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Lower Limb 1, Movement summary
(main muscles), Significant landmarks,…
Lower Limb 1
Anatomical movements
Flexion VS Extension, Anterior or Posterior
Movement along the sagittal plane of the human body
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Lateral rotation VS Medial rotation
Movement of ant surface of thigh away from or towards the Medline (hip joint)
Plantarflexion VS Dorsiflexion
Movement of ant part of foot away or towards the lower leg (ankle joint)
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Muscles
Hip and Thigh
Psoas major
- Proximal attachment: Lumber vertebra (transverse process and bodies)
- Distal attachment: lesser trochanter of femur
- Innervation: Lumbar plexus
- Blood supply: iliolumbar artery
- Action: Flexes thigh at hip joint
Psoas minor
- Proximal attachment: Bodies and
intervertebral discs T12-L5
- Distal attachment: pectineal line
- Innervation: spinal nerves
- Blood supply: iliolumbar artery
- Action: assists in trunk flexion
Iliacus
- Proximal attachment: Iliac fossa
- Distal attachment: lesser trochanter of femur
- Innervation: Femoral nerve
- Blood supply: Medial circumflex femoral artery
- Action: Flexes the thigh at the hip joint
Tensor fascia lata
- Proximal attachment: Anterior superior iliac spine (ASIS), iliac crest
- Distal attachment: iliotibial band
- Innervation: superior gluteal nerve
- Blood supply: Lateral circumflex femoral artery & superior gluteal artery
- Action: Abduct and medially rotates the thigh
Pectineus
- Proximal attachment: Superior ramus of pubis
- Distal attachment: pectineal line, the line between lesser trochanter of femur and linea aspera
- Innervation: femoral nerve and obturator nerve
- Blood supply: Medial circumflex
femoral artery
- Action: Adduct, flex and medial rotate thigh
Thigh
Sartorius
- Proximal attachment: Anterior superior iliac spine (ASIS)
- Distal attachment: Media epicondyle of tibia
- Innervation: Femoral nerve
- Blood supply: Profunda femoris
- Action: Flex, Abduct, lateral rotation at hip joint; flex, medial rotation at knee joint
Vasalus lateralis
- Proximal attachment: Greater tronchanter, lateral part of linear aspera
- Distal attachment: Common quadriceps femoris tendon in to the tibial tuberosity; (lateral border of patella, tibial tuberosity via patellar ligament)
- Innervation: Femoral nerve
- Blood supply: Lateral circumflex femoral artery
- Action: Extend knee joint, flex hip joint
Vastus Intermedius
- Proximal attachment: Upper part of anterior
and lateral surface of femur
- Distal attachment: Common quadriceps femoris tendon in to the tibial tuberosity
- Innervation: Femoral nerve
- Blood supply: lateral circumflex femoral artery
- Action: Extend knee joint, flex hip joint
Vastus medialis
- Proximal attachment: Intertronchantric line, medial part of linea aspera
- Distal attachment: Common quadriceps femoris tendon in to the tibial tuberosity
- Innervation: Femoral nerve
- Blood supply: Femoral artery and profundus femoris artery
- Action: Extend knee joint, flex hip joint
Rectus femoris
- Proximal attachment: Anterior inferior iliac spine (AIIS), acetabulum, (capsule of hip joint)
- Distal attachment: Common quadriceps femoris tendon in to the tibial tuberosity
- Innervation: Femoral nerve
- Blood supply: lateral circumflex femoral artery
- Action: extend knee joint, flex hip joint
Adductor longus
- Proximal attachment: Pubis
- Distal attachment: middle 1/3 of linea aspera
- Innervation: Obturator nerve
- Blood supply: Deep femoral
- Action: adduct thigh, medial rotation
Adductor magnus
- Proximal attachment: Inferior rami of the
pubis and the rami of ischium (adductor); ischial tuberosity (hamstring)
- Distal attachment: linea aspera (adductor); Adductor tubercle and medial supracondylar line of the femur (hamstring)
- Innervation: Obturator nerve
- Blood supply: deep femoral
- Action: The adductor component also flexes the thigh, with the hamstring portion extending the thigh
Gracilis
- Proximal attachment: Pubis
- Distal attachment: Anterior medial aspect of tibia
- Innervation: Obturator nerve
- Blood supply: obturator artery
- Action: adduct thigh, flex knee
Obturator Externus
- Proximal attachment: Lateral surface of obturator membrane and the ischiopubic ramus
- Distal attachment: Posterior part of
greater trochanter
- Innervation: Obturator nerve
- Blood supply: obturator artery
- Action: Adduction and lateral rotation of the thigh.
Biceps Femoris
- Proximal attachment: Long head - ischial tuberosity; short head - linea aspera
- Distal attachment: Fibular head and lateral condyle of the tibia
- Innervation: Long head innervated by the tibial nerve; short head is innervated by the common fibular nerve of the tibia (sciatic nerve)
- Blood supply: Profunda femoris
& Inferior gluteal artery
- Action: Flexion at the knee. It also
extends the thigh at the hip, and laterally rotates at the hip and knee
Semitendinosus
- Proximal attachment: Ischial tuberosity
- Distal attachment: Medial tibia
- Innervation: Tibia nerve
- Blood supply: Profunda femoris
& Inferior gluteal artery
- Action: knee flexion, hip extension, medial rotation of thigh and knee.
Semmembranosus
- Proximal attachment: Ischial tuberosity
- Distal attachment: Medial condyle of tibia
- Innervation: Tibia nerve
- Blood supply: Profunda femoris
& Inferior gluteal artery
- Action: knee flexion, hip extension, medial rotation of thigh and knee.
Gluteal
Gluteus maximus
- Proximal attachment: Posterior surface of ilium, sacrum, coccyx
- Distal attachment: gluteal tuberosity
- Innervation: Inferior gluteal nerve
- Blood supply: superior and inferior gluteal artery
- Action: Abduction, extension and lateral rotation of hip
Gluteus medius
- Proximal attachment: Posterior surface of ilium. (Iliac crest, anterior gluteal line)
- Distal attachment: Greater trochanter of femur
- Innervation: Superior gluteal nerve
- Blood supply: superior and inferior gluteal artery
- Action: Abduct, flex and medial rotation of thigh
Gluteus minimus
- Proximal attachment: Posterior surface of the ilium but inferior to gluteus medius
- Distal attachment: Greater trochanter of femur
- Innervation: Superior gluteal nerve
- Blood supply: Superior and inferior gluteal artery
- Action: abduction, flexion and lateral rotation of thigh
Piriformis
- Proximal attachment: Anterior surface of sacrum
- Distal attachment: Greater tronchanter of femur
- Innervation: Nerves of the piriformis; sacral plexus
- Blood supply: superior and inferior gluteal artery
- Action: abduct, extend and lateral rotation
Joints
Hip
Pubofemoral ligament
Spiral orientation, adds stability
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Superior to inferior
- Greater trochanter
- Lesser trochanter
- Shaft
- Lateral and medial epicondyles
- Lateral and medial condyles
- Medial and lateral tibial condyle
- Head of fibula
- Superior tibiofibular joint
- Inferior tibiofibular joint
- Medial malleolus (tibia)
- Lateral malleolus (fibula)
- Bottom of fibula is identified by a spoonlike shape
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Femoris Triangle
- inguinal ligament superiorly
- adductor longus medially
- sartorius laterally
Content (VAN from medial to lateral)
- Femoral vein
- Femoral artery
- Femoral nerve
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