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gross_lecture_4[1] - Gross Anatomy I Lower Limb Fascia...

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Gross Anatomy I – Lower Limb Fascia, Vessels, and Cutaneous Nerves of Lower Limb Fascia lata = deep fascia of the thigh. It attaches to: inguinal ligament, pubic arch, body of pubis, pubic tubercle iliac crest, sacrum, coccyx, sacrotuberous ligament, ischial tuberosity, & exposed portions of bone. o Encloses large thigh muscles especially laterally where it is thickened to form the iliotibial tract (IT band) Extends from iliac tubercle to the anterolateral tibial tubercle (Gerdy tubercle) Venous Drainage of Lower Limb o Superficial veins Great saphenous vein is formed by the union of the dorsal digital vein of the great toe, and the dorsal venous arch of the foot Ascends anterior to the medial malleolus Passes posterior to the medial condyle of the femur Anastomoses freely with the small saphenous vein Traverses into the saphenous opening in the fascia lata Empties into the femoral vein Small saphenous vein arises on the lateral side of the foot from the union of the dorsal digital vein of the 5 th dorsal digit with the dorsal venous arch Ascends posterior to the lateral malleolus as a continuation of the lateral marginal vein Passes along the lateral border of the calcaneal tendon Inclines to the midline of the fibula and penetrates the deep fascia Ascends between the heads of the gastrocnemius muscle Empties into the popliteal vein in the popliteal fossa o Perforating veins penetrate the deep fascia close to their origin from the superficial veins. They contain valves that allow blood to flow only from the superficial veins to the deep veins. o Deep veins in the lower limb accompany all the major arteries and their branches. Deep veins in the lower limb are typically paired, and are contained within a sheath with an artery. Lymphatic Drainage in the Lower Limb Cutaneous Innervation of the Lower Limb o Most cutaneous innervation originates from the lumbar and sacral plexuses Dermatomes S1 and S2 pass inferiorly down the posterior aspect of the limb separating near the ankle to pass to the lateral and medial margins of the foot L1-L5 extend as bands from the posterior midline of the trunk into the limb; passing laterally and inferiorly around the limb to its anterior and medial aspects, reflecting medial rotation Thigh and Gluteal Region Anterior Thigh Muscles o Flexors of the Hip and Extensors of the Knee Pectineus- flat quadrangular muscle, located in the anterior part of the superomedial aspect of the thigh, that adducts and flexes the thigh and assists with medial rotation of the thigh
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Iliopsoas (chief flexor of the thigh)- formed by the merger of 2 muscles (psoas major and iliacus). This muscle is also a postural muscle, active during standing in maintaining normal lumbar lordosis and, indirectly, the compensatory thoracic kyphosis.
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