MSK Lower Limbs-2 PDF

MSK, Lower limbs -2 Assistant Prof. Tarek Abdelkader What will be covered in the lectures ❑Anatomical movements √ ❑Boney skeleton of lower limps √ ❑Muscles √ Gluteal region √ Thigh √ Leg & Foot ❑Joints Hip joint √ Knee joint Ankle joint ❑Blood supply and nerves Le...

MSK, Lower limbs -2 Assistant Prof. Tarek Abdelkader What will be covered in the lectures ❑Anatomical movements √ ❑Boney skeleton of lower limps √ ❑Muscles √ Gluteal region √ Thigh √ Leg & Foot ❑Joints Hip joint √ Knee joint Ankle joint ❑Blood supply and nerves Leg Ant. compartment Tibialis Anterior Fibularis Longus Extensor Digitorum Longus Gastrocnemius Fibularis Tertius Extensor Hallucis Longus Extensor Retinaculum Muscle Proximal Distal attachment Nerve supply Blood supply Action attachment Tibialis Anterior Lateral surface of Medial cuneiform Deep fibular nerve Anterior tibial Dorsiflexion and the tibia & lateral and the base of 1st artery inversion of foot tibial condyle metatarsal Extensor Upper tibia and The tendon travels Extends digits 2-5 Digitorum Longus fibula, to the dorsal and dorsiflexion of interosseous surface of the foot. foot membrane The tendon splits into four, each attach to the bases of distal phalanges of toes 2-5 Extensor Hallucis Middle shaft of the The base of the Extension of big Longus fibula and distal phalanx of toe & dorsiflexion interosseous the great toe and inversion of membrane foot Fibularis Tertius Ant. surface of the attaches to the Dorsiflexion and fibula & base of metatarsal eversion of foot tibiofibular V ligament  Gastrocnemius Fibularis Longus Soleus Tibialis Anterior Extensor Digitorum Longus Flexor Digitorum Longus Leg medial and lateral Fibularis Brevis view Tibialis Posterior Muscle Proximal Distal attachment Nerve supply Blood supply Action attachment Fibularis Longus Head of the fibula Medial cuneiform Superficial fibular Fibular artery Plantarflexion and and the lateral and base of 1st (peroneal) nerve eversion of foot tibial condyle metatarsal Fibularis Brevis distal two-thirds of The tendon then Superficial fibular Fibular artery Plantarflexion and the surface of attaches to a (peroneal) nerve eversion of foot fibular shaft tuberosity on 5th metatarsal  Plantaris Gastrocnemius Leg Post. Compartment superficial muscles Short saphenous vein Sural nerve Soleus Achilles tendon (Tendocalcaneus) Muscle Proximal Distal attachment Nerve supply Blood supply Action attachment Gastrocnemius Lateral & medial Fuse with soleus Tibial nerve Sural artery and Plantarflexes at heads attach to muscle to from the post tibial the ankle joint, the lateral and calcaneal tendon and because it medial femoral and inserts into crosses the knee, condyles calcaneus bone it is a flexor there respectively Plantaris Lateral Calcaneal tendon Tibial nerve Sural artery It plantarflexes at supracondylar line and inserts into the ankle joint of the femur calcaneus bone Soleus Soleal line of the Calcaneal tendon Tibial nerve Sural artery and Plantarflexes the tibia and proximal and inserts into post tibial foot at the ankle fibular area calcaneus bone joint  Popliteus Tibialis posterior Flexor Digitorum Longus Flexor Hallucis Longus Leg Post. Compartment deep muscles Muscle Proximal Distal attachment Nerve supply Blood supply Action attachment Popliteus Lateral condyle of Just superior to Tibial nerve Sural artery Laterally rotates the femur & lateral soleal line on the the femur on the meniscus tibia tibia Tibialis Posterior Interosseous Navicular Post. Tibial artery Inverts and membrane tuberosity, plantarflexes the between the tibia adjacent tarsal foot, maintains the and fibula, and bones and the medial arch of the posterior surfaces bases of the foot of the two bones metatarsals Flexor Digitorum Medial surface of Divides into 4 Post. Tibial artery Flexes the lateral Longus the tibia parts attaching four toes into the bases of the distal phalanges of 2nd to 5th toes Flexor Hallucis Posterior surface Base of the distal Post. Tibial artery Flexes the great Longus of the fibula phalanx of the & fibular artery toe great toe Popliteal fossa  Flexor digitorum longus Flexor hallucis longus Lumbricals of the foot Abductor hallucis Abductor digiti minimi Plantar aponeurosis Flexor digitorum brevis Sole of the foot superficial Muscle Proximal Distal attachment Nerve supply Blood supply Action attachment Abductor hallucis Calcaneus Proximal phalanx Medial or lateral medial or lateral Abducts the big toe tuberosity & of 1st toe plantar nerve plantar artery plantar aponeurosis Abductor digiti Calcaneus Proximal phalanx Abducts & flexes the minimi tuberosity & of 5th toe small toe plantar aponeurosis Flexor digitorum Medial tubercle of Medial and lateral Flexes 2nd to 5th brevis plantar calcaneus sides of middle toes. and plantar phalanges 2nd to aponeurosis 5th toes Lumbricals Arise form the Proximal phalanx Flex the tendons of flexor of 2nd to 4th toes metatarsophalangeal digitorum longus joint  Flexor hallucis longus Sole of the foot deep Flexor hallucis brevis Lumbricals of the foot Flexor digitorum longus Abductor hallucis Quadratus plantae Movements at the knee joint Biceps femoris Surface anatomy Surface anatomy Surface anatomy  Knee joint Cruciate Ligaments Menisci Tibial collateral ligament Patellar ligament Fibular collateral ligament Ankle joint Medial Ligament Lateral Ligament Movements at the ankle joint Gastrocnemius Tibialis anterior Soleus extensor hallucis longus Plantaris extensor digitorum Tibialis posterior longus Flexor hallucis longus Flexor digitorum longus Fibularis longus Fibularis brevis. Movements at the subtalar joint Tibialis anterior, Fibularis Longus Tibialis posterior Fibularis brevis Flexor hallucis longus Fibularis tertius Arches of the foot metatarsal bases, the cuboid and the three cuneiform bones calcaneus, talus, navicular, three cuneiforms and first three metatarsal bones calcaneus, cuboid and 4th and 5th metatarsal bones  Arterial blood supply Common iliac artery Internal iliac > Gluteal arteries & Obturator artery External iliac > Femoral artery Femoral artery Profunda femoris Circumflex femoral artery (branches from profunda femoris artery) popliteal artery (continuation of the femoral artery after it passes through the adductor hiatus to the back of the knee ) Anterior tibial artery (continues in the foot as Dorsalis pedis) Posterior tibial artery Fibular (peroneal) artery (branch from posterior tibial artery) Genicular branches Arterial blood supply Descending Aorta Common Iliac artery Internal Iliac artery External Iliac artery Femoral artery Obturator artery Profunda femoris artery Circumflex femoral artery Profunda femoris Circumflex femoral artery artery Femoral artery  Popliteal artery Anterior tibial artery Posterior tibial artery Fibular artery Dorsalis pedis artery  Venous drainage Superficial veins: only 2 main veins 1. Small saphenous vein (formed by both; the dorsal venous arch of the foot and dorsal vein of the big toe) 2. Great saphenous vein (formed by both; the dorsal venous arch of the foot and dorsal vein of the big toe) Deep veins Dorsal and planter veins of the foot Anterior, posterior tibial and fibular veins in the leg which will give popliteal at the back of knee joint (popliteal fossa) Femoral vein, profunda femoris and circumflex femoral vein (all will drain into the external iliac vein) Superior & Inferior gluteal veins will drain the gluteal region and empty in the internal iliac vein  Popliteal vein Anterior tibial vein Fibular vein Posterior tibial vein Venous drainage Great saphenous vein Small saphenous vein Dorsal venous arch Great saphenous vein Profunda femoris vein Femoral vein  Nerves of the lower limb Hip region & Thigh Gluteal region Inferior & superior gluteal nerves Femoral nerve Pudendal nerve Saphenous nerve Sciatic nerve Obturator nerve Popliteal fossa Leg Tibial nerve Tibial nerve Deep fibular nerve Common fibular nerve Superficial fibular nerve Sural nerve Nerves of the lower limb Femoral nerve Saphenous nerve Obturator nerve Inferior gluteal nerve Superior gluteal nerve Pudendal nerve Sciatic nerve  Sciatic nerve Tibial nerve Common fibular nerve Deep fibular nerve Superficial fibular nerve Saphenous nerve  Tibial nerve Superficial fibular nerve Sural nerve  Dorsalis pedis Vein Dorsalis pedis artery Dorsal venous arch Lateral view CT scan – sagittal view  Anteroposterior view Lateral view Lateral view  Atlas of Clinical Gross Anatomy 2nd Ed Functional Anatomy Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists Fundamentals of Anatomy & Physiology-Pearson Human Anatomy Atlas – Visible Body Thank you