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Lower Limb What is a limb? Skeleton Joints Pelvis or limb girdle Hip/Hip Muscles Lumber and sacral plexus—getting spinal nerves out onto limb Muscles—anterior and posterior compartments Surface anatomy Frolich, Human Anatomy, Lower LImb Skeleton (homologous upper limb) Muscles--ante posterior compartments Nerves--sciati femoral Surface anato What is a limb? Ventral somatic outgrowth of outer tube Bones (made of bony tissue, cartilage, and other tissues) Joints Muscles Nerves (with motor neurons to muscles, sensory neurons to skin, proprioceptors) No viscera--all innervation is somatic (motor or sensory) from ventral ramus of spinal nerve (except autonomics to blood vessels) Frolich, Human Anatomy, Lower LImb Upper Limb Lower Frolich, Human Anatomy, Lower LImb Pelvis Scapula Humerus Femur Radius, Tibia, fibula ulna Carpals Tarsals Digits Metatarsals Metacarpals Phalanges Upper Limb Frolich, Human Anatomy, Lower LImb Scapula Humerus Radius, ulna Carpals Digits Metacarpals Phalanges Frolich, Human Anatomy, Lower LImb Tibia/fibula Tibia--big toe side Fibula--little toe side (no pronation/supination) Frolich, Human Anatomy, Lower LImb Ankle Talus--forms ankle joint Calcaneus--forms heel Frolich, Human Anatomy, Lower LImb Foot Function: Support weight Act as lever when walking Tarsals Talus = ankle • Between tibia + fibula • Articulates w/both Calcaneus = heel • Attachment for Calcaneal tendon • Carries talus Metatarsals Phalanges Frolich, Human Anatomy, Lower LImb Homologous to metacarpals Smaller, less nimble Joints of Lower Limb Hip (femur + acetabulum) Knee (femur + patella) Plane Gliding of patella Synovial Knee (femur + tibia) Frolich, Human Anatomy, Lower LImb Ball + socket Multiaxial Synovial Hinge Biaxial Joints of Lower Limb Proximal Tibia + Fibula Distal Tibia + Fibula pg 218 Slight “give” Fibrous Ankle (Tibia/Fibula + Talus) Frolich, Human Anatomy, Lower LImb Plane Gliding Synovial Hinge Uniaxial Synovial Lower Limb Movements Hip Bending on posterior side is flexion (except hip) Bending on anterior sided is extension (except hip) Knee Dorsiflexion/plantarflexion Inversion/eversion Toes Frolich, Human Anatomy, Lower LImb Flexion/extension Ankle Flexion/extension Abduction/adduction Lateral/medial rotation Flexion/extension Pelvic tilt and a reverse lumbar curve (or how we got to be upright) Bowl concept pelvis spills forward Hernia “beer belly” In human minor pelvis is behind (posterior) to guts and abdominal cavity Compare human pelvic position with quadruped (cat for instance) Frolich, Human Anatomy, Lower LImb Human pelvis still has quadruped orientation Frolich, Human Anatomy, Lower LImb Bony structure of the pelvis MAIN STRUCTURES Hip bone (innominate, os coxae)--fusion of Ilium (“hips”) Ischium (“rear”) Pubis (anterior midline) Sacrum and coccyx Acetabulum Femur--head, neck, greater trochanter Frolich, Human Anatomy, Lower LImb HOLES False and true pelvis (major, minor pelvis) Pelvic inlet, pelvic outlet Sacrotuberous ligament Sacrospinous ligament Greater, lesser sciatic foramen Obturator foramen Frolich, Human Anatomy, Lower LImb Female Cavity is broad, shallow Pelvic inlet oval + outlet round Bones are lighter, thinner Pubic angle larger Coccyx more flexible, straighter Ischial tuberosities shorter, more everted Frolich, Human Anatomy, Lower LImb Male Cavity is narrow, deep Smaller inlet + outlet Bones heavier, thicker Pubic angle more acute Coccyx less flexible, more curved Ischial tuberosities longer, face more medially Posterior and lateral hip Gluts (gluteal nn.) Lateral rotators (spinal nn.) Frolich, Human Anatomy, Lower LImb Maximus—extensor of thigh Medius--pelvic tilt (relative to insertion with foot planted) Piriformis syndrome Anterior Hip Iliopsoas iliacus psoas Quadratus lumborum Frolich, Human Anatomy, Lower LImb Lumbar and sacral plexus Mr. Bill is happy—so easy Lumbar plexus forms femoral n.—anterior Sacral plexus forms sciatic n.--posterior Femoral n. Sciatic n. Frolich, Human Anatomy, Lower LImb With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense Lumbar plexus (femoral nerve) Frolich, Human Anatomy, Lower LImb Sacral plexus (sciatic nerve) Dermatomes show twisting of leg during development Dorsal becomes anterior: thus “dorsiflexion” and extension in anterior compartment (unlike upper limb) Ventral becomes posterior: thus flexion is in posterior compartment (unlike upper limb) Frolich, Human Anatomy, Lower LImb Anterior/Posterior compartments ANTERIOR POSTERIOR COMPARTMENT 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 Anterior thigh (femoral n.) Sartorius (Tailor’s muscle) Quads (four) Rectus femoris (crosses hip) 3 vastus mm. (vast--big) Frolich, Human Anatomy, Lower LImb Posterior thigh (sciatic n.) Hamstrings Biceps femoris Semimembranous Semitendinous Frolich, Human Anatomy, Lower LImb Medial thigh (obturator n.) Adductor muscles 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.) Extensors (dorsiflexors) Fibularis (peroneus) longus Extensor digitorum longus Extensor hallicus longus Tibialis anteriorus Frolich, Human Anatomy, Lower LImb Lateral Leg (superficial fibular n.) Frolich, Human Anatomy, Lower LImb Fibularis brevis/longus Posterior Leg (tibial n.) Flexors (plantarflexors) Frolich, Human Anatomy, Lower LImb Gastrocs and soleus Flexor digitorum longus Flexor hallucus longus Human gait Humans only large mammal marathoners, ultra-runners Prehistoric cultures hunted by exhausting large prey Bipedalism very efficient energetically Gastroc-Achilles spring One other large mammal more efficient—also bipedal Frolich, Human Anatomy, Lower LImb Intrinsics of foot Frolich, Human Anatomy, Lower LImb pg 792 Surface Anatomy: Anterior Thigh + Leg Palpate Femoral Triangle 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 Popliteal fossa Boundaries pg 793 Frolich, Human Anatomy, Lower LImb Biceps femoris (sup-lat) Semitendinosis + semimembranosis (supmed) Gastrocnemius heads (inf) Contents Diamond-shape fossa behind knee Popliteal a + v Calcaneal (Achilles) tendon Blood supply to lower limb Internal Iliac Cranial + Caudal Gluteals= gluteals Internal Pudendal = perineum, external genitalia Obturator = adductor muscles External Iliac Femoral = lower limb • Deep femoral = adductors, hamstrings, quadriceps 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