Introduction to the Lower Limb

Basic Organization of the Lower Limb• Axial Skeleton vs Appendicular Skeleton

Articulation with Axial Skeleton

Basic Organization of the Lower Limb

• Segments– Pelvic girdle (gluteal)

Basic Organization of the Lower Limb

• Segments– Pelvic girdle (gluteal)– Thigh

Basic Organization of the Lower Limb

• Segments– Pelvic girdle (gluteal)– Thigh– Leg

Basic Organization of the Lower Limb

• Segments– Pelvic girdle (gluteal)– Thigh– Leg– Foot

Development of the Lower Limb

Development of the Lower Limb

Angle of Inclination

Angle of Anteversion

Vasculature of the Lower Limb

Superficial veins

Great saphenous v.

Small saphenous v.

Arterial Blood Supply

External Iliac a

Femoral a

Internal Iliac a

Superior gluteal a

Inferior gluteal a

Obturator a

Superior Gluteal aInferior Gluteal a

Branches of Internal Iliac Artery

Branches of Internal Iliac Artery

Obturator artery

External Iliac Artery

Femoral Artery

ASIS

Femoral a.

Deep femoral a

Adductor Canal

Femoral a.

Deep femoral a

Adductor Canal

Deep Femoral Artery

Femoral a.

Deep femoral a

Adductor Hiatus

Popliteal a

Femoral artery

Popliteal artery

Popliteal Fossa

Colateral circulation:Medial superior genicular a.Lateral superior genicular a.Middle genicular a.Medial inferior genicular a.Lateral inferior genicular a.

Popliteal artery

Posterior AnteriorTibial a. Tibial a.

Branches of the Popliteal Artery

Posterior Tibial Artery

Fibular a.

Med. Plantar a. Lat. Plantar a.

Anterior Tibial Artery

Dorsalis Pedis Artery

medial lateral

Dorsal & Plantar CirculationPosterior Tibial a

Medial & Lateral Plantar aa.

Dorsalis Pedis a.

Arcuate a. Deep plantar a.

Deep plantar a.

Gluteal Fascia Fascia Lata Crural Fascia

Fascia of the Lower Limb

Fascia Lata

Fascial Compartments

Crural Fascia

Fascial Compartments

Innervation of the Lower Limb

Gluteal innervation:Gluteus maximus: inferior gluteal n.

Gluteal innervation:

Superior gluteal n:

• gluteus medius m.

• gluteus minimus m.

• tensor fascia lata

Innervation & blood supply to gluteus maximus m.

Inferior gluteal n

Superior and inferior gluteal a & v

Nerve to obturator internus

Nerve to quadratus femoris

Anterior compartment of the thigh

Medial compartment of the thigh

Posterior compartment of the thighHamstring mm: arise from ischial tuberosity & innervated by tibial division of sciatic n.

Superficial posterior compartment of the leg

Innervation: tibial n.

Deep posterior copartment of the leg

Innervation: tibial nerve

Tibial nerve

Medial & Lateral plantar nerves

Common Fibular (Peroneal) division of the sciatic nerve

Lateral crural compartment:

Superficial fibular nerveFibularis longus

Fibularis brevis

Anterior crural compartment:

Deep fibular nerveTibialis anterior m.

Extensor hallucis longus m.

Extensor digitorum longus m.

Fibularis tertius m.

Dorsum of the foot: deep fibular nerveExtensor hallucis brevis

Extensor digitorum brevis

Key dermatomesnipples - T4

umbilicus - T10

hip crease - L1

great toe - L4

5th toe - S1

ANTERIOR

COMPARTMENT

MEDIAL

COMPARTMENT

POSTERIOR

COMPARTMENT

LATERAL

COMPARTMENT

THIGH

LEG

FOOT

NERVE

CORD LEVELS

MUSCLES SUPPLIED

SUPERIOR GLUTEAL NERVE

INFERIOR GLUTEAL NERVE

N. TO OBTERATOR INTERNUS

N. TO QUADRATUS FEMORUS