Anatomy 2: Superficial Lower Limb

Question 1

Discuss the functions, attachments, and specialization of the deep fascia of the thigh and leg.

Answer 1

Deep fascia

• i.Fascia lata - forms IT band.
• -1.IT Band functions to:
• –a.Hold knee in extension
• –b.Preventing displacement of femoral head from acetabulum.

CLINICAL CORRELATION: IT Band Syndrome - common cause of lateral knee pain in runners and cyclists. Caused by inflammation of IT band by repeated sliding over lateral femoral epicondyle. Diagnosed via hx, positive Ober’s test, or MRI. Treatment: modifying physical activity, reducing acute inflammation with ice and anti-inflammatory meds, and stretching and strengthening exercises.

• ii. Saphenous opening - gap in fascia lata
• iii. Crural fascia - fascia enveloping leg and foot. Continuous with fascia lata.
• iv. Femoral sheath - covered in A/M thigh

Question 2

Describe the locations of lymph nodes associated with the lower limb and the regions of the body that drain into these nodes.

Answer 2

Superficial inguinal lymph nodes drain into external iliac or deep inguinal

Question 3

5. Describe the origin, course, and cutaneous distribution patterns of cutaneous nerves to the lower limb.

Answer 3

Gluteal region

i. Lateral - T12 and L1 (iliohypogastric)
ii. Superior - Superior cluneal nerves dorsal rami L1-3 (may be damaged by iliac crest grafting)
iii. Medial - Middle cluneal nerves dorsal rami S1-3
iv. Inferior - Inferior cluneal nerves (branches of posterior femoral cutaneous) VENTRAL RAMI S1-3

Thigh

• Anterior
  1. Lateral femoral cutaneous L2,3
  2. Anterior cutaneous nerves of thigh L2-4
  3. Cutaneous branch of obturator nerve L2-4
  4. Subcostal, ilioinguinal and genitofemoral nerves
• Posteriorly
  1. Post. Femoral cutaneous (ventral S1-3)
• -a.Branches are all cutaneous

Leg and foot

i. Anterior - lateral sural and superficial fibular
ii. Medial - saphenous nerve (branch of deep fibular)
iii. Posterior - Posterior femoral cutaneous, lateral sural cutaneous (COMMON FIBULAR), medial sural cutaneous (TIBIAL), and sural (communicating branches of fibular and tibial)