Block Iv: Lower Limb

Front 1

femur

Back 1

the bone of the thigh

the femur is the longest and strongest bone in the body

Front 2

head (femur)

Back 2

smooth, rounded proximal end

the head of the femur articulates with the acetabulum of the pelvis

Front 3

fovea capitis femoris

Back 3

a shallow pit in the head of the femur

it is the attachment site of the ligamentum capitis femoris; a small artery for supply of the head is found within this ligament

Front 4

neck (femur)

Back 4

the constricted area distal to the head of the femur

most of the blood supply to the head of the femur courses along the surface of the neck

fractures of the neck of the femur may result in avascular necrosis of the head

Front 5

greater trochanter (femur)

Back 5

a large process that projects superiorly from the junction of the neck and shaft of the femur

the greater trochanter is the insertion site of the gluteus medius m., gluteus minimus m., piriformis m. and obturator internus m.

Front 6

gluteal tuberosity (femur)

Back 6

a roughened area located on the posterior surface of the femur at the superior end of the lateral lip of the linea aspera

it is one of the insertion sites of the gluteus maximus m.

Front 7

lesser trochanter (femur)

Back 7

a large process that projects from the posteromedial surface of the femur just distal to neck

the insertion site of the common tendon of the psoas major and iliacus mm. (iliopsoas m.)

Front 8

trochanteric fossa (femur)

Back 8

a depression on the medial side of the greater trochanter on its posterior surface where the greater trochanter joins the neck

it is the insertion site of the obturator internus m., superior gemellus m. and inferior gemellus m.

Front 9

intertrochanteric line (femur)

Back 9

a ridge on the anterior surface of the femur that connects the greater and lesser trochanters

it is the line of attachment of the fibrous joint capsule

Front 10

intertrochanteric crest (femur)

Back 10

a heavy ridge on the posterior surface of the femur that connects the greater and lesser trochanters

the quadratus femoris m. inserts on the intertrochanteric crest

Front 11

body (femur)

Back 11

the long slender shaft of the femur

the linea aspera runs the entire length of the posterior surface of the body

Front 12

linea aspera (femur)

Back 12

a vertical ridge on posterior surface of the femur

it is the insertion site of the medial (adductor) group of thigh muscles and the origin of the vastus intermedius m. and the short head of the biceps femoris m.

Front 13

adductor tubercle (femur)

Back 13

a process that projects superior to the medial epicondyle of the femur

it is the insertion site of the ischiocondylar part of the adductor magnus m.

Front 14

medial epicondyle (femur)

Back 14

the enlargement of bone on the medial side of the femur just superior to the medial condyle

it is the attachment site of the tibial collateral ligament of the knee joint

Front 15

lateral epicondyle (femur)

Back 15

the enlargement of bone on the lateral side of the femur just superior to the lateral condyle

it is the attachment site of the fibular collateral ligament and the site of origin of the popliteus m.

Front 16

medial condyle (femur)

Back 16

the rounded inferior end of the femur on the medial side

it articulates with the medial condyle of the tibia

Front 17

lateral condyle (femur)

Back 17

the rounded inferior end of the femur on the lateral side

it articulates with the lateral condyle of the tibia

Front 18

intercondylar fossa (femur)

Back 18

the deep depression on the posterior surface of the femur between the condyles

the anterior and posterior cruciate ligaments are located here

Front 19

patellar surface (femur)

Back 19

the smooth anterior surface at the inferior end of the femur

it articulates with the posterior surface the patella

Front 20

patella

Back 20

the bone that forms the knee cap

the patella is a sesamoid bone in the tendon of the quadriceps femoris muscle; it provides a protective function by withstanding the grinding forces of the quadriceps femoris tendon against the patellar surface of the femur, especially in full knee flexion

Front 21

tibia

Back 21

the bone on the medial side of the leg

the tibia is the weight-bearing bone of the leg

Front 22

medial condyle (tibia)

Back 22

the heavy prominence on the medial side of the proximal end of the tibia

the medial condyle articulates with the medial condyle of the femur; it is larger than the lateral condyle of the tibia

Front 23

lateral condyle (tibia)

Back 23

the heavy prominence on the lateral side of the proximal end of the tibia

articulates with the lateral condyle of the femur and with the head of the fibula

Front 24

intercondylar eminence (tibia)

Back 24

the ridge of bone on the proximal end of the tibia that projects between the condyles

has a medial and a lateral tubercle; it is the attachment site for the cruciate ligaments, medial meniscus and lateral meniscus

Front 25

tibial tuberosity

Back 25

the roughened protuberance on the anterior surface of the tibia located just distal to the condyles

the attachment site of the patellar ligament, which represents the insertion of the quadriceps femoris tendon

Front 26

body (tibia)

Back 26

the long, robust shaft of the tibia

the medial surface of the body of the tibia is subcutaneous throughout its length; when the shin is painfully bumped, the nerve endings are stimulated in the periosteum covering the body of the tibia

Front 27

interosseous border (tibia)

Back 27

the sharp ridge that runs longitudinally along the junction of the lateral surface and the posterior surface of the tibia

the interosseous membrane attaches to the interosseous border of the tibia

Front 28

soleal line (tibia)

Back 28

a ridge of bone that descends obliquely from lateral to medial on the posterior surface of the tibia

it is the site of origin of the soleus m.

Front 29

medial malleolus (tibia)

Back 29

the large bony prominence on the medial side of the ankle

forms the medial side of the ankle joint; it articulates with the medial surface of the talus

Front 30

fibula

Back 30

the slender bone on the lateral side of the leg

the fibula is not a weight-bearing bone, it is a muscle attachment bone

Front 31

head (fibula)

Back 31

the enlarged proximal end of the fibula

it articulates with the lateral condyle of tibia; the fibular collateral ligament of the knee attaches to the head of the fibula

Front 32

neck (fibula)

Back 32

the constricted portion of the fibula located just inferior to the head

fractures of the neck of the fibula can injure the common fibular n.

Front 33

body (fibula)

Back 33

the long slender shaft of the fibula

the interosseous membrane attaches to the entire length of the interosseous border of the fibula

Front 34

interosseous border (fibula)

Back 34

the sharp ridge that runs longitudinally along the medial surface of the fibula

the interosseous membrane attaches to the interosseous border of the fibula

Front 35

lateral malleolus (fibula)

Back 35

the enlarged distal end of the fibula

forms the lateral side of the ankle joint; it articulates with the lateral surface of the talus; forcible lateral displacement of the foot can cause the fibula to fracture superior to the lateral malleolus, a condition called a Pott's fracture

Front 36

tarsal bones

Back 36

the bones of the ankle

there are seven tarsal bones: talus, calcaneus, navicular, medial cuneiform, intermediate cuneiform, lateral cuneiform, cuboid

Front 37

talus

Back 37

the most proximal of the tarsal bones

articulates with the medial malleolus of the tibia and the lateral malleolus of the fibula to form the ankle mortise joint

Front 38

body (talus)

Back 38

the proximal part of the talus

its superior (trochlear) part participates in the ankle joint and its inferior part articulates with the calcaneus

Front 39

trochlea (talus)

Back 39

the superior portion of the body of the talus that lies between the two malleoli

it has a smooth articular surface; it participates in the formation of the ankle joint

Front 40

head (talus)

Back 40

the portion of the talus that projects anteriorly

articulates with the navicular bone

Front 41

neck (talus)

Back 41

the constricted part of the talus located proximal to the head

Front 42

calcaneus

Back 42

the tarsal bone which forms the heel

it is the largest and strongest bone in the foot; a fracture of the calcaneus which separates the tuberosity from the body can be a debilitating injury

Front 43

calcaneal tuberosity

Back 43

the posterior roughened area of the calcaneus which contacts the ground during weight-bearing

insertion site of the calcaneal (Achilles') tendon

Front 44

sustentaculum tali (calcaneus)

Back 44

the shelf-like medial projection of bone located inferior to the medial malleolus

it is a shelf of bone that articulates with and supports the talus; it is grooved inferiorly by the tendon of the flexor hallucis longus m.

Front 45

navicular

Back 45

the tarsal bone located distal to the talus and proximal to the three cuneiform bones

articulates with the head of the talus and all three cuneiform bones; it is the attachment site for an important ligament (plantar calcaneonavicular or "spring" ligament) that supports the medial longitudinal arch of the foot

Front 46

cuneiform, medial

Back 46

the most medial bone in the distal row of tarsal bones

the cuneiform bones articulate with the navicular bone proximally and the bases of the metatarsal bones distally

Front 47

cuneiform, middle

Back 47

the intermediate bone of the three cuneiform bones

the cuneiform bones articulate with the navicular bone proximally and the bases of the metatarsal bones distally

Front 48

cuneiform, lateral

Back 48

the bone that is located between the middle cuneiform and the cuboid bone

the cuneiform bones articulate with the navicular bone proximally and the bases of the metatarsal bones distally

Front 49

cuboid

Back 49

the most lateral bone in the distal row of tarsal bones

articulates with the calcaneus proximally and the fourth and fifth metatarsal bones distally

Front 50

metatarsals

Back 50

the bones located between the tarsal bones and the phalanges

there are five metatarsal bones in the foot

Front 51

base (metatarsals)

Back 51

the proximal end of the metatarsal

articulates with the distal row of tarsal bones

Front 52

body (metatarsals)

Back 52

the slender shaft of the metatarsal

also known as the diaphysis

Front 53

head (metatarsals)

Back 53

the rounded distal end of the metatarsal

articulates with the proximal phalanx of the corresponding digit

Front 54

phalanx (phalanges)

Back 54

the distal two or three bones in the digits of the foot

there are a total of 14 phalanges in the foot; the great toe has two phalanges (proximal and distal) and each of the other four toes has three phalanges (proximal, middle and distal)

phalanx means "line of soldiers"

Front 55

base (phalanx)

Back 55

the proximal end of the phalanx

the base of the proximal phalanx articulates with the head of the corresponding metatarsal bone; the base of the middle or distal phalanx articulates with the head of the next most proximal phalanx

Front 56

body (phalanx)

Back 56

the slender shaft of the phalanx

also known as the diaphysis; the body of the distal phalanx is very short

Front 57

head (phalanx)

Back 57

the distal end of the phalanx

the proximal, middle and distal phalanges each have a head; the head of a proximal or middle phalanx articulates with the base of the next most distal phalanx

Front 58

coccyx

Back 58

the most inferior portion of the vertebral column

results from the fusion of the four coccygeal vertebrae; it may be a single bone or the first coccygeal vertebra may be separated from the other three; it articulates with the fifth sacral segment; coccygeal vertebrae are reduced in complexity, having no pedicles, laminae or spines

Front 59

sacrum

Back 59

a triangular bone that is the posterior skeletal element forming the pelvis

it is formed by 5 fused vertebrae; the sacrum and two os coxae bones form the pelvis

Front 60

base (sacrum)

Back 60

the superior part of the sacrum

includes the articular surface for the fifth lumbar vertebra and the superior portion of the two ala

Front 61

promontory (sacrum)

Back 61

a projection of the superior part of the sacrum in an anterior direction

the body of the fifth lumbar vertebra sits on the sacral promontory and articulates with it through a symphysis

Front 62

ala (sacrum)

Back 62

the lateral portion of the sacrum

paired; it projects laterally from the body of the sacrum; it represents the fused costal and transverse processes of the first sacral vertebra

Front 63

anterior sacral foramina

Back 63

an opening in the anterior surface of the sacrum

there are four pairs; each transmits the ventral primary ramus of the respective sacral spinal nerve; branches of the lateral sacral aa. Enter the sacral canal through these openings

Front 64

posterior sacral foramina

Back 64

an opening in the posterior surface of the sacrum

there are four pairs; each transmits the dorsal primary ramus of the respective sacral spinal nerve

Front 65

sacral canal

Back 65

the opening in the center of the sacrum

it is the continuation of the vertebral canal at sacral vertebral levels

Front 66

sacral hiatus

Back 66

an opening in the posterior surface of the sacrum in the midline

it is a normal feature that results from the failure of fusion of the laminae of the fifth sacral segment (and sometimes the fourth) during development

Front 67

articular surface (sacrum)

Back 67

the roughened area located on the lateral surface of the sacrum

articulates with the ilium in the sacroiliac articulation

Front 68

body (sacrum)

Back 68

the central portion of the sacrum

the body is equivalent to the bodies of the other vertebra

Front 69

base (sacrum)

Back 69

the superior surface of the sacrum

articulates with the fifth lumbar vertebra through an intervertebral disk

Front 70

levator ani m.

Back 70

1. from the posterior surface of the body of the pubis, fascia of the obturator internus m. (arcus tendineus levator ani), ischial spine to the anococcygeal raphe and coccyx

2. elevates the pelvic floor

3. branches of the ventral primary rami of spinal nerves S3-S4

4. inferior gluteal a.

the combination of puborectalis, pubococcygeus & iliococcygeus is the levator ani m.; coccygeus and levator ani combined form the pelvic diaphragm

Front 71

coccygeus m.

Back 71

1. from the ischial spine to the side of the coccyx and lower sacrum

2. elevates the pelvic floor

3. branches of the ventral primary rami of spinal nerves S3-S4

4. inferior gluteal a.

coccygeus and levator ani combined form the pelvic diaphragm

Front 72

piriformis m.

Back 72

1. from the anterior surface of sacrum to theupper border of greater trochanter of femur

2. laterally rotates and abducts thigh

3. ventral rami of S1-S2

leaves the pelvis by passing through the greater sciatic foramen

Front 73

obturator internus m.

Back 73

1. from the the internal surface of the obturator membrane and margin of the obturator foramen to the greater trochanter on its medial surface above the trochanteric fossa

2. laterally rotates and abducts the thigh

3. nerve to the obturator internus m.

4. obturator a.

leaves the pelvis by passing through the lesser sciatic foramen; the superior and inferior gemellus mm. insert on the obturator internus tendon

Front 74

gluteus maximus m.

Back 74

1. from the posterior gluteal line, posterior surface of sacrum and coccyx, sacrotuberous ligament to the: upper fibers: iliotibial tract; lowermost fibers: gluteal tuberosity of the femur

2. extends the thigh; laterally rotates the femur

3. inferior gluteal nerve

4. superior and inferior gluteal aa.

a site of intramuscular injection

Front 75

gluteus medius m.

Back 75

1. from the external surface of the ilium between the posterior and anterior gluteal lines to the greater trochanter of the femur

2. abducts the femur; medially rotates the thigh

3. superior gluteal nerve

4. superior gluteal a.

the angle at which the gluteus medius tendon approaches the greater trochanter of the femur is anterior to the axis of rotation of the thigh, resulting in medial rotation

Front 76

gluteus minimus m.

Back 76

1. from the external surface of the ilium between the anterior and inferior gluteal lines to the greater trochanter of the femur

2. abducts the femur; medially rotates the thigh

3. superior gluteal nerve

4. superior gluteal a.

the angle at which the gluteus minimus tendon approaches the greater trochanter of the femur is anterior to the axis of rotation of the thigh, resulting in medial rotation

Front 77

inferior gemellus m.

Back 77

1. from the ischial tuberosity to the obturator internus tendon

2. laterally rotates the femur

3. nerve to the quadratus femoris m.

4. inferior gluteal a.

gemellus is a Latin word that means "little twin"

Front 78

superior gemellus m.

Back 78

1. from the ischial spine to the obturator internus tendon

2. laterally rotates the femur

3. nerve to the obturator internus m.

4. inferior gluteal a.

gemellus is a Latin word that means "little twin"

Front 79

quadratus femoris m.

Back 79

1. from the lateral border of the ischial tuberosity to thequadrate line of the femur below the intertrochanteric crest

2. laterally rotates the thigh

3. nerve to quadratus femoris m.

4. inferior gluteal a.

nerve to the quadratus femoris m. also innervates the inferior gemellus m.

Front 80

tensor fasciae latae m.

Back 80

1. from the anterior part of the iliac crest, anterior superior iliac spine to the iliotibial tract

2. flexes, abducts, and medially rotates the thigh

3. superior gluteal nerve

4. superior gluteal a.

redirects the rotational forces of the gluteus maximus m.

Front 81

sartorius m.

Back 81

1. from the anterior superior iliac spine to the medial surface of the tibia (pes anserinus)

2. flexes, abducts and laterally rotates the thigh; flexes leg

3. femoral nerve

4. lateral femoral circumflex a., saphenous a.

sartorius means "tailor"; its actions put the lower limb in the traditional cross-legged seated position of a tailor

Front 82

iliopsoas m.

Back 82

1. from the iliac fossa; bodies and transverse processes of lumbar vertebrae to the lesser trochanter of the femur

2. flexes the thigh; flexes and laterally bends the lumbar vertebral column

3. branches of the ventral primary rami of spinal nerves L2-L4; branches of the femoral nerve

4. iliolumbar a.

a combination of the iliacus and psoas major mm.

Front 83

iliacus m.

Back 83

1. from the iliac fossa and iliac crest; ala of sacrum to the lesser trochanter of the femur

2. flexes the thigh; if the thigh is fixed it flexes the pelvis on the thigh

3. femoral nerve

4. iliolumbar a.

inserts in company with the psoas major m. via the iliopsoas tendon

Front 84

psoas major m.

Back 84

1. from the bodies and transverse processes of lumbar vertebrae to the lesser trochanter of femur (with iliacus) via iliopsoas tendon

2. flexes the thigh; flexes & laterally bends the lumbar vertebral column

3. branches of the ventral primary rami of spinal nerves L2-L4

4. subcostal a., lumbar aa.

the genitofemoral nerve pierces the anterior surface of the psoas major m.

Front 85

pectineus m.

Back 85

1. from the pecten of the pubis to the pectineal line of the femur

2. adducts, flexes, and medially rotates the thigh

3. femoral nerve and possibly the anterior division of the obturator nerve

4. medial femoral circumflex a.

pectineus often has a dual innervation

Front 86

rectus femoris m.

Back 86

1. straight head: anterior inferior iliac spine; reflected head: above the superior rim of the acetabulum to the patella and tibial tuberosity (via the patellar ligament)

2. extends the leg, flexes the thigh

3. femoral nerve

4. lateral circumflex femoral a.

part of the quadriceps femoris muscle

Front 87

vastus medialis m.

Back 87

1. from the medial intermuscular septum, medial lip of the linea aspera to the patella and medial patellar retinaculum

2. extends leg

3. femoral nerve

4. lateral femoral circumflex a.

part of the quadriceps femoris muscle

Front 88

vastus lateralis m.

Back 88

1. from the lateral intermuscular septum, lateral lip of the linea aspera and the gluteal tuberosity to the patella and medial patellar retinaculum

2. extends leg

3. femoral nerve

4. lateral femoral circumflex a., perforating branches of the deep femoral a.

part of the quadriceps femoris muscle

Front 89

vastus intermedius m.

Back 89

1. from the anterior and lateral surface of the femur to the patella

2. extends the leg

3. femoral nerve

4. lateral femoral circumflex a.

part of the quadriceps femoris muscle

Front 90

adductor longus m.

Back 90

1. from the medial portion of the superior pubic ramus to the linea aspera of the femur

2. adducts, flexes, and medially rotates the femur

3. anterior division of the obturator nerve

4. obturator a., deep femoral a.

the most anterior of the adductor group of muscles

Front 91

adductor brevis m.

Back 91

1. from the inferior pubic ramus to the pectineal line and linea aspera (deep to the pectineus and adductor longus mm.)

2. adducts, flexes, and medially rotates the femur

3. anterior division of the obturator nerve

4. obturator a., deep femoral a.

anterior and posterior divisions of the obturator nerve lie on the anterior and posterior surfaces of adductor brevis

Front 92

adductor magnus m.

Back 92

1. from the ischiopubic ramus and ischial tuberosity to the linea aspera of the femur; the ischiocondylar part inserts on the adductor tubercle of the femur

2. adducts, flexes, and medially rotates the femur; extends the femur (ischiocondylar part)

3. posterior division of the obturator nerve; tibial nerve (ischiocondylar part)

4. obturator a., deep femoral a., medial femoral circumflex a.

the ischiocondylar part of adductor magnus is a hamstring muscle by embryonic origin and action, so it is innervated by the tibial nerve

Front 93

gracilis m.

Back 93

1. from the pubic symphysis and the inferior pubic ramus to the medial surface of the tibia (via pes anserinus)

2. adducts the thigh, flexes and medially rotates the thigh, flexes the leg

3. anterior division of the obturator nerve

4. obturator a.

the pes anserinus is the common insertion of the gracilis, sartorius, and semitendinosus mm.

Front 94

obturator externus m.

Back 94

1. from the external surface of the obturator membrane and the superior and inferior pubic rami to the trochanteric fossa of the femur

2. laterally rotates the thigh

3. obturator nerve

4. obturator a.

the tendon of the obturator externus m. passes inferior to the neck of the femur to reach its insertion site

Front 95

biceps femoris m.

Back 95

1. long head: ischial tuberosity; short head: lateral lip of the linea aspera to the head of fibula and lateral condyle of the tibia

2. extends the thigh, flexes the leg

3. long head: tibial nerve; short head: common fibular (peroneal) nerve

4. perforating branches of the deep femoral a.

one of the "hamstring" muscles

Front 96

semitendinosus m.

Back 96

1. from the lower, medial surface of ischial tuberosity (common tendon with biceps femoris m.) to the medial surface of tibia (via pes anserinus)

2. extends the thigh, flexes the leg

3. tibial nerve

4. perforating branches of the deep femoral a.

pes anserinus is the common insertion for the gracilis, sartorius, and semitendinosus mm.

Front 97

semimembranosus m.

Back 97

1. from the upper, outer surface of the ischial tuberosity to the medial condyle of the tibia

2. extends the thigh, flexes the leg

3. tibial nerve

4. perforating branches of the deep femoral a.

one of the "hamstring" muscles

Front 98

gastrocnemius m.

Back 98

1. from the femur; medial head: above the medial femoral condyle; lateral head: above the lateral femoral condyle to the dorsum of the calcaneus via the calcaneal (Achilles') tendon

2. flexes leg; plantar flexes foot

3. tibial nerve

4. sural aa. (from the popliteal a.), posterior tibial a.

the calcaneal tendon of the gastrocnemius and soleus is the thickest and strongest tendon in the body

Front 99

plantaris m.

Back 99

1. from above the lateral femoral condyle (above the lateral head of gastrocnemius) to the dorsum of the calcaneus medial to the calcaneal tendon

2. flexes the leg; plantar flexes the foot

3. tibial nerve

4. popliteal a.

plantaris has a long slender tendon that is equivalent to the tendon of the palmaris longus m. of the arm; its tendon is often called the "freshman nerve" because it is often misidentified by the freshman medical student

Front 100

popliteus m.

Back 100

1. from the lateral condyle of the femur to the posterior surface of the tibia above soleal line

2. flexes and rotates the leg medially (with the foot planted, it rotates the thigh laterally)

3. tibial nerve

4. popliteal a.

has a round tendon of origin; unlocks the knee joint to initiate flexion of the leg

Front 101

soleus m.

Back 101

1. from the posterior surface of head and upper shaft of the fibula, soleal line of the tibia to the dorsum of the calcaneus via the calcaneal (Achilles') tendon

2. plantar flexes the foot

3. tibial nerve

4. posterior tibial a.

soleus, gastrocnemius, and plantaris mm. are sometimes called the triceps surae muscle

Front 102

flexor digitorum longus m.

Back 102

1. from the middle half of the posterior surface of the tibia to the bases of the distal phalanges of digits 2-5

2. flexes the metatarsophalangeal, proximal interphalangeal and distal interphalangeal joints of digits 2-5; plantar flexes the foot

3. tibial nerve

4. tibial a.

equivalent to the flexor digitorum profundus m. of the arm

Front 103

flexor hallucis longus m.

Back 103

1. from the lower 2/3 of the posterior surface of the fibula to the base of the distal phalanx of the great toe

2. flexes the metatarsophalangeal and proximal interphalangeal joints of the great toe; plantar flexes the foot

3. tibial nerve

4. fibular (peroneal) a. and tibial a.

very important in the "push off" part of the normal gait

Front 104

tibialis posterior m.

Back 104

1. from the interosseous membrane, posteromedial surface of the fibula, posterolateral surface of the tibia to the tuberosity of the navicular and medial cuneiform, metatarsals 2-4

2. plantar flexes the foot; inverts the foot

3. tibial nerve

4.fibular (peroneal) a. and tibial a.

acts as both an antagonist (dorsiflexion/plantar flexion) and a synergist (inversion) of the tibialis anterior m.

Front 105

tibialis anterior m.

Back 105

1. from the lateral tibial condyle and the upper lateral surface of the tibia to the medial surface of the medial cuneiform and the 1st metatarsal

2. dorsiflexes and inverts the foot

3. deep fibular (peroneal) nerve

4. anterior tibial a.

acts as both an antagonist (dorsiflexion/plantar flexion) and a synergist (inversion) of the tibialis posterior m.

Front 106

extensor hallucis longus m.

Back 106

1. from the middle half of the anterior surface of the fibula and the interosseous membrane to the base of the distal phalanx of the great toe

2. extends the metatarsophalangeal interphalangeal joints of the great toe

3. deep fibular (peroneal) nerve

4. anterior tibial a.

one of the muscles involved in anterior compartment syndrome

Front 107

extensor digitorum longus m.

Back 107

1. from the lateral condyle of the tibia, anterior surface of the fibula, lateral portion of the interosseous membrane to the dorsum of the lateral 4 toes via extensor expansions (central slip inserts on base of middle phalanx, lateral slips on base of distal phalanx)

2. extends the metatarsophalangeal, proximal interphalangeal and distal interphalangeal joints of the lateral 4 toes

3. deep fibular (peroneal) nerve

4. anterior tibial a.

involved in anterior compartment syndrome

Front 108

fibularis (peroneus) tertius m.

Back 108

1. from the distal part of the anterior surface of the fibula to the dorsum of the shaft of the 5th metatarsal bone

2. everts the foot

3. deep fibular (peroneal) nerve

4. anterior tibial a.

in the anterior compartment of the leg, not the lateral compartment (which contains fibularis longus and brevis)

Front 109

fibularis (peroneus) longus m.

Back 109

1. from the upper two/thirds of the lateral surface of the fibula; after crossing the plantar surface of the foot deep to the intrinsic muscles, it inserts on the medial cuneiform and the base of the 1st metatarsal bone

2. extends (plantar flexes) and everts the foot

3. superficial fibular (peroneal) nerve

4. fibular (peroneal) a.

lies superficial to the fibularis brevis m. in the lateral compartment of the leg

Front 110

fibularis (peroneus) brevis m.

Back 110

1. from the lower one third of the lateral surface of the fibula to the tuberosity of the base of the 5th metatarsal

2. extends (plantar flexes) and everts the foot

3. superficial fibular (peroneal) nerve

4. fibular (peroneal) a.

stress fracture of the base of the 5th metatarsal bone is a common runner's injury

Front 111

extensor hallucis brevis m.

Back 111

1. from the superolateral surface of the calcaneus to the dorsum of base of proximal phalanx of the great toe

2. extends the great toe

3. deep fibular (peroneal) nerve

4. dorsalis pedis a.

usually considered to be the medial-most part of the extensor digitorum brevis m.

Front 112

extensor digitorum brevis m.

Back 112

1. from the superolateral surface of the calcaneus to the extensor expansion of toes 1-4

2. extends toes 1-4

3. deep fibular (peroneal) nerve

4. dorsalis pedis a.

the part of the extensor digitorum brevis that goes to the great toe is called the extensor hallucis brevis m.

Front 113

abductor hallucis m.

Back 113

1. from the medial side of the tuberosity of calcaneus to the medial side of the base of the proximal phalanx of the great toe (hallux)

2. abducts the great toe; flexes the metatarsophalageal joint

3. medial plantar nerve

3. medial plantar a.

forms the medial margin of the sole of the foot

Front 114

abductor digiti minimi m.

Back 114

1. from the medial and lateral sides of the tuberosity of the calcaneus to the lateral side of the base of the proximal phalanx of the 5th digit

2. abducts the 5th toe; flexes the metatarsophalageal joint

3. lateral plantar nerve

4. lateral plantar a.

forms the lateral margin of the sole of the foot

Front 115

flexor digitorum brevis m.

Back 115

1. from the tuberosity of the calcaneus, plantar aponeurosis, intermuscular septae to the base of the middle phalanx of digits 2-5 after splitting to allow passage of the flexor digitorum longus tendons

2. flexes the metatarsophalangeal & proximal interphalangeal joints of digits 2-5

3. medial plantar nerve

4. medial and lateral plantar aa.

equivalent to the flexor digitorum superficialis m. of the arm

Front 116

flexor hallucis brevis m.

Back 116

1. from the cuboid, lateral cuneiform, medial side of the first metatarsal to the: medial belly: medial side of proximal phalanx of the great toe; lateral belly: lateral side of the proximal phalanx of the great toe

2. flexes the metatarsophalangeal joint of the great toe

3. medial plantar nerve (lateral belly occasionally receives innervation from the lateral plantar nerve)

4. medial plantar a.

each tendon of insertion contains a sesamoid bone

Front 117

flexor digiti minimi brevis m.

Back 117

1. from the base of 5th metatarsal bone to the lateral side of base of proximal phalanx of 5th digit

2. flexes the metatarsophalangeal joint of the 5th digit

3. lateral plantar nerve

4. lateral plantar a.

Front 118

quadratus plantae m.

Back 118

1. from the anterior portion of the calcaneus and the long plantar ligament to the tendons of the flexor digitorum longus m.

2. assists the flexor digitorum longus in flexing the toes

3. lateral plantar nerve

4. lateral plantar a.

changes the line of force of the flexor digitorum longus m. to bring it in line with the long axis of the foot

Front 119

lumbrical mm.

Back 119

1. from the tendons of the flexor digitorum longus to the medial side of the extensor expansion of digits 2-5

2. flex the metatarsophalangeal joint, extend the proximal interphalangeal & distal interphalangeal joints of digits 2-5

3. medial (1st) lumbrical: medial plantar nerve; lateral three lumbricals: lateral plantar nerve

4. medial and lateral plantar aa.

have the same action on the toes that the lumbricals in the hand have on the fingers

Front 120

adductor hallucis m.

Back 120

1. oblique head: from the bases of metatarsals 2-4; transverse head: from the heads of metatarsals 3-5 to thelateral side of base of the proximal phalanx of the great toe

2. adducts the great toe (moves it toward midline of the foot; i.e.toward the 2nd digit)

3. deep branch of the lateral plantar nerve

4. plantar arterial arch

the plantar arterial arch passes superior to the oblique head of adductor hallucis

Front 121

plantar interosseous mm.

Back 121

1. from the base and medial side of metatarsals 3-5 to the bases of proximal phalanges and extensor expansions of digits 3-5

2. adduct digits 3-5 (move these digits toward the midline of the foot as defined by a plane through the second digit); flex the metacarpophalangeal and extend interphalangeal joints of digits 3-5

3. deep branch of the lateral plantar nerve

4. plantar metatarsal aa.

remember PAD (Plantar interossei ADduct) and DAB (Dorsal interossei ABduct), and logic will tell you where these muscles must insert

Front 122

dorsal interosseous mm.

Back 122

1. from the shafts of adjacent metatarsal bones to the bases of the proximal phalanges for digit 2 (both sides) & digits 3,4 (lateral side)

2. abduct digits 2-4 (move these digits away from midline as defined by a plane passing through the 2nd digit); flex the metatarsophalangeal joints and extend the interphalangeal joints of those digits

3. deep branch of the lateral plantar nerve

4. dorsal metatarsal aa.

four in number; remember DAB (Dorsal interossei ABduct) and PAD (Plantar interossei ADduct), then logic can tell you where these muscles insert

Front 123

lumbosacral trunk

Back 123

1. from part of the ventral primary ramus of L4 united with the ventral primary ramus of L5

2. no named branches; it contributes to the formation of the sacral plexus

3. motor to muscles of the hip and posterior thigh

4. sensory to sacral plexus

the lumbosacral trunk is not considered to be part of the lumbar plexus

Front 124

sacral plexus

Back 124

1. from the lumbosacral trunk (ventral primary rami of spinal nerves L4-L5), ventral primary rami of spinal nerves S1-S4

2. branches incl. superior & inferior gluteal nn., n. to obturator internus m., n. to quadratus femoris m., sciatic n., n. to piriformis, posterior femoral cutaneous n., pudendal n., n. to pelvic diaphragm, pelvic splanchnic nn.

3. motor to muscles of the pelvic diaphragm; muscles of the urogenital diaphragm; muscles of the posterior hip, posterior thigh, leg and foot

4. sensory to skin of the perineum, posterior thigh, leg and foot (excluding the medial side of the leg and foot)

the sacral plexus is often grouped with the lumbar plexus as the "lumbosacral plexus"

Front 125

femoral n.

Back 125

1. from the lumbar plexus (ventral primary rami of spinal nerves L2-L4)

2. branches incl. anterior femoral cutaneous brs., nn. to: sartorius m., rectus femoris m., vastus lateralis m., vastus intermedius m., vastus medialis m., pectineus m.

3. motor to sartorius, rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, pectineus

4. sensory to skin of anterior thigh

passes under inguinal ligament lateral to femoral a.

Front 126

lateral femoral cutaneous n.

Back 126

1. from lumbar plexus (ventral primary rami of spinal nerves L2-L3)

2. anterior & posterior brs.

3. sympathetic motor innervation to skin

4. sensory to skin of the lateral thigh

cutaneous nn. carry postganglionic sympathetic axons to skin

Front 127

obturator n.

Back 127

1. from the lumbar plexus (ventral primary rami of spinal nerves L2-L4)

2. branches incl. anterior and posterior brs.

3. motor to muscles of the medial thigh: adductor longus m., adductor brevis m. and adductor magnus m., gracilis m., obturator externus m.

4. sensory to skin of the lower medial thigh

passes through the obturator canal

Front 128

nerve to the obturator internus m.

Back 128

1. from the sacral plexus (ventral primary rami of spinal nerves L5-S2 )

2. branches incl. n. to the superior gemellus m.

3. motor to obturator internus m., superior gemellus m.

4. sensory none

crosses the ischial spine and enters the ischioanal fossa by passing through the lesser sciatic foramen

Front 129

pudendal n.

Back 129

1. from the ventral primary rami of spinal nerves S2-S4 (sacral plexus)

2. branches incl. inferior rectal n., perineal n., dorsal n. of the clitoris/penis

2. motor branches supply: external anal sphincter, bulbospongiosus m., ischiocavernosus m., superficial & deep transverse perineus mm., sphincter urethrae m., sphincter urethrovaginalis, compressor urethrae

4. sensory branches supply: skin of the anus, posterior scrotum/labium majus, clitoris/penis

passes through the pudendal canal formed by fascia on the medial surface of the obturator internus m.

Front 130

saphenous n.

Back 130

1. from the femoral n.

2. branches incl. infrapatellar br.

3. motor none

4. sensory to skin of the medial side of the leg and medial side of the foot

travels with the great saphenous v.; it does not pass through the adductor hiatus at the knee; it passes anterior to the medial malleolus at the ankle

Front 131

posterior femoral cutaneous n.

Back 131

1. from sacral plexus (ventral primary rami of spinal nerves S1-S3)

2. branches incl. inferior cluneal nn.; perineal br.

3. sympathetic motor innervation to skin

4. sensory to skin of the lower buttock & posterior thigh

carry postganglionic sympathetic axons to skin

Front 132

superior gluteal n.

Back 132

1. from sacral plexus (ventral primary rami of spinal nerves L4-L5, S1)

2. superior & inferior brs.

3. motor to gluteus medius m., gluteus minimus m., tensor fasciae latae m.

4. sensory none

passes through the greater sciatic foramen superior to the piriformis m.

Front 133

inferior gluteal n.

Back 133

1. from sacral plexus (ventral primary rami of spinal nerves L5, S1-S2)

2. no named branches

3. motor to gluteus maximus m.

4. sensory none

passes through the greater sciatic foramen inferior to the piriformis m.

Front 134

nerve to the quadratus femoris m.

Back 134

1. from sacral plexus (ventral primary rami of spinal nerves L4-L5, S1)

2. branches incl. n. to the inferior gemellus m.

3. motor to quadratus femoris m., inferior gemellus m.

4. sensory none

passes anterior to the obturator internus tendon

Front 135

sciatic n.

Back 135

1. from sacral plexus (ventral primary rami of spinal nerves L4-L5 and S1-S3)

2. branches incl. tibial n., common fibular (peroneal) n.

3. motor to semitendinosus m., semimembranosus m., biceps femoris m., ischioconylar part of the adductor magnus m.; its branches supply all muscles of the leg and foot

4. sensory branches supply the skin of the leg and foot (excluding the medial side of leg & foot)

composed of tibial and common fibular divisions; branches to muscles come from one of the two divisions, so that the sciatic n. is considered to have no direct muscular brs., only 2 terminal brs.

Front 136

tibial n.

Back 136

1. from sciatic n.

2. branches incl. medial sural cutaneous n., medial calcaneal brs., medial and lateral plantar nn.

3. motor to semimembranosus m., semitendinosus m., long head of biceps femoris m., ischiocondylar portion of adductor magnus m.; mm. of the superficial and deep posterior compartments of the leg (gastrocnemius m., soleus m., plantaris m., tibialis posterior m., flexor hallucis longus m., flexor digitorum longus m.); muscles of the plantar side of the foot

4. sensory to skin of the plantar surface of the foot and toes; skin of the dorsal surface of the distal toes (nail bed region)

the larger of the two divisions of the sciatic n.

Front 137

common fibular n.

Back 137

1. from sciatic n.

2. branches incl. lateral sural cutaneous n., superficial and deep fibular nn.

3.motor to superficial fibular n.: muscles of the lateral compartment of the leg (fibularis longus and brevis mm.); deep fibular n.: muscles of the anterior compartment of the leg (tibialis anterior m., extensor hallucis longus m., extensor digitorum longus m., fibularis tertius m.) and muscles of the dorsum of the foot (extensor digitorum brevis m.and extensor hallucis brevis m.)

4. sensory to superficial fibular n.: distal 1/3 of the anterior surface of the leg, dorsum of the foot excluding the web between the great toe and the 2nd toe and distal interphalangeal segments of all toes; deep fibular n.: skin of the web between the great toe and the 2nd toe

"peroneal" is old terminology which has been replaced by "fibular"

Front 138

sural n.

Back 138

1.formed by the union of the fibular communicating br. of the lateral sural cutaneous n. and the medial sural cutaneous nn.

2. branches incl. lateral calcaneal brs., lateral dorsal cutaneous n. of the foot

3. motor none

4. sensory to skin of the posterior surface of the lower leg; skin of the lateral side of the foot

courses posterior to the lateral malleolus at the ankle with the lesser saphenous v.

Front 139

deep fibular n.

Back 139

1. from common fibular n.

2. one proper digital br.

3. motor to muscles of the anterior compartment of the leg (tibialis anterior m., extensor hallucis longus m., extensor digitorum longus m., fibularis tertius m.) and muscles of the dorsum of the foot (extensor digitorum brevis m.and extensor hallucis brevis m.)

4. sensory to skin of the web between the great toe and the 2nd toe

"peroneal" is old terminology which has been replaced by "fibular";

Front 140

anterior compartment syndrome

Back 140

trauma to the anterior side of the leg can result in pressure buildup in the anterior compartment (from swelling or bleeding) that can damage the deep fibular n., resulting in "foot drop"

Front 141

superficial fibular n.

Back 141

1. from common fibular n.

2. branches incl. medial dorsal cutaneous n. to the medial side of the foot; dorsal digital nn. to the lateral 3 toes

3. motor to muscles of the lateral compartment of the leg (fibularis longus and brevis mm.)

4. sensory to distal 1/3 of the anterior surface of the leg; dorsum of the foot excluding the skin of the web between the great toe and the 2nd toe and the distal interphalangeal segments of all toes

"peroneal" is old terminology which has been replaced by "fibular"; the nail beds are supplied by nerves from the plantar surface of the foot

Front 142

medial plantar n.

Back 142

1. from the tibial n.

2. branches incl. plantar cutaneous brs.; proper plantar digital n. (medial side of the great toe); common plantar digital nn. (1st-3rd)

3. motor to abductor hallucis m., flexor hallucis brevis m., flexor digitorum brevis m., 1st lumbrical m.

4. sensory to skin of the medial side of the plantar surface of the foot; skin of the plantar surface of the medial 3 1/2 toes (and the nail bed of these toes) medial plantar n. accompanies the medial plantar a. though the sole of the foot

Front 143

lateral plantar n.

Back 143

1. from the tibial n.

2. superficial and deep branches

3. motor to quadratus plantae m., abductor digiti minimi m., flexor digiti minimi brevis m., lateral 3 lumbrical mm., adductor hallucis m., plantar & dorsal interosseous mm.

4. sensory to skin of the lateral side of the plantar surface of the foot; skin of the plantar surface of the lateral 1 1/2 toes (and the nail bed of these toes)

accompanies the lateral plantar a. though the sole of the foot

Front 144

proper plantar digital nn.

Back 144

1. from common plantar digital; medial plantar n. (to the medial side of the great toe); superficial br. of the lateral plantar n. (to the lateral side of the 5th toe)

2. no named branches

3. motor to flexor hallucis brevis m. (from the proper plantar digital n. on the medial side of the great toe) skin of the plantar surface of the toes and dorsal surface of the distal interphalangeal segment

the nail bed is supplied by the proper plantar digital nn.

Front 145

common plantar digital nn.

Back 145

1. from medial plantar n. (1st-3rd); superficial br. of the lateral plantar n. (4th)

2. branches incl. proper plantar digital nn.

3. motor to 1st lumbrical m.

4. sensory to skin of the plantar surface of the toes (except the medial side of the great toe and the lateral side of the 5th toe)

the dorsal surfaces of the distal tips of the toes (nail bed regions) are supplied by the proper plantar digital brs. of these nn.

Front 146

common iliac a.

Back 146

1. from the abdominal aorta

2. branches into external iliac a., internal iliac a.

3. supplies pelvis, lower limb

abdominal aorta bifurcates at the level of the L4 vertebral body to form the right and left common iliac aa.; the common iliac artery bifurcates anterior to the sacroiliac articulation into its terminal brs. (external iliac a. and internal iliac a.)

Front 147

external iliac a.

Back 147

1. from common iliac a.

2. branches incl. inferior epigastric a., deep circumflex iliac a., femoral a.

3. supplies lower limb

continuous with the femoral a., the name change occurs at the inguinal ligament; the common iliac artery bifurcates anterior to the sacroiliac articulation

Front 148

internal iliac a.

Back 148

1. from the common iliac a.

2. anterior division gives rise to the : umbilical a., obturator a., uterine a., vaginal a., inferior vesical a., middle rectal a., internal pudendal a., inferior gluteal a.; posterior division gives rise to the: iliolumbar a., lateral sacral a., superior gluteal a.

3. supplies pelvic viscera, gluteal region, hip, medial thigh

common iliac artery bifurcates anterior to the sacroiliac articulation to form the internal iliac a. and the external iliac a.

Front 149

umbilical a.

Back 149

1. from the internal iliac a., anterior division

2. branches incl. superior vesical aa., a. of the ductus deferens

3. supplies superior part of the bladder; ductus deferens

distal to the branches described at left, the lumen of the umbilical a. becomes obliterated after birth and the remnant of the vessel becomes the medial umbilical ligament

Front 150

uterine a.

Back 150

1.from the internal iliac a., anterior division

2. branches incl. tubal br., vaginal br.

3. supplies uterus, uterine tube

anastomoses with the ovarian a. and the vaginal a.; it passes superior to the ureter in the pelvis; remember the saying "water under the bridge"

Front 151

obturator a.

Back 151

1. from the internal iliac a., anterior division

2. branches incl. pubic br., acetabular br., anterior br., posterior br.

3. supplies medial thigh and hip

anterior and posterior brs. pass on the anterior and posterior sides of the adductor brevis m.; aberrant obturator a. arises from the inferior epigastric a. in 30% of cases

Front 152

vaginal a.

Back 152

1. from the internal iliac a., anterior division; occasionally it arises from uterine a.

2. numerous unnamed branches

3. supplies vagina

anastomoses with the uterine a.; participates in the formation of the azygos arteries along the lateral surface of the vagina

Front 153

inferior vesical a.

Back 153

1. from the internal iliac a., anterior division or it may arise from the middle rectal a.

2. no named branches

3. supplies lower part of the urinary bladder, prostate/vagina

anastomoses with the middle rectal a.

Front 154

middle rectal a.

Back 154

1. from the internal iliac, anterior division

2. no named branches

3. supplies middle portion of the rectum

anastomoses with the inferior rectal a and the superior rectal a.

Front 155

internal pudendal a.

Back 155

1. from the internal iliac a., anterior division

2. branches incl. inferior rectal a., perineal a., artery of the bulb of the clitoris/penis, urethral a., deep clitoral/penile a., dorsal clitoral/penile a.

3. supplies anus, muscles of the superficial and deep perineal spaces, clitoris/penis, posterior aspect of the scrotum/labium majus

the primary blood supply to the perineum

Front 156

inferior gluteal a.

Back 156

1. from the internal iliac a., anterior division

2. unnamed muscular branches

3. supplies gluteus maximus m., hip joint

participates in the formation of the cruciate anastomoses of the hip

Front 157

iliolumbar a.

Back 157

1. from the internal iliac a., posterior division

2. branches incl. iliac br., lumbar br.

3. supplies iliacus m., psoas major m., quadratus lumborum m.

lumbar br. of the iliolumbar a. sends a small spinal br. into the vertebral canal

Front 158

lateral sacral a.

Back 158

1. from the internal iliac a., posterior division

2. branches incl. spinal brs.

3. supplies sacrum, sacral nerve rootlets, meninges, adjacent muscles

there are usually 2 lateral sacral aa. on each side, a superior one and an inferior one

Front 159

superior gluteal a.

Back 159

1. from the internal iliac, posterior division

2. branches incl. superficial br., deep br.

3. supplies gluteus maximus m., gluteus medius m., gluteus minimus m., hip joint

participates in the formation of the cruciate anastomoses of the hip

Front 160

femoral a.

Back 160

1. from the external iliac a.

2. branches incl. superficial epigastric a., superficial circumflex iliac a., superficial external pudendal a., deep external pudendal a., deep femoral a., descending genicular a., popliteal a.

3. supplies thigh, leg and foot

continuous with the popliteal a., the name change occurs at the adductor hiatus

Front 161

deep femoral a.

Back 161

1. from the femoral a.

2. branches incl. medial circumflex femoral a., lateral circumflex femoral a., perforating aa. (3 or 4)

3. supplies hip joint, proximal thigh, posterior thigh

the primary blood supply to muscles of the posterior compartment of the thigh

Front 162

lateral femoral circumflex a.

Back 162

1. from the deep femoral a.

2. branches incl. ascending br., transverse br., descending br.

3. supplies lateral thigh and hip

arises from the femoral a. in ~14% of cases

Front 163

medial femoral circumflex a.

Back 163

1. from the deep femoral a.

2. branches incl. ascending br., descending br.

3. supplies medial thigh and hip

arises from the femoral a. in ~20% of cases

Front 164

popliteal a.

Back 164

1. from the femoral a.

2. branches incl. anterior tibial a., posterior tibial a., 5 genicular brs.

3. supplies knee, leg and foot

the continuation of the femoral a., the name change occurs at the adductor hiatus

Front 165

superior medial genicular a.

Back 165

1. from the popliteal a.

2. no named branches

3. supplies medial aspect of knee

anastomoses with the other genicular brs. of the popliteal a., circumflex fibular a. and anterior tibial recurrent a. to form the genicular anastomosis

Front 166

superior lateral genicular a.

Back 166

1. from the popliteal a.

2. no named branches

3. supplies lateral aspect of knee

anastomoses with the other genicular brs. of the popliteal a., circumflex fibular a. and anterior tibial recurrent a. to form the genicular anastomosis

Front 167

middle genicular a.

Back 167

1. from the popliteal a.

2. no named branches

3. supplies cruciate ligaments and deep structures of the knee

anastomoses with the other genicular brs. of the popliteal a., circumflex fibular a. and anterior tibial recurrent a. to form the genicular anastomosis

Front 168

inferior medial genicular a.

Back 168

1. from the popliteal a.

2. no named branches

3. supplies medial aspect of the knee

anastomoses with the other genicular brs. of the popliteal a., circumflex fibular a. and anterior tibial recurrent a. to form the genicular anastomosis

Front 169

inferior lateral genicular a.

Back 169

1. from the popliteal a.

2. no named branches

3. supplies lateral aspect of the knee

anastomoses with the other genicular brs. of the popliteal a., circumflex fibular a. and anterior tibial recurrent a. to form the genicular anastomosis

Front 170

anterior tibial a.

Back 170

1. from the popliteal a.

2. branches incl. anterior tibial recurrent a., posterior tibial recurrent a., anterior malleolar a., medial malleolar a., lateral malleolar a., dorsalis pedis a.

3. supplies anterior leg; dorsum of foot and deep foot

becomes continuous with the dorsalis pedis a.; the name change occurs at the level of the ankle joint

Front 171

posterior tibial a.

Back 171

1. from the popliteal a.

2. branches incl. fibular a. (peroneal), circumflex fibular a., nutrient a. of the tibia, communicating br., posterior medial malleolar brs., medial calcaneal brs., lateral plantar a., medial plantar a.

3. supplies posterior and lateral leg, plantar aspect of the foot

the direct continuation of the popliteal a. the name change occurs at the inferior border of the popliteus m. where the popliteal a. bifurcates; the tibial a. bifurcates on the medial side of the foot to give rise to the medial plantar a. and lateral plantar a.

Front 172

fibular a.

Back 172

1. from the posterior tibial a.

2. branches incl. nutrient br., lateral malleolar a., communicating br., perforating br.

3. supplies muscles and fascia of the lateral leg ankle

anastomoses at the ankle with the anterior and posterior tibial aa.; also known as: peroneal a.

Front 173

dorsalis pedis a.

Back 173

1. from the anterior tibial a.

2. branches incl. lateral tarsal a., medial tarsal a., arcuate a., 1st dorsal metatarsal a., deep plantar a.

3. supplies dorsal aspect of the foot;

anastomoses with the plantar arterial arch; the anterior tibial artery continues as the dorsalis pedis - the name change occurs at the level of the ankle

Front 174

deep plantar a.

Back 174

1. from the dorsalis pedis

2. branches incl. plantar metatarsal aa. (4)

3. supplies deep foot; its plantar metatarsal brs. and their brs. supply the toes, including the dorsum of the distal phalangeal segment

anastomoses with lateral plantar a. to form the plantar arterial arch; the branches mentioned at left arise from the plantar arterial arch

Front 175

lateral plantar a.

Back 175

1. from the posterior tibial a.

2. branches incl. proper plantar digital a. to lateral side of 5th digit

3. supplies deep foot; the plantar arterial arch and its brs. supply the toes, including the distal phalangeal segment dorsally

becomes continuous with the plantar arterial arch

Front 176

medial plantar a.

Back 176

1. from the posterior tibial a.

2. branches incl. digital brs. (3)

3. supplies medial side of the sole of the foot

anastomoses with the plantar metatarsal aa., but does not usually participate in formation of the plantar arterial arch

Front 177

plantar arterial arch

Back 177

1. from the lateral plantar a.

2. branches incl. plantar metatarsal aa. (4)

3. supplies deep foot; its plantar metatarsal brs. and their brs. supply the toes, including the dorsum of the distal phalangeal segment

anastomoses with the deep plantar br. of the dorsalis pedis a.

Front 178

arcuate a.

Back 178

1. from the dorsalis pedis a.

2. branches incl. dorsal metatarsal aa. (3)

3. supllies dorsum of the foot, excluding the pollex and the distal phalangeal segments of the digits

anastomoses with the lateral tarsal a.

Front 179

greater saphenous v.

Back 179

1. tributaries incl. medial end of dorsal venous arch of foot, perforating communications with deep veins, superficial epigastric v., superficial circumflex iliac v., superficial external pudendal v.

2. drains into femoral v.

3. drains the skin and superficial fascia of the medial side of the foot and leg; skin and superficial fascia of most of the thigh; lower abdominal wall; perineal region

frequently used as graft material in coronary bypass surgery

Front 180

lesser saphenous v.

Back 180

1. tributaries incl. lateral end of the dorsal venous arch of foot

2. drains into the popliteal v.

3. drains the skin and superficial fascia of the lateral side of the foot and leg

passes deeply into the popliteal fossa

Front 181

dorsal venous arch of the foot

Back 181

1. tributaries incl. dorsal digital vv. and dorsal metatarsal vv.

2. drains into great saphenous v. medially, small saphenous v. laterally

3. drains the dorsum of the digits and the superficial structures of the dorsum of the foot

visible through the thin skin on the dorsum of the foot

Front 182

dorsal metatarsal v. of the foot

Back 182

1. tributaries incl. dorsal digital vv.

2. drains into dorsal venous arch of the foot

3. drains the dorsal aspects of the digits of the foot

drains the adjacent sides of two digits

Front 183

sacrospinous ligament

Back 183

syndesmosis

connects ischial spine to lateral surface of sacrum & coccyx

together with sacrotuberous ligament, converts greater & lesser ischiadic (sciatic) notches into greater & lesser ischiadic (sciatic) foramina

Front 184

sacrotuberous ligament

Back 184

syndesmosis

connects ischial tuberosity to lateral surface of sacrum & coccyx

together with sacrospinous ligament, converts greater & lesser ischiadic (sciatic) notches into greater & lesser ischiadic (sciatic) foramina

Front 185

acetabulum

Back 185

a cup-shaped depression in the lateral surface of the os coxae bone

acetabulum means vinegar cup; it is the socket for the head of the femur; it is formed by the: ilium (1/5), ischium (2/5) and pubis (2/5); the acetabular fossa lies in the floor of the acetabulum

Front 186

acetabular notch

Back 186

a notch in the inferior margin of the acetabulum

it is spanned by the transverse acetabular ligament; the acetabular br. of the obturator a. enters the hip joint by passing through the acetabular notch

Front 187

acetabular labrum

Back 187

fibrocartilage

fibrocartilage forming rim of acetabulum; deepens the acetabulum

Front 188

transverse acetabular ligament

Back 188

fibrocartilage

bridges the acetabular notch; forms a bridge over the artery in the ligament of the femoral head (ligamentum capitis femoris)

Front 189

ligament of the femoral head

Back 189

fibrocartilage

intracapsular ligament connecting transverse acetabular ligament with fovea capitis femoris; also known as: ligamentum capitis femoris

Front 190

pubofemoral ligament

Back 190

fibrocartilage

capsular ligament of hip joint connecting superior pubic ramus to medial surface of femoral neck

Front 191

iliofemoral ligament

Back 191

fibrocartilage

capsular ligament of the hip joint connecting anterior inferior iliac spine to intertrochanteric line

Front 192

ischiofemoral ligament

Back 192

fibrocartilage

capsular ligament of the hip joint connecting body of ischium to posterior femoral neck

Front 193

patellar ligament

Back 193

tendon

connects quadriceps femoris muscle group to the tibial tuberosity; patella is a sesamoid bone within the quadriceps tendon

Front 194

knee joint

Back 194

synovial

femoral condyles articulate with tibial condyles

reinforced by intracapsular ligaments (anterior cruciate & posterior cruciate), a capsular ligament (tibial collateral ligament), and an extracapsular ligament (fibular collateral ligament)

contains medial & lateral menisci

Front 195

tibial collateral ligament

Back 195

capsular ligament of the knee joint connecting medial epicondyle of femur with medial surface of medial tibial condyle

its attachment to the medial meniscus is clinically relevant

Front 196

fibular collateral ligament

Back 196

tendon

extracapsular ligament, not part of the fibrous capsule of the knee; connects lateral epicondyle of femur with fibular head

Front 197

anterior cruciate ligament

Back 197

tendon

intracapsular ligament connecting anterior aspect of intercondylar eminence of tibia with medial surface of lateral femoral condyle

Front 198

posterior cruciate ligament

Back 198

tendon

intracapsular ligament connecting posterior aspect of intercondylar eminence of tibia with lateral surface of medial femoral condyle

Front 199

medial meniscus

Back 199

fibrocartilage

intra-articular disc within knee joint between medial femoral condyle & medial tibial condyle

attached to tibial collateral ligament, coronary ligament, & intercondylar eminence

Front 200

lateral meniscus

Back 200

fibrocartilage

intra-articular disc within knee joint between lateral femoral condyle & lateral tibial condyle

attached to coronary ligament & intercondylar eminence

Front 201

anterior tibiofibular ligament

Back 201

synovial, hinge

connects distal ends of tibia & fibula anteriorly

Front 202

posterior tibiofibular ligament

Back 202

synovial, hinge

connects distal ends of tibia & fibula posteriorly

Front 203

interosseous membrane of leg

Back 203

syndesmosis

connects shafts of tibia & fibula

Front 204

interosseous ligaments of foot

Back 204

syndesmosis

intracapsular ligaments connecting adjacent tarsal bones

Front 205

ankle joint

Back 205

synovial, hinge

articulation between distal end of tibia, medial malleolus, lateral malleolus and talus

reinforced by deltoid ligament (anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar), anterior talofibular, calcaneofibular & posterior talofibular ligament

Front 206

calcaneofibular ligament

Back 206

synovial, hinge

connects lateral malleolus with calcaneus

Front 207

plantar calcaneocuboid ligament

Back 207

syndesmosis

connects calcaneus & cuboid inferiorly

Front 208

long plantar ligament

Back 208

syndesmosis

connects calcaneus with cuboid & bases of lateral 3 metatarsals

Front 209

plantar calcaneonavicular ligament

Back 209

syndesmosis

connects sustentaculum tali with inferior surface of navicular

also known as: spring ligament

Front 210

deltoid ligament

Back 210

synovial, hinge

connects medial malleolus with talus, navicular & calcaneus

its four parts arranged from anterior to posterior: anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar

also known as: medial ligament of ankle

Front 211

anterior tibiotalar ligament

Back 211

synovial, hinge

part of deltoid ligament connecting medial malleolus with talus

Front 212

posterior tibiotalar ligament

Back 212

synovial, hinge

part of deltoid ligament connecting medial malleolus with talus posteriorly

Front 213

tibiocalcaneal ligament

Back 213

synovial, hinge

part of deltoid ligament connecting medial malleolus with sustentaculum tali

Front 214

tibionavicular ligament

Back 214

synovial, hinge

part of deltoid ligament connecting medial malleolus with navicular

Front 215

tarsometatarsal joints

Back 215

synovial

reinforced by dorsal & plantar ligaments

Front 216

metatarsophalangeal joints

Back 216

synovial

(5) chondyloid joint connecting head of metatarsal with proximal phalanx

reinforced by collateral ligaments

Front 217

longitudinal arch of the foot

Back 217

combination of synovial joints & syndesmoses

passes from calcaneus to talus to navicular to cuneiforms to metatarsals; supported by plantar calcaneonavicular ligament & many other ligaments

supported by tendons of tibialis anterior & tibialis posterior mm.

Front 218

transverse arch of the foot

Back 218

combination of synovial joints & syndesmoses

passes through distal row of tarsal bones

supported by shape of bones and many ligaments

supported by tendons of fibularis longus & tibialis anterior & tibialis posterior mm.

Front 219

obturator fascia

Back 219

fascia covering the obturator internus m.

attaches to the margin of the obturator foramen; it has a thickening (arcus tendineus m. levatoris ani) that is the origin of the iliococcygeus portion of the pelvic diaphragm

Front 220

fascia lata

Back 220

deep fascia forming a tubular investment of the thigh

thickened along the lateral intermuscular septum of the thigh where it is called the iliotibial tract/band

connected to the femur by the lateral and medial intermuscular septa; scarpa's fascia attaches to fascia lata below the inguinal ligament

Front 221

femoral ring

Back 221

opening into the femoral canal

its boundaries are: medial - lacunar ligament, lateral - fascia on the femoral vein, anterior - inguinal ligament, posterior - fascia on the pectineus m.

if a femoral hernia develops, the herniated gut passes through the femoral ring

Front 222

femoral canal

Back 222

a short diverticulum within the femoral sheath that extends distal to the inguinal ligament on the medial side of the femoral vessels

boundaries are: medial - lacunar ligament; lateral - fascia on the femoral vein; anterior - inguinal ligament; posterior - fascia on the pectineus m.

the medial compartment of the femoral sheath; it opens into the abdominal cavity superiorly at the femoral ring

may be the site of a femoral hernia; usually contains a deep inguinal lymph node (gland of Cloquet)

Front 223

adductor canal

Back 223

a musculo-fascial canal that contains the large neurovascular bundle of the anterior thigh

boundaries are: anterior - sartorius m.; lateral - vastus medialis m.; posterior - adductor longus m. and adductor magnus m.

begins proximally at the inferior angle of the femoral triangle and ends distally at the adductor hiatus

contains the femoral a. and v., the saphenous n. and the nerve to the vastus medialis m.

also known as: Hunter's canal, subsartorial canal

Front 224

adductor hiatus

Back 224

an opening in the tendon of insertion of the adductor magnus m.

boundaries are: medial - portion of the tendon of adductor magnus that attaches to the adductor tubercle, lateral - insertion of the adductor magnus into the linea aspera, inferior - femur

femoral a. and v. pass through the adductor hiatus to reach the posterior surface of the knee, where their name changes to popliteal a. and v.

Front 225

popliteal fossa

Back 225

the shallow depression on the posterior surface of the knee

boundaries are: superomedial - tendons of semimembranosus and semitendinosus mm., superolateral - tendon of biceps femoris m., inferior - medial and lateral heads of the gastrocnemius m.

contains: popliteal a. and v. and their branches; tibial n, common fibular n., popliteus m.

Front 226

Iliotibial tract (band)

Back 226

thickened strip of fascia lata, from iliac tubercle to the anterolateral tubercle of the tibia (Gerdy’s tubercle).

Forms conjoined tendon of tensor fascia latae and gluteus maximus mm.

Front 227

Superficial lymphatic vessels

Back 227

accompany saphenous veins to superficial inguinal lymph nodes and popliteal lymph nodes.

Front 228

Deep lymphatic vessels

Back 228

accompany deep veins to deep inguinal lymph nodes.

Front 229

Superficial inguinal lymph nodes

Back 229

drain to external iliac lymph nodes or deep inguinal lymph nodes.

Front 230

Deep inguinal lymph nodes

Back 230

drain to external iliac lymph nodes.

Front 231

Sacral Plexus Branches

Back 231

Lumbosacral trunk (L4,L5)
Superior gluteal n. (L4,L5,S1)
Inferior gluteal n. (L5,S1,S2)
N. to piriformis (S1,S2)
Sciatic n. (L4,L5,S1,S2,S3)
N. to quadratus femoris (L4,L5,S1)
N. to obturator internus (L5,S1,S2)
Post. femoral cut. n. (S2,S3)
Pudendal n. (S2,S3,S4)

Front 232

Trochanteric bursa

Back 232

Between gluteus maximus and greater trochanter

Front 233

Ischial bursa

Back 233

Between gluteus maximus and ischial tuberosity

Front 234

Gluteofemoral bursa

Back 234

Between iliotibial tract and vastus lateralis

Front 235

Thru the lesser sciatic foramen:

Back 235

Obturator internus tendon
N. to obturator internus (L5,S1,2)
Pudendal n. (S2-4)
Internal pudendal a./v.

Front 236

Thru the greater sciatic foramen:

Back 236

Above piriformis m.:
Superior gluteal a./v.
Superior gluteal n. (L4,5,S1)

Below piriformis m.:
Inferior gluteal a./v.
Inferior gluteal n. (L5,S1,2)
N. to quadratus femoris (L4,5,S1)
Sciatic n. (L4,5,S1-3)
Posterior femoral cut. n. (S1-3)
N. to obturator internus (L5,S1,2)
Pudendal n. (S2-4)
Internal pudendal a./v.

Front 237

Piriformis syndrome

Back 237

occurs when the sciatic nerve is compressed or irritated by the piriformis muscle causing pain, tingling, and numbness in the buttocks, posterior thigh, and leg.

May be due to anatomical variations in the muscle-nerve relationship, or from overuse or strain.

Front 238

Innervation of the Hip Joint

Back 238

Superior gluteal n. (L4,5,S1)- To superior of hip joint

Obturator n. (L2,3,4)- To inferior of hip joint

Femoral n. (L2,3,4)- To anterior of hip joint

N. to quadratus femoris (L5,S1)-To posterior of hip joint

Front 239

Flexion/Extension at the Hip Joint

Back 239

Flexion: Iliopsoas m.

Extension: Hamstring mm.; gluteus maximus m.

Front 240

Abduction/Adduction at the Hip Joint

Back 240

Abduction: Gluteus medius & minimus mm.

Adduction: Adductor longus, brevis, & magnus; gracilis; pectineus mm.

Front 241

Rotation at the Hip Joint

Back 241

Medial (internal) rotation: Gluteus medius & minimus mm.

Lateral (external) rotation: Piriformis, sup. & inf. gemelli, quadratus femoris, obutrator internus & externus mm.

Front 242

Tibialis Anterior Tendon

Back 242

begins halfway down the leg and descends along the anterior surface of the tibia.

passes within its own synovial sheath deep to the superior and inferior extensor retinacula to its attachment on the medial side of the foot.

located farthest from the axis of the ankle joint, giving it the most mechanical advantage and making it the strongest dorsiflexor.

Front 243

extensor digitorum longus tendon

Back 243

four tendons that become tendinous superior to the ankle and attach to the phalanges of the lateral four toes.

surrounded by a common synovial sheath as they diverge on the dorsum of the foot and pass to their distal attachments

Each forms a membranous extensor expansion (dorsal aponeurosis) over the dorsum of the proximal phalanx of the toe, which divides into two lateral bands and one central band

The central band inserts into the base of the middle phalanx, and the lateral slips converge to insert into the base of the distal phalanx.

Front 244

superior extensor retinaculum

Back 244

a strong, broad band of deep fascia, passing from the fibula to the tibia, proximal to the malleoli.

Front 245

inferior extensor retinaculum

Back 245

a Y-shaped band of deep fascia that attaches laterally to the anterosuperior surface of the calcaneus.

forms a strong loop around the tendons of the fibularis tertius and the extensor digitorum longus muscles.

Front 246

calcaneal tendon

Back 246

most powerful (thickest and strongest) tendon in the body

a continuation of the flat aponeurosis formed halfway down the calf where the bellies of the gastrocnemius terminate

becomes thicker (deeper) but narrower as it descends until it becomes essentially round in cross-section superior to the calcaneus

typically spirals a quarter turn (90°) during its descent, so that the gastrocnemius fibers attach laterally and the soleal fibers attach medially; significant to the ability to absorb energy (shock) and recoil

Front 247

Flexor Hallucis Longus Tendon

Back 247

passes posterior to the distal end of the tibia and occupies a shallow groove on the posterior surface of the talus, which is continuous with the groove on the plantar surface of the sustentaculum tali

then crosses deep to the tendon of the flexor digitorum longus in the sole of the foot

runs between two sesamoid bones in the tendons of the flexor hallucis brevis, which protect from the pressure of the head of the 1st metatarsal bone.

Front 248

plantar aponeurosis

Back 248

arises posteriorly from the calcaneus and functions like a superficial ligament.

divide into five bands that become continuous with the fibrous digital sheaths that enclose the flexor tendons that pass to the toes.

reinforced by transverse fibers at the anterior end of the sole, inferior to the heads of the metatarsals forming the superficial transverse metatarsal ligament

Front 249

extensor expansion

Back 249

(dorsal aponeurosis) formed by each EDL tendon over the dorsum of the proximal phalanx of the toe, which divides into two lateral bands and one central band

The central band inserts into the base of the middle phalanx, and the lateral slips converge to insert into the base of the distal phalanx.

Front 250

superior fibular retinaculum

Back 250

spans between the distal tip of the fibula and the calcaneus where the lateral compartment of the leg ends inferiorly

where the tendons of the two muscles of the lateral compartment (fibularis longus and brevis) enter a common synovial sheath

Front 251

inferior fibular retinaculum

Back 251

Distal to the superior fibular retinaculum, where the common sheath shared by the fibular muscles splits to extend through separate compartments

Front 252

flexor retinaculum

Back 252

formed when the transverse intermuscular septum ends as reinforcing transverse fibers that extend between the tip of the medial malleolus and the calcaneus

subdivided deeply, forming separate compartments for each tendon of the deep muscle group, as well as for the tibial nerve and posterior tibial artery as they bend around the medial malleolus.