Human Anatomy - Kotsan I. Ya. 2009

Muscles and fascia of the lower limb
Muscles of the plantar surface of the foot
Topography of the lower limb

The human lower limb is conventionally divided into the following regions and areas:

The gluteal region (regio glutealis) overlies the gluteal Muscles and is bounded superiorly by the iliac crest, inferiorly by the gluteal fold, medially by the sacrum and coccyx, and laterally by a line drawn from the anterior superior iliac spine to the lateral end of the gluteal fold.

The hip region (regio coxalis) is lateral and projects onto the hip joint.

The trochanteric region (regio trocanterica) overlies the greater trochanter of the Femur.

The thigh (femoral region) (femur (regio femoralis)) features anterior and posterior regions. The anterior region (surface) of the thigh (regio (facies) femoralis anterior) overlies the quadriceps femoris Muscle and is bounded superiorly by the inguinal ligament and inferiorly by a horizontal line drawn 3 cm above the Patella. Within the anterior thigh lies the femoral triangle (trigonum femorale), bounded superiorly by the inguinal ligament, laterally by the medial border of the sartorius muscle, and medially by the lateral border of the adductor longus muscle. The femoral artery, vein, and femoral canal pass through the region of the femoral triangle. The posterior region (surface) of the thigh (regio (facies) femoralis posterior) is bounded superiorly by the gluteal fold and inferiorly by a horizontal line drawn through the upper angle of the popliteal fossa.

The knee (genus) has anterior and posterior regions. The anterior knee region (regio genus anterior) is bounded superiorly by a horizontal line drawn 3 cm above the Base of the patella and inferiorly by a horizontal line drawn through the tibial tuberosity. The posterior knee region (regio genus posterior) shares the same superior and inferior boundaries as the anterior region, located on the posterior aspect of the limb.

The leg (crus) comprises anterior and posterior regions. The anterior region (surface) of the leg (regio (facies) cruralis anterior) is bounded superiorly by a horizontal line drawn at the level of the tibial tuberosity, inferiorly by a horizontal line passing through the bases of the lateral and medial malleoli, medially by the medial border of the Tibia, and laterally by the groove separating the fibular muscles from the soleus muscle. The posterior region (surface) of the leg (regio (facies) cruralis posterior) shares the same anatomical landmarks as the corresponding anterior region, with the boundaries extending across the posterior aspect of the limb. Within the posterior leg, the upper, most prominent part is known as the calf (sural region) (sura (regio suralis)).

In the ankle region, the anterior and posterior talocrural regions (regiones talocrurales anterior et posterior) are distinguished; they are bounded superiorly by a horizontal line drawn through the bases of the malleoli and inferiorly by an oblique line passing across the tips of the malleoli laterally, the angle between the leg and the dorsum of the FOOT anteriorly, and the upper margin of the calcaneal tuberosity posteriorly.

The foot (pes) is divided into the heel (calcaneal region), dorsum of the foot (dorsal region of the foot), sole (plantar region) of the foot, borders (lateral and medial), tarsus, metatarsus, and digits.

The heel (calcaneal region) (calx (regio calcanea)) corresponds to the calcaneal tuberosity. The dorsum of the foot (dorsal region) (dorsum (regio dorsalis) pedis) occupies the dorsal and lateral surfaces of the foot, extending from the ankle flexion crease to the proximal Phalanges of the digits. The SOLE OF THE foot (plantar region) (planta (regio plantaris) pedis) is situated on the plantar surface, stretching from the distal PARTS OF THE calcaneal tuberosity to the proximal phalanges of the digits. The lateral border of the foot (margo lateralis pedis) and the medial border of the foot (margo medialis pedis) demarcate the dorsal and plantar surfaces from their respective sides. The tarsus (tarsus) and metatarsus (metatarsus) are Regions of the foot corresponding to their respective bones. The digits (digiti) of the foot include the great toe (first digit) (hallux (digitus primus)), second digit (digitus secundus), third digit (digitus tertius), fourth digit (digitus quartus), and little toe (fifth digit) (digitus minimus (quintus)). The digits feature dorsal digital surfaces (facies digitales dorsales) and plantar digital surfaces (facies digitales plantares).

Muscles, tendons, fasciae, and BONES OF THE lower limb shape its surface topography and bound various openings, canals, fossae, and grooves. Knowledge of these structures is of great practical importance because they transmit Blood and Lymphatic vessels and nerves, and contain Lymph Nodes. Furthermore, interfascial spaces, fibrous and synovial sheaths, and canals can serve pathways for the spread of inflammatory processes from a primary focus, sites for hernia formation, and so forth.

In the region of the greater sciatic foramen, There are two clefts formed because the piriformis muscle, as it passes through the greater sciatic foramen, does not occupy it entirely. One of these clefts lies above the piriformis muscle and is termed the suprapiriform foramen (foramen suprapiriforme), while the second, located below it, is the infrapiriform foramen (foramen infrapiriforme). Major Vessels and nerves emerge from the pelvic cavity through these foramina, heading toward the gluteal region and the free lower limb.

Near the upper margin of the obturator foramen lies the obturator canal (canalis obturatorius), formed by the obturator groove of the pubic bone and the upper margin of the internal obturator muscle. The canal is 2.0–2.5 cm long. Through it, the obturator vessels and nerve pass from the pelvic cavity to the adductor Muscles of the thigh.

Posterior to the inguinal ligament lie the muscular and vascular lacunae, separated from each other by the iliopectineal arch. The muscular lacuna (lacuna musculorum) is situated between the lateral segment of the inguinal ligament, the iliac bone, and the iliopectineal arch. The iliopsoas muscle and femoral nerve pass through the muscular lacuna. The vascular lacuna (lacuna vasorum) is located between the medial segment of the inguinal ligament, the pubic bone, and the iliopectineal arch. The femoral artery, vein, and a branch of the genitofemoral nerve pass through the vascular lacuna.

Within the femoral triangle, beneath the Superficial layer of the fascia lata of the thigh, a well-defined iliopectineal groove is visible, bounded medially by the pectineus muscle and laterally by the iliopsoas muscle. Distally, this groove continues into the so-called femoral groove, which lies between the adductor longus and adductor magnus muscles medially, and the vastus medialis muscle laterally. Inferiorly, near the apex of the femoral triangle, the femoral groove transitions into the adductor canal, whose entrance is concealed beneath the sartorius muscle.

In the region of the femoral triangle, a femoral hernia may lead to The formation of the femoral canal (canalis femoralis), which does not exist under normal anatomical conditions. The anterior wall of the canal is formed by the inguinal ligament and the upper horn of the falciform margin of the saphenous opening; the posterior wall is formed by the Deep Layer of the fascia lata covering the pectineus muscle; and the lateral wall is the femoral vein. The canal lacks a medial wall, as the superficial and deep layers of the fascia lata converge here. When a femoral hernia develops, its inlet is the femoral (internal) ring, and its outlet is the saphenous opening. The internal femoral ring (annulus femoralis) is located in the medial part of the vascular lacuna. It is bounded anteriorly by the inguinal ligament, posteriorly by the pectineal ligament, and laterally by the femoral vein. Under normal conditions, the femoral ring is closed by the deep inguinal lymph node (Rosenmüller's node) and the Connective Tissue femoral septum (septum femorale), which represents a lax portion of the transversalis fascia at this site.

The saphenous opening (hiatus saphenus) is an aperture in the fascia lata of the thigh located just inferior to the medial segment of the inguinal ligament. The opening is filled with loose connective tissue known as the cribriform fascia (fascia cribrosa) because it is perforated by the great saphenous vein, lymphatic vessels, and nerves.

From the apex of the femoral triangle originates the adductor canal (canalis adductorius), which connects the anterior thigh region with the popliteal fossa. In cross-section, the canal resembles a triangular prism; its medial wall is formed by the adductor magnus muscle, its lateral wall by the vastus medialis muscle, and its anterior wall by a tendinous membrane stretched between these muscles. The inlet of the canal is located in its upper part and is bounded by the same structures as the canal itself. There are two outlets from the canal: a lower and an anterior one. The lower outlet is the tendinous (adductor) hiatus (hiatus tendineus (adductorius)), located on the posterior surface of the thigh in the popliteal fossa between the bundles of the adductor magnus tendon. The anterior outlet of the adductor canal is located in a fibrous lamina. The neurovascular bundle passes through the adductor canal and divides such that the femoral vessels emerge through the lower opening, while the descending genicular artery and saphenous nerve emerge through the anterior opening.

In the posterior region of the knee is the popliteal fossa (fossa poplitea), which is diamond-shaped. The superior angle of the popliteal fossa is bounded laterally by the biceps femoris muscle and medially by the semimembranosus muscle. The inferior angle lies between the medial and lateral heads of the gastrocnemius muscle. The floor of the fossa is formed by the popliteal surface of the femur and the posterior capsule of the knee joint. The popliteal fossa is filled with adipose tissue, lymphatic vessels and nodes, as well as the neurovascular bundle formed by the tibial nerve, popliteal vein, and popliteal artery.

In the posterior region of the leg, between the superficial and deep muscles, lies the cruropopliteal canal (canalis cruropopliteus) — Gruber's canal — which extends from the lower boundary of the popliteal fossa to the medial margin of the Water/144.html">Origin of the calcaneal (Achilles) tendon. The anterior wall of the canal in its upper two-thirds is formed by the tibialis posterior muscle, and more distally by the flexor hallucis longus muscle. The posterior wall is formed by the anterior surface of the soleus muscle. The cruropopliteal canal has three openings: superior (inlet), anterior, and inferior (outlet). The superior opening is bounded anteriorly by the popliteus muscle and posteriorly by the tendinous arch of the soleus muscle. The anterior opening is located in the proximal part of the interosseous membrane of the leg. The inferior opening is situated in the distal third of the leg, where the soleus muscle transitions into a tendon. The posterior tibial artery, Veins, and tibial nerve run through the cruropopliteal canal. In the middle third of the leg, the inferior fibular muscle canal branches laterally from the cruropopliteal canal; its walls are formed by the posterior surface of the Fibula anteriorly and the flexor hallucis longus muscle posteriorly. The fibular artery and veins pass through this canal.

In the upper third of the leg, between the lateral surface of the fibula and the peroneus longus (fibularis longus) muscle, lies an independent superior fibular muscle canal, through which the superficial fibular nerve passes.

On the sole of the foot, corresponding to the course of the plantar vessels and nerves, the lateral and medial plantar grooves are distinguished. They are located on either side of the flexor digitorum brevis muscle. The medial plantar groove runs between the medial margin of the flexor digitorum brevis and the lateral margin of the abductor hallucis muscle, whereas the lateral plantar groove lies between the lateral margin of the flexor digitorum brevis and the abductor digiti minimi muscle.

Main Latin terms

Iliopsoas muscle — m. iliopsoas

Psoas major muscle — m. psoas major

Iliacus muscle — m. iliacus

Psoas minor muscle — m. psoas minor

Obturator internus muscle — m. obturator internus

Piriformis muscle — m. piriformis

Tensor fasciae latae muscle — m. tensor fasciae latae

Gluteus maximus muscle — m. gluteus maximus

Trochanteric bursa of gluteus maximus — bursa trochanteria musculus glutei maximi

Gluteus medius muscle — m. gluteus medius

Gluteus minimus muscle — m. gluteus minimus

Trochanteric bursa of gluteus minimus — bursa trochanterica musculus glutei minimi

Quadratus femoris muscle — m. quadratus femoris

Superior gemellus muscle — m. gemellus superior

Inferior gemellus muscle — m. gemellus inferior

Obturator externus muscle — m. obturator externus

Sartorius muscle — m. sartorius

Anserine bursa — bursa anserina

Quadriceps femoris muscle — m. quadricepsfemoris

Rectus femoris muscle — m. rectus femoris

Vastus lateralis muscle — m. vastus lateralis

Vastus medialis muscle — m. vastus medialis

Vastus intermedius muscle — m. vastus intermedius

Biceps femoris muscle — m. biceps femoris

Inferior subtendinous bursa of biceps femoris — bursa

subtendinea musculi bicipitis femoris inferior

Semitendinosus muscle — m. semitendinosus

Semimembranosus muscle — m. semimembranosus

Bursa of semimembranosus muscle — bursa musculi semimembranosi

Gracilis muscle — m. gracilis

Pectineus muscle — m. pectineus

Adductor longus muscle — m. adductor longus

Adductor brevis muscle — m. adductor brevis

Adductor magnus muscle — m. adductor magnus

Adductor minimus muscle — m. adductor minimus

Adductor hiatus — hiatus tendineus (adductorius)

Tibialis anterior muscle — m. tibialis anterior

Extensor digitorum longus muscle — m. extensor digitorum longus

Fibularis tertius muscle — m. peroneus tertius

Extensor hallucis longus muscle — m. extensor hallucis longus

Triceps surae muscle — m. triceps surae

Gastrocnemius muscle — m. gastrocnemius

Lateral HEAD — caput laterale

Medial head — caput mediale

Soleus muscle — m. soleus

Tendinous arch of soleus muscle — arcus tendineus m. solei

Lateral subtendinous bursa of gastrocnemius muscle — bursa subtendinea musculi gastrocnemii lateralis

Medial subtendinous bursa of gastrocnemius muscle — bursa

subtendinea musculi gastrocnemii medialis

Calcaneal (Achilles) tendon — tendo calcaneus (achillis)

Calcaneal tendon bursa — bursa tendinis calcanei

Plantaris muscle — m. plantaris

Popliteus muscle — m. popliteus

Tibialis posterior muscle — m. tibialis posterior

Flexor digitorum longus muscle — m. flexor digitorum longus

Flexor hallucis longus muscle — m. flexor hallucis longus

Fibularis longus muscle — m. peroneus longus

Fibularis brevis muscle — m. peroneus brevis

Extensor digitorum brevis muscle — m. extensor digitorum brevis

Extensor hallucis brevis muscle — m. extensor hallucis brevis

Abductor hallucis muscle — m. abductor hallucis

Flexor hallucis brevis muscle — m. flexor hallucis brevis

Adductor hallucis muscle — m. adductor hallucis

Abductor digiti minimi muscle — m. abductor digiti minimi

Flexor digiti minimi brevis muscle — m. flexor digiti minimi brevis

Flexor digitorum brevis muscle — m. flexor digitorum brevis

Quadratus plantae muscle — m. quadratus plantae

Lumbrical muscles — mm. lumbricales

Plantar interossei muscles — mm. interossei plantares

Dorsal interossei muscles — mm. interossei dorsales

Fascia lata — fascia lata

Iliac fascia — fascia iliaca

Iliotibial tract — tractus iliotibialis

Gluteal fascia — fascia glutea

Lateral intermuscular septum of thigh — septum intermusculare femoris laterale

Medial intermuscular septum of thigh — septum intermusculare femoris mediale

Posterior intermuscular septum of thigh — septum intermusculare femoris posterior

Crural fascia — fascia cruris

Anterior intermuscular septum of the leg — septum intermusculare cruris anterius

Posterior intermuscular septum of the leg — septum intermusculare cruris posterior

Superior extensor retinaculum — retinaculum musculorum extensorum superius

Inferior extensor retinaculum — retinaculum musculorum extensorum inferius

Flexor retinaculum — retinaculum musculorum flexorum

Superior peroneal retinaculum — retinaculum musculorum peroneorum superius

Inferior peroneal retinaculum — retinaculum musculorum peroneorum inferius

Tendon sheath of tibialis anterior — Vagina tendinis musculi tibialis anterioris

Tendon sheath of extensor hallucis longus — vagina tendinis musculi extensoris hallucis longi

Tendon sheaths of extensor digitorum longus — vagina tendinum musculi extensoris digitorum pedis longi

Tendon sheath of tibialis posterior — vagina tendinis musculi tibialis posterioris

Tendon sheaths of flexor digitorum longus — vagina tendinum musculi flexoris digitorum pedis longi

Tendon sheath of flexor hallucis longus — vagina tendinis musculi flexoris hallucis longi

Common tendon sheath of peroneal muscles — vagina tendinum musculi peroneorum communis

Fascia of the foot — fascia pedis

Dorsal fascia of the foot — fascia dorsalis pedis

Plantar aponeurosis — aponeurosis plantaris

Transverse fascicles — fasciculi transversi

Superficial transverse metatarsal ligament — lig. metatarseum transversum superficiale

Gluteal region — regio glutealis

Hip region — regio coxalis

Thigh (femoral region) — femur (regio femoralis)

Anterior femoral region — regio (facies) femoralis anterior

Posterior femoral region — regio (facies) femoralis posterior

Knee — genus

Anterior region of the knee — regio genus anterior

Posterior region of the knee — regio genus posterior

Leg (shank) — crus

Anterior region (surface) of the leg — regio (facies) cruralis anterior

Posterior region (surface) of the leg — regio (facies) cruralis posterior

Calf (sural region) — sura (regio suralis)

Anterior and posterior talocrural regions — regiones talocrurales anterior et posterior

Foot — pes

Heel (calcaneal region) — calx (regio calcanea)

Dorsum of the foot (dorsal region) — dorsum (regio dorsalis) pedis

Sole of the foot (plantar region) — planta (regio plantaris) pedis

Lateral margin of the foot — margo lateralis pedis

Medial margin of the foot — margo medialis pedis

Tarsus — tarsus

Metatarsus — metatarsus Toes — digiti

Great toe (first digit) — hallux (digitus primus)

Second toe — digitus secundus

Third toe — digitus tertius

Fourth toe — digitus quartus

Little toe (fifth digit) — digitus minimus (quintus)

Dorsal surfaces of the toes — fascies digitales dorsales

Plantar surfaces of the toes — fascies digitales plantares

Suprapiriform foramen — foramen suprapiriforme

Infrapiriform foramen — foramen infrapiriforme

Obturator canal — canalis obturatorius

Muscular lacuna — lacuna musculorum

Vascular lacuna — lacuna vasorum

Femoral canal — canalis femoralis

Femoral ring — anulus femoralis

Saphenous hiatus — hiatus saphenus

Adductor canal — canalis adductorius

Aortic hiatus / Tendinous hiatus (adductor hiatus) — hiatus tendineus (adductorius)

Popliteal fossa — fossa poplitea

Cruropopliteal canal — canalis cruropopliteus