Term
| What anchors the lower limb to the axial skeleton |
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Definition
| sacroiliac joint and by strong ligaments, which link the pelvic bone to the sacrum |
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Term
| What are the regiosn of division of the lower limbs? |
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Definition
- the gluteal region is posterolateral and between the iliac crest and the fold of skin (gluteal fold) that defines the lower limit of the buttocks;
- anteriorly, the thigh is between the inguinal ligament and the knee joint-the hip joint is just inferior to the middle third of the inguinal ligament and the posterior thigh is between the gluteal fold and the knee;
- the leg is between the knee and ankle joint;
- the foot is distal to the ankle joint.
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Term
femoral triangle What passes through It? |
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Definition
| a pyramid-shaped depression formed by muscles in the proximal regions of the thigh and by the inguinal ligament, which forms the base of the triangle. The major blood supply and one of the nerves of the limb (femoral nerve) enter into the thigh from the abdomen by passing under the inguinal ligament and into the femoral triangle |
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Term
popliteal fossa What passes through it |
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Definition
| posterior to the knee joint and is a diamond-shaped region formed by muscles of the thigh and leg. Major vessels and nerves pass between the thigh and leg through the popliteal fossa. |
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Term
| Function of the Lower limbs? |
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Definition
- Support the weight of the body with minimal expenditure of energy. When standing erect the center of gravity is anterior to the edge of the SII vertebra in the pelvis . The vertical line through the center of gravity is slightly posterior to the hip joints, anterior to the knee and ankle joints, and directly over the almost circular support base formed by the feet on the ground and holds the knee and hip joints in extension.
- Locomotion:This involves the integration of movements at all joints in the lower limb to position the foot on the ground and to move the body over the foot.Movements at the hip joint are flexion, extension, abduction, adduction, medial and lateral rotation, and circumduction.Movements at the knee are mainly flexion and extension. Movements at the ankle are dorsiflexion (movement of the dorsal side of foot towards the leg) and plantarflexion.
| Movements at the hip joint are flexion, extension, abduction, adduction, medial and lateral rotation, and circumduction |
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Term
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Definition
The leg contains two bones: - the tibia is medial in position, is larger than the laterally positioned fibula, and is the weightbearing bone;
- the fibula does not take part in the knee joint and forms only the most lateral part of the ankle joint-proximally, it forms a small synovial joint (superior tibiofibular joint) with the inferolateral surface of the head of the tibia.
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Term
| What links the tibia and fibula together? |
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Definition
| The tibia and fibula are linked along their lengths by an interosseous membrane, and at their distal ends by a fibrous inferior tibiofibular joint, and little movement occurs between them. The distal surfaces of the tibia and fibula together form a deep recess. The ankle joint is formed by this recess and part of one of the tarsal bones of the foot (talus), which projects into the recess. The ankle is most stable when dorsiflexed. |
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Term
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Definition
Bones of the foot consist of the tarsal bones, the metatarsals, and the phalanges. There are seven tarsal bones, which are organized in two rows with an intermediate bone between the two rows on the medial side. Inversion and eversion of the foot, or turning the sole of the foot inward and outward, respectively, occur at joints between the tarsal bones. The tarsal bones articulate with the metatarsals at tarsometatarsal joints, which allow only limited sliding movements |
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Term
What links the metatarsals together? What are the movements of the mertatarsophalangeal joints? What are the movements of the interphalangeal joints? |
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Definition
Independent movements of the metatarsals are restricted by deep transverse metatarsal ligaments, which effectively link together the distal heads of the bones at the metatarsophalangeal joints. There is a metatarsal for each of the five digits, and each digit has three phalanges except for the great toe (digit 1), which has only two. The metatarsophalangeal joints allow flexion, extension, abduction, and adduction of the digits, but the range of movement is more restricted than in the hand The interphalangeal joints are hinge joints and allow flexion and extension. | |
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Term
| What are the division of muscles in the thigh? |
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Definition
In the thigh, there are medial (adductor), anterior (extensor), and posterior (flexor) compartments: - most muscles in the medial compartment act mainly on the hip joint;
- the large muscles (hamstrings) in the posterior compartment act on the hip (extension) and knee (flexion) because they attach to both the pelvis and bones of the leg;
- muscles in the anterior compartment (quadriceps femoris) predominantly extend the knee.
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Term
| What are the division of muscles in the Leg? |
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Definition
Muscles in the leg are divided into lateral (fibular), anterior, and posterior compartments. - muscles in the lateral compartment predominantly evert the foot;
- muscles in the anterior compartment dorsiflex the foot and extend the digits;
- muscles in the posterior compartment plantarflex the foot and flex the digits; one of the muscles can also flex the knee because it attaches superiorly to the femur
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Term
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Definition
| Muscles found entirely in the foot (intrinsic muscles) modify the forces produced by tendons entering the toes from the leg and provide dynamic support for the longitudinal arches of the foot when walking, particularly when levering the body forward on the stance limb just before toe-off. |
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Term
| What are the major entry/exit points of the lower limb? |
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Definition
Unlike in the upper limb where most structures pass between the neck and limb through a single axillary inlet, in the lower limb, there are four major entry and exit points between the lower limb and the abdomen, pelvis, and perineum. These are: - the gap between the inguinal ligament and pelvic bone;
- the greater sciatic foramen;
- the obturator canal (at the top of the obturator foramen); and
- the lesser sciatic foramen
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Term
| LL communication with the Abdomen? |
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Definition
The lower limb communicates directly with the abdomen through a gap between the pelvic bone and the inguinal ligament . Structures passing though this gap include: - muscles-psoas major, iliacus, and pectineus;
- nerves-femoral and femoral branch of the genitofemoral nerves, and the lateral cutaneous nerve of thigh;
- vessels-femoral artery and vein;
- lymphatics.
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Term
| LL communication with the Pelvis? |
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Definition
Posteriorly, structures communicate with the gluteal region through the greater sciatic foramen and include: - a muscle-piriformis;
- nerves-sciatic, superior and inferior gluteal, and pudendal nerves;
- vessels-superior and inferior gluteal arteries and veins, and the internal pudendal artery
| Anteriorly, the obturator nerve and vessels pass between the pelvis and thigh through the obturator canal. This canal is formed between bone at the top of the obturator foramen and the obturator membrane, which closes most of the foramen during life | |
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Term
| LL communication with the Perineium |
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Definition
Structures pass between the perineum and gluteal region through the lesser sciatic foramen | The most important with respect to the lower limb is the tendon of the obturator internus muscle. | | The nerve and artery of the perineum (the internal pudendal artery and pudendal nerve) pass out of the pelvis through the greater sciatic foramen into the gluteal region and then immediately pass around the ischial spine and sacrospinous ligament and through the lesser sciatic foramen to enter the perineum. | |
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Term
What are the lines that divide the gluteal surface of the ilium It is divided into ___ regions. |
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Definition
- the inferior gluteal line originates just superior to the anterior inferior iliac spine and curves inferiorly across the bone to end near the posterior margin of the acetabulum-the rectus femoris muscle attaches to the anterior inferior iliac spine and to a roughened patch of bone between the superior margin of the acetabulum and the inferior gluteal line;
- the anterior gluteal line originates from the lateral margin of the iliac crest between the anterior superior iliac spine and the tubercle of the crest, and arches inferiorly across the ilium to disappear just superior to the upper margin of the greater sciatic foramen-the gluteus minimus muscle originates from between the inferior and anterior gluteal lines;
- the posterior gluteal line descends almost vertically from the iliac crest to a position near the posterior inferior iliac spine-the gluteus medius muscle attaches to bone between the anterior and posterior gluteal lines, and the gluteus maximus muscle attaches posterior to the posterior gluteal line
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Term
| Muscles attachemnt to the ischial tuberosity? |
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Definition
| Associated mainly with the hamstring muscles of the posterior thigh . It is divided into upper and lower areas by a transverse line. | The upper area of the ischial tuberosity is oriented vertically and is further subdivided into two parts by an oblique line, which descends, from medial to lateral, across the surface: - the more medial part of the upper area is for the attachment of the combined origin of the semitendinosus muscle and the long head of the biceps femoris muscle;
- the lateral part is for the attachment of semimembranosus muscle
The lower area of the ischial tuberosity is oriented horizontally and is divided into medial and lateral regions by a ridge of bone: - the lateral region provides attachment for part of the adductor magnus muscle;
- the medial part faces inferiorly and is covered by connective tissue and by a bursa.
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Term
| What is found in the walls of the acetabulum? |
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Definition
The wall of the acetabulum consists of nonarticular and articular parts: - the nonarticular part is rough and forms a shallow circular depression (the acetabular fossa) in central and inferior parts of the acetabular floor-the acetabular notch is continuous with the acetabular fossa;
- the articular surface is broad and surrounds the anterior, superior, and posterior margins of the acetabular fossa
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Term
Lunate surface of acetabulum |
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Definition
| The smooth crescent-shaped articular surface (the lunate surface) is broadest superiorly where most of the body's weight is transmitted through the pelvis to the femur. The lunate surface is deficient inferiorly at the acetabular notch. | |
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Term
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Definition
Head:Forms about two thirds of a sphere and is directed medially, upward, and slightly forward to fit into the acetabulum.Has a depression in its articular surface, the fovea capitis femoris, to which the liga-mentum capitis femoris is attached. Neck: A cylindrical strut of bone that connects the head to the shaft of the femur. It projects superomedially from the shaft at an angle of approximately 125°, and projects slightly forward. The orientation of the neck relative to the shaft increases the range of movement of the hip joint.Is separated from the shaft in front by the intertrochanteric line, to which the iliofemoral ligament is attached |
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Term
Proximal Femur Greater trochanter? Lesser trochanter |
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Definition
Greater trochanter - Projects upward from the junction of the neck with the shaft.
- Provides an insertion for the gluteus medius and minimus, piriformis, and obturator internus muscles.
- Receives the obturator externus tendon on the medial aspect of the trochanteric fossa
Lesser trochanter -
Lies in the angle between the neck and the shaft. -
Projects at the inferior end of the intertrochanteric crest. -
Provides an insertion for the iliopsoas tendon
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Term
Proximal Femur intertrochanteric line intertrochanteric crest |
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Definition
Intertrochanteric line is a ridge of bone on the anterior surface of the upper margin of the shaft that descends medially from a tubercle on the anterior surface of the base of the greater trochanter to a position just anterior to the base of the lesser trochanter. It is continuous with the pectineal line (spiral line), which curves medially under the lesser trochanter and around the shaft of the femur to merge with the medial margin of the linea aspera on the posterior aspect of the femur. Intertrochanteric crest is on the posterior surface of the femur and descends medially across the bone from the posterior margin of the greater trochanter to the base of the lesser trochanter. It is a broad smooth ridge of bone with a prominent tubercle (the quadrate tubercle) on its upper half, which provides attachment for the quadratus femoris muscle
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Term
Proximal Femur Linea aspera Pectineal line |
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Definition
Linea aspera - Is the rough line or ridge on the body (shaft) of the femur.
- Exhibits lateral and medial lips that provide attachments for many muscles and the three intermuscular septa.
Pectineal line - Runs from the lesser trochanter to the medial lip of the linea aspera.
- Provides an insertion for the pectineus muscle.
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Term
| Describe the Hip (Coxal) Joint |
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Definition
- Is a multiaxial ball-and-socket synovial joint between the acetabulum of the hip bone and the head of the femur and allows abduction and adduction, flexion and extension, and circumduction and rotation.
- Is stabilized by the acetabular labrum; the fibrous capsule; and capsular ligaments such as the iliofemoral, ischiofemoral, and pubofemoral ligaments.
- Has a cavity that is deepened by the fibrocartilaginous acetabular labrum and is completed below by the transverse acetabular ligament, which bridges and converts the acetabular notch into a foramen for passage of nutrient vessels and nerves.
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Term
| What are the structures of the hip joint? |
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Definition
Acetabular labrum Is a complete fibrocartilage rim that deepens the articular socket for the head of the femur and consequently stabilizes the hip joint Fibrous capsule Is attached proximally to the margin of the acetabulum and to the transverse acetabular ligament. Is attached distally to the neck of the femur as follows: anteriorly to the intertrochanteric line and the root of the greater trochanter and posteriorly to the intertrochanteric crest. Encloses part of the head and most of the neck of the femur. Is reinforced anteriorly by the iliofemoralischiofemoralpubofemoral ligament, posteriorly by the ligament, and inferiorly by the ligament. |
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Term
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Definition
- Is the largest and most important ligament that reinforces the fibrous capsule anteriorly and is in the form of an inverted Y.
- Is attached proximally to the anterior-inferior iliac spine and the acetabular rim and distally to the intertrochanteric line and the front of the greater trochanter of the femur.
- Resists hyperextension and lateral rotation at the hip joint during standing.
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Term
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Definition
Reinforces the fibrous capsule posteriorly, extends from the ischial portion of the acetabular rim to the neck of the femur medial to the base of the greater trochanter, and limits extension and medial rotation of the thigh. |
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Term
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Definition
Reinforces the fibrous capsule inferiorly, extends from the pubic portion of the acetabular rim and the superior pubic ramus to the lower part of the femoral neck, and limits extension and abduction. |
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Term
What are the ligaments of the femur? Vascular and nerve innervations |
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Definition
iliofemoral ligament - pubofemoral ligament -ischiofemoral ligament The fibers of all three ligaments are oriented in a spiral fashion around the hip joint so that they become taut when the joint is extended. This stabilizes the joint and reduces the amount of muscle energy required to maintain a standing position. Vascular supply to the hip joint is predominantly through branches of the obturator artery, medial and lateral circumflex femoral arteries, superior and inferior gluteal arteries, and first perforating branch of the deep artery of the thigh. The articular branches of these vessels form a network around the joint | The hip joint is innervated by articular branches from the femoral, obturator, and superior gluteal nerves, and the nerve to the quadratus femoris. | | |
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Term
| What are the gateways to the lower limb? |
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Definition
- obturator canal,
- the greater sciatic foramen,
- the lesser sciatic foramen,
- the gap between the inguinal ligament and the anterosuperior margin of the pelvis
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Term
Obturator canal What are its boarders? What passes through it? | |
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Definition
Obturator canal is an almost vertically oriented passageway at the anterosuperior edge of the obturator foramen. It is bordered: - above by a groove (obturator groove) on the inferior surface of the superior ramus of the pubic bone;
- below by the upper margin of the obturator membrane, which fills most of the obturator foramen, and by muscles (obturator internus and externus) attached to the inner and outer surfaces of the obturator membrane and surrounding bone.
The obturator canal connects the abdominopelvic region with the medial compartment of the thigh. The obturator nerve and vessels pass through the canal. |
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Term
| What are its boarders? What passes through it? |
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Definition
Greater sciatic foramen is formed on the posterolateral pelvic wall and is the major route for structures to pass between the pelvis and the gluteal region of the lower limb (Fig. 6.34). The margins of the foramen are formed by: - the greater sciatic notch;
- parts of the upper borders of the sacrospinous and sacrotuberous ligaments;
- the lateral border of the sacrum
The piriformis muscle passes out of the pelvis into the gluteal region through the greater sciatic foramen and separates the foramen into two parts, a part above the muscle and a part below: 1.the superior gluteal nerve and vessels pass through the greater sciatic foramen above the piriformis; 2.the sciatic nerve, inferior gluteal nerves and vessels, pudendal nerve and internal pudendal vessels, posterior cutaneous nerve of thigh, nerve to the obturator internus and gemellus superior and the nerve to the quadratus femoris and gemellus inferior pass through the greater sciatic foramen below the muscle. |
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Term
Boarders What passes through itÉ |
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Definition
Lesser sciatic foramen is inferior to the greater sciatic foramen on the posterolateral pelvic wall . It is also inferior to the lateral attachment of the pelvic floor to the pelvic wall and therefore connects the gluteal region with the perineum: - the tendon of obturator internus passes from the lateral pelvic wall through the lesser sciatic foramen into the gluteal region to insert on the femur;
- the pudendal nerve and internal pudendal vessels, which first exit the pelvis by passing through the greater sciatic foramen below the piriformis muscle, enter the perineum below the pelvic floor by passing around the ischial spine and sacrospinous ligament and medially through the lesser sciatic foramen.
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Term
| Gap between the inguinal ligament and pelvic bone |
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Definition
| The large crescent-shaped gap between the inguinal ligament above and the anterosuperior margin of the pelvic bone below is the major route of communication between the abdomen and the anteromedial aspect of the thigh. The psoas major, iliacus, and pectineus muscles pass through this gap to insert onto the femur. The major blood vessels (femoral artery and vein) and lymphatics of the lower limb also pass through it, as does the femoral nerve, to enter the femoral triangle of the thigh |
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Term
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Definition
Femoral nerve carries contributions from the anterior rami of L2 to L4 and leaves the abdomen by passing through the gap between the inguinal ligament and superior margin of the pelvis to enter the femoral triangle on the anteromedial aspect of the thigh. In the femoral triangle it is lateral to the femoral artery. The femoral nerve: - innervates all muscles in the anterior compartment of the thigh;
- in the abdomen, gives rise to branches that innervate the iliacus and pectineus muscles;
- innervates skin over the anterior aspect of the thigh, anteromedial side of the knee, the medial side of the leg, and the medial side of the foot
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Term
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Definition
Obturator nerve, like the femoral nerve, originates from L2 to L4. It descends along the posterior abdominal wall, passes through the pelvic cavity and enters the thigh by passing through the obturator canal. The obturator nerve innervates: - all muscles in the medial compartment of the thigh, except the part of adductor magnus muscle that originates from the ischium and the pectineus muscle, which are innervated by the sciatic and the femoral nerves, respectively;
- the obturator externus muscle;
- skin on the medial side of the upper thigh.
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Term
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Definition
Largest nerve of the body and carries contributions from L4 to S3. It leaves the pelvis through the greater sciatic foramen inferior to the piriformis muscle, enters and passes through the gluteal region (Fig. 6.35), and then enters the posterior compartment of the thigh where it divides into its two major branches: - the common fibular nerve;
- the tibial nerve.
| | Posterior divisions of L4 to S2 are carried in the common fibular part of the nerve and the anterior divisions of L4 to S3 are carried in the tibial part. | The sciatic nerve innervates: - all muscles in the posterior compartment of the thigh;
- the part of adductor magnus originating from the ischium;
- all muscles in the leg and foot;
- skin on the lateral side of the leg and the lateral side and sole of the foot.
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Term
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Definition
- Begins as the continuation of the external iliac artery distal to the inguinal ligament, descends through the femoral triangle, and enters the adductor canal.
- Has a palpable pulsation, which may be felt just inferior to the midpoint of the inguinal ligament.
- Is vulnerable to injury because of its relatively superficial position in the femoral triangle.
- Includes several branches:
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Term
| 4 major Arteries of the LL |
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Definition
Superior gluteal artery Inferior gluteal artery Obturator artery Femoral artery |
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Term
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Definition
The superficial veins form two major channels-the great saphenous vein and the small saphenous vein.
The greater saphenous vein begins at the medial end of the dorsal venous arch of the foot, passes anterior to the medial malleolus, runs on the medial side of the lower limb, and empties into the femoral vein. The small saphenous vein begins at the lateral end of the dorsal venous arch, passes posterior to the lateral malleolus, ascends on the posterior side of the leg along with the sural nerve, and empties into the popliteal vein. |
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