Lower Limb

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Irfan Dotani

General Structures Bones List of Muscles Joints and Ligaments Arteries Veins Nerves
Hip Ilium, Ischium, Pubic Bone, Acetabulum, Foramen obturatum Piriformis, Superior gemellus, Inferior gemellus, Tensor fasciae latae, Sartorius, Gluteus medius, Gluteus minimus Iliofemoral ligament, Pubofemoral ligament, Ischiofemoral ligament, Hip joint capsule Gluteal artery, Pudendal artery, Perforating arteries, Femoral artery, Obturator artery Great saphenous vein, Femoral vein Saphenous nerve, Obturator nerve, Femoral nerve, Clunial nerve, Sciatic nerve, Cutaneous nerve, Gluteal nerve, Pudendal nerve
Knee Femur, Tibia, Patella Quadriceps femoris muscle, Hamstring, Gastrocnemius muscle, Vastus mediali, Vastus lateralis muscle, Popliteus muscle, Soleus muscle, Articularis genus muscle Anterior cruciate ligament (ACL), Posterior cruciate ligament (PCL), Medial collateral ligament (MCL), Lateral collateral ligament (LCL), patellofemoral joint, tibiofemoral joint Genicular artery, Popliteal artery, Tibial artery Varicose veins, Femoral veins Sciatic nerve, Tibial nerve, Peroneal nerve,
Ankle Fibula, Tibula, Talus, Medial malleolus, Lateral malleolus Anterior tibial, Posterior tibial, Peroneal tibial, Extensors, Flexors Tibiofibular ligament, Deltoid ligament, Tibiofibular Syndesmosis joint, Motrise Joint, Plantar fascia Anterior tibial artery, Peroneal (fibular) artery, Anterior medial malieolar artery, plantar artery, communicating branch Popliteal vein, saphenous vein, femoral vein, Tributaries of LSV Peroneal vein, Sural nerve, Tibial nerve, Fibular nerve
Thigh Femur, Tibia, Fibula Quadriceps femoris muscle, Hamstring, Biceps femoris muscle, Vastus medialis, Adductor longus muscle, Vastus lateralis muscle, Sartorius muscle, Semitendinosus muscle, Semimembranosus muscle, Gracilis muscle, Adductor magnus muscle, Pectineus muscle, Adductor brevis muscle, Illiopsoas, Illiacus muscle, Tensor fasciae latae muscle, External obturator muscle, Quadratus femoris muscle, Articularis genus muscle Hip joint capsule, Iliofemoral ligament, Pubofemoral ligament, Ischiofemoral ligament Gluteal artery, Pudendal artery, Perforating arteries, Femoral artery, Obturator artery\ Great saphenous vein, Femoral vein Saphenous nerve, Obturator nerve, Femoral nerve, Clunial nerve, Sciatic nerve, Cutaneous nerve, Gluteal nerve, Pudendal nerve
Foot Phalanges, Metatarsals, Cuneiform bones, Cuboid bone, Navicular bone Abductor hallucis muscle, Extensor digitorum brevis muscle, Flexor digitorum brevis muscle, Tibialis anterior muscle, Extensor hallucis longus muscle, Flexor hallucis brevis muscle, Plantar interossei muscles, Quadratus plantae muscle, Abductor digiti minimi muscle of foot, Lumbricals of the hand, Dorsal interossei of the foot, Extensor hallucis brevis muscle Inferior (Distal) Tibiofibular Joint, Talocalcaneal Joint, Talocalcaneonavicular Joint, Calcaneocuboid Joint, Naviculocuneiform Joint, Cuboideonavicular Joint, Intercuneiform And Cuneocuboid Joints, Tarsometatarsal Joints, Intermetatarsal Joints, Metatarsophalangeal Joints, Interphalangeal Joints, Cuboideonavicular ligament, Intercuneiform ligament, Metatarsal ligament Dorsalis pedis artery, Posterior tibial artery, Anterior tibial artery, Arcuate artery of the foot, Medial plantar artery, Plantar arc, Deep plantar artery, Plantar metatarsal arteries, Medial tarsal arteries, Proper plantar digital arteries Superficial dorsal vein, Lateral plantar vein, Saphenous vein, Posterior tibial vein Lateral plantar nerve, Tibial nerve, Medial plantar nerve, Plantar digital nerves

Lower limb bony structures

Parts Function Image
Hip Ilium The ilium forms the sacroiliac joint with the sacrum along its medial side and forms the superior end of the hip joint at the acetabulum. The sacroiliac joint is a planar joint that allows a slight degree of gliding between the pelvis and the spinal column. The hip joint is a ball-and-socket joint that permits the thigh to have a free range of motion. <figure-inline><figure-inline></figure-inline></figure-inline>
Ischium Forms the lower and back part of the hip bone. <figure-inline><figure-inline></figure-inline></figure-inline>
Pubic Bone The ventral and anterior of the three parts that come together to create the pelvic bone. <figure-inline><figure-inline></figure-inline></figure-inline>
Acetabulum A cup-shaped opening on each side of the pelvic girdle formed where the ischium, ilium, and pubis all meet, and into which the head of the femur inserts. <figure-inline><figure-inline></figure-inline></figure-inline>
Foramen obturatum The large opening created by the ischium and pubis bones of the pelvis through which nerves and blood vessels pass. <figure-inline><figure-inline></figure-inline></figure-inline>
Parts Function Image
Knee Femur Supports the weight of the body and allowing motion of the leg. The femur articulates proximally with the acetabulum of the pelvis forming the hip joint, and distally with the tibia and patella to form the knee joint. <figure-inline><figure-inline></figure-inline></figure-inline>
Tibia It forms the knee joint with the femur and the ankle joint with the fibula and tarsus. <figure-inline><figure-inline></figure-inline></figure-inline>
Patella The patella increases the leverage that the quadriceps tendon can exert on the femur by increasing the angle at which it acts. Also acts as protection for the muscles underneath the patella. <figure-inline><figure-inline></figure-inline></figure-inline>
Parts Function Image
Ankle Fibula Long, thin and lateral bone of the lower leg. It runs parallel to the tibia, or shin bone, and plays a significant role in stabilizing the ankle and supporting the muscles of the lower leg. <figure-inline><figure-inline></figure-inline></figure-inline>
Tibula Known as the shinbone and is the second largest bone in the body. Helps with weight-bearing and stabilization. <figure-inline><figure-inline></figure-inline></figure-inline>
Talus The talus bone forms the primary connection between the lower leg and foot and is vital for mobility. In fact, the structure of the talus bone is so unique it can form the connection between numerous other bones such as the tibia, fibula, calcaneus (heel) and navicular or tarsal bones found in the foot. <figure-inline><figure-inline></figure-inline></figure-inline>
Medial malleolus The medial malleolus is the prominence on the inner side of the ankle, formed by the lower end of the tibia. <figure-inline><figure-inline></figure-inline></figure-inline>
Lateral malleolus The lateral malleolus is the prominence on the outer side of the ankle, formed by the lower end of the tibia. <figure-inline><figure-inline></figure-inline></figure-inline>
Parts Function Image
Thigh Femur Supports the weight of the body and allowing motion of the leg. The femur articulates proximally with the acetabulum of the pelvis forming the hip joint, and distally with the tibia and patella to form the knee joint. <figure-inline><figure-inline></figure-inline></figure-inline>
Tibia It forms the knee joint with the femur and the ankle joint with the fibula and tarsus. <figure-inline><figure-inline></figure-inline></figure-inline>
Fibula Long, thin and lateral bone of the lower leg. It runs parallel to the tibia, or shin bone, and plays a significant role in stabilizing the ankle and supporting the muscles of the lower leg. <figure-inline><figure-inline></figure-inline></figure-inline>
Parts Function Image
Foot Phalanges The phalanges of the foot help us balance, walk, and run. <figure-inline><figure-inline></figure-inline></figure-inline>
Metatarsals Metatarsals are convex in shape (arch upward), are long bones, and give the foot its arch. They work with connective tissues, ligaments, and tendons to provide movement in the foot <figure-inline><figure-inline></figure-inline></figure-inline>
Cuneiform bones This bone is cube-shaped and connects the foot and the ankle. It also provides stability to the foot. <figure-inline><figure-inline></figure-inline></figure-inline>
Cuboid bone The cuboid bone is one of the seven tarsal bones located on the lateral (outer) side of the foot. This bone is cube-shaped and connects the foot and the ankle. It also provides stability to the foot. <figure-inline><figure-inline></figure-inline></figure-inline>
Navicular bone The navicular is a boat-shaped bone located in the top inner side of the foot, just above the transverse. It helps connect the talus, or anklebone, to the cuneiform bones of the foot <figure-inline><figure-inline></figure-inline></figure-inline>

Lower limb muscles

Muscle Function Insertion/Arise Innervation Blood supply Image
Hip Piriformis
  • Part of the lateral rotators of the hip, along with the quadratus femoris, gemellus inferior, gemellus superior, obturator externus, and obturator internus
  • The piriformis laterally rotates the femur with hip extension and abducts the femur with hip flexion
Arise:
  • The front of the sacrum by three fleshy digitations
  • Attached to the portions of bone between the first, second, third, and fourth anterior sacral foramina, and to the grooves leading from the foramina
  • A few fibers also arise from the margin of the greater sciatic foramen, and from the anterior surface of the sacrotuberous ligament.

Insertion:

  • The muscle passes out of the pelvis through the greater sciatic foramen, the upper part of which it fills
  • It is inserted by a rounded tendon into the upper border of the greater trochanter behind, but often partly blended with, the common tendon of the obturator internus and superior and inferior gemellus muscles.
Piriformis nerve:
  • Arise from posterior division of the ventral rami of the first and second sacral nerves
Branches of the internal iliac artery:
  • Inferior gluteal
  • Superior gluteal
  • Internal pudendal arteries
<figure-inline></figure-inline>
Superior gemellus
  • Help to steady the femoral head in the acetabulum.
  • Help to laterally rotate the extended thigh and abduct the flexed thigh at the hip.

Insertion:

  • Medial surface of greater trochanter of femur, in common with obturator internus.

Arise:

  • The Gemellus inferior arises from the upper part of the tuberosity of the ischium, immediately below the groove for the Obturator internus tendon.

Innervation:

  • Nerve to the obturator internus or nerve to quadratus femoris or both (L4-S1)

Arterial supply:

  • Inferior gluteal artery
<figure-inline></figure-inline>
Inferior gemellus
  • Help to laterally rotate the extended thigh and abduct the flexed thigh at the hip.

Insertion:

  • Medial surface of greater trochanter of femur, in common with obturator internus.

Arise:

  • Arises from the outer (gluteal) surface of the spine of the ischium, blends with the upper part of the tendon of the Obturator internus.

Innervation:

  • Nerve to the quadratus femoris or nerve to the obturator internus or both (L4-S1).

Arterial supply:

  • Inferior gluteal artery
<figure-inline></figure-inline>
Tensor fasciae latae
  • Works in synergy with the gluteus medius and gluteus minimus muscles to abduct and medially rotate the femur. The TFL is a hip abductor muscle.
  • Helps stabilize and steady the hip and knee joints by putting tension on the iliotibial band of fascia.

Insertion:

  • Iliotibial band

Arise:

  • Anterior superior iliac spine, outer lip of anterior iliac crest and fascia latae

Innervation:

  • Superior gluteal nerve (L4, L5, S1)

Arterial supply:

  • Superior gluteal and lateral circumflex femoral artery.
<figure-inline></figure-inline>
Sartorius
  • Flexes and laterally rotates the hip joint and flexes the knee.

Insertion:

  • Superior aspect of the medial surface of the tibial shaft near the tibial tuberosity.

Arise:

  • Anterior superior iliac spine.

Innervation:

  • Femoral nerve

Arterial supply:

  • Muscular branches of the femoral artery.
<figure-inline></figure-inline>
Gluteus medius
  • Major abductor of thigh; anterior fibers help to rotate hip medially; posterior fibers help to rotate hip laterally

Insertion:

  • Lateral and superior surfaces of greater trochanter.

Arise:

  • Dorsal ilium inferior to iliac crest

Innervation:

  • Superior gluteal nerve (L4, L5, S1)

Arterial supply:

  • Superior gluteal artery
<figure-inline></figure-inline>
Gluteus minimus
  • Abducts and medially rotates the hip joint.

Insertion:

  • Interior surface of greater trochanter.

Arise:

  • Dorsal ilium between inferior and anterior gluteal lines; also from edge of greater sciatic notch.

Innervation:

  • Superior gluteal nerve (L4, L5, S1)

Arterial supply:

  • Superior gluteal artery
<figure-inline></figure-inline>
Gluteus maximus
  • Major extensor of hip joint, assists in laterally rotating the thigh; upper and middle third section of the muscle are abductors.

Insertion:

  • Primarily in fascia lata at the iliotibial band; also into the gluteal tuberosity on posterior femoral surface.

Arise:

  • Posterior aspect of dorsal ilium posterior to posterior gluteal line, posterior superior iliac crest, posterior inferior aspect of sacrum and coccyx, and sacrotuberous ligament.

Innervation:

  • Inferior gluteal nerve (L5, S1, S2)

Arterial supply:

  • Inferior and superior gluteal arteries and the first perforating branch of the profunda femoris artery.
<figure-inline></figure-inline>
Muscle Function Insertion/Arise Innervation Blood supply Image
Knee Quadriceps femoris muscle
Superior gemellus
Hamstring
Gastrocnemius muscle
Vastus mediali
Vastus lateralis muscle
Popliteus muscle
Soleus muscle