Download Anatomy of Lower Limb and Foot

PROJECT HD | HBS2ALF
Prepared by: Jasmine Kouch
Course: Bachelor of Health Sciences/Master of Podiatric Practice
Prepared for: Semester 1, 2014
Anatomy of Lower Limb and Foot
1. Vertebral Column
Part
Spinous Process
Lamina
Facet joint (zygapophysial joint)
Pedicle
Body
Spinal canal
Transverse Process
Articular Processes
Intervertebral discs
Function
Attachment site for muscles and ligaments
Forms the vertebral arch, attachment site for ligamentum flavum
Synovial joint that connects the superior articular process and the
inferior articular process directly above it.
Prevents excessive rotation and flexion.
Forms the vertebral arch
Weight transmission/bearing
Contains the spinal cord
Enclosed within the vertebral foramen. In the intervertebral spaces, it is
protected by ligamentum flavum posteriorly and posterior longitudinal
ligament anteriorly.
Attachment site for muscles and ligaments
Attachment for the next vertebra
Fibrocartilage joint that holds vertebrae together.
Allows slight movement.
Main job is shock absorption.
Superior articular process and
facet
Inferior articular process and
facet
Superior and inferior vertebral
notches
Regions of the Vertebral Column
Region
Number of Vertebrae
Cervical
7
Distinguishing Features
 Oblique
 Allows flexion/extension, lateral flexion
 C3-C7 have bifid spinous processes
Thoracic
12
Lumbar
5
Sacral
5
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Body is more oval shaped
Sits on the coronal plane
Allows rotation
No transverse foramen
Singular spinous process
Body is a small semi-circular shape
Articulates with the ribs
Demifacets for articulation with the ribs
Lies on the sagittal plane
Allows stability, protects tissues
Allows flexion/extension, slight rotation
Singular spinous process
No transverse process
Assists with weight transfer to the lower limbs
Fused
Typical ligaments of the vertebral column
Ligament
General Attachment
Anterior longitudinal
From: Anterior tubercle of C1
To: Pelvic surface of upper sacrum
Posterior longitudinal
From: Posterior surface of body of C2
To: Posterior surface of body of S1
Supraspinous
From: Tip of C7 spinous process
To: Tip of S1 spinous process
Function
3 layers:
 Superficial: extends over 3-4
vertebrae
 Intermediate: extends over 2-3
vertebrae
 Deep: laterally short fibers
connecting adjacent vertebrae
Limits extension of the vertebral column
2 layers of collagen fibers:
 Superficial: extends over 3-4
vertebrae
 Deep: pass between adjacent
vertebrae
Limits flexion of the vertebral column
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Thicker and broader at lumbar
region
3
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Continuous from ligamentum
nuchae
Helps maintain upright position
of the head
From: external occipital protuberance
to the spine of C7
To: external occipital crest, posterior
tubercle C1, medial aspect of cervical
bifid spines
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Provides attachment for cervical
muscles
Tendon-like structure
Sustains the weight of the head
Ligamentum flavum
From: C2
To: S1
Connects the lamina to adjacent
vertebrae
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Preserves upright posture
 Especially after flexion
Elastic
Interspinous
From: Spinous process
To: Spinous process
Connects from root to apex from each
vertebrae
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Narrow and elongated in the
thoracic region
Thicker and quadrilateral in the
lumbar region
Limits flexion of the spine
Ligamentum nuchae
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Intertransverse
From: Transverse process
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Limits lateral flexion of the spine
4
To: Transverse process
Connects adjacent transverse
processes
Curvatures of the vertebral column
Region
Curvature
Contributing structures, time of appearance and
function
Cervical
Anteriorly concave
Toddler period (after birth)
- Weight bearing of the head and neck
Thoracic
Anteriorly convex
When the child starts standing
- Supports for weight bearing
- Posture
- In the foetus it was anteriorly concaved
Lumbar
Anteriorly concave
Appears after birth
Sacral
Anteriorly convex
Appears before birth
***Primary curvatures: appear before birth – thoracic and sacral
***Secondary curvatures: appear after birth – cervical and lumbar
5
Muscles of the vertebral column
Muscle
Sternocleidoma
stoid
Origin
**TWO HEADS
Anterior surface of
sternum
& Upper surface of
medial 1/3 of the clavicle
Insertion
Lateral surface of
mastoid process of
temporal bone and
adjacent part of the
superior nuchal line
Trapezius
External occipital
protuberance,
ligamentum nuchae,
medial superior nuchal
line, spinous processes
of C7-T12
Posterior border of
lateral 1/3 of clavicle,
acromion process and
spine of scapula
Splenius
Capitis: ligamentum
nuchae and spinous
process of C7-T4
Capitis: mastoid proess
and occipital bone
Cervicis: Spinous process
of T3-T6
Scalenes
Cervical vertebrae
C2-C7
Cervicis: posterior
tubercles of transverse
process C1-C3
1st and 2nd ribs
Joint Crossed
Cervical
intervertebral
joint (anteriolaterally)
Action
Unilaterally
Cervical rotation to opposite
side
Cervical lateral flexion to
same side
Bilaterally
Cervical flexion
Assists in forced inspiration
Bilaterally
Rotation
Retraction
Elevation
Depression of scapula
Nerve Supply
Motor: accessory nerve
Sensory: cervical plexus
Capitis: Neck
Extension
Lateral flexion
Rotation of face
Capitis: lateral branches
of dorsal rami C3-C5
Motor: accessory nerve
Motor and sensory: C3,
C4 spinal nerves
Cervicis: lateral branches
of dorsal rami C5-C7
Cervicis: Neck
Lateral flexion
Rotation
**The two work together for pure
extension
Elevation of 1st and 2nd ribs
Cervical nerves C3-C6
Diagram
Erector Spinae
Spinous process of T9T12, dorsal segment of
iliac crest
Spinous process of T1T2
Transversospina
les
Transverse process
Spinous process
External
Oblique
Ribs 5-12, iliac crest
Pubic crest, ASIS, iliac
crest, linea alba
Intervertebral
joints
(posteriorly)
Intervertebral
joints (anteriorlaterally)
Internal Oblique
Lateral 2/3 of inguinal
ligament, iliac crest
Rib cartilage 9-12,
xiphoid process, linea
alba, pubic crest,
pectin pubis
Intervertebral
joints (anteriorlaterally)
Rectus
abdominis
Crest of pubis
Costal cartilage of ribs
5-7, xiphoid process of
sternum
Intervertebral
joints (anteriorly)
Extends the vertebral column
Posterior branch of
spinal nerve
Unilaterally:
Rotation of vertebral
column
Bilaterally:
Extension of vertebral
column
Dorsal rami of spinal
nerves
Trunk
Spine
-
Ventral rami of T6-T12
Contralateral rotation
Lateral flexion
With internal oblique
Raises pressure in the
abdominal cavity and pelvis
Assists in defecation and
micturition
Produce forced expiration
Trunk
Ipsilateral rotation
Spine
Lateral flexion
Flexion of lumbar spine
Ventral rami T6-L1
Thoraco-abdominal
nerves T7-T11
7
Psoas major
Transverse process L1L5, intervertebral discs
from inferior T12 to
superior L5, body of L1L4
Posterior aspect of
lesser trochanter of
the femur
Psoas minor
Bodies of T1-L5 and their
intervening
intervertebral discs
Pectin pubis, iliopubic
eminence, lateral iliac
fascia
With iliacus
Flexion of hip joint
Medial rotation of hip
Unilaterally
Lateral flexion of lumbar
spine
Weak flexor of lumbar spine
Lumbar plexus
Ventral rami L1-L3
(occasionally L4)
Lumbar Plexus
Ventral rami L1
8