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Muscles of lower limb<br />
innervation, blood supply<br />
Miloš Grim<br />
Winter semester 2012/2013<br />
Institute of Anatomy,<br />
First Faculty of Medicine,<br />
Charles University in Prague
Muscles and fasciae of lower limb<br />
- musculi membri inferioris<br />
1. Muscles of the iliac and gluteal region – mm. coxae<br />
2. Muscles of the thigh – mm. femoris<br />
anterior, medial, posterior group<br />
3. Muscles of the leg – mm. cruris<br />
anterior, lateral, posterior (calf) group<br />
4. Muscles of the foot – mm. pedis<br />
dorsal, plantar<br />
5. Synovial sheaths in the ankle region<br />
6. Fascie of the lower limb
Lumbar plexus T12, L1 – 4<br />
(in psoas major )<br />
iliohypogastric nerve<br />
ilioinguinal nerve<br />
genitofemoral nerve<br />
lateral femoral cutaneous nerve<br />
obturatory nerve L2 - 4<br />
femoral nerve L1 –4<br />
Sacral plexus L4, S1-5, Co<br />
(on piriformis muscle)<br />
superior gluteal nerve<br />
inferior gluteal nerve<br />
posterior femoral cutaneous nerve<br />
pudendal nerve<br />
sciatic nerve L4 – S3<br />
tibial nerve,<br />
common peroneal nerve
Lumbar plexus T12, L1 – 4<br />
(in psoas major )<br />
iliohypogastric nerve<br />
ilioinguinal nerve<br />
genitofemoral nerve<br />
lateral femoral cutaneous nerve<br />
obturatory nerve L2 - 4<br />
femoral nerve L1 –4<br />
Sacral plexus L4, S1-5, Co<br />
(on piriformis muscle)<br />
superior gluteal nerve<br />
inferior gluteal nerve<br />
posterior femoral cutaneous<br />
nerve<br />
pudendal nerve<br />
sciatic nerve L4 – S3<br />
tibial nerve,<br />
common peroneal nerve
vascular lacuna<br />
muscular lacuna<br />
obturator canal
infrapiriform foramen<br />
suprapiriform foramen
Development of segmental pattern of limb innervation
Femoral artery<br />
deep artery of thigh<br />
popliteal artery<br />
anterior tibial artery<br />
dorsal artery of foot<br />
posterior tibial artery<br />
Peroneal artery<br />
medial plantar artery<br />
lateral plantar artery
Aortic bifurcation<br />
Common iliac artery<br />
External iliac artery<br />
Internal iliac artery<br />
Internal pudendal artery
External iliac artery<br />
artery: inferior epigastric artery, deep circumflex<br />
iliac artery<br />
Femoral artery: deep artery of thigh, medial and lateral circumflex<br />
arteries, perforating arteries
Superficial veins of lower limb<br />
Great saphenous veins,<br />
Small saphenous vein<br />
Deep veins of lower limb<br />
Femoral vein<br />
Popliteal vein
Details of superficial veins<br />
Great saphenous vein<br />
External pudendal veins<br />
Superficial epigastric vein<br />
Superficial circumflex iliac vein<br />
Accessory saphenous vein<br />
Great saphenous vein<br />
Dorsal venous<br />
network of foot
Fascia lata<br />
Saphenous opening<br />
Iliotibial tract<br />
Popliteal fascia<br />
Crural fascia<br />
Great saphenous vein:<br />
External pudendal veins,<br />
Superficial epigastric vein,<br />
Femoropopliteal vein
Muscles of the iliac region<br />
three muscles that originate from the lumbar vertebral column<br />
(psoas<br />
major and minor) and the iliac bone (iliacus(<br />
iliacus)<br />
iliopectineal arch, inguinal lig.<br />
muscular space (containing<br />
psoas major, iliacus and the femoral nerve,<br />
vascular space(transmitting<br />
the femoral vessels)
Muscles of the gluteal region<br />
The glutei:<br />
maximus, medius and minimus (extensors+abductors<br />
at the hip)<br />
more deeply: lateral rotators of the hip joint:<br />
piriformis, obturator internus, the superior and inferior gemelli,<br />
and quadratus femoris
Muscles of the gluteal region<br />
The glutei: maximus, medius and minimus<br />
(extensors+abductors<br />
at the hip)<br />
more deeply: lateral rotators of the hip joint:<br />
piriformis, obturator internus, the superior and inferior gemelli,<br />
and quadratus femoris
Muscles of the Thigh
Muscles of the<br />
Thigh<br />
Anterior group<br />
Posterior group<br />
Medial group<br />
(<strong>adductors</strong>)<br />
Fascia lata<br />
Iliotibial tract<br />
Lateral + medial<br />
femoral<br />
intermuscular<br />
septum<br />
Fossa iliopectinea<br />
Femoral canal
Muscles of the Thigh - Anterior Group<br />
Tensor of fascia lata,<br />
Sartorius,<br />
Quadriceps femoris:<br />
rectus femoris,<br />
(act<br />
at both hip<br />
and knee joints)<br />
vastus medialis,<br />
lateralis,<br />
and intermedius,<br />
which act<br />
only at the knee<br />
Femoral trigon<br />
Adductor canal<br />
Femoral vessels<br />
Femoral nerve
Muscles of the Thigh<br />
Posterior Group<br />
(„hamstrings“)<br />
biceps femoris,<br />
semitendinosus,<br />
semimembranosus,<br />
cross both hip and knee<br />
joints, integrating extension<br />
at the hip with flexion at the<br />
knee<br />
form the proximal lateral and<br />
proximal medial margins of<br />
the popliteal fossa
Posterior Group<br />
(„hamstrings“)<br />
biceps femoris,<br />
semitendinosus,<br />
semimembranosus<br />
,<br />
Adductor canal<br />
Perforating arteries
Muscles of the<br />
Thigh<br />
Medial Group<br />
gracilis,<br />
pectineus,<br />
adductor longus,<br />
adductor brevis,<br />
adductor magnus<br />
obturator externus
Anterior and medial group
Femoral<br />
Femoral<br />
artery<br />
artery, vein<br />
vein,<br />
Femoral<br />
Femoral<br />
nerve:<br />
nerve:<br />
saphenous<br />
saphenous n.<br />
n.<br />
muscular<br />
muscular<br />
branches<br />
branches<br />
Iliopectineal<br />
Iliopectineal<br />
fossa<br />
fossa,<br />
Femoral<br />
Femoral<br />
trigon<br />
trigon,<br />
Adductor<br />
Adductor<br />
Hiatus<br />
Hiatus<br />
Vastoadductor<br />
Vastoadductor<br />
lamina<br />
lamina<br />
Adductor<br />
Adductor hiatus<br />
hiatus<br />
Infrapiriform<br />
Infrapiriform<br />
foramen<br />
foramen<br />
Suprapiriform<br />
Suprapiriform<br />
foramen<br />
foramen,<br />
Popliteal<br />
Popliteal<br />
fossa<br />
fossa<br />
Ischiadic<br />
Ischiadic<br />
nerve:<br />
nerve:<br />
Tibial<br />
Tibial nerve,<br />
nerve,<br />
Common<br />
Common<br />
peroneal<br />
peroneal<br />
nerve,<br />
nerve,<br />
Perforating<br />
Perforating<br />
arteries<br />
arteries
Popliteal fossa
Popliteal fossa
etinaculum<br />
mm. ext.<br />
sup.,inf.<br />
vaginae<br />
tendinum<br />
tarsales ant.<br />
a. tibialis ant.<br />
n. tibialis<br />
n. peroneus<br />
prof.
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