TOPOGRAPHICAL ANATOMY OF LOWER LIMB

N,1

Introduction

The lower limb:- thigh with three compartments - gluteal region - leg with three compartments - foot wth a dorsum and a sole

Interests

Man is bipodal Support and propulsion function of lower limb Transmission of weight and propulsion functions

GLUTEAL REGION

Boundaries: Behind pelvis From iliac crest to the gluteal fold Greater trochanter in front Lower part by gluteal fold - rounded buttock Two buttocks separated by natal cleft

Contents:Muscles: gluteal maximus, medius,minimus and deeply placed piriformis,obturator internus, superior and inferior gemellus as well as quadratus femoris Nerve: Sciatic Artery: Gluteals

The thigh region

Enclosed by deep fascia and fascia lata Anterior compartment Boundaries: Inguinal ligament above Knee below Laterally and medially by intermuscular septa Contents: Muscles: Sartorius, tensor fascia lata, quadriceps Nerve: Femoral Artery: Femoral Veins: Femoral and great saphenous

The femoral triangle

Boundaries:- Upper third of thigh just below the inguinal ligament which forms the base -Laterally, medial border of sartorius muscle - Medially the medial border of adductor longus -Inferiorly, the adductor canal through which femoral vessels pass into the popliteal fossa -Anterior wall is composed of the skin and fascia lata - Posterior wall is composed of muscles; adductor longus,pectineus,psoas major,and iliacus from medial to lateral side - Central hollow occupied by femoral vessels

Contents of the femoral triangle

The femoral vessels,the vein medial to the artery The profunda femoral artery from the posterolateral side of the femoral artery The lateral and medial circumflex arteries The deep external pudendal artery Three or four deep inguinal lymph nodes The femoral branch of genito femoral nerve The lateral cutaneous nerve of thigh The femoral nerve

Medial compartment of thigh

Bounderies:- Medially, is the medial intermuscular septum -No septum between it and posterior compartment Contents:- Muscles; gracilis, the three adductors longus brevis and magnus. Deeply lies obturator externus -Nerve; Obturator -Artery; Profunda femoris assisted proximally by obturator artery

The posterior compartment

Boundaries:- From buttock to back of knee -Separated from anterior compartment by the intermuscular septum - Not separated from the medial compartment by a septum since adductor magnus has two components fused from the adductors and from the hamstring. Contents:- Muscles; The hamstring muscles; semi tendinosus, the semi membranosus, and the biceps femoris - Nerve; Tibial component of the sciatic nerve except short head of the biceps femoris which comes from the common fibular part - Artery; Profunda femoris and its perforating branches. The upper part receives blood from the gluteal artery and the lower from the popliteal artery.

Popliteal fossa

Boundaries:- Above; semi membranosus and the semitendinosus on the medial side and the biceps femoris on the lateral side, diverging from the apex - Heads of gastrocnemus muscles below - Roof by the fascia lata - The floor by the popliteal surface of the femur, the capsule of the knee joint, renforced by the oblique popliteal ligament and the popliteus muscle covered by its fascia. Contents:- Muscles; Heads of gastrocnemus, popliteus, -Nerve; tibial and fibular - popliteal lymph nodes - Popliteal artery and vein

The anterior compartment of the leg region

Boundaries:- Medially, the subcutaneous surface of the tibia -Anterolaterally, the extensor muscular compartment Contents:- -Two intermuscular septae pass from deep fascia to enclose the peroneal compartment - Between the anterior intermuscular septum and the tibia lies the extensor compartment and between the posterior intermuscular septum and the tibia posteriorly lies the much bulky flexor compartment or calf.

Extensor compartment of the leg

Boundaries:- Between the deep fascia and the interosseous membrane -medially by extensor surface of tibia - Laterally by the extensor surface of the fibula Contents:-Muscles;tibialis anterior,extensor hallucis longus, extensor digitorum longus, and peroneus tertius -Nerve;fibular artery; anterior tibial vessels Lower end there is the extensor retinaculum

Dorsum of foot

Main veins form here: Great and short saphenous veins Nerve from the peroneal as the saphenous nerve Inferior extensor retinaculum prevents bowstringing of extensor tendons

Lateral compartment of the leg

Boundaries:- Between the peroneal surface of the fibula and deep fascia of the leg -In front and behind by the anterior and posterior intermuscular septum Contents:-Muscles; peroneus longus, and brevis - Nerve;superficial peroneal nerve - Artery; peroneal artery - vein; small saphenous vein

Posterior compartment of the leg

Boundaries:- The calf is medially limited by the medial border of the tibia, and laterally by the lateral border of the fibula Contents:- Muscles; two layers are found here separated by an intermuscular septum . Superficial muscles are the two gastrocnemus the plantaris, and the soleus. Deep muscles are the flexors, popliteus,flexor digitorum longus, flexor hallucis longus and tibialis posterior Nerve; tibial Artery: posterior and peroneal branches of posterior tibial artery.

Sole of foot

Essentially for strength and resilience Strength by massive tarsal bones and toe bones Resilience assured by multiple joints, arch arrangement and the powerful ligaments and the tie-beam aponeurosis Presence of sesamoid bones for the transmission of pull of small muscles.