Overview of lower limb

• Bony pelvis and proximal femur form hip joint
• Distal femur and proximal tibia form knee joint
• Distal tibia and distal fibula and talus form ankle joint
• Acetabulum

  • socket of hip joint, articulates with head of femur
• Iliac crests are higher (longer) in males, sacrum is longer.
• The female pelvis is broader than males; distance between the ASIS is larger, greater angle of pubic arch.
• IIiofemoral ligament is Y shaped and is the strongest in hip joint
• Hip joint ligaments

  • iliofemoral
  • ischiofemoral
  • pubofemoral
• The patella is a large triangular sesamoid bone in the tendon of quadriceps femoris. Smooth cartilage of posterior surface articulates with intercondylar groove of femur.
• Tibial interosseus access can be used for resuscitation when intravenous access is not available. Drill into medial aspect of proximal tibia and deliver drugs/fluids into circulation via medullary canal.
• The knee is a hinge joint; surrounding muscle, tendons and ligaments provide stability. Femur articulates with tibia - femur is not involved.
• Menisci of knee are fibrocartilage, deepen articular surface and absorb shock.
• Ankle is a hinge joint that allows dorsiflexion and plantarflexion.
• Deltoid ligament of ankle is medial
• Lateral ligaments of ankle

  • anterior talofibular
  • posterior talofibular
  • calcaneofibular
• Gluteal region - buttocks, hip region, gluteal muscles over pelvic girdle
• Thigh (femoral) region - from inguinal region (groin) to knee
• Knee area - knee joint, posterior neurovascular structures in popliteal fossa
• Leg area - connects knee and foot
• Foot and ankle - extremity of lower limb
• Flexion decreases the angle at the joint
• Abduction moves the thigh apart (away from the midline)
• Inversion brings the sole of the foot inwards
• Medial rotation is rotation towards the midline
• Extension increases the angle at the joiny
• Adduction moves the thighs together (towards the midline)
• Eversion turns the sole of the foot outwards
• Lateral rotation is rotation away from the midline
• Superficial muscles of gluteal region

  • gluteus maximus
  • gluteus medius
  • gluteus minimus
  • tensor fascia lata
• Gluteus maximus - hip extensor, lateral rotator
• Gluteus medius - abductor and rotator
• Gluteus minimus - abductor and medial rotator
• Tensor fascia lata - continuous with iliotibial band, flexes and abducts hip, locks knee in extension
• Deeper, small muscles of gluteal region

  • quadratus femoris
  • piriformis
  • gemelli (superior and inferior)
  • obturator internus/externus
• Quadratus femoris - external rotator
• Piriformis - abductor and lateral rotator
• Gemelli (superior and inferior) - abductors
• Obturator internus/externus - abductors
• Anterior thigh is innervated by femoral nerve
• Muscles of anterior thigh

  • sartorius
  • quadriceps femoris
  • rectus femoris
  • vastus lateralis
  • vastus intermedius
  • vastus medialis
  • iliopsoas
  • pectineus