ANAT20006 Principles of Human Structure

Lecture 6.3: Lower Limb 2 muscles & movements

Dr. Simon Murray

Dept. Anatomy & Neuroscience (E716)
ssmurray@unimelb.edu.au

Copyright The University of Melbourne 2009

April 14th 2016

Muscles and Movements of the Lower Limb

Vertebral column & back

General References:

General Anatomy: Principles & Applications

by N Eizenberg, C Briggs, C Adams & G Ahern.

An@tomedia OnLine:
http://www.anatomediaonline.com.ezp.lib.unimelb.edu.au/

Gray's Anatomy for Students (2nd or 3rd Edition)

by RL Drake, AW Vogl & AWM Mitchell

Gray's Anatomy for Students, Third Edition OnLine:

https://www-clinicalkey-com-au.ezp.lib.unimelb.edu.au/#!/browse/book/3-s2.0-C20110061707

Aclands Video Atlas of Human Anatomy

http://www.aclandanatomy.com.ezp.lib.unimelb.edu.au/

Muscles and Movements of the Lower Limb

Overview:

Movements
Fascia
Muscles

- pelvic girdle
- thigh
- leg
- foot

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 1.12

Movements of the Lower Limb

Movements:

Flexion / extension

Hip

abduction / adduction

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.05A-C

internal / external rotation

Movements of the Lower Limb

Movements:

Knee flexion / extension

Knee and foot

ankle dorsiflexion / plantar flexion

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.06A&B

foot inversion / eversion

The Lower Limb - Fascia

Fascia

intermuscular septa

- layer of fibrous tissue

- divides thigh and leg into compartments

- surrounds individual muscles

- surrounds groups of muscles
- divides muscles into compartments
- reduces friction / allows muscle to glide

Specialized fascia of the thigh

fascia lata
- thickens laterally to form the
iliotibial band (ITB)
- attaches to lateral knee

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.13 & 6.46

Muscles of the pelvic girdle

Anteriorly:
Iliopsoas muscle
iliacus
psoas major
psoas minor

Strong hip flexor muscles

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.12

Muscles of the pelvic girdle

Posteriorly:
Gluteal muscles
Gluteus maximus
-only recruited in power extension

Gluteus medius
Gluteus minimus
- abduct the hip
- but primarily maintain position of pelvis in locomotion

Extensor and Abductor muscles of the hip

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.11 & 6.44B

Muscle compartments of the thigh

Anterior
quadricep muscles - most extensive
knee extensors

Posterior
hamstring muscles
hip extensors & knee flexors

Medial
adductor muscles
hip adductors

(Lateral)
gluteal muscles
does not extend into thigh

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill Livingston Elsevier, Philadelphia PA,
2010. ISBN 978-0-443-06952-9. Fig. 6.50B & 6.55
Basmajian J, Slonecker C. Grants Method of Anatomy. Williams & Wilkins 1986 ISNN 0-683-00374-7, Ch 24 Fig 23.17

Anterior muscle compartment of the thigh

Anterior compartment
Sartorius
Quadriceps muscle
- made up of 4 large & powerful muscles
- rectus femoris (flexes at hip)
- 3 vastus muscles: medialis
lateralis
intermedius

Extensors of the knee

vastus muscles produce powerful extension at

the knee, eg. during the stride phase of gait

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.57

Anterior muscle compartment of the thigh

Anterior compartment
Normal alignment of patella maintained by vastus medialis

vastus medialis weakness may lead to

- abnormal tracking of patella cartilage degeneration
- patella dislocation (laterally)

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.72A

Posterior muscle compartment of the thigh

Posterior compartment
Hamstring muscles
- three 2-joint muscles:
- semimembranosus
- semitendinosus
- biceps femoris (long head)

Flexors of the knee

origin of
hamstrings
2-joint muscle - prone to strain when acting
across both joints simultaneously

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 5.20 & 6.61

Medial muscle compartment of the thigh

Medial compartment
Adductor muscles
Adductors of the hip

Common source of groin pain & pathology

common at bony attachment (osteitis pubis)
(especially adductor longus)

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.58

Muscle compartments of the leg

Anterior
contains ankle dorsi-flexors

Anterior

Posterior
contains ankle plantar-flexors

Lateral

most extensive

Lateral
contains ankle everters

Posterior (deep & superficial)

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.79

Anterior muscle compartment of the leg

Anterior compartment
- Tibialis anterior
- Extensor hallucis longus (EHL)
- Extensor digitorum longus (EDL)
Dorsiflexors of the ankle
Extensors of the toes
Overuse may lead to shin splints (tenoperiostosis)

extensor retinaculum

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.88 & 6.105

Anterior muscle compartment of the leg

Anterior compartment
Deep fascia
- separates muscle compartments & muscles
- muscles surrounded by tight fascia

compartment syndrome:
if swelling occurs, neurovascular structures
susceptible to compression

N Eizenberg, C Briggs, C Adams, G Ahern. An@tomedia: General Anatomy, Principles &

Applications, McGraw Hill, ISBN 9780070134676. 1st ed. 2008, Fig. 15.5

Lateral muscle compartment of the leg

Lateral compartment
Peroneal (Fibularis) muscles
- longus
- brevis
Everters of the foot
- strain
- proprioceptive role in ankle sprains

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.86A

Posterior muscle compartment of the leg

Posterior compartment
superficial:
- Gastrocnemius
- Plantaris
- Soleus
Plantarflexors of the ankle

Note:
- power vs. postural roles
- venous sinuses in soleus
Clinical significance:
- calf strain
- venous return
- achilles tendinitis

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.82A&B

Posterior muscle compartment of the leg

Posterior compartment
deep:
- Tibialis posterior
- Flexor hallucis longus
- Flexor digitorum longus
Dorsiflexors of the ankle and toes

Tarsal tunnel

flexor retinaculum

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.86A & 6.104B

Intrinsic muscles of the foot

Intrinsic muscles of the foot

Plantar muscles
- hallucis muscles
- digiti minimi muscles
- central muscles

layers

Long tendons
Plantar aponeurosis & ligaments that support arches

RL Drake, AW Vogl, AWM Mitchell, Gray's Anatomy for Students, 2nd Edition, Churchill
Livingston Elsevier, Philadelphia PA, 2010. ISBN 978-0-443-06952-9. Fig. 6.113 & 6.114

Applied Anatomy of Muscles of the Lower Limb

2 joint muscles

- susceptible to strain when acting across both joints simultaneously

- active insufficiency
- prone to strain in dynamic activities:
gastrocnemius / soleus
hamstrings
(quadriceps)

Weakest site may be

tendon/bone interface
avulsion fracture

N Eizenberg, C Briggs, C Adams, G Ahern. An@tomedia: General Anatomy, Principles &

Applications, McGraw Hill, ISBN 9780070134676. 1st ed. 2008, Fig. 6.13

 Copyright The University of Melbourne 2009