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By: Muhammad Bilal Mirza 4th year PMC.
MUSCLES OF LOWER LIMB
Region
Muscle
Function
Origin
Insertion
Innervation
Blood Supply
Gluteal
Gluteus medius
Hip abductor
Hip medial rotator
Hip abductor
Hip medial rotator
Hip abductor
Hip medial rotator
Stabilizes hip, knee
Dorsal iliac crest
Greater trochanter
Superior gluteal
Superior gluteal
Dorsal ilium
Greater trochanter
Superior gluteal
Superior gluteal
Ant. sup. iliac spine
Iliotibial tract
Superior gluteal
Superior gluteal
Lat. circum. fem.
Gluteus minimus
Tensor fascia lata
All three gluteal muscles act as hip abductors and medial rotators and receive the superior gluteal nerve and artery.
Gluteus medius covers gluteus minimus.
Pelvic
Gluteus maximus
Hip extensor
Hip lateral rotator
Ilium, sacrum,
coccyx
Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris
Hip lateral rotator
Hip lateral rotator
Hip lateral rotator
Hip lateral rotator
Hip lateral rotator
Sacrum
Ischial spine
Inner obturator
Ischial tuberosity
Lateral obturator
Obturator externus
Hip lateral rotator
Outer obturator
Iliotibial tract
Gluteal tuberosity of
femur
Greater trochanter
Greater trochanter
Greater trochanter
Greater trochanter
Intertrochanteric
crest
Greater trochanter
Inferior gluteal
Inf & sup gluteal
Sacral plexus
Sacral plexus
Sacral plexus
Sacral plexus
Sacral plexus
Inf & sup gluteal
Inf. gluteal
Inf. gluteal
Inf. gluteal
Med. circum. fem.
Obturator
Obturator
Med. circum. fem.
Hold hands to mimic chicken tail to understand direction of gluteus maximus fibers (inferolaterally) and why it is a hip extensor.
Last 6 muscles are the classic lateral rotators.
All classic lateral rotators insert into greater trochanter, receive sacral plexus and inferior gluteal a. EXCEPT
- Piriformis also gets sup gluteal a. due to position (inf. and sup. gluteal aa. emerge around piriformis)
- Quadratus femoris is lower (no more room on trochanter) and receives med. circum. fem. a.
- Obturator externus must receive obturator n. and a. through obturator canal
Piriformis through quadratus femoris listed in superior-to-inferior order.
Region
Anterior Thigh
Muscle
Sartorius
Iliopsoas
Function
Hip flexor
Hip abductor
Hip lateral rotator
Knee flexor
Iliacus
Psoas
Pectineus
Hip flexor
Rectus femoris
Hip adductor
Hip flexor
Knee extensor
Vastus medialis
Vastus intermedialis
Vastus lateralis
Knee extensor
Knee extensor
Knee extensor
Origin
Ant. sup. iliac spine
Ventral ilium
L1-L5
Pubic ramus
Ant. inf. iliac spine
Ilium above acetab.
Upper femur
Upper shaft femur
Upper shaft femur
Insertion
Upper medial tibia
Innervation
Femoral
Blood Supply
Femoral
Upper medial tibia
Femoral
Lumbar plexus
Femoral
Patellar ligament
Femoral
Med. circum. fem.
Obturator
Lat. circum. fem.
Patellar ligament
Patellar ligament
Patellar ligament
Femoral
Femoral
Femoral
Femoral
Lat. circum. fem.
Lat. circum. fem.
Lesser trochanter
Internal iliac
All muscles above EXCEPT iliopsoas basically receive femoral n. and a.
The 3-and-1 quadriceps femoris are knee extensors, go from femur into patellar ligament, and receive femoral n. and a. EXCEPT
- Rectus femoris spans two joints
Sartorius also spans two joints and runs inferomedially.
Rectus femoris is most anterior muscle of thigh and covers vastus intermedialis
As expected, medial to lateral: medialis, intermedius, lateralis.
Medial Thigh
Gracilis
Adductor longus
Adductor brevis
Adductor magnus
Hip adductor
Knee flexor
Hip adductor
Hip lateral rotator
Hip adductor
Hip lateral rotator
Hip adductor
Hip lateral rotator
Pubis
Upper medial tibia
Obturator
Pubis
Post. shaft femur
Obturator
Pubis
Post. shaft femur
Obturator
Pubis
Post. shaft femur
Obturator
Obturator
Med. circum. fem.
Obturator
Med. circum. fem.
Obturator
Med. circum. fem.
Obturator
And bunches other
The 3-and-1 medial thigh muscles are all hip adductors, go from pubis to femur, and receive obturator n. and a. EXCEPT
- Gracilis spans two joints and thereby flexes knee
Hamstring part of adductor magnus receives sciatic n.
Gracilis is most medial muscle and covers adductor magnus
From anterior to posterior: longus, brevis, magnus
Posterior Thigh
Biceps femoris, long
head
Biceps femoris,
short head
Semitendinosus
Semimembranosus
Hamstring part of
adductor magnus
Hip extensor
Knee flexor
Knee flexor
Ischial tuberosity
Fibula head
Tibial
Lateral shaft femur
Fibula head
Fibular
Hip extensor
Knee flexor
Hip extensor
Knee flexor
Hip extensor
Ischial tuberosity
Tibial
Ischial tuberosity
Upper medial shaft
tibia
Medial condyle tibia
Ischial tuberosity
Adductor tubercle
Tibial
Tibial
Perforating branch
of profunda femoris
Perforating branch
of profunda femoris
Perforating branch
of profunda femoris
Perforating branch
of profunda femoris
Perforating branch
of profunda femoris
The 3-and-1 hamstring muscles are all hip extensors and knee flexors, come from ischial tuberosity, receive tibial n. & perf. br. EXCEPT
- Hamstring part of adductor magnus only spans hip, and is not a knee flexor
Short head of biceps femoris also is a major exception
From medial to lateral: semimembranosus, semitendinosus, biceps femoris
Region
Muscle
Function
Origin
Insertion
Innervation
Blood Supply
Anterior Leg
Tibialis anterior
Dorsiflexion
Inversion (DI)
Shaft tibia
Deep fibular
Anterior tibial
Deep fibular
Anterior tibial
Shaft fibula
Medial cuneiform
Dorsal base 1st
metatarsal
Distal phalanx of
big toe
Phalanges toes 2-5
Extensor hallucis
longus
Extensor digitorum
longus
Fibularis tertius
Dorsiflexion
Inversion (DI)
Dorsiflexion
Eversion (DE)
Dorsiflexion
Eversion (DE)
Lower shaft fibula
Deep fibular
Anterior tibial
Lower shaft fibula
Base 5th metatarsal
Deep fibular
Anterior tibial
Plantar base 1st
metatarsal
Lateral base 5th
metatarsal
Superficial fibular
Perforating branch
of fibular artery
Perforating branch
of fibular artery
All dorisflexors; inversion/eversion dependent on insertion point relative to 2 nd toe.
All receive deep fibular n. (so called as viewed from posterior) and anterior tibial a.
Lateral Leg
Fibularis longus
Fibularis brevis
Plantarflexion
Eversion (PE)
Plantarflexion
Eversion (PE)
Shaft fibula
Lower shaft fibula
Superficial fibular
Tendons of muscles run under lateral malleolus.
Easy to feel lateral muscles tense with plantarflexion and eversion.
Posterior Leg
Gastrocnemius
Soleus
Plantaris
Popliteus
Tibialis posterior
Flexor hallucis
longus
Flexor digitorum
Plantarflexion (P)
Knee flexor
Plantarflexion (P)
Knee flexor
Condyles tibia
Calcaneum
Tibial
Shafts tibia and
fibula
Calcaneum
Tibial
Plantarflexion (P)
Knee flexor
Unlocks knee
Plantarflexion
Inversion (PI)
Plantarflexion
Inversion (PI)
Plantarflexion
Lateral femur
Calcaneum
Tibial
Lateral femur
Shafts tibia and
fibula
Lower shaft tibia
Shaft tibia
Navicular tuberosity
Tibial
Tibial
Plantar distal 1st
phalanx
Plantar 2-5 phalanx
Tibial
Lower shaft tibia
Tibial
Sural (br. of
popliteal)
Posterior tibial
Fibular
Sural
Sural
Posterior tibial
Posterior tibial
Fibular
Posterior tibial
Fibular
Posterior tibial
longus
Inversion (PI)
base
Gastrocnemius and soleus converge in Achilles tendon, which inserts into calcaneum
Sustentaculum tali contains “Tom, Dick, Harry” (superior to inferior): tendons of Tibialis posterior, flex. Digitorum longus, flex. Hallucis
longus
Region
Dorsal foot
Plantar foot, 1st
layer
Plantar foot, 2nd
layer
Muscle
Extensor hallucis
brevis
Extensor digitorum
brevis
Function
Extend hallux
Origin
Calcaneum
Insertion
1 phalanx
Innervation
Deep fibular
Extend toes
Calcaneum
2-4 phalanx
Deep fibular
Abductor hallucis
Abduct hallux
Medial calcaneum
Medial 1 phalanx
Medial plantar
Abductor digiti
minimi
Flexor digitorum
brevis
Abduct toe 5
Calcaneum
Proximal 5 phalanx
Lateral plantar
Flex toes 2-4
Medial calcaneum
Middle 2-4 phalanx
Medial plantar
Quadratus plantae
Laterally pull flexor
digitorum longus
tendon
Extend toes
Calcaneum
Flexor digitorum
longus tendon
Lateral plantar
Flexor hallucis
brevis
Adductor hallucis
Flexor digiti minimi
Flex hallux
Cuboid, cuneiform
Proximal 1 phalanx
Medial plantar
Adduct hallux
Flex toe 5
Base 2-4 metatarsal
Base 5 metatarsal
Proximal 1 phalanx
Proximal 1 phalanx
Lateral plantar
Lateral plantar
Dorsal interossei (4)
Abduct toe
Metatarsals
Phalanges
Lateral plantar
Plantar interossei
(4)
Adduct toes
Metatarsals
Phalanges
Lateral plantar
Lumbricals
Plantar foot, 3rd
layer
Plantar foot, 4th
layer
Flexor digitorum
longus tendon
Lateral plantar
except #1 (med. pl.)
Blood Supply
Dorsalis pedis
Arcuate
Dorsalis pedis
Arcuate
All lateral plantar innervation except medial plantars as marked in italics.
Interossei mnemonic PAD/DAB: plantar adduction, dorsal abduction
Anterior tibial gives rise to dorsalis pedis and arcuate aa.
Posterior tibial gives rise to medial and lateral plantar aa.
Best way to remember is what you saw in dissection! Know location and function (more important than origin/insertion).