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Lower Limb. What is a limb? Skeleton Joints Pelvis or limb girdle Hip/Hip Muscles Lumber and sacral plexus—getting spinal nerves out onto limb Muscles—anterior and posterior compartments Surface anatomy. Skeleton (homologous with upper limb) Muscles--anterior, posterior compartments

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Lower Limb


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lower limb
Lower Limb
  • What is a limb?
  • Skeleton
  • Joints
  • Pelvis or limb girdle
  • Hip/Hip Muscles
  • Lumber and sacral plexus—getting spinal nerves out onto limb
  • Muscles—anterior and posterior compartments
  • Surface anatomy
  • Skeleton (homologous with upper limb)
  • Muscles--anterior, posterior compartments
  • Nerves--sciatic, femoral
  • Surface anatomy
what is a limb
What is a limb?
  • Ventral somatic outgrowth of outer tube
    • Bones (made of bony tissue, cartilage, and other tissues)
    • Joints
    • Muscles
    • Nerves (with motor neurons to muscles, sensory neurons to skin, proprioceptors)
  • No viscera--all innervation is somatic (motor or sensory) from ventral ramus of spinal nerve (except autonomics to blood vessels)
slide3

Upper Limb

Lower Limb

  • Scapula
  • Humerus
  • Radius, ulna
  • Carpals
  • Digits
    • Metacarpals
    • Phalanges
  • Pelvis
  • Femur
  • Tibia, fibula
  • Tarsals
  • Digits
    • Metatarsals
    • Phalanges
slide4

Upper Limb

  • Scapula
  • Humerus
  • Radius, ulna
  • Carpals
  • Digits
    • Metacarpals
    • Phalanges
tibia fibula
Tibia/fibula
  • Tibia--big toe side
  • Fibula--little toe side

(no pronation/supination)

ankle
Ankle
  • Talus--forms ankle joint
  • Calcaneus--forms heel
slide8

Foot

  • Function:
    • Support weight
    • Act as lever when walking
  • Tarsals
    • Talus = ankle
      • Between tibia + fibula
      • Articulates w/both
    • Calcaneus = heel
      • Attachment for Calcaneal tendon
      • Carries talus
  • Metatarsals
    • Homologous to metacarpals
  • Phalanges
    • Smaller, less nimble
slide9

Joints of Lower Limb

  • Hip (femur + acetabulum)
    • Ball + socket
    • Multiaxial
    • Synovial
  • Knee (femur + patella)
    • Plane
    • Gliding of patella
    • Synovial
  • Knee (femur + tibia)
    • Hinge
    • Biaxial
    • Synovial
slide10

Joints of Lower Limb

  • Proximal Tibia + Fibula
    • Plane
    • Gliding
    • Synovial
  • Distal Tibia + Fibula
    • Slight “give”
    • Fibrous
  • Ankle (Tibia/Fibula + Talus)
    • Hinge
    • Uniaxial
    • Synovial

pg 218

lower limb movements
Hip

Flexion/extension

Abduction/adduction

Lateral/medial rotation

Knee

Flexion/extension

Ankle

Dorsiflexion/plantarflexion

Inversion/eversion

Toes

Flexion/extension

Bending on posterior side is flexion (except hip)

Bending on anterior sided is extension (except hip)

Lower Limb Movements
slide12

Pelvic tilt and a reverse lumbar curve (or how we got to be upright)

  • Bowl concept
    • pelvis spills forward
    • Hernia
    • “beer belly”
    • In human minor pelvis is behind (posterior) to guts and abdominal cavity
  • Compare human pelvic position with quadruped (cat for instance)
slide14

Bony structure of the pelvis

MAIN STRUCTURES

  • Hip bone (innominate, os coxae)--fusion of
    • Ilium (“hips”)
    • Ischium (“rear”)
    • Pubis (anterior midline)
  • Sacrum and coccyx
  • Acetabulum
  • Femur--head, neck, greater trochanter

HOLES

  • False and true pelvis (major, minor pelvis)
  • Pelvic inlet, pelvic outlet
  • Sacrotuberous ligament
  • Sacrospinous ligament
  • Greater, lesser sciatic foramen
  • Obturator foramen
slide16

Female Male

  • Cavity is broad, shallow
  • Pelvic inlet oval + outlet round
  • Bones are lighter, thinner
  • Pubic angle larger
  • Coccyx more flexible, straighter
  • Ischial tuberosities shorter, more everted
  • Cavity is narrow, deep
  • Smaller inlet + outlet
  • Bones heavier, thicker
  • Pubic angle more acute
  • Coccyx less flexible, more curved
  • Ischial tuberosities longer, face more medially
posterior and lateral hip
Posterior and lateral hip
  • Gluts (gluteal nn.)
    • Maximus—extensor of thigh
    • Medius--pelvic tilt (relative to insertion with foot planted)
  • Lateral rotators (spinal nn.)
    • Piriformis syndrome
anterior hip
Anterior Hip
  • Iliopsoas
    • iliacus
    • psoas
  • Quadratus lumborum
lumbar and sacral plexus
Lumbar and sacral plexus
  • Mr. Bill is happy—so easy
  • Lumbar plexus forms femoral n.—anterior
  • Sacral plexus forms sciatic n.--posterior

Femoral n.

Sciatic n.

slide20
Lumbar plexus (femoral nerve)

Sacral plexus (sciatic nerve)

With leg out to side like quadruped, lumbar-anterior, sacral-posterior makes sense

dermatomes show twisting of leg during development
Dermatomes show twisting of leg during development

Dorsal becomes anterior: thus “dorsiflexion” and extension in anterior compartment (unlike upper limb)

Ventral becomes posterior: thus flexion is in posterior compartment (unlike upper limb)

anterior thigh femoral n
Anterior thigh (femoral n.)
  • Sartorius (Tailor’s muscle)
  • Quads (four)
    • Rectus femoris (crosses hip)
    • 3 vastus mm. (vast--big)
posterior thigh sciatic n
Posterior thigh (sciatic n.)
  • Hamstrings
    • Biceps femoris
    • Semimembranous
    • Semitendinous
medial thigh obturator n
Medial thigh (obturator n.)
  • Adductor muscles
    • Gracilis
    • Adductor
      • Magnus
      • Longus
      • brevis
anterior leg deep fibular n
Anterior Leg (deep fibular n.)
  • Extensors (dorsiflexors)
    • Fibularis (peroneus) longus
    • Extensor digitorum longus
    • Extensor hallicus longus
    • Tibialis anteriorus
posterior leg tibial n
Posterior Leg (tibial n.)
  • Flexors (plantarflexors)
    • Gastrocs and soleus
    • Flexor digitorum longus
    • Flexor hallucus longus
human gait
Human gait
  • Humans only large mammal marathoners, ultra-runners
  • Prehistoric cultures hunted by exhausting large prey
  • Bipedalism very efficient energetically
  • Gastroc-Achilles spring
  • One other large mammal more efficient—also bipedal
surface anatomy anterior thigh leg

pg 792

Surface Anatomy: Anterior Thigh + Leg
  • Palpate
    • Patella
    • Condyles of femur
  • Femoral Triangle
    • Sartorius (lateral)
    • Adductor longus (medial)
    • Inguinal ligament (superior)
    • Femoral a + v, lymph nodes

pg 785

surface anatomy posterior leg
Surface Anatomy: Posterior Leg
  • Popliteal fossa
    • Diamond-shape fossa behind knee
  • Boundaries
    • Biceps femoris (sup-lat)
    • Semitendinosis + semimembranosis (sup-med)
    • Gastrocnemius heads (inf)
  • Contents
    • Popliteal a + v
  • Calcaneal (Achilles) tendon

pg 793

blood supply to lower limb
Blood supply to lower limb
  • Internal Iliac
    • Cranial + Caudal Gluteals= gluteals
    • Internal Pudendal = perineum, external genitalia
    • Obturator = adductor muscles
  • External Iliac
    • Femoral = lower limb
      • Deep femoral = adductors, hamstrings, quadriceps
    • Popliteal (continuation of femoral)
      • Geniculars = knee
      • Anterior Tibial = ant. leg muscles, further branches to feet
      • Posterior Tibial = flexor muscles, plantar arch, branches to toes