Lower Extremity Review
A review of the muscles of the lower extremity.
Terms
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- Flexor digitorum Longus Origin
- Tibia (shaft: posterior surface of middle 2/3), Fascia covering Tibialis posterior
- Semimembranosus Origin
- Ischium (tuberosity, superior and lateral facets), Complex proximal tendon along with fibers from biceps femoris and semitendinosus
- Gluteus Medias Origin
- Ilium (Outer surface between the iliac crst and the posterior gluteal line), gluteal aponeurosis
- Gastrocnemius Insertion
- Calcaneus (via tendo calcaneus into middle posterior surface). Fibers of tendon rotate 90 degees such that those associated w/ Gastrocnemius are attached more laterally on the calcaneus
- Semitendinosus Innervation
- L5-S2 Sciatic Nerve (tibial division)
- Flexor hallucis Longus Insertion
- Hallux (base of distal phalanx, plantar surface) Slip to tendon of flexor digitorum longus
- Piriformis Function
- Hip external rotation, abducts the flexed hip (assis), (muscle probably too small to do much of this)
- Piriformis Insertion
- Femur (greater trochanter, superior border of the medial aspect)
- Adductor Longus Origin
- Pubis (anterior at the angle where the crest meets the symphysis)
- Semitendinosus Function
- Knee flexion, Knee internal rotation, Hip extension, Hip internal rotation (accessory)
- Gluteus Maximus Insertion
- Iliotibial tract of fascia lata, Femur (gluteal tuberosity)
- Flexor Hallucis Longus Function
- Hallux IP flexion, Hallux MP flexion (acessory, Ankle plantar flexion and foot inversion (accessory)
- Anterior Tibialis Function
- Ankle dorsiflexion (talocrural joint), Foot inversion & adduction (supination) at subtalar & midtarsal joints, Supports medial-longitudinal arch of foot in walking
- Biceps Femoris Long Head Function
- Hip extension and external rotation
- Psoas Major Function
- Hip flextion (origin flexed), Trunk Flexion (insertion fixed), External Hip rotation, Lumbar spin flextion (muscles on both sides)
- Psoas Minor Origin
- T12-L1 vertebral bodies (sides) and the interverteral disc between them
- Semitendinosus Origin
- Ischium (tuberosity, inferior medial aspect), Aponeurosis to share tendon with biceps femoris (long head), Pes ansernia
- Gastrocnemius Medial Head Origin
- Femur (medial condyle, depression on upper posterior part; popliteal surface adjacent to medial condyle, capsule of knee joint, aponeurosis
- Biceps Femoris Both Insertion
- Tibia (lateral condyle via lamina from lateral hamstring tendon), Fascia on lateral leg
- Rectus Femoris Function
- Knee extension (none of the heads functions independently), Hip flexion (by rectus femoris, which crosses the hip joint)
- Flexor Hallucis Longus Innervation
- L5-S2 tibial nerve (low branches)
- Rectus Femoris Insertion
- Patella (base; from an aponeurosis which gradually narrows into a tendon which inserts into the center portion of the Quadriceps tendon, thence into the ligamentum patellae to a final insertion on the tibial tuberosity)
- Posterior Tibialis Insertion
- Navicular bone (tuberosity), Cuneiform bones (media, intermediate, lateral), Cuboid (slip), 2nd, 3rd, 4th metatarsals (bases) (variable)
- Soleus Insertion
- Aponeurosis over posterior surface of muscle, which, with tendon of gastrocnemius , thickens to become the tendon calcaneus, Calcaneus (posterior surface via tendon calcaneus along w/ gastrocnemius),Tendinous raphe in midline of muscle
- Iliacus Insertion
- Feber (lesser trochanter via insertion on tendon of the Psoas major & shaft below lesser trochanter)
- Flexor digitorum Longus Function
- Toes 2-5: MP, PIP, DIP flexion, Ankle plantar flexion (accessory), Foot inversion (accessory)
- Anterior Tibialis Innervation
- L4-L5 (often S1) Deep peroneal nerve
- Gluteus Maximus Origin
- Ilium (posterior gluteal line & crest), Sacrum (dorsal surface), Coccyx (lateral surface), Erector Spinae aponeurosis, sacrotuberous ligament, Aponeurosis of gluteus medius
- Iliacus Innervation
- L2-L3 femoral nerve
- Iliacus Function
- Hip Flexion, Flexes pelvis on femur
- Posterior Tibialis Origin
- Tibia (proximal 2/3 of posterior lateral shaft), Fibula (proximal 2/3 of posterior medial shaft & head), Interosseous membrane (entire posterior surface except lower portion where Flexor hallucis longus originates), Deep transverse fascia & intermuscular septa
- Piriformis Innervation
- S1-S2 Spinal nerves (nerve to piriformis)
- Biceps Femoris Short Head Origin
- Femur (linea aspera, entire length of lateral lip; lateral supracondylar line) Lateral intermuscular septum
- Soleus Innervation
- S1-S2 Tibial Nerve
- Rectus Femoris Origin
- Arises by 2 tendons, which conjoin to form an aponeurosis from which the muscle fibers arise: Ilium (anterior inferior iliac spine), Acetabulum (groove above posterior rim & superior margin of labrum), Capsule of hip joint
- Peroneus Longus Insertion
- 1st metatarsal (lateral plantar side of base), 1st (medial) cuneiform (lateral plantar aspect), 2nd metatarsal (occasionally by a slip)
- Psoas Minor Insertion
- Pecten pubis (pectinal line), Ilium (iliopectinal eminence and linea terminalis of inner suface of the pelvis), iliac fascia
- Gracilis Innervation
- L2-L3 Obturator nerve (anterior division) (ventral rami)
- Gluteus Medias Innervation
- L4-S1 Superior gluteal nerve (inferior branch)
- Posterior Tibialis Function
- Foot inversion, Ankle plantar flexion (accessory)
- Biceps Femoris Long Head Origin
- Ischium (tuberosity, inferior & medial aspects, in common with tendon of semitendinosus), Sacrotuberous ligament
- Pectineus Insertion
- Femur (shaft: on a line from lesser trochanter to linea aspera)
- Iliacus Origin
- Ilium (superior 2/3 of iliac fossa), Iliac crest (inner lip), Anterior sacroiliac and iliolumbar ligaments, Lateral Sacrum
- Tensor Fascia Lata Origin
- Ilium (Iliac crest; anterior part of outer lip; anterior superior iliac spine (ASIS)), Fascia lata (deep surface)
- Gluteus Medias Function
- Hip abduction (in all positions), Hip internal rotation (anterior fibers), Hip external rotation (posterior fibers), Hip flexion (anterior fibers), Hip extension (posterior fibers)
- Pectineus Origin
- Pecten pubis (between iliopectinal eminence and pubic tubercle), Anterior fascia
- Rectus Femoris Innervation
- L2-L4 femoral nerve
- Peroneus Longus Function
- Foot eversion, Ankle plantar flexion (assist), Depression of 1st metatarsal, Support of longitudinal & transverse arches
- Semimembranosus Innervation
- L5-S2 Sciatic nerve (tibial division)
- Biceps Femoris Long Head Insertion
- Aponeurosis of long head distally
- Adductor Longus Function
- Hip adduction, Hip flexion, Hip rotation (depends on position of the thigh), Hip external rotation (when hip is in extension; accessory)
- Gracilis Insertion
- Tibia (medial surface of shaft below tibial condyle), Pes anserina, Deep fascia of leg
- Soleus Function
- Ankle plantar flexion, foot inversion
- Psoas Minor Innervation
- L1 Spinal Nerve
- Semimembranosus Insertion
- Tibia (tubercle on medial condyle), Oblique popliteal ligament of knee joint, aponeurosis over distal part of muscle to form tendon of insertion
- Tensor Fascia Lata Insertion
- Iliotibial tract (both layers)
- Anterior Tibialis Insertion
- 1st (medial) cuneiform bone (on medial & plantar surfaces), 1st metatarsal bone (base)
- Sartorius Innervation
- L3-L3 femoral nerve (2 branches usually)
- Flexor digitorum Longus Innervation
- L5-S2 Tibial nerve
- Tensor Fascia Lata Function
- Hip flexion, hip internal rotation, knee flexion (accessory via iliotibial band) once the knee is flexed beyond 30 degrees (no confirmation), Knee extension with external rotation, Knee external rotation (assist)
- Biceps Femoris Short Head Insertion
- Deep surface of aponeurosis to form lateral hamstring tendon; Fibula (head, lateral aspect via main portion of lateral hamstring tendon)
- Psoas Major Innervation
- L2-L4 (lumbar plexus), spinal nerves (ventral rami), L1
- Gluteus Medias Insertion
- Femur (greater trochanter, oblique ridge on lateral surface)
- Gastrocnemius lateral Head Origin
- Femur (lateral condyle and posterior surface of shaft above lateral condyle; lower supracondylar line), capsule of knee aponeurosis
- Pectineus Innervation
- L2-L3 femoral nerve, L3 accessory obturator nerve (when present)
- Peroneus Longus Innervation
- L5-L1 Superficial peroneal nerve
- Sartorius Function
- Hip external rotation, abduction, and flexion, Knee flexion, knee internal rotation, assists in tailor sitting
- Soleus Origin
- Fibula (head, posterior surface, shaft; proximal 1/3 on posterior surface), Tibia (soleal line & middle 1/3 of medial side of shaft), Fibrous arch between tibia & fibula, Aponeurosis (anterior aspect)
- Sartorius Insertion
- Tibia (proximal medial surface of the shaft distal to the tibial condyle), Aponeurosis Capsule of the knee joint
- Psoas Minor Function
- Flexion of trunk and lumbar spine
- Biceps Femoris Short Head Innervation
- L5-S2 Sciatic nerve (common peroneal division)
- Peroneus Longus Origin
- Fibula (head & upper 2/3 of lateral shaft), Tibia (lateral condyle, occasionally), Deep crural fascia & intermuscular septa
- Anterior tibialis Origin
- Tibia (lateral condyle & proximal 2/3 of lateral surface), Interosseous membrane, deep surface of crural fascia, intermuscular septum
- Gracilis Function
- Hip adduction, knee flexion, internal (medial) rotation of knee (accessory)
- Adductor Longus Innervation
- L2 or L3-L4 Obturator nerve (anterior division)
- Gastrocnemius Innervation
- S1-S2 Tibial Nerve
- Piriformis Origin
- Sacrum (via 3 digitations attached between1st and 4th anterior sacral foramina), Ilium (gluteal surface near posterior iliac spin (PSIS)), capsule of sacroiliac joint, sacrotuberous ligament (pelvis surface)
- Pectineus Function
- Hip adduction, Hip flexion (accessory)
- Semimembranosus Function
- Knee flexion, knee internal rotation, hip extension, hip internal rotation (accessory)
- Sartorius Origin
- Ilium (ASIS, notch below ASIS)
- Semitendinosus Insertion
- Tibia (shaft on proximal medial side), Deep fascia of leg
- Posterior Tibialis Innervation
- L4-L5 (sometimes S1) Tibial nerve (low branches)
- Psoas Major Origin
- L1-L5 vertebrae (transverse processes, inferior border), T12-L5 vertebral bodies and intervertebral discs between them, Tendinous arches across the lumbar vertebral bodies
- Gastrocnemius Function
- Ankle plantar flexion, knee flexion (assessory), foot eversion
- Psoas Major Instertion
- Lower Trochanter of the Femur
- Tensor Fascia Lata Innervation
- L4-S1 Superior gluteal nerve (inferior branch)
- Adductor Longus Insertion
- Femur (by an aponeurosis on the middle 1/3 of the linea aspera on its medial lip)
- Gluteus Maximus Function
- Hip extension (Powerful), Hip external rotation, Hip abduction (upper fibers), Hip adduction (lower fibers), through its insertion into the iliotibial band, it sabilizes the knee
- Gracilis Origin
- Pubis (inferior ramus near symphysis via aponeurosis), ischial ramus
- Biceps Femoris Long Head Innervation
- L5-S2 Sciatic nerve (tibial division)
- Biceps Femoris Short Head Function
- Knee flexion (short head), Knee external rotation
- Flexor digitorum Longus Insertion
- Toes 2-5 (distal phalanges: base, plantar surface)
- Flexor Hallucis Longus Origin
- Fibula (shaft: inferior 2/3 of posterior surface), Interosseous membrane, Posterior Crural intermuscular septum, Fascia over tibialis posterior
- Gluteus Maximus Innervation
- L5-S2 inferior gluteal nerve