Lower Limb Skeleton homologous with upper limb n

Lower Limb Skeleton (homologous with upper limb) n Muscles--anterior, posterior compartments n Nerves--sciatic, femoral n Surface anatomy n Frolich, Human Anatomy, Lower LImb

Upper-Lower Limb Comparison See Table M&M, Table 8. 1 Frolich, Human Anatomy, Lower LImb

Frolich, Human Anatomy, Lower LImb

Tibia/fibula Tibia--big toe side n Fibula--little toe side (no pronation/supination) n Frolich, Human Anatomy, Lower LImb

Ankle n n Tarsus--forms ankle joint Calcaneus--forms heel Frolich, Human Anatomy, Lower LImb

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

Joints of Lower Limb n Hip (femur + acetabulum) n n Knee (femur + patella) n n Plane Gliding of patella Synovial Knee (femur + tibia) n n Frolich, Human Anatomy, Lower LImb Ball + socket Multiaxial Synovial Hinge Biaxial

Joints of Lower Limb n Proximal Tibia + Fibula n n Distal Tibia + Fibula n n n pg 218 Slight “give” Fibrous Ankle (Tibia/Fibula + Talus) n Frolich, Human Anatomy, Lower LImb Plane Gliding Synovial Hinge Uniaxial Synovial

Lower Limb Movements n Hip n n n Bending on posterior side is flexion (except hip) Bending on anterior sided is extension (except hip) n n n Knee n n n Dorsiflexion/plantarflexion Inversion/eversion Toes n Frolich, Human Anatomy, Lower LImb Flexion/extension Ankle n n Flexion/extension Abduction/adduction Lateral/medial rotation Flexion/extension

Anterior/Posterior compartments ANTERIOR POSTERIOR COMPARTMENT MOVEMENT Extension Flexion MUSCLES Quads Shin Hamstrings Gastrocs NERVES Femoral n. (lumbar plexus) Sciatic n. (sacral plexus) Frolich, Human Anatomy, Lower LImb

Thigh movements by compartment Frolich, Human Anatomy, Lower LImb

Posterior Thigh n Gluts (gluteal nn. ) n n n Lateral rotators (spinal nn. ) n n Piriformis syndrome Hamstrings (sciatic n. ) n n n Frolich, Human Anatomy, Lower LImb Maximus—extensor of thigh Medius--pelvic tilt Biceps femoris Semimembranous Semitendinous

Anterior thigh (femoral n. ) n n Sartorius (Tailor’s muscle) Quads (four) n n Rectus femoris (crosses hip) 3 vastus mm. (vast--big) Frolich, Human Anatomy, Lower LImb

Medial compartment (obturator n. ) n Adductor muscles n n Gracilis Adductor • Magnus • Longus • brevis Frolich, Human Anatomy, Lower LImb

Leg movements by compartment (in leg all nn are branches of sciatic) Frolich, Human Anatomy, Lower LImb

Anterior Leg (deep fibular n. ) n n Fibularis (peroneus) longus Extensor digitorum longus Extensor hallicus longus Tibialis anteriorus Frolich, Human Anatomy, Lower LImb

Lateral Leg (superficial fibular n. ) n Frolich, Human Anatomy, Lower LImb Fibularis brevis/longus

Posterior Leg (tibial n. ) n n n Frolich, Human Anatomy, Lower LImb Gastrocs and soleus Flexor digitorum longus Flexor hallucus longus

Intrinsics of foot Frolich, Human Anatomy, Lower LImb

n With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense n Lumbar plexus (femoral nerve) Frolich, Human Anatomy, Lower LImb Sacral plexus (sciatic nerve)

Dermatomes show twisting of leg in development Frolich, Human Anatomy, Lower LImb

Blood supply to lower limb n Internal Iliac n n Cranial + Caudal Gluteals= gluteals Internal Pudendal = perineum, external genitalia Obturator = adductor muscles External Iliac n Femoral = lower limb • Deep femoral = adductors, hamstrings, quadriceps n 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

Surface Anatomy: Posterior Pelvis n n Iliac crest Gluteus maximus = cheeks Natal/gluteal cleft = crack Gluteal folds = bottom of cheek Frolich, Human Anatomy, Lower LImb pg 789

pg 792 Surface Anatomy: Anterior Thigh + Leg n Palpate n n n Femoral Triangle n n pg 785 Frolich, Human Anatomy, Lower LImb Patella Condyles of femur Sartorius (lateral) Adductor longus (medial) Inguinal ligament (superior) Femoral a + v, lymph nodes

Surface Anatomy: Posterior Leg n Popliteal fossa n n Boundaries n n pg 793 Frolich, Human Anatomy, Lower LImb Biceps femoris (sup-lat) Semitendinosis + semimembranosis (supmed) Gastrocnemius heads (inf) Contents n n Diamond-shape fossa behind knee Popliteal a + v Calcaneal (Achilles) tendon