Lower Limb Muscles Flashcards
What are the 2 groups of muscles in the gluteal region?
What are their functions?
Superficial muscles:
- they abduct and extend the femur
Deep muscles:
- they laterally rotate the femur
What are the superficial muscles in the gluteal region?
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- Tensor fascia lata
They act to abduct and extend the lower limb at the hip joint
What are the attachments, actions and innervation of gluteus maximus?
origin:
- gluteal surface of ileum, sacrum and coccyx
attachment:
- iliotibial tract and gluteal tuberosity of femur
actions:
- main extensor of the thigh
- assists in lateral rotation
innervation:
- inferior gluteal nerve
What are the attachments, actions and innervation of gluteus medius?
Origin:
- gluteal surface of the ilium
Insertion:
- greater trochanter of femur
actions:
- abducts and medically rotates the lower limb
- secures the pelvis and prevents pelvic drop during walking
innervation:
- superior gluteal nerve
What are the attachments, actions and innervation of gluteus minimus?
origin:
- ilium
insertion:
- greater trochanter
actions:
- abducts and medically rotates the limb
- prevents pelvic drop of the opposite limb during walking
innervation:
- superior gluteal nerve
What are the attachments, actions and innervation of the tensor fascia lata?
Origin:
- anterior superior iliac spine
Insertion:
- iliotibial tract, which attaches to the lateral condyle of the tibia
action:
- assists gluteus medius and gluteus minimus in abduction and medial rotation of the lower limb
innervation:
- superior gluteal nerve
What are the deep muscles of the gluteal region?
- Piriformis
- Superior and inferior gemelli
- Quadratus femoris
- Obturator internus
They laterally rotate the lower limb
What are the attachments, actions and innervation of piriformis?
Origin:
- anterior surface of the sacrum
insertion:
- travels through greater sciatic foramen
- Inserts into greater trochanter of femur
actions:
- lateral rotation and abduction
innervation:
- nerve to piriformis
What are the attachments, actions and innervation of obturator internus?
Origin:
- pubis and ischium at obturator foramen
insertion:
- travels through lesser sciatic foramen
- attaches to greater trochanter of femur
actions:
- lateral rotation and abduction
innervation:
- nerve to obturator internus
What are the attachments, actions and innervations of the gemelli?
origin:
- superior gemellus - ischial spine
- inferior gemellus - ischial tuberosity
insertion:
- greater trochanter of femur
actions:
- lateral rotation and abduction
innervation:
- superior gemellus - nerve to obturator internus
- inferior gemellus - nerve to quadratus femoris
What are the attachments, actions and innervation of quadratus femoris?
Origin:
- ischial tuberosity
insertion:
- quadrate tuberosity on the intertrochanteric crest
actions:
- lateral rotation
innervation:
- nerve to quadratus femoris
Label the muscles of the gluteal region


What is the innervation and general action of the muscles in the anterior compartment of the thigh?
Innervation:
- femoral nerve (L2-L4)
Action:
- extension of the leg at the knee joint
What are the muscles within the anterior compartment of the thigh?
- Pectineus
- Sartorius
- Quadriceps femoris
- Iliopsoas (the end passes into the anterior compartment)
What are the origins and insertions of iliopsoas?
Origin:
- Psoas major originates from the lumbar vertebrae
- iliacus originates from the iliac fossa
Insertion:
- lesser trochanter of femur
What are the actions and innervation of iliopsoas?
Actions:
- flexes the thigh at the hip joint
innervation:
- psoas major - anterior rami of L1-L3
- iliacus - femoral nerve
Label the muscles of the anterior thigh


What are the 4 muscles that make up quadriceps femoris?
- Rectus femoris
- Vastus lateralis
- Vastus medialis
- Vastus intermedius
What are the attachments, actions and innervation of vastus lateralis?
Origin:
- greater trochanter and lateral lip of linea aspera
Insertion:
- Quadriceps tendon, which attaches to the patella
Action:
- extends the knee joint and stabilises the patella
Innervation:
- femoral nerve
What are the attachments, actions and innervation of vastus medialis?
Origin:
- intertrochanteric line and medial lip of linea aspera
Actions:
- extends the knee joint and stabilises the patella
Innervation:
- femoral nerve
What are the attachments, actions and innervation of vastus intermedius?
Origin:
- anterior and lateral surfaces of femoral shaft
Actions:
- extends the knee joint and stabilises the patella
Innervation:
- femoral nerve
What are the attachments, actions and innervation of rectus femoris?
Origin:
- Ilium (just superior to acetabulum)
actions:
- flexes the thigh at the hip joint
- extends the leg at the knee joint
Innervation:
- femoral nerve
What are the attachments, actions and innervation of sartorius?
Origin:
- anterior superior iliac spine
Insertion:
- superior, medial surface of the tibia
Actions:
- flexes, abducts and laterally rotates the hip
- flexes the knee joint
Innervation:
- femoral nerve
Label the muscles


What is meant by pectineus being a “transitional muscle”?
it has a dual innervation
it is a transitional muscle between the anterior and medial thigh compartments
What is the passage of sartorius like?
it is long and thin and runs across the thigh in an inferomedial direction
it is more superficial than the other muscles in the leg
What are the attachments, actions and innervation of pectineus?
Origin:
- pectineal line on anterior surface of pelvis
Insertion:
- Pectineal line on posterior femur (just inferior to lesser trochanter)
Actions:
- adduction and flexion at the hip joint
Innervation:
- femoral nerve
- also receives a branch from the obturator nerve
Label the prosection image


What are the 5 medial thigh muscles?
What is their artery and nerve supply?
The ‘hip adductors’
- Gracilis
- Obturator externus
- Adductor brevis
- Adductor longus
- Adductor Magnus
They are supplied by the obturator nerve and obturator artery
Label the muscles of the medial thigh


What are the attachments of the 2 parts of the adductor Magnus muscle?
Adductor part:
- originates from inferior rami of pubis and rami of ischium
- attaches to linea aspera
Hamstring part:
- orginates from ischial tuberosity
- attaches to adductor tubercle and medial supracondylar line of the femur
What are the actions and innervation of adductor magnus?
Actions:
- adduction of the thigh
- the adductor part also flexes the thigh
- the hamstring portion also extends the thigh
Innervation:
- ‘adductor part - obturator nerve (L2-L4)
- hamstring part - sciatic nerve (L4-S3)
What are the attachments, innervation and actions of adductor longus?
Origin:
- originates from the pubis and expands into a fan shape
Insertion:
- linea aspera of femur
Innervation:
- obturator nerve (L2-L4)
Why can the adductor brevis be used as an anatomical landmark?
it lies between the anterior and posterior divisions of the obturator nerve
What are the attachments, actions and innervation of the adductor brevis?
Origin:
- body of pubis and inferior pubic rami
Insertion:
- Linea aspera of femur
- proximal to adductor longus
actions:
- Adduction of the thigh
Innervation:
- obturator nerve (L2-L4)
What are the attachments, innervation and actions of obturator externus?
Origin:
- membrane of obturator foramen and adjacent bone
Insertion:
- posterior aspect of greater trochanter
Actions:
- adduction and lateral rotation of the thigh
Innervation:
- Obturator nerve (L2-L4)
What are the attachments and passage of gracilis?
Originates from the inferior ramus of the pubis and body of the pubis
descends vertically down the leg to attach to the medial surface of the tibia
it attaches between the tendons of sartorius (anteriorly) and semitendinosus (posteriorly)
What are the actions and innervation of gracilis?
Actions:
- adduction of the thigh at the hip
- flexion of the leg at the knee
Innervation:
- obturator nerve (L2-L4)
Label the medial thigh muscles


What are the muscles in the posterior compartment of the thigh?
The Hamstrings
- Biceps femoris
- Semitendinosus
- Semimembranosus
What are the actions and innervation of the posterior thigh muscles?
they extend at the hip and flex at the knee
they are innervation by the sciatic nerve (L4-S3)
Label the muscles of the posterior thigh


What are the attachments of the biceps femoris muscle?
Long head:
- originates from the ischial tuberosity of the pelvis
short head:
- originates from the linea aspera on the posterior surface of the femur
insertion:
- the two heads form a tendon, which inserts into the head of the fibula
What are the actions and innervation of biceps femoris?
Actions:
- flexion at the knee
- also extends the thigh at the hip
- laterally rotates the hip and knee
Innervation:
- long head - tibial part of sciatic nerve
- short head - common fibular part of the sciatic nerve
What are the attachments, actions and innervation of semitendinosus?
Origin:
- ischial tuberosity of pelvis
Insertion:
- medial surface of the tibia
Actions:
- flexion of the leg at the knee joint
- extension of the thigh at the hip
- medially rotates the thigh and leg
What are the attachments, actions and innervation of semimembranosus?
Origin:
- ischial tuberosity of pelvis
- more superiorly than the semitendinosus and biceps femoris
Insertion:
- medial tibial condyle
Actions:
- flexion of the leg at the knee joint
- extension of the thigh at the hip joint
- medially rotates the thigh and leg
Innervation:
- tibial part of sciatic nerve
Label the cross section of the thigh


What are the 4 muscles in the anterior compartment of the leg?
- Tibialis anterior
- Extensor digitorum longus
- Extensor hallucis longus
- Fibularis tertius
What is the general action of the anterior leg muscles?
What is their blood supply and innervation?
They dorsiflex and invert the foot at the ankle joint
they are innervated by the deep fibular nerve (L4 - S1)
they are supplied by the anterior tibial artery
What are the attachments, actions and innervation of tibialis anterior?
Origin:
- lateral surface of the tibia
Insertion:
- medial cuneiform and the base of metatarsal I
Actions:
- dorsiflexion and inversion of the foot
Innervation:
- deep fibular nerve
Label the muscles of the anterior leg


What are the attachments, actions and innervation of extensor digitorum longus?
Origin:
- lateral condyle of the tibia and medial surface of fibula
Insertion:
- the tendons insert onto the dorsal surface of the 4 toes
Actions:
- extension of the lateral four toes
- dorsiflexion of the foot
Innervation:
- deep fibular nerve
What are the attachments, actions and innervation of extensor hallucis longus?
Origin:
- medial surface of the fibular shaft
Insertion:
- the tendon attaches to the base of the distal phalanx of the big toe
Action:
- extension of the big toe
- dorsiflexion of the foot
Innervation:
- deep fibular nerve
Label the tendons of the foot


What is significant about fibularis tertius?
It arises from the most inferior part of the EDL
It is not present in all individuals
What are the attachments, actions and innervation of fibularis tertius?
Origin:
- originates with the EDL from the medial surface of the fibula
Insertion:
- the tendon attaches to metatarsal V
Actions:
- Eversion and dorsiflexion of the foot
innervation:
- deep fibular nerve
What is footdrop a clinical sign of?
What is it usually a consequence of?
It indicates paralysis of the muscles in the anterior compartment of the leg
It occurs due to damage to the common fibular (peroneal) nerve (from which the deep fibular nerve arises)
What is the appearance of the leg like in foot drop and why?
The muscles in the anterior compartment are paralysed
the unopposed pull of the muscles in the posterior leg produce permanent plantarflexion
What are the 2 muscles in the lateral compartment of the leg?
What is their innervation and main function?
- Fibularis brevis
- Fibularis longus
They are innervated by the superficial fibular nerve
Their main function is eversion (turning the sole of the foot outwards)
Label the muscles of the lateral leg?


What are the attachments and path of the tendon of fibularis longus?
Origin:
- superior and lateral surface of the fibula and lateral tibial condyle
Path of the tendon:
- the tendon descends into the foot, posterior to the lateral malleolus
- it crosses under the foot
Insertion:
- bones on the medial side of the foot - mainly medial cuneiform and base of metatarsal I
What are the actions and innervation of fibularis longus?
Actions:
- eversion and plantarflexion of the foot
- supports the lateral and transverse arches of the foot
Innervation:
- superficial fibular (peroneal) nerve (L4-S1)
What are the attachments, actions and innervation of fibularis brevis?
Origin:
- inferolateral surface of fibular shaft
Insertion:
- tendon passes posterior to the lateral malleolus and over the calcaneus and cuboidal bones
- attaches to a tubercle on metatarsal V
Actions:
- eversion of the foot
Innervation:
- superficial fibular (peroneal) nerve
What is the general action and innervation of the muscles in the posterior compartment of the leg?
the posterior compartment muscles are organised into a superficial and deep layer
they act to plantarflex and invert the foot
they are innervated by the tibial nerve
What is the insertion of the superficial muscles in the posterior leg?
They all insert into the calcaneus of the foot via the calcaneal tendon
What are the two bursae associated with the calcaneal tendon?
What is their role?
Subcutaneous calcaneal bursa:
- lies between the skin and calcaneal tendon
Deep bursa of the calcaneal tendon:
- lies between the tendon and the calcaneus
The bursae work to minimise friction during movement
What are the muscles in the superficial layer of the posterior leg?
- Plantaris
- Gastrocnemius
- Soleus
What are the attachments of gastrocnemius?
Origin:
- lateral head originates from lateral femoral condyle
- medial head originates from medial femoral condyle
- the fibres converge to form a single muscle belly
Insertion:
- The muscle belly combines with soleus to form the calcaneal tendon
- this inserts onto the calcaneus
What are the actions and innervation of gastrocnemius?
Actions:
- plantarflexion of the ankle
- flexion of the knee
Innervation:
- tibial nerve
Label the superficial layer of posterior leg muscles


What are the attachments, actions and innervation of plantaris?
Origin:
- lateral supracondylar line of femur
Insertion:
- the tendon blends with the calcaneal tendon
Actions:
- weak plantarflexor of the ankle
- weak flexor of the knee
Innervation:
- tibial nerve
What are the attachments, actions and innervation of soleus?
Origin:
- soleal line of the tibia and proximal fibular area
Insertion:
- joins the calcaneal tendon
Actions:
- plantarflexion of the ankle
Innervation:
- tibial nerve
What are the 4 muscles in the deep compartment of the posterior leg?
- Popliteus
- Tibialis posterior
- Flexor digitorum longus
- Flexor hallucis longus
Label the muscles in the deep layer of the posterior thigh


What are the attachments, actions and innervation of popliteus?
Origin:
- lateral condyle of femur and posterior horn of lateral meniscus
Insertion:
- it inserts above the origin of the soleus muscle
Actions:
- laterally rotates the femur on the tibia
- this is “unlocking” the knee joint so that flexion can occur
Innervation:
- tibial nerve
What are the attachments, actions and innervation of tibialis posterior?
Origin:
- interosseous membrane between tibia and fibula
Insertion:
- the tendon enters the foot posterior to the medial malleolus
- it inserts onto the plantar surface of the medial tarsal bones
Actions:
- inversion and plantarflexion of the foot
- maintains the medial arch of the foot
Innervation:
- tibial nerve
What are the attachments, actions and innervation of flexor digitorum longus?
Origin:
- medial surface of tibia
Insertion:
- plantar surfaces of the lateral four digits
Actions:
- flexes the lateral four toes
Innervation:
- Tibial nerve
What are the attachments, actions and innervation of flexor hallucis longus?
origin:
- posterior surface of the fibula
Insertion:
- plantar surface of the phalanx of the big toe
Actions:
- flexes the big toe
Innervation:
- tibial nerve
Label the tendons of the posterior leg


What are the 2 intrinsic muscles on the dorsal aspect of the foot?
What is their innervation?
- Extensor digitorum brevis
- Extensor hallucis brevis
They are both innervated by the deep fibular nerve
What are the attachments, actions and innervation of extensor digitorum brevis?
Origin:
- calcaneus, interosseous talocalcaneal ligament and inferior extensor retinaculum
Insertion:
- attaches to long extensor tendons of the 4 lateral digits
Actions:
- aids EDL in extending lateral four toes at metatarsophalangeal and interphalangeal joints
Innervation:
- deep fibular nerve
What are the attachments, actions and innervation of extensor hallucis brevis?
Origin:
- calcaneus, interosseous talocalcaneal ligament and inferior extensor retinaculum
Insertion:
- base of the proximal phalanx of the big toe
Action:
- aids EHL in extending the big toe at the metatarsophalangeal joint
Innervation:
- deep fibular nerve
What is the collective action of the intrinsic muscles in the sole of the foot?
What is their innervation?
they stabilise the arches of the foot and control movement of the digits
they are all innervated by either the medial plantar nerve or the lateral plantar nerve
these are both branches of the tibial nerve
What are the 3 muscles in the first layer of plantar muscles?
The first layer is located immediately underneath the plantar fascia
- Abductor hallucis
- Flexor digitorum brevis
- Abductor digiti minimi
What are the attachments, actions and innervation of abductor hallucis?
Origin:
- medial tubercle of calcaneus, flexor retinaculum and the plantar aponeurosis
Insertion:
- medial base of proximal phalanx of the big toe
Action:
- abducts and flexes the big toe
Innervation:
- medial plantar nerve
Label the first layer of plantar muscles


What are the attachments, actions and innervation of flexor digitorum brevis?
Origin:
- medial tubercle of calcaneus and plantar aponeurosis
Insertion:
- middle phalanges of lateral 4 digits
Actions:
- flexes the lateral 4 digits at the proximal interphalangeal joints
Innervation:
- medial plantar nerve
What are the attachments, actions and innervation of abductor digiti minimi?
Origin:
- medial and lateral tubercles of the calcaneus and the plantar aponeurosis
Insertion:
- lateral base of the proximal phalanx of the 5th digit
Actions:
- abducts and flexes the 5th digit
Innervation:
- lateral plantar nerve
What are the muscles that make up the second layer of plantar muscles?
- Quadratus plantae
- Lumbricals
- Tendons of flexor digitorum longus
Label the second layer of plantar muscles


What are the attachments, actions and innervation of quadratus plantae?
Origin:
- medial and lateral plantar surface of the calcaneus
Insertion:
- Attaches to the tendons of flexor digitorum longus
Actions:
- Assists FDL in flexing the lateral four digits
Innervation:
- lateral plantar nerve
What are the attachments, actions and innervation of the four lumbrical muscles of the foot?
Origin:
- tendons of flexor digitorum longus
Insertion:
- extensor hoods of the lateral 4 digits
Actions:
- flexes the metatarsophalangeal joints, whilst extending the interphalangeal joints
Innervation:
- the most medial lumbrical is innervated by the medial plantar nerve
- the remaining 3 are innervated by the lateral plantar nerve
What muscles make up the third layer of plantar muscles?
- Flexor hallucis brevis
- Adductor hallucis
- Flexor digiti minimi brevis
Label the third layer of plantar muscles


What are the attachments, actions and innervation of flexor hallucis brevis?
Origin:
- plantar surfaces of the cuboid and lateral cuneiforms
Insertion:
- base of the proximal phalanx of the big toe
Actions:
- flexes the proximal phalanx of the big toe at the metatarsophalangeal joint
Innervation:
- medial plantar nerve
What are the attachments, actions and innervation of adductor hallucis?
Origin:
- oblique head - bases of 2nd, 3rd and 4th metatarsals
- transverse head - plantar ligaments of the metatarsophalangeal joints
Insertion:
- lateral base of proximal phalanx of the big toe
Actions:
- adduction of the big toe
- assists in forming the transverse arch of the foot
Innervation:
- deep branch of lateral plantar nerve
What are the attachments, actions and innervation of flexor digiti minimi brevis?
Origin:
- base of fifth metatarsal
Insertion:
- base of proximal phalanx of fifth digit
Actions:
- flexes proximal phalanx of fifth digit
Innervation:
- superficial branch of lateral plantar nerve
What makes up the fourth layer of plantar muscles?
the plantar interossei - which are unipennate
and
the dorsal interossei - which are bipennate
What are the attachments, actions and innervation of the 3 plantar interossei?
origin:
- the medial side of metatarsals 3 to 5
insertion:
- medial sides of phalanges of digits 3 to 5
Actions:
- abducts digits 3 to 5
- flexes the metatarsophalangeal joints
innervation:
- lateral plantar nerve
What are the attachments, actions and innervation of the 4 dorsal interossei?
Origin:
- sides of metatarsals 1 to 5
Insertion:
- first muscle attaches to medial side of proximal phalanx of the second digit
- second to fourth muscles attach to lateral sides of the proximal phalanges of digits 2 - 4
Actions:
- abducts digits 2 to 4
- flexes the metatarsophalangeal joints
Innervation:
- lateral plantar nerve