Organization of the Lower Limb Most illustrations from: Thieme Atlas of Anatomy: Musculoskeletal System. M Schuenke, et al, 2006. Anatomy: A Regional Atlas of the Human Body. Carmine Clemente, 4th edition. Segments of the Lower Limb Limb Girdle pelvic girdle (gluteal)
Free limb - thigh - leg - foot Limb Development Lower limb develops in an
anterolateral position at the level of the L2 to S3 trunk segments Great toe positioned in cephalic direction with the soles of the feet in an ateriomedial direction Knee positioned in a
posteriolateral position Limb Rotation Lower Limb Rotation Medial rotation Adduction
Extension Joints of the Lower Limb Articulation with Axial Skeleton Sacroiliac jt. Sternoclavicular jt,
Os Coxae Hemipelvis is composed of the ilium, ischium and pubis with articulations centered in acetabulum triradiate articulation Fusion of the 3 bones is complete between 20 and 25 years of age Tri-radiate Articulation
Superficial & deep posterior crural compartments Crural Fascia posterior Lumbosacral Plexus Innervation of the Lower Limb: Lumbosacral Plexus (L1 - S3)
Lumbosacral Plexus L1 - S3 Gluteal innervation: Superior gluteal n gluteus medius m.
gluteus minimus m. tensor fascia lata Inferior gluteal n (L4,5, S1): (L5, S1,2):
gluteus maximus m. N to obturator internus (L5, S1, 2): oburator internus superior gemellus Nerve to quadratus femoris (L4,5, S1): inferior gemellus quadratus femorus
Compartmental Innervation Of the Free Limb Anterior compartmen t Thigh Leg Foot
Medial compartment Posterior compartme nt Lateral compartmen t Anterior (extensor) compartment of the
thigh Innervation: femoral nerve anterior anterior Medial (adductor) compartment of the thigh Innervation: obturator nerve*
media l media l *Adductor Magnus innervated by both obturator n and tibial division of sciatic n Posterior compartment of the thigh
Hamstring mm: arise from ischial tuberosity & are innervated by tibial division of sciatic n. Innervation: Tibial division of sciatic nerve Except short head of biceps femoris: common fibular division of sciatic nerve
posterior Posterior compartment of the leg Innervation: tibial n. Superficial posterior crural compartment posterior Deep posterior
crural compartment Plantar surface of the foot Innervation: Medial & lateral plantar nerves Innervation of intrinsic muscles of the foot Medial plantar n
flexor digitorum brevis flexor hallucis brevis abductor hallucis m 1st lumbrical Lateral plantar n abducator digiti minimi quadratus plantae 2nd, 3rd & 4th lumbricals adductor hallucis Flexor digiti minimi dorsal & plantar interossei
Common fibular nerve Nerve supply to the lateral and anterior crural compartments anterior lateral anterior lateral Lateral crural
compartment: Superficial fibular nerve Fibularis longus Fibularis brevis lateral Anterior crural compartment: Deep fibular nerve Tibialis anterior m. Extensor hallucis longus m.
Extensor digitorum longus m. Fibularis tertius m. anterior Dorsum of the foot: deep fibular nerve Extensor hallucis brevis Extensor digitorum brevis Compartmental Innervation of Free Limb
Anterior compartme nt Thigh Femoral n. Medial compartme nt
Posterior compartme nt Obturator n.* Tibial division of sciatic n. * *adductor magnus -
*short head of biceps obturator n and tibial n femoris - common fib. division of sciatic n. Leg Deep fibular n.
Tibial nerve Foot Deep fibular n. Tibial n. (medial and lateral plantar n.)
Lateral compartme nt Superficial fibular n. Dermatomes Key dermatomes* thumb - C6
5th digit of hand C8 nipples - T4 umbilicus - T10 hip crease - L1 great toe - L4 5th toe - S1 *area of skin supplied by a dorsal nerve root Key dermatomes* of the Lower
Limb umbilicus - T10 hip crease - L1 great toe - L4 5th toe - S1 *area of skin supplied by a dorsal nerve root Cutaneous Nerve Supply to the Lower Limb
References Clemente, C. 1997 Anatomy: A Regional Atlas of the Human Body, 4th edition. Lippincogtt Williams & Wilkins. Rinabesm C,H, 1972. Cunninghams Textbook of Anatomy, 11th edition. Oxford University Press. Rosse, C & Gaddum-Rosse, P. 1997. Hollinsheads Textbook of Anatomy 5th edition. LippincottRaven Schuenke, M et al, 2006 Thieme Atlas of Anatomy: Musculoskeletal System. Thieme. Slaby, F., et al. 1994. Gross Anatomy in the Practice of Medicine. Lea & Febiger.
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