Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Human Anatomy ppt lectures Topic 89 Introduction Interior Extremity Notes. - anatomy ppt free download human anatomy ppt lectures, medicine notes ppt, anatomy handwritten notes pdf, mbbs 1st year anatomy notes pdf download, best anatomy notes pdf, human anatomy notes pdf, anatomy easy notes pdf, anatomy notes online, anatomy short notes, Anatomy ppt, Powerpoint Presentations and lecture notes.
gibbons
humans
gorillas
bonobos
chimps
orangutans
orangutans
bonobos
chimps
gorillas
gibbons
humans
Campbell and Loy, Humankind Emerging, 8th ed, p. 138f
Is Bipedalism is bad for your health?
Pulled muscles, slipped discs & rheumatism
Varicose veins
Calluses/flat feet
Haemorrhoids !!!!
Bipedal Locomotion
Why bipedalism?
Apes
The ability to assume a fairly
erect posture produced
important changes
Chimpanzee
The Primates, Time-Life (1974) p. 71
Bipedalism
Bipedalism is related to tool
use
Bipedalism
Bipedalism also makes hunting
more energy efficient
Bipedalism
Seed and nut gathering
and
Feeding from bushes
Bipedalism
Bipedalism and vision
(visual surveillance)
Bipedalism
body temperature
Organization of the Lower Limb
Segments of the Lower Limb
? Limb Girdle
? pelvic girdle (gluteal)
? Free limb
- thigh
- leg
- foot
Parts and regions of the lower limb
? Gluteal region:between iliac
crest superiorly and gluteal
fold inferiorly
? Thigh:between hip and knee
? Knee:joint between leg and
thigh
? Leg:between knee and foot
? Ankle
? Foot
Composition of Lower Limb
? Skeleton (homologous with upper limb)
? Muscles--anterior, posterior compartments
? Nerves--sciatic, femoral, Obturator
? Surface anatomy
Bones of the Lower Limb
? Function:
? Locomotion
? Carry weight of entire erect body
? Support
? Points for muscular attachments
? Components:
? Thigh
? Femur
? Knee
? Patella
? Leg
? Tibia (medial)
? Fibula (lateral)
? Foot
? Tarsals (7)
? Metatarsals (5)
? Phalanges (14)
Thigh
? Femur
? Largest, longest,
strongest bone in the
body!!
? Receives a lot of stress
? Courses medially
? Articulates with
acetabulum proximally
? Articulates with tibia and
patella distally
Knee
? Patella
? Triangular sesamoid
bone
? Protects knee joint
? Improves leverage of
thigh muscles acting
across the knee
? Contained within
patellar ligament
Leg
? Tibia
? Receives the weight of body from
femur and transmits to foot
? Second to femur in size and weight
? Articulates with fibula proximally
and distally
? Interosseous membrane
? Fibula
? Does NOT bear weight
? Muscle attachment
? Not part of knee joint
? Stabilize ankle joint
Foot
? Function:
? Supports the weight of the
body
? Act as a lever to propel the
body forward
? Parts:
? Tarsals
? Talus = ankle
? Calcaneus = heel
? Navicular
? Cuboid
? Medial, lateral and
intermediate cuneiforms
? Metatarsals
? Phalanges
Fascia of the Lower Limb
Gluteal Fascia Fascia Lata
Crural Fascia
Fascial Compartments of the Thigh
anterior compartment
Fascia Lata
medial compartment
posterior compartment
Anterior compartment
Medial (adductor) compartment
Posterior compartment
Deep fascia ? fascia lata
Iliotibial tract
Saphenous hiatus
falciform margin
cribriform fascia
Anterior/Posterior compartments
ANTERIOR
POSTERIOR
COMPARTMENT COMPARTMENT
MOVEMENT
Extension
Flexion
MUSCLES
Quads
Hamstrings
Shin
Gastrocs
NERVES
Femoral n.
Sciatic n.
(lumbar plexus)
(sacral plexus)
Muscles of Hip and Thigh
? Gluteals
? Posterior pelvis
? Extend thigh
? Rotate thigh
? Abducts thigh
? Anterior Compartment Thigh
? Flexes thigh at hip
? Extends leg at knee
? Medial/Adductor Compartment
? Adducts thigh
? Medially rotates thigh
? Posterior Compartment Thigh
? Extends thigh
? Flexes leg
Gluteals
? Gluteus maximus
? Action - Extends thigh, some lateral rotation
and abduction
? Gluteus medius
? Gluteus minimus
? Action - Abduction, medial rotation
? Lesser Gluteals help stabilize hip to
allow fluent bipedal walking
Posterior Pelvis
? Tensor fasciae latae
? Action - Flex thigh, abduct
thigh, medial rotation of thigh
Anterior Compartment Thigh
? Quadriceps femoris
? Rectus femoris
? Vastus lateralis
? Vastus medialis
? Vastus intermedius
? Action ? extends knee
? Sartorius
All above innervated by the femoral nerve!!!
Anterior Compartment Thigh
? Iliopsoas
?
Medial compartment (obturator n.)
? Adductor muscles
? Gracilis
? Adductor
? Magnus
? Longus
? brevis
Posterior Compartment - Hamstring
? Biceps femoris (2 heads)
? Action - thigh extension, knee
flexion, lateral rotation
? Semitendinosus
? Semimembranosus
? Action - thigh extension, knee
flexion, medial rotation
Sciatic nerve innervates all of the above muscles!!!
Muscles of the Leg
? Anterior Compartment
? Dorsiflex ankle, invert foot,
extend toes
? Innervation: Deep fibular
nerve
? Lateral Compartment
? Plantarflex, evert foot
? Innervation: Superficial
Fibular nerve
? Posterior Compartment
? Superficial and deep layers
? Plantarflex foot, flex toes
? Innervation: Tibial nerve
Anterior Compartment
? Tibialis anterior
? Action - dorsiflexion, foot inversion
? Extensor digitorum longus
? Action ? toe extension
? Extensor hallucis longus
? Action - extend big toe, dorsiflex foot
All innervated by deep fibular nerve
Lateral Compartment
? Fibularis (peroneus) longus
? Action - plantarflex, evert foot
? Fibularis (peroneus) brevis
? Action ? same as above!!
All innervated by the superficial fibular nerve
Superficial Posterior Compartment
? Triceps surae
? Gastrocnemius (2 heads)
? Origin - medial and lateral condyles of femur
? Insertion - posterior calcaneus via Achilles
tendon
? Soleus
? Origin ? tibia and fibula
? Insertion ? same as above
? Action of both ? plantarflex foot
? Plantaris (variable)
? Origin ? posterior femur
? Insertion ? same as above!
? Action ? plantarflex foot, week knee flexion
All innervated by the tibial nerve
Deep Posterior Compartment
?
Popliteus
? Origin - lateral condyle femur
and lateral meniscus
? Insertion ? proximal tibia
? Action ? flex and medially rotate leg
?
Flexor digitorum longus
? Origin - tibia
? Insertion - distal phalanges of toe 2-5
? Action ? plantarflex and invert foot, flex toe
?
Flexor hallucis longus
? Origin - fibula
? Insertion - distal phalanx of hallux
? Action - plantarflex and invert foot, flex toe
?
Tibialis posterior
? Origin ? tibia, fibula, and interosseous
membrane
? Insertion - tarsals and metatarsals
? Action - plantarflex and invert foot
All innervated by the tibial nerve
Leg movements by compartment (in
leg all nare branches of sciatic)
Intrinsics of foot
Frolich, Human Anatomy,
Lower LImb
Innervation
Plexuses of the Lower Limb
? "Lumbosacral plexus"
? Lumbar Plexus
? Arises from L1-L4
? Lies within the psoas major
muscle
? Mostly anterior structures
? Sacral Plexus
? Arises from spinal nerve L4-S4
? Lies caudal to the lumbar
plexus
? Mostly posterior structures
Lumbar Plexus
?
Femoral nerve
? Cutaneous branches
? Thigh, leg, foot (e.g. saphenous nerve)
? Motor branches
? Anterior thigh muscles (e.g. quadriceps, sartorius,
iliopsoas)
?
Obturator nerve
? Sensory
? Skin medial thigh; hip, knee joints
? Motor
? Adductor muscles
?
Lateral femoral cutaneous
? Sensory
? Skin lateral thigh
?
Genitofemoral
? Sensory
? Skin scrotum, labia major, anterior thigh
? Motor
? Cremaster muscle
Sacral Plexus
? Sciatic
? Motor:
? Hamstring
? Branches into:
? Tibial nerve
? Cutaneous
? Posterior leg and sole of foot
? Motor
? Posterior leg, foot
? Common fibular (peroneal) nerve
? Cutaneous
? Anterior and lateral leg, dorsum foot
? Motor
? Lateral compartment, tibialis anterior, toe
extensors
? Superior gluteal nerve
? Motor
? Gluteus medius and minimus, tensor fasciae
latae
Sacral Plexus (continued)
? Inferior gluteal nerve
? Motor
? Gluteus maximus
? Posterior femoral cutaneous
nerve
? Sensory
? Inferior buttocks, posterior
thigh, popliteal fossa
? Pudendal nerve
? Sensory
? External genitalia, anus
? Motor
? Muscles of perineum
Vasculature
Arteries
? Common iliac (from aorta)
branches into:
? Internal iliac
? Supplies pelvic organs
? External iliac
? Supplies lower limb
Arteries
? Internal iliac branches into:
? Cranial and Caudal Gluteals
(Superior and Inferior)
? Gluteals
? Internal Pudendal
? Perineum, external genitalia
? Obturator
? Adductor muscles
? Other branches supply rectum,
bladder, uterus, vagina, male
reproductive glands
Arteries
? External iliac becomes.......
? Femoral
? Once passes the inguinal ligament
? Lower limb
? Branches into Deep femoral
? Adductors, hamstrings, quadriceps
? Branches into Medial/lateral femoral circumflex
? Head and neck of femur
? Femoral becomes......
? Popliteal (continuation of femoral)
? Branches into:
? Geniculars
? Knee
? Splits into:
? Anterior Tibial
? Anterior leg muscles, further branches to feet
? Posterior Tibial
? Flexor muscles, plantar arch, branches to toes
Veins
? Deep Veins: Mostly share names of
arteries
? Ultimately empty into Inferior Vena Cava
? Plantar
? Tibial
? Fibular
? Popliteal
? Femoral
? External/internal iliac
? Common iliac
? Superficial Veins
? Dorsal venous arch (foot)
? Great saphenous (empties into femoral)
? Small saphenous (empties into popliteal)
SURFACE ANATOMY
All of the following structures
are palpable in the inguinal
region:
Symphysis pubis.
Body of pubis.
Pubic tubercle.
Anterior Superior Iliac
Spine.
The inguinal ligament extends
between:
pubic tubercle and
ASIS.
In the mid-inguinal point you can
feel the pulsations of the femoral
artery.
The femoral vein lies on the
medial side of the artery.
While the femoral nerve lies lateral
to the artery.
54
? Midinguinal point:
? It is a point on the inguinal
ligament midway between the
symphysis pubis and the ASIS.
? The femoral artery is an important
site for vascular access as a large
number of arteriographic
procedures are undertaken
through its percutaneous
puncture, (coronary angiography).
55
Anterior Compartment of Thigh
Superficial structures
Cutaneous nerves:
Femoral branch of jenitofemoral
n.
ilioinguinal n.
Lateral cutaneous n. of thigh
Anterior cutaneous n. of thigh
medial cutaneous n. of thigh
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
Innervation
of the Lower Limb
Superficial arteries:
superficial epigastric
a.
superficial iliac
circumflex a.
external pudendal a.
Superficial veins
Superficial epigastric v.
Superficial circumflex iliac v.
Superficial External
pudendal v.
Superficial lateral femoral v.
Great saphenous v.
Superficial inguinal
lymph nodes:
Horizontal group
Vertical group
Superficial inguinal
lymph nodes
Superior group:
Lies just distal to the
inguinal ligament
Receive lymph from
anterior abdominal wall
below umbilicus, gluteal
region, perineal region,
external genital organs
Superficial inguinal lymph nodes
Inferior group:
Lies vertical along the
terminal great
saphenous v.
Receives all superficial
lymphatics of lower limb,
except for those from
the posterolateral part
of calf
Efferent vessels drain into
the deep inguinal ln. or
external iliac ln.
THE FEMORAL TRIANGLE
SIGNIFICANCE
? The femoral triangle is a hollow in
the anterior thigh region.
? Many large neurovascular structures
pass through this area, and can be
accessed relatively easily.
? Thus, it is an area of both anatomical
and clinical importance.
Surface anatomy of the femoral
triangle
BOUNDARIES
? Superior border ? Formed by
the inguinal ligament.
? Lateral border ? Formed by
the medial border of the
sartorius muscle.
? Medial border ? Formed by
the
medial
border
of
the adductor longus muscle.
The rest of this muscle forms
part of the floor of the
triangle.
THE FEMORAL TRIANGLE
? It also has a floor and a
roof:
? Anteriorly, the roof of the
femoral triangle is formed
by the fascia lata.
? Posteriorly, the base of the
femoral triangle is formed
by the pectineus, iliopsoas
and adductor longus
muscles.
Inguinal Ligament
? The inguinal ligament
acts as a flexor
retinaculum, supporting
the contents of the
femoral triangle during
flexion at the hip
The contents of the femoral triangle
? Contents
? The femoral triangle
contains some of the
major neurovascular
structures of the lower
limb. Its contents (lateral
to medial) are:
? Femoral nerve ?
Innervates the anterior
compartment of the
thigh, and provides
sensory branches for the
leg and foot.
The contents of the femoral triangle
? Femoral artery ?
Responsible for the
majority of the arterial
supply to the lower limb.
? Femoral vein ? The great
saphenous vein drains
into the femoral vein
within the triangle.
? Femoral canal ? A
structure which contains
deep lymph nodes and
vessels
This post was last modified on 05 April 2022