Lower Limbs

1. Lower Limbs Lu Xiaoli Regional Anatomy & Operative Surgery China Medical University

3. 32 Bones • Hip Bone (1) • Femur (1) • Patella (1) • Tibia (1) • Fibula (1) • Tarsals (8) • Metatarsals (5) • Proximal Phalanges (5) • Intermediate Phalanges (5) • Distal Phalanges (4)

4. Hip

9. Femoral Bone

13. Patella

14. Tibia & Fibula

17. Proximal End of Left Tibia

24. Gluteal Region

25. Iliac Crest Gluteal Crease

26. Superficial Layers • Skin • Superficial Fascia • Deep Layers • Deep Fascia • Muscles • Suprapiriform & Infrapiriform Foramen • Lesser Sciatic Foramen • Hip Joint

27. Superficial Fascia • the middle part is thinnest • Contains Superficial blood vessels, lymphatic vessels and cutaneous nerves

28. Bedsore (Decubitus Ulcer)

29. Arteries Superficial branches of • 4th lumbar artery • Inferior gluteal artery • Lateral sacral artery • Superior gluteal artery • Inferior gluteal artery

30. Cutaneous Nerves • branches of the subcostal nerve (T12) • dorsal rami of lumbar nerves • dorsal rami of sacral nerves • inferior cluneal nerves • posterior femoral cutaneous nerve

31. Deep Fascia • Attach to iliac crest superiorly • Invest gluteus maximus • Attach to Sacral bone and coccyx medially • Continuous with fascia lata laterally

32. Muscles Superficial Gluteus Maximus Tensor Fasciae Latae Glluteus Medius Piriformis Superior Gemellus Obturator Internus Inferior Gemellus Quadratus Femoris Middle Deep Gluteus Minimus Obturator Externus

33. Gluteus Maxinus • Tensor Fasciae Latae

34. Glluteus Medius • Piriformis • Superior Gemellus • Obturator Internus • Inferior Gemellus • Quadratus Femoris

35. Gluteus Minimus • Obturator Externus

36. Suprapiriform Foramen

37. Infrapiriform Foramen

38. Sciatic n. • Tibial n. • Common Fibular n.

39. 66.3% 27.3% Tibial n. Common Fibular n. 6.4%

41. Piriformis Syndrome Pain radiates down the back of the leg

42. Iliac crest Ischial tuberosity

43. Lesser Sciatic Foramen • Boundaries • front: tuberosity of ischium • above: spine of ischium & sacrospinous lig. • behind: sacrotuberous lig. • Contents • tendon of Obturator internus • internal pudendal a. • internal pudendal v. • pudendal n.

47. Hip Anterior Posterior

48. It is based on this capsular attachment that fractures of the neck of femur are classified as: • INTRACAPSULAR: within the capsular attachment. • EXTRACAPSULAR: outside the attachment of the capsule • Mixed

49. Intracapsular • Lig. of head of femur • Transverse acetabular lig.

50. Extracapsular(Anterior) • Iliofemoral lig. • Pubofemoral lig.