Unit Exam 4- Lower Limb, Pelvis, Head, and Neck Flashcards
Lower Limb Function
Support, Locomotion, and Maintenance of Equilibrium
Weight- Axial Skeleton->Pelvis->Hip->Lower Limb
Propulsive Force- L. Limb->Hip->Pelvis->Axial Skeleton
Regions of Lower Limb
Gluteal Region, Thigh, Knee, Leg, and Ankle and Foot
Fascia Lata
Deeper, strong investing layer of fascia that limits outward expansion of muscle to aid blood return
Continuous except superiorly at Saphenous Opening
Iliotibial Band
Thick portion of Fascia Lata on the lateral side of the leg
Runs from Hip to Knee
Great Saphenous Vein
Largest and Longest vein in the Body
Runs from the Foot to the Groin in Subcutaneous tissue
Accompanied by the Saphenous Nerve around the Tibia
Small Saphenous Vein
Begins Posterior to the Lateral Malleolus
Passes along the lateral side of the Foot with the Sural Nerve and ascends along the Lateral side of the Calcaneal Tendon
Passes between two heads of Gastrocnemius to the Popliteal Fossa
Ends in the Popliteal Vein (Sometimes in the Great or Accesory Saphenous)
Accessory Saphenous Vein
Essentially the Median Cubital Vein of the leg
Connects the Great and Small Saphenous
Deep Veins
All paired with an artery
Contained within a Vascular Sheath
Deep Veins: Femoral, Politeal, Anterior Tibial, Posterior Tibial, Fibular, and Deep vein of Thigh
Popliteal Vein
Becomes the Femoral Vein of the Thigh passes the Knee into the Leg
Femoral Vein
Becomes the External Iliac Vein once it passes the Inguinal Ligament
Deep Vein of Thigh
This vein is received by the Femoral Vein before the Inguinal Ligament
Vein Drainage in Reverse
Femoral Breaks into 3: Deep Vein of Thigh, Popliteal, and Great Saphenous
Deep Vein of the Thigh leads nowhere
Great Saphenous only leads to Dorsal Venous Arch near the Big Toe.
Popliteal splits into Small Saphenous and Fibular
Small Saphenous only leads to Dorsal Veinous Arch near the Little Toe
As Fibular goes towards Popliteal, Anterior Tibial and Posterior Tibial joins it. It also ends at the Plantar Veins which leads into Fibular and Posterior Tibial. The Dorsal Veinous Arch leads into Anterior Tibial. Also some of Great Saphenous perforates into the Anterior Tibial
Femoral Triangle
Lateral Border is Sartorius Muscle Superior Border is the Inguinal Ligament Medial Border is Adductor Longus Muscle In the Triangle: Most Lateral is Femoral Nerve Lateral is the Femoral Artery Intermediate is Femoral Vein Medial is space filled with Areolar Tissue Lymph Nodes From Medial to Lateral Is "VAN"
Adductor Hiatus
Tendinous Opening in the Adductor Muscle where the Femoral Vein and Artery leave the Adductor Canal
Compartment Syndrome
Fascical Compartments are closed spaces, sustained intense use, blunt trauma, burns can lead to edema within a compartment
Pressure rises to a point where small nerves and blood vessels are compressed and blood flow and pulses are diminished
Happens because Fascia is very tight and not elastic
Varicose Veins
Great Saphenous Veins becomes engorged such that valves are not effective and blood flows back under gravity.
Major Arteries of the Thigh
Femoral Artery, Deep Artery of the Thigh, Medial and Lateral Circumflex Femoral Artery, and Obturator
Femoral Artery
Continuation of External Iliac Artery Distal to Inguinal Ligament
Supplies Anterior and Anteriomedial aspects of the Thigh
Deep Artery of the Thigh
Branches off of the Femoral Artery 1-5 cm Inferior to the Infuinal Ligament
Perforating Arteries pass through Adductor Magnus
Supply muscles in Medial, Posterior, and Lateral part of Anterior Compartments
Medial and Lateral Circumflex Femoral Arteries
Deep Arteries of the Thigh- May arise from Femoral Artery
Medial supplies most of blood to head and neck of Femur and joins Inferior Gluteal Artery
Lateral Supplies Anterior part of Gluteal Region, winds around Femur, and joins Genicular Periarticular Anastomosis
Obturator Artery
Comes from Internal Iliac Artery or (in 20%) as an Accessory
Anterior Branch supplies Obturator Externus, Pectineus, Adductors of the Thigh, and Gracilis
Posterior Branch supplies muscles attached to the Ischial Tuberosity
Major Arteries of the Leg
Popliteal and Genicular, Anterior Tibial, Posterior Tibial, Fibular, Dorsal Artery of the Foot, and Lateral Plantar Artery
Study Slide 30 from power point of Lower Limb
Lymphatic Drainage of the Lower Limb
Superficial Lymphatic Vessels accompany the Saphenous Veins and Tributaries
Deep Lymphatic Vessels accompany Deep Veins
Cutaneous Nerves of Lower Limb
Originate from the Lumbar and Sacral Plexus from L1-S3
Genitofemoral Nerve Sensory Location
About where Iliopsoas (or Hip Flexors are)
Ilioinguinal Nerve Sensory Location
Most medial- Crotchal Region
Obturator Nerve Sensory Location
Medial, just Inferior to the Ilioinguinal Nerve Sensory Location
Femoral Nerve Sensory Location
Pretty much the whole Intermediate portion of the Thigh and also covers the knee
Saphenous Nerve Sensory Location
All of the Medial and almost all of the Anterior of the Leg and the Posterior Medial Half of the Calf/Leg
Big Butts
Allow for Superior Muscle Place and Angled Femur
Angleness of the Hips
They are angled for Bipedal Locomotion and Stability
Compartments of the Thigh
Anterior Compartment (Lateral Intermuscular Septum- Between Ant/Post), Posterior Compartment, and Medial Compartment (Medial Intermuscular Septum- Between Ant/Med) IT Band is on the Outside of the Anterior Comparment
Trendelenburg Gait
Abnormal Gait caused by weakness of the Abductor Muscles (Glutes)
Possibly a Lesion of the Superior Gluteal Nerve
Causes them to have to Rotate/Swing their Pelvis while walking
Piriformis is a Landmark of the Gluteal Region
It determines the names of Blood Vessels and Nerves
Iliopsoas
Chief Flexors of the Thighs
Important Antigravity Postural Muscles- Help Maintain Erect Posture at the Hip Joints
Sartorius
The most Superficial Muscle in the Anterior Part of the Thigh
Quadriceps Femoris
3 Vastus muscls only act on the Knee
Rectus Femoris acts on the Knee and Hip
Important Functions are Rising from Sitiing, Walking up Stairs, Absorbing Jarring shock from Heel Strikes while walking
All muscles insert into the Common Quadriceps Tendon and on to the Tibial Tuberosity
Adductors of the Thigh
They Stabilize the Stance and Correct Lateral Sway of the Trunk (Rocking Boat) and on Uneven Surfaces
All are supplied by the Obturator Nerve
Ischial Tuberosity
The Portion of the Pelvis that I’m sitting on… Saddle Bones
Hamstring Muscles
Span the Hip and Knee Joints making them Extensors of the Thigh and Flexors of the Leg
Deep Fibular Nerve
The most commonly severed nerve in the Body
Superficial Muscles of the Leg
Gastrocnemius, Soleus, and Plantaris
All are innervated by Tibial Nerve and insert into the Calcaneus via the Calcaneal Tendon
Deep Posterior Leg
Popliteus, Flexor Hallucis Longus, Flexor Digitorum Longus, and Tibialis Posterior
Foot and Muscles
20 muscles- 14 muscles on the sole arranged into 4 Layers
Vast Majority of the muscles of the foot are dedicated to Gait, maintaining weight bearing arches of the foot, and supporting stance
Pivot Point
The Point where the motion of the rotating body is 0
Perpendicular to the Joint Motion
Femoral Nerve
Lateral to the Great Vessels
Originates from L2-L4
Outside of the Femoral Sheath
Innervates Sartorius, Quadriceps, and Pectineus Iliacus
Sciatic Nerve
Originates L4-L5, S1-S3
Enters through the Sciatic Foramen below the Piriformis
Deep to Gluteus Max
Branches into Tibial Nerve and Common Fibular Nerve
Obturator Nerve
L2-L4
Passes through Obturator Canal
It Splits into Anterior and Posterior going on either side of the Adductor Brevis
Popliteal Fossa
The Knee Pit
Tibial Nerve
Originates from Sciatic
Supplies Gastrocnemius, Plantaris, Soleus, Popliteus
Common Fibular Nerve
Originates from Sciatic
Lateral border of the Popliteal Fossa
THIS NERVE IS THE MOST INJURED NERVE IN THE BODY
Divides into Superficial and Deep Fibular Nerves
Deep Fibular supplies the Extensors of the Leg
Superficial supplies Medial side and Dorsum of the Foot
Plantar Nerves
Medial and Lateral
Innervate the side of the foot indicated by the name
Hip Joint
Wide range of motion, but less than the Shoulder Joint
Mobility is sacrificed for Stability
Allows Flexion/Extension, Abduction/Adduction, Medial/Lateral Rotation, and Circumduction
Ball and Socket Joint
Head of Femur sits in Acetabular Fossa
Articular Capsule covers the Joint from the Greater Trochanter to the Acetabulum (Reinforced by 3 Ligaments)
Acetabular Labrum deepens the Capsule
Iliofemoral Ligament
From AIIS to Trochanteric Line Inverted Y-Shaped Ligament for the Hip Joint Anterior side Limits Extension (Hyperextension) and Lateral Rotation
Pubofemoral Ligament
From Superior Ramus to Intertrochanteric Line
Limits Extension, Abduction, and Lateral Rotation
Ischiofemoral
Posterior side Ligament
Spiral-Shaped attaching Ischium to the Greater Trochanter
Limits Extension and Medial Rotation
Muscles that Act on the hip
They stabilize the Hip, are Lateral Rotators , and are Innervated by the Sacral Plexus
Obturator Internus, Obturator Externus, Gluteus Minimus, Piriformis, Superior Gemellus, Inferior Gemellus, and Quadratus Femoris
Knee Joint
Largest and most complex Synovial Joint in the Body Functions as a Hinge Joint, but allows Flexion/Extension and Medial/Lateral Rotation (at Full Extension) Tibiofemoral Joint (between Tibial and Femoral Condyles) and Patellofemoral Joint (between Patella and Patellar surface of Femur) Fibula does not participate Tibial and Femoral Condyles are separated by C-Shaped pieces of Fibrocartilage
Patella
Largest Seismoid bone in the Body
Menisci
Medial/Lateral Menisci deepen Tibial Condyles and serve as cushions
Medial Meniscus (C) in more open than Lateral (O)
Lateral Miniscus is less likely to tear than Medial
Both are attached to Tibia by Anterior/Posterior Horns
Medial is more fixed allowing it to be more commonly trapped between Tibia and Femur causing injury
Ligaments of Knee Joint
Patellar Ligament- Extends from Inferior Patella to Tibial Tuberosity
Oblique Popliteal Ligament- Tendinous Expansion of Semimembranous- Strengthens poster aspect of Joint Capsule
Artcuate Politeal Ligament- Edge of Articular Capsule that arches over Politeus Muscle as it Exits Joint
Lateral (Fibular) Collateral Ligament- Extends from Lateral Femoral Epicondyle to Head of Fibula (Does not attach to Meniscus)
Medial (Tibial) Collateral Ligament- From Medial Femoral Epicondyle to Tibia (Attaches to Meniscus)
Cruciate Ligaments- Strong Intracapsular Ligaments- Main bond between Femur and Tibia- Anterior and Posterior according to Attachments- PCL Attaches to Medial Condyle of Femur- ACL Attaches to Lateral Condyle of Femur
Bursa of the Knee
Suprapatellar Bursa- Extends Superiorly, Deep to Quadriceps Femoris- Above (Patella)
Prepatellar Bursa- In Subcutaneous Tissue betweeen Patellar Ligament and Skin
Deep Infrapatellar Bursa- There are Many- Between Patellar Ligament and Tibia Bursae associated with Popliteus (As it exits Joint)
Tibia and Fibula
Proximal Tibiofibular Joint- Synovial Joint between head of fibula and Articular Surface on Lateral Condyle of Tibia
Interosseus Membrane- Runs in betweeen and binds Tibia and Fibula together and also provides muscle attachments
Distal Tibiofibular Joint- Fibrous Joint between lower ends of Tibia and Fibula
Calcaneus
Largest and strongest bone of the Foot
Also the first one to Ossify
Ankle Joint
Synovial Hinge Joint
Consists of Deep Socket that embraces upper part of Talus
Ligaments of Ankle
Medial (Deltoid) Ligament- Attaches from Medial Malleolus to Navicular, Talus, and Calcaneus parts- Contains 4 Slips: Anterior Tibiotalar, Posterior Tibiotalar, Tibionavicular, and Tibiocalcaneal
Lateral Ligament- Weaker overall- 3 Bands: Anterior Talofibular Ligament (most frequently sprained), Posterior Talofibular, and Calcaneofibular
Transverse Tarsal Joints
3 Articulations
Allow for Inversion/Eversion
Between Calcaneus/Talus and Navicular/Cuboid
Tarsometatarsal Joints
Between Navicular/Cuneiforms and Metatarsals
Intermetatarsal Joints
In between Metatarsals
Metatarsophalangeal Joint
Allow for Flexion/Extension
Synovial Ellipsoid (Condylar) Joints
Plantar Ligaments, Deep Transverse Metatarsal Ligaments, and Collateral Ligaments
Interphalangel Joint
Allow Flexion/Extension
Synovial Hinge Joint
Between Distal, Middle, and Proximal Phalanxes
Plantar and Collateral Ligaments
Foot as a Functional Unit
Main function is to support body weight
Serves as a lever to propel body forward in walking and running
Arches of the Foot- 3 Arches (medial, lateral, and transverse)
Medial Arch- Highest Arch- Calcaneus, Talus, Navicular, Cuneiforms, and Metatarsals 1-3
Transverse Arc- All Metatarsals, Cuboid and Cuneiforms
Lateral (External) Longitudinal Arch- Calcaneus, Cuboid, Metatarsals 4-5
When muscles are fatigued->Muscular support gives way->Ligaments are stretched->Pain
Pes Planus
Flat Foot
Condition in which medial Longitudinal Arch is depressed or collapsed
Tend to walk with feet inverted
Heel Pain and Arch pain and Fasciatis pain as fascia is stretched
Pes Cavus
Claw Foot
Condition in which Medial Longitudinal Arch is abnormally high
Tend to walk with foot everted resulting in fasciatis
Pelvis
Cavity that lies below and behind abdomen
The point where the trunk communicates with lower libs
2 Parts: Upper- Area flanked by wings (ala) of the coxal bones AKA the “false” pelvis; Lower- Area below the belvic brim AKA “true” pelvis
False pelvis has no impact on pelvis
True pelvis has to accommodate birth
Pelvic Differences in Gender
Structure- M-Thick and Heavy, F-Thin and Light
Greater Pelvis- M-Deep, F-Shallow
Lesser Pelvis- M-Narrow/Deep, F-Wide/Shallow
Pelvic Inlet- M-Heart-Shaped/Narrow, F-Oval/Wide
Pelvic Outlet- M-Smaller, F-Larger
Pubic Arch/Subpubic Angle- M-80
Obturator Formaen- M-Round, F-Oval
Acetabulum- M-Large, M-Small
Greater Sciatic Notch- M-70/Inverted V, F-90
Floor of Pelvis
Pelvic Diaphragm- Muscle and Fascia that line the Floor of the Pelvis
Perineal Membrane- Urogenital Diaphragm
Deep Perineal Pouch
Peritoneal Reflections
Vesicouterine Pouch- Female- Between Uterus and Bladder
Rectouterine Pouch- Female- Between Rectum and Uterus
Rectovesical Pouch- Male- Between Bladder and Rectum
Peritoneum is the lining that invests and covers…
Male Internal Genital Organs
Ductus (Vas) Deferns, Seminal Vesicles, Ejaculatory Duct, Prostate, Bulbourethral Glands
Female Internal Genital Organs
Vagina, Uterus, Uterine (Fallopian) Tubes, Ovaries
Venous Drainage
Male- Prostatic Venous Plexus
Female- Uteric Venous Plexus and Vaginal Venous Plexus
Location of Ureter vs. Ductus Deferens
Ureter lies on top of the External Iliac Artery and ducks underneath the Vas Deferens (in males) or Uterine Artery (in females) on its way to the Urinary Bladder
REFERRED TO AS WATER UNDER THE BRIDGE
Rectal Veins
Site for Hemorrhoids and Portal/Systemic Shunts
Superior Rectals- Portal System
Middle and Inferior Rectals- Systemic
Lymphatics of the Pelvic Region
Lymphatics follow Arteries and all Drain in the Disterna Chyli (Thoracic Duct)
Prostatic Venous Plexus
There are no Valves in the Prostatic Venous Plecus thus Cancer can potentially go up through the Vertebra Venous System
Prostate Cancer Metastasizes this way
Suspensory Ligament
Of the Ovary
Contains Ovarian Vessels and Nerves
Internal Iliac Artery
Produces Anterior and Posterior Trunks
Anterior Trunk produces Obterator and Internal Pudendal
Posterior produces Superior/Inferior Gluteal
Platysma
The only Superficial structure of the neck with the vessels and nerves
Lies just deep to the Superficial and Deep Fascia
3 Principle Layers of the Neck
Investing Layer- Sternocleidomastoid and Trapezius
Prevertebral Layer- The Back muscles and the Vertebrae
Pretracheal Layer- Thyroid Gland, Esophagus, and Trachea
There’s also the Carotid Sheath- Deep fascia around Carotid Artery, Internal Jugular Vein, and Vagus Nerve
Function of them all is to support muscles, vessels, and viscera
Permits movement, but prevents spread of infection
Pretracheal Layer
Communicates freely with Mediastinum and Cervical Cavity
This means that Infections can spread through these areas.
Carotid Sheath also communicates freely with the Miastinum
Nerves of the Cervical Plexus
Lesser Occipital Nerve, Great Auricular Nerve, Transverse Cutaneous Nerve, Supraclavicular
External Jugular
Drains into Subclavian
Receives drainage from Posterior Auricular, Posterior Retromandibular, Cervical Dorsal, Suprascapular, and Anterior Jugular
Brachiocephalic
Internal Jugular Vein and Subclavian Vein (what External Jugular drains into) both drain into Brachiocephalic
Superficial Lymph Nodes
Most are located along the External Jugular Vein and receive drainage from the Mastoid and Occipital Nodes
These then drain into the Deep Cervical Lymph Nodes
Posterior Triangle
Contains Transverse Cervical Artery, Suprascapular Artery, Occipital Artery, Subclavian Artery, Cervical Plexus, and Phrenic Nerve
Posterior Border of Sternocleidomastoid
Anterior Border of Trapezius
Middle Third of the Clavicle
Torticollis (Wry Neck)
Congenital- Due to Excessive Stretching of Sternocleidomastoid muscle during labor Spasmodic- Usually Psychogenic Injury to Spinal part of Accessory Nerve Injury to Brachial Plexus Causes looking down and to the Side
4 Components of the Anterior Triangle
Muscular Triangle
Submental Triangle
Sunbmandibular Triangle
Carotid Triangle
Submental Triangle
Inferior to the Chin on the Midline
Contains Submental Lymph Nodes and Mylohyoid muscle and is the origin of the Anterior Jugular Vein
Bordered by the Anterior bellies of the Left and Right Digastric Muscles and then the Hyoid bone
Submandibular Triangle
Bordered by the Mandible and the Anterior and Posterior bellies of the Digastric muscles
Contains Submandicular Gland, portions of the Hypoglossal nerve, Facial Artery, and Facial Vein
Carotid Triangle
Bordered Omohyoid, Sternocleidomastoid, and Posterior bellies of the Digastric muscles
Contains portions of the Common Carotid Artery, Internal Jugular Veins, Ansa Cervicalis and Vagus Nerve
Tendonous Loop of Digastric
Tendon connection point in the Submandibular Triangle with Anterior Digastric, Mylohyoid, Stylohyoid, and Posterior Digastric connecting with it
Connected to the Hyoid Bone
Internal Carotid Vein
Largest in Caliber of the Veins of the Neck
Carotid Sinus is the part that helps with recovery from standing up and getting lightheaded (Baroreceptor)
Carotid Body is the part that detects changes in the chemical concentration (Chemoreceptor)
Ansa Cervicalis
The motor division of the Cervical Plexus
Innervates Infrahyoid Muscles
Muscular Triangle
Bordered by the Midline of the neck, Sternocleidomandibular, and Omohyoid
Contains Infrahyoid muscles and Thyroid Parathyroid Glands
Facial Vein and Artery
Vein runs Superficial to the Submandibular Gland
Artery runs Deep to the Submandibular Gland
Skin of the Face
Attached to loose connective tissue in which muscles of expression are located
Muscles of Expression are attached to the overlying skin
There is no deep fascia
Richly innervated and highly vascular (that’s why the face bleeds so much)
Muscles of Expression
These are supplied by branches of Facial Nerve
Bell’s Palsey- loss of innervation of the Facial Nerve- Results in loss of Facial Tone and Expression
Facial Nerve
Posterior Auricular- Occipitals
Temporal Branch- Supplies Frontalis Muscle
Zygomatic Branch- Supplies Orbicularis Oculi and Inferior Muscle
Buccal Branch- Supplies Buccinator and Orbicularis Oris
Marginal Mandibular- Risorius and Muscles of the Chin
Cervical- Platysma
Orbicularis Oculi
Orbital Part- Forced blinking
Palpebral Part- Natural blinking
Blood Supply of the Face
Mostly supplied by Superficial Temporal Artery and Facial Artery (Both arise from the External Carotid)
Internal Carotid only supplies a small part
S.C.A.L.P.
Skin Connective Tissue Aponeurosis Loose Connective Tissue Periosteum Scalp tells us what forms the scalp
Veinous Drainage of the Face
What you can cover with you hand on your face is facial and everything else is External Jugular
Danger Triangle of the Face
Triangle from the Unibrow (peak) to the mouth (base) surrounding the nose
Large venous plexus that extends from orbit to petrous part of temporal bone
Receive blood from facial vein and sphenopariatial sinus
SIGNIFICANT BECAUSE INFECTIONS IN THIS AREA CAN SPREAD TO THE BRAIN
Cranial Meninges
Dura Mater–>Arachnoid Mater–>(Subarachnoid space with Cerebral Spinal Fluid)–>Pia Mater
Sinus of the brain
Cranial Sinuses are vessels formed by the Dura Mater
Cavernous Sinus is the part behind the Danger Triangle of the face. Looks like it’s behind the nose
Gluteus Maximus
Origin: Ilium Posterior to Posterior Gluteal Line, Dorsal Surface of Sacrum/Coccyx, Sacrotuberous Ligament
Insertion: Iliotibial Tract and Tuberosity of Femur
Action: Extends Flexed Thigh, Assists in Lateral Rotation, and Abducts Thigh
Nerve: Inferior Gluteal Nerve
Blood Supply: Inferior Gluteal Arteries
Gluteus Medius
Origin: Lateral surface of Ilium
Insertion: Lateral surface of Greater Trochanter of Femur
Action: Abducts/medially rotates thigh at hips and steadies pelvis on leg with opposite leg is raised
Nerve: Superior Gluteal Nerve
Blood Supply: Superior Gluteal Artery
Gluteus Minimus
Origin: Lateral surface of Ilium
Insertion: Anterior Surface of Greater Trochanter of Femur
Action: Abducts/medially rotates thigh at hips and steadies pelvis on leg when opposite leg is raised
Nerve: Superior Gluteal Nerve
Blood Supply: Superior Gluteal Artery
Tensor Fascia Latae
Origin: Anterior Superior Iliac Spine and Anterior part of Iliac Crest
Insertion: Iliotibial Tract
Action: Abducts, medially rotates, and flexes thigh at hip. Helps keep knee extended
Nerve: Superior Gluteal Nerve
Blood Supply: Ascending branch of Lateral Circumflex Femoral Artery
Sartorius
Origin: Anterior Superior Iliac Spine and notch below it
Insertion: Superior part of Medial surface of Tibia
Action: Abducts, Laterally Rotates, and Flexes thigh; Flexes knee
Nerve: Femoral Nerve
Blood Supply: Profunda Femoris and Lateral Circumflex Femoral Arteries
Rectus Femoris
Origin: Anterior Inferior Iliac Spine and Ilium Superior to Acetabulum
Insertion: Base of Patella and Tibial Tuberosity via patellar Ligament
Action: Extends leg at knee and flexes thigh at hip
Nerve: Femoral Nerve
Blood Supply: Profunda Femoris and Lateral Circumflex Femoral Arteries
Vastus Lateralis
Origin: Greater Trochanter, Lateral Lip of Linea Aspera of Femur
Insertion: Base of Patella and to Tibial Tuberosity via Patellar Ligament
Action: Extends leg at Knee
Nerve: Femoral Nerve
Blood Supply: Lateral Circumflex Femoral and Profunda Femoris Arteries
Vastus Medialis
Origin: Intertrochanteric Line, Medial lip of Linea Aspera of Femur
Insertion: Base of Patella and to Tibial Tuberosity via Patellar Ligament
Action: Extends leg at Knee
Nerve: Femoral Nerve
Blood Supply: Femoral and Profunda Femoris Arteries
Vastus Intermedius
Origin: Anterior and Lateral surfaces of body of Femur
Insertion: Base of Patella and to Tibial Tuberosity via Patellar Ligament
Action: Extends Leg at Knee
Nerve: Femoral Nerve
Blood Supply: Lateral Circumflex Femoral and and Profunda Femoris Arteries
Adductor Longus
Origin: Body of Pubis Inferior to Pubic Crest
Insertion: Middle Third of Linea Aspera of Femur
Action: Adducts thigh at hip
Nerve: Obturator Nerve (Anterior Division)
Blood Supply: Profunda Femoris and Medial Circumflex Femoral Arteries
Adductor Brevis
Origin: Body and Inferior Pubic Ramus
Insertion: Pectineal Line and Proximal Part of Linea Aspera of Femur
Action: Adducts thigh at Hip, Weak Hip Flexor
Nerve: Obturator Nerve
Blood Supply: Profunda Femoris, Medial Circumflex Femoral, and Obturator Arteries
Adductor Magnus
Origin: Inferior Pubic Ramus, Ramus of Ischium (Hamstring part is the Ischial Tuberosity)
Insertion: Gluteal Tuberostiy, Linea Aspera, Medial Supracondylar Line (Hamstring Part is the Adductor Tubercle of Femur)
Action: Adductor Part: Adducts and Flexes Thigh; Hamstring Part: Extends Thigh
Nerve: Adductor Part: Obturator Nerve; Hamstring Part: Sciatic Nerve (Tibial Division)
Blood Supply: Femoral, Profunda Femoris, and Obturator Arteries
Gracilis
Origin: Body and Inferior Ramus of Pubis
Insertion: Superior Part of Medial Surface of Tibia
Action: Adducts thigh at hips and stabilizes joint, acts with Psoas Major
Nerve: Obturator Nerve
Blood Supply: Profunda Femoris Artery, Medial Circumflex Femoral Artery
Piriformis
Origin: Anterior Surface of Sacral Segments 2-4, Sacrotuberous Ligament
Insertion: Superior Border of Greater Trochanter of Femur
Action: Laterally rotates extended thigh, Abducts flexed thigh at hip
Nerve: Ventral Rami of L5, S1, S2
Blood Supply: Superior and Inferior Gluteal Arteries, Internal Pudendal Artery
Quadratus Femoris
Origin: Lateral Margin of Ischial Tuberosity
Insertion: Quadrate Tubercle on Intertrochanteric Crest of Femur
Action: Laterally Rotates Thigh at Hip
Nerve: Nerve to Quadratus Femoris
Blood Supply: Medial Circumflex Femoral Artery
Pectineus
Origin: Superior Ramus of Pubis
Insertion: Pectineal line of Femur
Action: Adducts and Flexes Thigh; Assists with Medial Rotation
Nerve: Femoral Nerve
Blood Supply: Medial Circumflex Femoral Artery and Obturator Artery
Semitendinosus
Origin: Ischial Tuberosity
Insertion: Superior Part of of Medial Surface of Tibia
Action: Flexes Knee, Extends Thigh
Nerve: Sciatic Nerve (Tibial Division)
Blood Supply: Perforating branch of Profunda Femoris and Medial Circumflex Femoral Arteries
Semimembranosus
Origin: Ischial Tuberostiy
Insertion: Posterior part of Medial Condyle of Tibia
Action: Flexes Leg, Extends Thigh
Nerve: Sciatic Nerve (Tibial Division)
Blood Supply: Perforating branch of Profunda Femoris and Medial Circumflex Femoral Arteries
Biceps Femoris
Origin: Long Head: Ischial Tuberosity; Short Head: Linea Aspera and Lateral Supracondylar Line of Femur
Insertion: Lateral Side of Head of Fibula
Action: Flexes and Laterally Rotates Leg, Extends thigh at High
Nerve: Sciatic Nerve (Long=Tibial Division) (Short=Common Fibular Division)
Blood Supply: Perforating Branches of Profunda Femoris, Inferior Gluteal, and Medial Circumflex Femoral Arteries
Tibialis Anterior
Origin: Lateral Condyle of Tibia, Lateral Surface of Tibial Shaft, Interosseus Membrane
Insertion: Medial and Plantar surfaces of the Base of 1st Metatarsal and Cuneiform
Action: Dorsiflexion of Ankle and Invertor of Foot
Nerve: Deep Peroneal Nerve
Blood Supply: Anterior Tibial Artery
Extensor Digitorum Longus
Origin: Lateral Condyle of Fibula, Medial Fibular Shaft surface, upper part of Interosseus Membrane
Insertion: Dorsum of Middle and Distal Phalanges of Digits 2-5
Action: Extend toes 2-5 and Dorsiflexes Ankle
Nerve: Deep Peroneal Nerve
Blood Supply: Anterior Tibial Artery
Extensor Haluucis Longus
Origin: Anterior Surface of Fibula and Interosseus Membrane
Insertion: Base and Dorsal surface of Distal Phalanx of Great Toe
Action: Extends Great Toe and Dorsiflexes Ankle
Nerve: Deep Peroneal Nerve
Blood Supply: Anterior Tibial Artery
Fibularis Tertius
Origin: Medial Fibular Shaft surface
Insertion: Dorsal Surface of base of 5th Metacarpal
Action: Dorsiflex, Evert, and Abduct the Foot
Nerve: Deep Peroneal Nerve
Blood Supply: Anterior Tibial Artery
Fibularis Longus
Origin: Head of Fibula, Upper half of Lateral Fibular Shaft surface
Insertion: Plantar Posterolateral aspect of Medial Cuneiform and Lateral side of 1st Metacarpal Base
Action: Everts foot and Plantar Flexes Ankle; Also supports arch of the foot
Nerve: Superficial Peroneal Nerve
Blood Supply: Anterior Tibial and Peroneal Arteries
Fibularis Brevis
Origin: Inferior Lateral Fibular Surface and Anterior and Posterior surfaces of the Intermuscular Septa
Insertion: Lateral Surface of Styloid Process of 5th Metacarpal Base
Action: Everts Foot and Plantar Flexes Ankle
Nerve: Superficial Peroneal Nerves
Blood Supply: Muscular Branches of Peroneal Artery
Gastrocnemius
Origin: Medial head- Posterior Nonarticular surface of Medial Femoral Condyle; Lateral Head- Lateral Surface of Femoral Lateral Condyle
Insertion: The Deep Tendon of Soleus which is the formation of the Achilles Tendon; Inserts on the Middle Third of Posterior Calcaneal Surface
Action: Powerful Plantar Flexor of Ankle
Nerve: Tibial Nerve
Blood Supply: A Sural Branch of the Popliteal Artery
Soleus
Origin: Posterior Aspect of Fibular Head, Upper quarter of Posterior Surface of Fibular, Middle Third of Medial Border of Tibial Shaft, and Posterior Surface of a Tendinous Arch Spanning the two sites of Bone Origin
Insertion: Unites with Gastrocnemius Aponeurosis to form the Achilles Tendon and inserting on posterior Calcaneus Surface
Action: Powerful plantar Flexor of Ankle
Nerve: Posterior Tibial, Peroneal, and Sural Arteries
Blood Supply:
Plantaris
Origin: Inferior Aspect of Lateral Supracondylar Line of Distal Femur
Insertion: Middle Third of Posterior Calcaneal Surface medial to Achilles Tendon
Action: Tibial Nerve
Nerve: Sural Arteries
Blood Supply:
Popliteal
Origin: Anterior Part of the Popliteal Groove on Lateral Surface of Lateral Femoral Condyle
Insertion: Posterior Surface of Tibia in a fan-like fashion, just Superior to the Popliteal Line
Action: Rotates Knee Medially and Flexes Leg on the Thigh
Nerve: Tibial Nerve
Blood Supply: Medial Inferior Genicular Branch of Popliteal Artery and Muscular Branch ofPosterior Tibial Artery
Flexor Hallucis Longus
Origin: Inferior 2/3 of Posterior Surface of Fibula and Lower part of Interosseus Membrane
Insertion: Plantar Surface of base of Distal Phalanx of Great Toe
Action: Flexes Great Toe, Helps Supinate Ankle, and is a very weak Plantar Flexor of Ankle
Nerve: Tibial Nerve
Blood Supply: Muscular Branch of Peroneal and Posterior Tibial Artery
Flexor Digitorum Longus
Origin: Posterior Surface of Tibia Distal to Politeal Line
Insertion: Plantar Surface of bases of 2-5 distal phalanges
Action: Flexes toes 2-5 and also helps in plantar Flexion of ankle
Nerve: Tibial Nerve
Blood Supply: Muscular branch of Posterior Tibial Artery
Tibialis Posterior
Origin: Posterior Tibia, Interosseus Membrane, and Proximal half of Posterior Fibula
Insertion: Tuberosity of Navicular Bone, All Cuneiforms, Cuboid, and bases of Metatarsals 2-4
Action: Plantarflexes Foot at Ankle and Inverts Foot
Nerve: Tibial Nerve
Blood Supply: Fibial Artery
Abductor Hallucis
Origin: Medial Tubercle of Tuberosity of Calcaneus, Flexor Retinaculum
Insertion: Medial side of Base of Proximal Phalanx of 1st Digit
Action: Abducts and Flexes 1st Digit
Nerve: Medial Plantar Nerve
Blood Supply: Medial Plantar and 1st Plantar Metatarsal Artery
Flexor Digitorum Brevis
Origin: Medial Tubercle of Tuberosity of Calcaneus
Insertion: Both Sides of Middle Phalangesof Digits 2-5
Action: Flexes Digits 2-5
Nerve: Medial Plantar Nerve
Blood Supply: Lateral Plantar Artery, Plantar Digital Artery, Arcuate Artery
Abductor Digiti Minimi
Origin: Middle and Lateral Tubercles of Tuberosity of Calcaneus
Insertion: Lateral Side of Base of Proximal Phalanx of 5th Digit
Action: Abducts and Flexes 5th Digit
Nerve: Lateral Plantar Nerve
Blood Supply: Medial-Lateral Plantar Artery, Plantar Metatarsal and Plantar Digital Arteries to 5th Digit
Quadratic Plantae
Origin: Medial and Lateral Sides of Plantar Surface of Calcaneus
Insertion: Posterolateral Edge of Flexor Digitorum Longus Tendon
Action: Corrects for Oblique Pull of Flexor Digitorum Longus Tendon and Assists in Flexion of Toes
Nerve: Lateral Plantar Nerve
Blood Supply: Medial and Lateral Plantar Arteries and Deep Plantar Arterial Arch
Lumbricals
Origin: Tendons of Flexor Digitorum Longus
Insertion: Medial Side of Dorsal Digits 2-5
Action: Flexes Proximal Phalanges at MTP Joint and Extends Phalanges at PIP and DIP Joints
Nerve: Medial Plantar Nerve (Medial) and Lateral Plantar Nerve (Lateral)
Blood Supply: Lateral Plantar Artery and Plantar Metatarsal Arteries
Flexor Hallucis Brevis
Origin: Plantar Surfaces of Cuboid and Lateral Cuneiform
Insertion: Both sides of base of Proximal Phalanx of 1st Digit
Action: Flexes Proximal Phalanx of 1st Digit
Nerve: Medial Plantar Nerve
Blood Supply: Medial Plantar Artery
Adductor Hallucis
Origin: Oblique Head- Bases of Metatarsals 2-4; Transverse Head- Ligaments of Metatarsophalangeal Joints of Digits 3-5
Insertion: Tendons of both heads Lateral to side of Base of Proximal Phalanx of 1st Digit
Action: Adducts 1st Digit and maintains Arch of Foot
Nerve: Deep Branch of Lateral Plantar Nerve
Blood Supply:
Flexor Digiti Minimi
Origin: Base of 5th Metatarsal
Insertion: Lateral Base of Proximal Phalanx of 5th Digit
Action: Flexes Proximal Phalanx of 5th Digit
Nerve: Superficial Branch of Lateral Plantar Nerve
Blood Supply: Lateral Plantar Artery, Plantar Digital Artery, Arcuate Artery
Plantar Interossei (3 Muscles)
Origin: Bases and Medial Sides of Metatarsals 3-5
Insertion: Medial Sides of Bases of Proximal Phalanges of Digits 3-5
Action: Adduct Digits and Flex Metatarsophalangeal Joint and Extend Phalanges
Nerve: Lateral Plantar Nerve
Blood Supply: Lateral Plantar Artery and Plantar Arch
Dorsal Interossei (4 Muscles)
Origin: Adjacent sides of Metatarsals 1-5
Insertion: Digit 1- Medial side of Proximal Phalanx of 2nd Digit; Digits 2-4- Lateral Sides of Digits 2-4
Action: Abduct Toes 2-4, Flex Metatarsophalangeal Joints, and Extend Phalanges
Nerve: Lateral Plantar Nerve
Blood Supply: Arcuate Artery, Dorsal and Plantar Metatarsal Arteries
Injured Common Fibular Nerve
Zenker’s Paralysis is paralysis of this Nerve
Foot Drop would occur with injury to this very commonly injured nerve
Muscles of the Lateral Compartment of the Leg and top of the Foot
Injured Tibial Nerve
Posterior compartment of the Leg and the bottom of the Foot
Injured Sciatic Nerve
Bye Fibular and Tibial Nerve
Injured Inferior Gluteal
Bye Gluteus Maximus
Injured Superior Gluteal Nerve
Bye Gluteus Medius/Minimus
This would also cause Trendelburg Gait
Injured Deep Fibular Nerve
Anterior Muscles of the Leg
Injured Superficial Fibular Nerve
Fibularis Longus/Brevis
Pelvic Floor
The pelvic floor acts to support the pelvic viscera, and assist in their functions
If the muscles of the floor become damaged, then dysfunction of these viscera can occur.
Innervated by the Pudendal Nerve
Levator Ani Muscles- Pubococcygeus, Puborectalis (maintain faecal continence), Iliococcygeus
Coccygeus Muscle
Fascia Coverings of the Muscles
Muscles of the Face
Orbicularis Oculi- Surround the eye- Palpebral part causes blinking and the outside part forces the eyes close
Zygomatics Major and Minor- They cause smiling
Levator Labii Superior- Lifts the Lips
Depressor Anguli Oris- Causes frowing
Depressor Labii Inferior- Lowers the lower lip
Orbicular Oris- Kissing muscle
Mental Muscle- Pulls chin out
Branches of External Carotid Artery
Some Anatomists Like F-ing, Others Prefer S&M Superior Thyroid Artery Ascending Pharyngeal Artery Lingual Artery Facial Artery Occipital Artery Posterior Auricular Artery Superficial Temporal Artery Maxillary Artery
Muscles of the Neck
Sternocleidomastoid, Stylohyoid, Myohyoid, Thyrohyoid, Sternohyoid, Sternothyroid, Omohyoid, Scalene Muscles, Disgastrics
Branches of Facial Artery
Tonsillar branch Submental artery Glandular branches Inferior labial artery Superior labial artery Lateral nasal branch Angular artery (terminal branch)
Spaces in the Pelvis
Rectouterine Space
Vesicouterine Space
Rectovesicle Space
Femoral Head Necrosis
A pathologic process that results from interruption of blood supply to the bone
A debilitating disease that usually leads to osteoarthritis of the hip joint in relatively young adults
