectineus (Femoral nerve) obturator externus

Lower leg

Anterior tibialis anterior extensotr digitorum longus extensor hallucis longus fibularis tertius Posterior Superficial gastrocnemius soleus Plantaris Deep tibialis posteror flexor hallucis longus flexor digitorum longus Popliteus

Lateral fibularis longus and brevis

Vasculature of the lower leg

abdominal trunk common iliac artery external and internal iliac artery femoral artery medial and lateral circumflex femoral artery deep femoral artery perforating arteries popliteal artery anterior posterior tibial arteries anterior tibial artery fibular artery and dorsalis pedis posterior tibial artery lateral and medial plantaris Plantar arch

veins have same names except for the small and great saphenous

great saphenous joins to the femoral vein

small saphenous connects to the popliteal vein

both arise from the plantar arch

the veins of the lower limb have many valves to aid venous return