Muscles of the Lower Extremity PDF

Muscles of the lower extremity Dr. Viktorija Cīrule Mm. membri inferioris Mm. cinguli membri inferioris Anterior compartment (2) Posterior compartment (10) Mm. membri inferioris liberi Mm. femoris Anterior compartment (2) Medial compartment (5)...

Muscles of the lower extremity Dr. Viktorija Cīrule Mm. membri inferioris Mm. cinguli membri inferioris Anterior compartment (2) Posterior compartment (10) Mm. membri inferioris liberi Mm. femoris Anterior compartment (2) Medial compartment (5) Posterior compartment (3) Mm. cruris Anterior compartment (3) Lateral compartment (2) Posterior compartment (6) Mm. pedis Muscles of the dorsal surface (2) The great toe muscles (3) The little toe muscles (3) Muscles of the middle group (5) Mm. cinguli membri inferioris – muscles of the pelvic girdle Anterior compartment: Posterior compartment: M. iliopsoas M. gluteus maximus M. psoas minor M. gluteus medius M. gluteus minimus M. tensor fasciae latae M. piriformis M. obturator internus M. obturator externus M. gemellus superior M. gemellus inferior M. quadratus femoris M. iliopsoas M. Iliacus ② Origo: Fossa iliaca M. psoas major M. psoas major ① Origo: Th12-L5 M. iliacus Insertio: Trochanter minor Functio: Flexio femoris Rotatio externa femoris Flexio trunci (if leg is fixated) M. psoas minor Origo: Th12-L1 M. psoas minor Insertio: Eminentia iliopubica Functio: Flexio trunci M. gluteus maximus ① Origo: Facies glutea behind linea glutea posterior Facies dorsalis ossis sacri et ossis coccygis Lig. sacrotuberale Fascia thoracolumbalis Insertio: Tuberositas glutea Tractus iliotibialis Functio: Extensio femoris Rotatio externa femoris Abductio femoris M. gluteus medius ② Origo: Fascia glutea between linea glutea anterior et posterior Insertio: Trochanter major Functio: Abductio femoris Rotatio interna femoris (anterior fibres) Rotatio externa femoris (posterior fibres) M. gluteus minimus ③ Origo: Facies glutea between linea glutea anterior et inferior Insertio: Trochanter major Functio: Abductio femoris Rotatio interna femoris (anterior fibres) Rotatio externa femoris (posterior fibres) M. tensor fasciae latae ④ Origo: Spina iliaca anterior superior Insertio: Continues as tractus iliotibialis Functio: Tenses tractus iliotibialis Flexio femoris Abductio femoris M. piriformis ⑤ Origo: Facies pelvica ossis sacri laterally from II-IV foramina sacralia anteriora M. piriformis Insertio: Trochanter major (goes through foramen ischiadicum majus) Functio: Abductio femoris Rotatio externa femoris M. obturator internus ① Origo: Membrana obturatoria inner surface Adjacent bone margins Insertio: M. obturator internus Fossa trochanterica (goes through foramen ischiadicum minus) Functio: Rotatio externa femoris Foramen ischiadicum minus M. obturator externus ① Origo: Membrana obturatoria external surface Adjacent bone margins Insertio: Fossa trochanterica Functio: Rotatio externa femoris M. gemellus superior ② Origo: Spina ischiadica Insertio: Fossa trochanterica Functio: M. gemellus superior Rotatio externa femoris M. gemellus superior ② Origo: Tuber ischiadicum Insertio: Fossa trochanterica Functio: M. gemellus inferior Rotatio externa femoris M. quadratus femoris ③ Origo: Tuber ischiadicum Insertio: Crista intertrochanterica Functio: Rotatio externa femoris M. quadratus femoris Adductio femoris Mm. femoris – muscles of the thigh Anterior compartment M. quadriceps femoris M. sartorius Medial compartment M. pectineus M. adductor brevis M. adductor longus M. adductor magnus M. gracilis Posterior compartment M. semitendinosus M. semimembranosus M. biceps femoris M. quadriceps femoris ② M. rectus femoris Origo: Spina iliaca anterior inferior M. vastus medialis Origo: Labium mediale lineae asperae M. vastus lateralis Vastus medialis Origo: Labium laterale lineae asperae M. vastus intermedius Origo: Facies anterior femoris M. quadriceps femoris ② Insertio: With lig. patellae to tuberositas tibiae Functio: Extensio cruris Flexio femoris – m. rectus femoris M. sartorius ① Origo: Spina iliaca anterior superior Insertio: M. sartorius Tuberositas tibiae Functio: Flexio femoris Flexio cruris Rotatio externa femoris Rotatio interna cruris M. pectineus ② Origo: Ramus superior et pecten ossis pubis Insertio: Linea pectinea femoris Functio: Flexio femoris Adductio femoris Rotatio externa femoris M. adductor brevis ④ Origo: Ramus inferior ossis pubis Insertio: Labium mediale lineae asperae upper 1/3 Functio: Flexio femoris Adductio femoris Rotatio externa femoris M. adductor longus ③ Origo: Ramus superior ossis pubis between symphysis and tuberculum pubicum Insertio: Labium mediale lineae asperae middle 1/3 Functio: Flexio femoris Adductio femoris Rotatio externa femoris M. adductor magnus ⑤⑥ Origo: Ramus inferior ossis pubis Ramus ossis ischii Tuber ischiadicum Insertio: Labium mediale lineae asperae whole length Epicondylus medialis femoris Functio: Adductio femoris Rotatio interna femoris Extensio femoris M. gracilis ⑦ Origo: Ramus inferior ossis pubis Insertio: Tuberositas tibiae Functio: Adducctio femoris Flexio cruris Rotatio interna cruris  Compartimentum femoris mediale M. obturator externus 1. M. pectineus 2. M. adductor brevis 3. M. adductor longus 4. M. adductor magnus 5. M. gracilis 1 1 1 2 3 3 2 3 3 4 5 5 5 5 4 M. semitendinosus ③ Origo: Tuber ischiadicum Insertio: Tuberositas tibiae Functio: Extensio femoris Flexio cruris Rotatio interna cruris M. semimembranosus ② Origo: Tuber ischiadicum Insertio: Condylus medialis tibiae Functio: Extensio femoris Flexio cruris Rotatio interna cruris M. biceps femoris ① Caput longum Origo: Tuber ischiadicum Caput breve Caput longum Origo: Labium laterale lineae asperae Caput Insertio: breve Caput fibulae Functio: Flexio cruris Caput longum Rotatio externa cruris Extensio femoris – caput longum Mm. cruris – muscles of the lower leg Anterior compartment M. tibialis anterior M. extensor digitorum longus M. extensor hallucis longus Lateral compartment M. fibularis longus (peroneus) M. fibularis brevis (peroneus) Posterior compartment 1. layer M. triceps surae M. plantaris 2. layer M. popliteus M. tibialis posterior M. flexor digitorum longus M. flexor hallucis longus M. tibialis anterior ① Origo: Condylus lateralis tibiae Facies lateralis tibiae Membrana interossea cruris Insertio: Basis ossis metatarsalis I Os cuneiforme mediale Functio: Extensio pedis Supinatio pedis Adductio pedis Strengthens longitudinal arch of foot M. extensor hallucis longus ② Origo: Facies medialis fibulae Membrana interossea cruris Insertio: Phalanx distalis hallucis Functio: Extensio hallucis Extensio pedis Supinatio pedis Adductio pedis M. extensor digitorum longus ③④ Origo: Condylus lateralis tibiae Fibula Membrana interossea cruris Insertio: Phalanx distalis II-V Functio: Extensio pedis Extensio digitorum II-V M. fibularis/peroneus longus ① Origo: Fibula Septum intermusculare posterius Insertio: Basis ossis metatarsalis I Os cuneiforme mediale Functio: Flexio pedis Abductio pedis Pronatio pedis Strengthens arches of foot M. fibularis/peroneus brevis ② Origo: Fibula Septa intermuscularia Insertio: Basis ossis metatarsalis V Functio: Flexio pedis Abductio pedis Pronatio pedis M. triceps surae (I) ① M. gastrocnemius Caput mediale Origo: Condylus medialis femoris Caput laterale M. soleus Caput mediale Caput laterale Origo: Condylus lateralis femoris M. soleus Origo: Linea m. solei Caput fibulae Arcus tendineus m. solei M. triceps surae (I) ① Insertio: Tuber calcanei (with tendo Achillis) Functio: Flexio pedis Supinatio pedis Whole muscle Adductio pedis Flexio cruris – m. gastrocnemius Rotatio externa cruris (caput laterale) Rotatio interna cruris (caput mediale) M. plantaris (I) ② Origo: Condylus lateralis femoris Insertio: With tendo Achillis, reaches tuber calcanei Functio: Flexio cruris Flexio pedis M. popliteus (II) ④ Origo: Condylus lateralis femoris Insertio: Facies posterior tibiae above linea m. solei Functio: Flexio cruris Rotatio interna cruris M. tibialis posterior (II) ① Origo: Facies posterior tibiae et fibulae Membrana interossea cruris Insertio: Os naviculare Ossa cuneifromia Functio: Flexio pedis Supinatio pedis Adductio pedis Strengthens arches of foot M. flexor digitorum longus (II) ② Origo: Facies posterior tibiae Lamina profunda fasciae cruris Insertio: Phalanx distalis II-V Functio: Flexio pedis Flexio phalangis (all) Strengthens longitudinal arch of foot M. flexor hallucis longus (II) ③ Origo: Fibula Membrana interossea cruris Insertio: Phalanx distalis hallucis Functio: Flexio hallucis Flexio pedis Supinatio pedis Adductio pedis Strengthens longitudinal arch of foot Mm. pedis – muscles of the foot Muscles of the dorsal surface M. extensor digitorum brevis M. extensor hallucis brevis The great toe muscles M. abductor hallucis M. flexor hallulcis brevis M. adductor hallucis The little toe muscles M. abductor digiti minimi M. flexor digiti minimi M. opponens digiti minimi Muscles of the middle group M. flexor digitorum brevis M. quadratus plantae Mm. lumbricales pedis (4) Mm. interossei dorsales (4) Mm. interossei plantares (3) M. extensor digitorum brevis Origo: Calcaneus upper and lateral surface Insertio: M. extensor digitorum brevis Attaches to m. extensor digitorum longus tendons at II-IV fingers Functio: Extensio digitorum II-IV M. extensor hallucis brevis Origo: Calcaneus upper surface Insertio: Attaches to extensor hallucis longus tendon Functio: Extensio hallucis M. extensor hallucis brevis The great toe muscles M. adductor hallucis M. abductor hallucis Caput transversum M. flexor hallucis brevis Functio: Abductio hallucis Flexio hallucis Strengthens longitudinal arch of foot M. adductor hallucis M. flexor hallucis brevis Caput obliquum Functio: M. abductor hallucis Flexio hallucis Strengthens longitudinal arch of foot M. adductor hallucis Caput obliquum Caput transversum Functio: Adductio hallucis Flexio hallucis Strengthens transverse arch of foot – caput transversum The little toe muscles M. flexor digiti M. abductor digiti minimi minimi brevis Functio: Abductio digiti minimi Flexio digiti minimi Strengthens longitudinal arch of foot M. opponens digiti minimi M. flexor digiti mimnimi brevis Functio: Flexio digiti minimi M. opponens digiti minimi Functio: M. abductor digiti minimi Adductio digiti minimi Oppositio digiti minimi M. flexor digitorum brevis ① Origo: Tuber calcanei Aponeurosis plantaris Insertio: Basis phalangis mediae II-V Functio: Flexio phalangis proximalis et mediae Strengthens longitudinal arch of foot M. quadratus plantae s. flexor accessorius② Origo: Tuber calcanei Insertio: M. flexor digitorum longus tendons Functio: Enhances flexio digitorum M. flexor digitorum longus cīpsla Strengthens longitudinal arch of foot M. quadratus plantae M. flexor digitorum brevis Mm. lumbricales pedis (4) ③ Origo: M. flexor digitorum longus tendons Insertio: Mm. lumbricales M. extensor digitorum longus II-V tendons Functio: Flexio phalangis proximalis Extensio phalangis mediae et distalis Mm. interossei plantares (3) V IV III Origo: Os metatarsale III, IV, V medial surfaces Insertio: Phalanx proximalis II, III, V medial surfaces Functio: Adductio digitorum (III, IV, V fingers to the II finger) Mm. interossei dorsales (4) V IV III Origo: II I I-V metatarsal bones Insertio: Phalanx proximalis II-IV Functio: Abductio digitorum (II, III, IV fingers from I, II finger to the I) Topography of the lower limb Canalis obturatorius Lacuna musculorum Lacuna vasorum Canalis femoralis Trigonum femorale Canalis adductorius Fossa poplitea Canalis obturatorius 2-3cm long Pelvis minor → ends between the muscles of the medial thigh compartment Upper wall: Sulcus obturatorius ossis pubis Other walls: Membrana obturatoria M. obturatorius internus M. obturatorius externus Lacuna musculorum Lacuna vasorum Spaces between lig. inguinale and os coxae From the ligament midpoint to eminentia iliopubica – arcus iliopectineus Laterally from arcus – lacuna musculorum Medially from arcus – lacuna vasorum Lacuna musculorum N. cutaneus femoris lateralis Through goes: M. iliopsoas M. iliopsoas N. femoralis N. cutaneus femoris lateralis N. femoralis Borders: Arcus iliopectineus Upper and anterior: Lig. inguinale Medial: Arcus iliopectineus Lateral and posterior: Ala ossis ilii Lacuna vasorum Through goes: A. et v. femoralis A. et v. femoralis Septum femorale R. femoralis n. genitofemoralis Arcus iliopectineus Nodus lymphaticus Medial angle – anulus femoralis (covered Lig. lacunare with peritoneum, septum femorale, nodus lymphoideus inguinalis profundus) Borders: Upper and anterior: Lig. inguinale Lateral: Arcus iliopectineus Lower and posterior: Ramus superior ossis pubis Pecten ossis pubis Lig. pectinale Medial: Lig. lacunare Canalis femoralis 3 walls, 2 openings Cornu superius fasciae latae Walls: Anterior: Cornu superius fasciae latae Canalis femoralis Medial: M. pectineus with fascia Lateral: V. femoralis V. femoralis M. pectineus Canalis femoralis Openings: Inner opening – anulus femoralis (normally doesn’t exist) Superiorly: Lig. inguinale Posteriorly: Ramus superior ossis pubis Pecten ossis pubis Lig. pectineale Medially: Lig. lacunare Laterally: V. femoralis Outer opening – hiatus saphenus (covered by fascia cribrosa) Hernia femoralis  M. sartorius Lig. inguinale Trigonum femorale M. pectineus Triangular deepening on the anterior M. iliopsoas surface of the thigh 3 borders: M. adductor longus Upper: Lig. inguinale Medial: M. adductor longus Lateral: M. sartorius Base: M. iliopsoas end part M. pectineus Between muscles there is the groove – sulcus iliopectineus → canalis (vasto)adductorius Canalis adductorius Goes downward and posteriorly, opens in fossa poplitea 3 walls: Medial: M. adductor magnus Laterals: M. vastus medialis Anterior: Fibrous plate stretched between m. adductor magnus and m. vastus medialis – lamina vastoadductoria Canalis adductorius 3 openings: Upper: Trigonum femorale apex Lower: Hiatus adductorius – forms in m. adductor magnus tendon, in the upper corner of fossa poplitea Anterior: Small oppening in lamina vastoadductoria lower part Fossa poplitea Behind the knee joint 4 margins: Upper medial: M. semitendinosus M. semimembranosus Upper lateral: M. biceps femoris Lower medial: Caput mediale m. gastrocnemii Lower lateral: Caput laterale m. gastrocnemii Base: Facies poplitea femoris Capsula articularis art. genus M. popliteus Fossa poplitea 4 angles: Upper: Opens canalis adductorius Lower: Connects with the space between: M. tibialis posterior Anteriorly M. flexor digitorum longus M. soleus – posteriorly 2 lateral wider angles Fasciae membri inferioris Fasciae of the pelvic girdle Inner fasciae Outer fasciae Fascia iliaca Fascia glutea Covers m. iliopsoas, forms Fascia thoracolumbalis osteofibrous sheath, grows to os continuation downward from coxae crista iliaca Goes under lig. inguinale, forms Downward continues as fascia lata arcus iliopectineus, continues as Encloses m. gluteus maximus, lamina profunda fasciae latae forms separate fibrous sheath Fascia obturatoria Other muscles of the pelvic girdle Covers inner surface of m. enclosed in one osteofibrous obturatorius internus, grows sheath together with the pelvic bones Fascia iliaca Fascia glutea Fascia lata Distally → fascia cruris Laterally forms thinckening – tractus iliotibialis Main part grows together with condylus lateralis tibiae Part of the fibres – retinaculum patellae laterale 2* septs: Septum intermusculare mediale – between anterior and medial compartment Attaches to labium mediale lineae asperae Septum intermusculare laterale – between anterior and posterior compartment Attaches to labium laterale lineae asperae Septum intermusculare posterius* – between medial and posterior compartment Attaches to labium mediale lineae asperae  Cornu superius Fascia lata Margo falciformis Cornu inferius Separate fibrous sheaths: M. gracilis M. sartorius M. tensor fasciae latae Trigonum femorale region: Lamina profunda – covers m. iliopsoas Lamina superficialis 2-4cm below lig. inguinale – hiatus saphenus Margo falciformis Cornu superius Cornu inferius Covered by fascia cribrosa Laminas fuse together near the margins of trigonum Between laminas – a. et v. femoralis  Fascia cruris Grows tightly to margo anterior et facies medialis tibiae Below malleoli → fascia dorsalis pedis 2 septs (attach to the fibula): Septum intermusculare cruris anterius Between anterior and lateral compartment Septum intermusculare cruris posterius Between lateral and posterior compartment Lamina profunda – separates 1st and 2nd layers of the posterior compartment, grows together with margo medialis tibiae In the malleoli region forms 5 thickenings – retinacula I. Retinaculum musculorum extensorum superius M. tibialis anterior M. extensor hallucis longus Crus anterior surface between fibula et margo anterior tibiae 1 common canal: M. extensor digitorum longus Tendons of the anterior compartment muscles, enclosed in synovial sheaths M. tibialis anterior M. extensor digitorum longus M. extensor hallucis longus Vessels, nerves II. Retinaculum musculorum extensorum inferius In front of art. talocruralis Attachment points: Lateraly: Calcaneus lateral surface Medially: Malleolus medialis tibiae Os naviculare Os cuneiforme mediale medial surfaces 3 septs goes to bones → 4 short canals II. Retinaculum musculorum extensorum inferius From medial to lateral side: M. tibialis anterior 1st canal: M. tibialis anterior tendon M. extensor hallucis longus 2nd canal: M. extensor hallucis longus tendon 3rd canal: A. et v. dorsalis pedis N. fibularis profundus 4th canal: M. extensor digitorum longus M. extensor digitorum tendon Each tendon has it’s own synovial sheath III. Retinaculum musculorum flexorum On the dorsal side of the foot behind malleolus medialis Malleolus medialis tibiae → calcaneus M. tibialis posterior medial surface 3 septs goes to bones → 4 canals (in downward direction): 1st canal: M. tibialis posterior tendon 2nd canal: M. flexor digitorum longus tendon 3rd canal: A. et v. tibialis posterior N. tibialis 4th canal: M. flexor hallucis longus tendon Each tendon has it’s own synovial sheath M. flexor digitorum longus M. flexor hallucis longus IV. Retinaculum musculorum fibularium superius Behind malleolus lateralis Malleolus lateralis → calcaneus lateral surface 1 common canal: M. fibularis longus Common synovial sheath M. fibularis brevis V. Retinaculum musculorum fibularium inferius Behind malleolus lateralis below retinaculum musculorum fibularium superius M. fibularis brevis 2 canals, through each goes 1 tendon: M. fibularis brevis M. fibularis longus 1 common synovial sheath splits into 2 M. fibularis longus Synovial sheaths On the dorsal side of the foot there are 7 synovial sheaths: M. tibialis anterior tendon M. extensor hallucis longus tendon M. extensor digitorum longus tendon M. tibialis posterior tendon M. flexor hallucis longus tendon M. flexor digitorum longus tendon Common sheath with m. fibularis longus et brevis tendons Synovial sheaths On the plantar side there are 6 synovial sheaths: M. fibularis longus end of the tendon (not connected with synovial sheath on the dorsal side) 5 sheaths around mm. flexor digitorum longus et brevis tendons at the region of the fingers  Fascia dorsalis pedis Lamina superficialis Lamina profunda Covers tendons of the Covers mm. interossei dorsales extensor muscles, superficial Grows together with ossa vessel and nerves. metatarsalia Connects, grows together with ossa metatarsalia I et V Fascia plantaris pedis Lamina superficialis Lamina profunda Covers mm. interossei plantares Grows together with ossa metatarsalia Connects, grows together with ossa metatarsalia I et V Fascia plantaris pedis Lamina superficialis middle part is thickened – aponeurosis plantaris Starts at tuber calcanei, goes towards the bases of the fingers, becomes thinner 2 septs start from the sides, goes to ossa metatarsalia II et V, separates muscle groups Plays major role in strengthening of the longitudinal arch of foot