LOWER LIMB

PART II
Anterior Compartment
of the lower leg
Fibularis Tertius
Lateral Compartment of lower limb
1.Fibularis Longus
2.Fibularis brevis
Superficial Posterior
compartment muscles
1.Gastrocnemius muscle
2.Plantaris muscle
3.
Deep posterior compartment of
the lower leg

1.Popliteus muscle
2.
3.
4.Tibilais posterior
Clinics
1)Paralysis of muscles of the anterior compartment of the leg due to injury of
deep peroneal nerve resulting loss of dorsiflexion of the foot as a result foot is
plantar flexed, this is known as foot drop usually happens when above nerve is
injured due to trauma, leprosy or peripheral neuritis. Sensory loss is confined to
interdigital cleft.

2)Paralysis of peroneus longus and brevis happens due to injury to superficial

peroneal nerve which causes inability to evert at subtalar joint.

3)Bursa is found at the insertion of semitendinous, sartorius and garcilis known as

anserine bursa which can get inflamed.

4)Foots skin is thick for protection, firmly adherent to underlying plantar

aponeurosis and it is creased for a better grip
5)The superficial fascia is fibrous and dense, binding to the deep fascia and
divide subcutaneous fat into compartments which serve as water cushions
reinforcing spring effect of the arches and it is highly thick at pressure bearing
points.

6)Deep fascia is specialized to form plantar aponeurosis in the sole, deep

transverse metatarsal ligaments and fibrous flexor sheath in the toes.

7)Plantar aponeurosis is triangular, apex is attached to the medial tubercle of

calcaneum and flexor digitorum brevis, base is distal, divides into five
processes which split into superficial and deep sip opposite to
metatarsophalangeal joint. It fixes the skin of the sole, protecting deeper
structures and helps in maintaining longitudinal arches of the foot and gives
origin to first layer of muscles.
1.Abductor hallucis muscle
2.Flexor digitorum brevis
3.Abductor digiti minimi
1.Quadratus plantae
2.Lumbricals
1.Flexor hallucis brevis
2.Adductor hallucis
3.Flexor digitorum minimi brevis
Clinics
• Fracture of the shaft 2nd 3rd or 4th metatarsel bones is called march
fracture seen in people who marches a lot.

• High heels can destroy normal foot architecture .

• Toes may be spread out Talipes.

Arteries
• Femoral artery is the main artery which supplies the lower limb

• It is the continuation of the external illiac artery.

• It becomes the femoral as it passes beneath inguinal ligament to enter the

femoral triangle.

• It branches supply most of the leg, thigh and foot.

Femoral artery
• External illiac artery continues as the femoral artery as it enters the thigh at the
mid inguinal point below the inguinal ligament, at this point it gives off four
superficial arteries, namely:
1. Superficial circumflex illiac artery

2. Superficial epigastric artery

3. Superficial external pudendal artery

4. Deep external pudendal artery

• The femoral artery emerges from the femoral sheath, later it enters the
adductor canal and at the femoral sheath it gives off the profunda femoris
artery which provides all the thigh muscles.

• Femoral artery is known as the common femoral artery above the origin of
profunda femoris and below it is named as the superficial femoral artery.
Profunda femoris artery
Superior and interior gluteal arteries originate from internal illiac artery and supply
the gluteal regions.
• Vascular supply to the knee is mostly from descending:
• Genecular branches of the femoral artery

• Popliteal

• lateral circumflex femoral artery

• circumflex femoral artery

• recurrent branches from the anterior tibial artery.

• These vessels form an anastomoses.

Popliteal artery
• Main artery of the leg, passes to the posterior compartment in between
popliteus and gastronemius muscle.

• It passes in between the soleal arch between the tibia and fibular heads and
then it divides into anterior and posterior tibial arteries.

• It supply the knee joint, gasronemius, soleus and plantaris muscles.

Branches of great
saphenous vein
Superficial veins
Perforator veins
Features Long Saphenous vein Short saphenous vein
Beginning Medial end of dorsal Lateral end of dorsal
venous plexus venous plexus
position Anterior to medial Posterior to lateral
malleolus malleolus
Number of valves 15-20 valves 8-10 valves
Relation of a sensory Saphenous nerve Sural nerve
nerve
Termination Femoral vein Popliteal vein