surface anatomy of the lower limb powerpoint.pptx

8/10/2019 surface anatomy of the lower limb powerpoint.pptx

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FASCIAL SKELETON

Deep fascia of the lower limb

Is well defined and forms a tough circumferential stockinglikestructure that contains the musculature.

Septa pass from the deep surface of the facial sheath to thebone within, confining the functional muscle groups withinosteofascial compartments

TOUGH FASCIA

Gives additional areas of attachment to the muscles andensures that they work to maxima effect

Thickening in the ensheating layer act as as additional

tendons example iliotibial tract Thickenings from fibrous retinacula where tendons cross

joints


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LOCATING THE SCIATIC NERVE


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Vertical line highest point of the iliac crest

Horizontal linemidway between the iliac crest

and ischial tuberosity


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FEMORAL TRIANGLE

- Depression formed in the anterior thigh Medial margin of adductor longus muscle

- Tendon can be palpated as a cord like structure that

attaches to bone immediately inferior to the pubictubercle

Medial margin of sartorius muscle

- Originates from the anterior superior iliac spine and

attach to the medial aspect of the tibia Inguinal ligament

- Originates from the anterior superior iliac spine andattach to the pubic tubercle


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Structures around the knee

Patella - prominent palpable feature at the knee

- the quadriceps femoris tendon attaches superiorly to it and the

patellar ligament connects the inferior surface of the patella to thetibial tuberosity

- DEEP TENDON REFLEX ( a tap on the patellar ligament tests reflex

activity mainly at spinal cord levels L3 and L4

Head of the fibula palpable protuberance on the lateral surface of the knee

inferior to the lateral condyle of the tibia. It can also be located following thetendon of the biceps femoris inferiorly.

Common fibular nervepasses around the lateral surface of the neck of the

fibula just inferior to the head and can often be felt as a cord-like structure in

this position.

Iliotibial tractflat tendinous structure, which attaches to the lateral tibial

condyle, is most prominent when the knee is fully extended. The anterior

edge of the tract raises a sharp vertical fold of skin posterior to the lateral

edge of the patella.


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POPLITEAL FOSSA

Diamond shaped depression formed between thehamstring and gastrocnemius muscle posterior to the knee

Border

Inferior border medial and lateral head of the

gastrocnemius muscle

Superior border

lateral biceps femoris muscle

medial (semimebranosus andsemitendinosus muscles)

*tendons of these muscles are palpable and often visible


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Contents (PPTC)

- Popliteal artery (deepest, upper medial side)

popliteal vein, tibial nerve and common

fibular nerve, posterior cutaneous nerve of

the thigh

* Small saphenous vein

penetrates deep part of the posteriorfascia in the upper leg and joins the popliteal vein


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TARSAL TUNNEL

- Medial side of the foot in the groove between the medialmalleolus and the heel (calcaneal tuberosity) and by theoverlying flexor retinaculum.

- Structures passes to the tarsal tunnel

from anteromedial to posterolateral (Tom Dick And AVery Nervous Harry)

Tibialis posterior, Flexor digitorum longus, posterior tibialartery and associated veins, tibial nerve flexorhallucis longus

*tendons pass in compartments formed by the septa of the

flexor retinaculum* The tibial artery is palpable just posteroinferior to the medialmalleolus on the anterior face of the visible groove betweenthe heel and the medial malleolus.


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Tibialis anterior tendonmedial side of the ankle anterior to the medial maleolus

Calcaneal tendon largest tendon entering the foot and is prominent on the posterior

aspect of the foot as it descends from the leg to the heel. A tap with a tendon hammer

of tendon. Test reflex activity of spinal cord levels S1 and S2.

Fibularis longus and fibularis brevis raise a linear fold of skin during eversion,

descends from the lower leg to the posterior edge of the lateral malleolus.

Fibularis brevis lateral surface of the foot descending obliquely to the base of

Metatarsal V. Fibularis tertius, extensor digitorum longus and extensor hallucis longusare visible on

the dorsal aspect of the foot from lateral to medial.


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MAJOR SUPERFICIAL VEINS

Begins as a dorsal venous arch in the foot

Medial arch curves superior and anteriorly as greatsaphenous vein then passes through an aperture in thefascia lata (saphenous ring) to join with the femoralvein in the femoral triangle. -internal iliac vein

Lateral arch passes through the posterior to the lateralmalleolus as the small saphenous vein passes throughthe deep fascia in the upper one third of the leg and

connects with the popliteal vein At the area of theadductor hiatus and then in the popliteal fossa.


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PLANTAR ARTERIAL ARCH


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lesser sciatic foramen

-obturator

Internal

Maximus iliotibial tract

- gluteal tuberosity

surface anatomy of the lower limb powerpoint.pptx

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