Anatomy of lower limb easy

1. LOWER LIMB

2. FASCIAS OF THE LOWER LIMB

3. I. ANTERIOR & MEDIAL ASPECTS OF THIGH

4. 1. Superficial fascia of the thigh
• THE FATTY LAYER OF THE
SUPERFICIAL FASCIA on the
anterior abdominal wall extends into
the thigh and continues down over
the lower limb without interruption.
• THE MEMBRANOUS LAYER OF
THE SUPERFICIAL FASCIA on the
anterior abdominal wall extends into
the thigh just for 1-2 inches below
and parallel to the inguinal ligament,
until it joins of the deep fascia of
thigh (fascia lata) forming a crease of
the skin called the Holden’s line.

5. 2. Fascial Compartments of the thigh
• Three fascial septa pass from
the inner aspect of the deep
fascial sheath of the thigh to the
linea aspera of the femur.
• By this means, the thigh is
divided into three
compartments— anterior,
medial, and posterior, each
having muscles, nerves, and
arteries.

7. 3. Deep fascia of the thigh (fascia lata)
SAPHENOUS OPENING:
• A gap in the fasia lata — 4 cm. below and lateral
to the pubic tubercle —
• Filled with the cribriform fascia —
• The structures passing through the saphenous
opening (or cribriform fascia):
• Arteries: Superficial epigastric artery,
Superficial circumflex iliac artery and
Superficial External pudendal artery…..
• Veins: Great sephanous vein…..
• Lymphatics: Which drain the superficial
inguinal lymph nodes into the deep
inguinal lymph nodes.

8. Figure-9: Superficial veins, arteries, and lymph nodes over the right femoral triangle. Note the
saphenous opening in the deep fascia and its relationship to the femoral sheath.

9. ILIO-TIBIAL TRACT:
• Lateral thickened part of the
fascia lata
• Receives the insertion of tensor
fasciae latae and the gluteus
maximus
• Helps maintain the knee joint
in the hyperextended
position.

10. 4. Femoral sheath
• Downward protrusion into the thigh, of the
fascial envelop lining the abdominal walls —
anterior wall is continuous above with the
fascia transversalis — posterior wall
continuous above with the fascia iliaca —
• Femoral sheath is divided into three
compartments by two septa —
• THE FEMORAL ARTERY occupies the lateral
compartment of the sheath —
• THE FEMORAL VEIN occupies the
intermediate compartment —
• THE LYMPH VESSELS: occupy the most
medial compartment, called the femoral canal
— The femoral canal contains One of the deep
inguinal lymph nodes (lymph node of Cloquet)
— The upper opening of the femoral canal is
called the
• FEMORAL RING — The femoral ring is
filled with plug of extraperitoneal connective
tissue, called the Femoral Septum.

11. Figure-10: Femoral sheath and the femoral canal in the right lower
limb.

13. II. GLUTEAL REGION

14. 1. Superficial Fascia of the Buttocks
• Superficial fascia is thick,
especially in women, and is
impregnated with large
quantities of fat.
• It contributes to the prominence
of the buttock.

15. 2. Deep Fascia of the Buttocks
• The deep fascia is continuous
below with the deep fascia, or
fascia lata, of the thigh.

16. Figure-11: Cutaneous nerves of the posterior
surface of the right lower limb.

17. III. ANTERIOR ASPECT OF LEG

18. 1. Fascial Compartments of the Leg
• Two intermuscular septa pass
from its deep aspect to be attached
to the anterior and posterior
borders of fibula.
• These, together with the
interosseous membrane, divide
the leg into three compartments—
anterior, lateral, and posterior
each, having its own muscles,
blood supply, and nerve supply.

19. 2. Interosseous membrane
• The interosseous membrane is a thick dense
fibrous sheet of connective tissue that
spans the space between tibia and fibula
forming a type of syndesmosis joint.
• The upper portion of the interosseous
membrane does not reach the
tibiofibular joint, but does create a large
concave border that allows the anterior tibial
vessels to pass through to the front of the
leg.
• The interosseous membrane binds the tibia
and fibula together and provides attachment
for neighboring muscles.

20. 3. Superior extensor retinaculum (SER) and inferior extensor
retinaculum (IER)
• SUPERIOR EXTENSOR
RETINACULUM is a transverse band of deep
fascia which is attached medially to anterior
border of the tibia and laterally to the anterior
border of the fibula ―
• INFERIOR EXTENSOR
RETINACULUM is a Y-shaped band placed in
front of the ankle-joint ― stem of the Y is attached
laterally to the calcaneus ― Medially, the two limbs
of the Y diverge, the Upper Limb is attached to the
medial malleolus and Lower Limb becomes
continuous with the plantar aponeurosis.
• They binds the tendons of the muscles of the
front of the leg as they pass to enter the sole.
• The tendons lie in compartments, each of which is
lined by a synovial sheath.

21. I. STRUCTURES THAT PASS SUPERFICIAL TO EXTENSOR RETINACULA
• 1. Superficial peroneal nerve

22. II. STRUCTURES THAT PASS DEEP TO EXTENSOR RETINACULA (from
medial to lateral)
• 1. Tibialis anterior
• 2. Extensor hallucis longus
• 3. Anterior tibial vessels
4. Deep peroneal nerve.
• 5. Extensor digitorum longus
• 6. Peroneus Tertius

23. IV. LATERAL ASPECT OF LEG

24. 1. Superior peroneal retinaculum (SPR) and inferior
peroneal retinaculum (IPR)
• SUPERIOR PERONEAL
RETINACULUM is attached
medially to lateral malleolus and
laterally to the calcaneus ― It binds
the tendons of peroneus longus and
brevis to the back of lateral malleolus
― Both the tendons have a common
synovial sheath.
• INFERIOR PERONEAL
RETINACULUM binds the tendons
of peroneus longus and brevis to the
side of calcaneum ― Both the
tendons have separate synovial
sheaths.

25. Figure-13: Peroneal retinacula.

26. V. POSTERIOR ASPECT OF LEG

27. 1. Flexor retinaculum
• It extends from the medial
malleolus to the medical
process of the calcaneus.
• It binds the tendons of the
deep muscles of the back of
the leg to the back of the
medial malleolus as they pass
forward to enter the sole.
• The tendons lie in compartments,
each of which is lined by a
synovial sheath.

28. I. STRUCTURES THAT PASS IN FRONT OF THE MEDIAL MALLEOLUS
• Great saphenous vein
• Saphenous nerve

29. II. STRUCTURES THAT PASS BEHIND THE MEDIAL MALLEOLUS
BENEATH THE FLEXOR RETINACULUM FROM MEDIAL TO LATERAL
• Tibialis posterior tendon
• Flexor digitorum longus
• Posterior tibial artery with venae
comitantes
• Tibial nerve
• Flexor hallucis longus
• As each of these tendons passes
beneath the flexor retinaculum,
it is surrounded by a synovial
sheath.

30. VI. SOLE OF THE FOOT

31. 1. Plantar aponeurosis
• The plantar aponeurosis is a
triangular thickening of the
deep fascia that protects the
underlying nerves, blood vessels, and
muscles.
• The apex of the aponeurosis is
attached to the medial and lateral
tubercles of the calcaneum.
• The base of the aponeurosis divides
into five slips that pass into the
heads of metatarsal bones.
• It helps in maintaining the
longitudinal arches of the foot

32. Figure-15: Plantar aponeurosis.