ANAT 315: CLINICAL HUMAN MUSCULOSKELETAL ANATOMY

Lower Extremity Joint/Muscle Summary Chart

Dr. Nicole M. Ventura

LECTURE 16: THE PELVIS AND GLUTEAL REGION

THE HIP JOINT

• Articulation between the head of the femur and lunate surface of acetabulum
• Synovial: ball and socket joint,
• Reinforcing structures and Ligaments: Involved in deepening the socket and stabilizing the joint
o Deepen acetabulum or within acetabulum
Acetabular labrum (fibrocartilagenous ring)
Transverse acetabular ligament
Ligament of head of the femur
o Stabilize and limit movement at the hip
Iliofemoral ligament – prevents hyperextension and limits lateral rotation
Pubofemoral ligament – limits abduction
Ischiofemoral ligament – limits medial rotation

MUSCLES OF THE GLUTEAL REGION:

Gluteal Layers
Muscle
Origin(s) Insertion(s) Action(s) Innervation
Name
Ilium and sacrum, Hip extension and
Gluteal tuberosity, Inferior gluteal
Gluteus sacrotuberus & lateral (external)
iliotibial tract/band nerve
Maximus posterior sacroiliac rotation of the
(fascia lata) (L5-S2)
ligaments thigh
Hip abduction,
medial rotation
Gluteus External / posterior Lateral surface of
(anterior), lateral
Medius ilium greater trochanter
rotation Superior Gluteal
(posterior) n.
(L4-S1)
Gluteus External / posterior Anterior surface of Hip abduction and
Minimus ilium greater trochanter medial rotation
Lateral Rotators of the Thigh:
Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Upper medial N. to Piriformis
Piriformis Anterior sacrum aspect of greater (anterior rami S1-
trochanter S2)
Internal margins
of surface of
Obturator N. to Obturator
obturator
Internus Internus (L5-S2)
foramen and
membrane Lateral rotation of
Greater
the thigh at the
trochanter N. to Obturator
Gemellus Ischial spine Hip
Internus (L5-S2)
Superior
N. to Quadratus
Gemellus Inferior Ischial tuberosity Femoris
(L4-S1)
N. to Quadratus
Quadratus Intertrochanteric
Ischial tuberosity Femoris
Femoris crest
(L4-S1)

Medial Compartment of the Thigh:

External margins
of surface of Lateral rotation of
Obturator Intertrochanteric Obturator N.
obturator the thigh at the
Externus crest (L2-L4)
foramen and hip
membrane

LECTURE 17: THE ANTERIOR AND MEDIAL THIGH

MEDIAL COMPARTMENT OF THE THIGH: Adductors of the Thigh
Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Femoral N. (L2-L4):
Superior ramus of Pectineal line of the Hip Flexion,
Pectineus 80%
pubis femur adduction
Obturator N.: 20%
Adductor Longus Body of the pubis Linea aspera
Hip adduction,
Body of the pubis Obturator N.
Proximal linea flexion and medial
Adductor Brevis and inferior pubic (L2-L4)
aspera rotation
ramus

Adductor Magnus
Inferior pubic Medial lip of linea Hip adduction, Obturator N.
Adductor part ramus, ischial aspera flexion and medial (L2-L4)
ramus rotation

Hamstring part Ischial tuberosity Adductor tubercle Extends the thigh Tibial part of sciatic
of the femur (L4)
Hip adduction, knee
Proximal
Body and inferior flexion, medial Obturator N.
Gracilis Anteromedial tibia
pubic ramus rotation of the leg (L2-L4)
via pes anserinus
when sitting
ANTERIOR COMPARTMENT OF THE THIGH: Generally hip flexors and knee extensors (except Sartorius)
Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Iliopsoas Iliacus – Iliac fossa
Lesser trochanter of the Hip flexion and lateral Branches from
Iliacus + Psoas Psoas Major – T12-
femur rotation L2-L4
Major L5 vertebrae
Hip flexion, abduction
Proximal Anteromedial Femoral N.
Sartorius ASIS and lateral rotation
tibia via pes anserinus (L2-L4)
Knee flexion
Quadriceps
Femoris

Rectus Femoris AIIS Hip flexion, Knee

extension
Vastus Lateralis Greater trochanter,
intertrochanteric Knee Extension
Tibial tuberosity via
line, lateral linea Femoral N.
quadriceps tendon and
aspera (L2-L4)
patellar ligament
Intertrochanteric
Vastus Medialis line and medial Knee Extension
linea aspera

Vastus Anterior and lateral

Intermedius shaft of femur Knee Extension

LECTURE 19: THE POSTERIOR THIGH, KNEE AND POPLITEAL FOSSA

MUSCLES OF THE POSTERIOR COMPARTMENT OF THE THIGH (Hip Extensors/Knee Flexors)

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Biceps Femoris

Long Head Ischial tuberosity Hip Extension, Knee Tibial (L5-S3)

Head of the
Flexion
Fibula
Short Head Linea aspera Knee Flexion Common
Fibular (L4-S2)
Anteromedial
surface of Hip extension, knee
Semitendinosus Ischial tuberosity Tibial (L5-S3)
proximal tibia via flexion
pes anserinus
Posterior medial Hip Extension, knee
Semimembranosus Ischial tuberosity Tibial (L5-S3)
tibial condyle flexion

POSTERIOR KNEE
Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Knee flexion and
Lateral condyle of the Posterior tibia above
Popliteus unlocking of the Tibial (L5-S3)
femur soleal line
knee
THE KNEE JOINT

• Largest synovial joint – Modified hinge (flexion, extension and slight medial and lateral rotation
– “locking and unlocking – screw-home mechanism” of the knee)
• Comprised of 3 articulations:
o Medial and lateral condyles of the fibula and tibia (right and left- 2)
o Patella and femur
• Associated structures include:
o Medial and Lateral Menisci – fibrocartilagenous discs between the femoral and tibial
condyles
o Extra- and Intra-capsular ligaments
o Bursae and fat pads

Extracapsular Ligaments of the Knee:

• Patellar ligament
• Lateral (fibular) collateral ligament (LCL)
• Medial (tibial) collateral ligament (MCL)

Intracapsular Ligaments of the Knee:

• Anterior cruciate ligament (ACL)

• Posterior cruciate ligament (PCL)
• Transverse ligament – connects menisci anteriorly
• Posterior meniscofemoral ligament

LECTURE 20: THE LEG & FOOT (1)

JOINTS OF THE LEG - TIBIOFIBULAR JOINTS:
REINFORCING
JOINT ARTICULATIONS STRUCTURES AND MOVEMENT
LIGAMENTS
Proximal Head of the fibula Anterior and posterior
Synovial plane joint with fibular notch on ligaments of the head of
Up and
Tibiofibular Joints

lateral tibial condyle the fibula

downward
Middle
gliding to
Solid syndesmosis joint Shafts and distal Interosseous Membrane
accommodate
Interosseous membrane articulating surfaces
for
of tibia and fibula
movements of
Distal Anterior, posterior and
the ankle
Solid syndesmosis joint transverse tibiofibular

BONES OF THE FOOT:

• Tarsals (7): Calcaneus, talus, cuboid, navicular, 3 cuneiforms (medial, intermediate, lateral)
• Metatarsals (5)
• Phalanges (14): Distal, Middle, Proximal in lateral 4 toes, proximal and distal in the hallux (big
toe)
THE ANKLE JOINT:
JOINT BONE ARTICULATIONS REINFORCING LIGAMENTS MOVEMENTS
Medial Collateral (Deltoid) Ligament

Ankle joint Deep socket formed by • tibiocalcaneal Dorsiflexion /

malleoli of tibia and fibula, • tibionavicular plantarflexion
Synovial uniaxial articulating inferior surfaces • anterior and posterior
hinge joint of tibia and fibula and tibiotalar
superior surface of talus Lateral Collateral Ligament
bone
• anterior and posterior
talofibular
• calcaneofibular

Ligaments that limit dorsiflexion: Ligaments that limit plantar flexion:

• Calcaneofibular ligament (lateral) • Anterior talofibular ligament

• Posterior talofibular ligament (medial) • Anterior tibiotalar ligament
• Posterior tibiotalar ligament • Tibionavicular ligament
• Tibiocalcaneal ligament

JOINTS OF THE FOOT:

JOINT BONE REINFORCING LIGAMENTS MOVEMENTS
ARTICULATIONS
Posterior, medial and lateral
Subtalar Talus and calcaneus talocalcaneal & Gliding
(anatomical (posterior aspect of interosseous talocalcaneal (plane/gliding)
talocalcaneal) Joint bones) ligaments Inversion/eversion

(Partially ball and

socket)
Talocalcaneonavicular Talus, navicular, plantar calcaneonavicular Gliding and slight
Joint calcaneus (spring) ligament rotation -
Inversion/eversion
Circumduction
Dorsal and plantar
Calcaneocuboid Joint Calcaneus and cuboid calcaneocuboid and long Inversion/eversion
plantar ligament
Base of metatarsals, 3
Dorsal, plantar and
Tarsometatarsal Joint cuneiforms and
interosseous ligaments
cuboid
Slight gliding
Dorsal (3) and plantar (3)
Cuneiforms and
Cuneonavicular Joint cuneonavicular ligaments
navicular
(to each cuneiform)
Head of metatarsals Condyloid; flexion
Metatarsophalangeal Plantar and 2 collateral
and bases of proximal extension, abduction
(MTP) Joints ligaments for each
phalanges & adduction
 Interphalangeal (IP) Bases and heads of Plantar and collateral Hinge; flexion and
Joints adjoining phalanges ligaments extension

ARCHES OF THE FOOT:

• Bones and ligaments of the foot form three arches relative to the ground that absorb and
distribute downward forces

ARCH REINFORCING STRUCTURES AND LIGAMENTS KEYSTONE

Medial • Plantar Aponeurosis
Longitudinal • Plantar Calcaneonavicular (Spring) Ligament Talus
• Long Plantar Ligament
Lateral Longitudinal • Short (calcaneocuboid) Plantar Ligament Cuboid

Intrinsic ligaments of the foot Intermediate

Transverse
Tendon of Fibularis (peroneus) longus & tibialis posterior Cuneiform

LECTURE 21: THE LEG & FOOT (2)

ANTERIOR COMPARTMENT OF THE LEG: (Dorsiflexors)

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Lateral tibial Deep fibular
Dorsiflexion and
Tibialis Anterior condyle and shaft of Medial cuneiform (peroneal) n.
inversion of foot
tibia (L4-5)
Lateral tibial Dorsum of lateral 4
condyle, head and toes via extensor Extension of the Deep fibular
Extensor Digitorum
anterior fibula and expansions (middle toes, dorsiflexion of (peroneal) n.
Longus
anterior interosseus and distal the foot (L5, S1)
membrane phalanges)
Deep fibular
Fibularis Distal anterior Dorsum of 5th Dorsiflexion and
(peroneal) n.
(Peroneus) Tertius fibula metatarsal shaft eversion of the foot
(L5, S1)
Anterior fibula and Extension of hallux, Deep fibular
Extensor Hallucis Base of the distal
interosseus dorsiflexion of the (peroneal) n.
Longus phalanx of hallux
membrane foot (L5, S1)

LATERAL COMPARTMENT OF THE LEG: (plantarflexors and foot eversion)

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Eversion and
Medial cuneiform plantar flexion of
Fibularis Head and proximal and base of 1st the foot
(Peroneus) Longus lateral fibula metatarsal (plantar Supports lateral Superficial Fibular
surface) longitudinal and (Peroneal) n.
transverse arch (L5, S1-2)
Eversion and
Fibularis Distal 2/3 of lateral
Metatarsal V plantar flexion of
(Peroneus) Brevis fibula
the foot
POSTERIOR COMPARTMENT OF THE LEG: (plantarflexors)
Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Gastrocnemuis
Flexes the leg at the
Medial Head Medial Femoral Condyle
Dorsum of the knee, plantar flexes
Lateral Head Lateral Femoral Condyle
Calcaneus via calcaneal the foot at the ankle
Tibial n. (S1,
Soleal line; head of the tendon Plantar flexes the
Soleus S2)
fibula foot at the ankle
Flexes the leg at the
Plantaris Lateral supracondylar line Posterior Calcaneus knee, plantar flexes
the foot at the ankle
Flexes the hallux,
Flexor Hallucis Distal 2/3 of posterior Base of the distal Tibial n.
plantar flexes and
Longus fibula phalanx of hallux (S2-3)
inverts the foot
Base of the distal Flexes toes, plantar
Flexor Digitorum Posterior Tibia distal to
phalanx of lateral 4 flexes and inverts
Longus soleal line
toes foot
navicular, cuboid, Tibial n.
Plantar flexes and
cuneiforms, (L4-5)
inverts the foot
Tibialis Posterior Posterior tibia, fibula and sustentaculum tali of
(supports medial
interosseous membrane calcaneus and bases of
longitudinal arch)
metatarsals 2-4

Notes:

• Tendon of flexor hallucis longus travels in the groove inferior to the sustentaculum tali of the
calcaneous
• Structures running posterior to the medial malleolus (from anterior to posterior):
o Tom Dick And Very Nervous Harry
o Tibialis posterior (TP), Flexor Digitorum Longus (FDL), Posterior Tibial a., Tibial n.,
Posterior Tibial v,. Flexor Hallucis Longus (FHL)
o Crossing of the tendon of TP and FDL proximal to tarsal tunnel, crossing of tendons of
FHL and FDL distal to tarsal tunnel in the plantar surface of the foot.
o Tendon of Flexor Hallucis longus travels inferior to the sustentaculum tali (a bony
prominence on the calcaneus)

LECTURE 22: THE INTRINSIC FOOT

INTRINSIC MUSCLES OF THE FOOT:

DORSUM OF THE FOOT:

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Extensor Hallucis Dorsal base of the Extends
Brevis proximal phalanx of hallux hallux Deep fibular
Superolateral
(peroneal) n.
calcaneus
Extensor Extensor expansion of Extends (L5,S1)
Digitorum Brevis toes II-IV toes
PLANTAR SURFACE OF THE FOOT:
Plantar Aponeurosis – Deep fascia of the sole extending from calcaneus to the skin over heads of the
metatarsals of the foot.

FIRST LAYER: 3 Muscles

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Flexor Digitorum Middle phalanx of
Flexes toes
Brevis Medial process of lateral 4 toes
Medial plantar n.
calcaneal Medial base of
Flexes and abducts (S2, S3)
Abductor Hallucis tuberosity proximal phalanx
hallux
of hallux
Lateral and medial
Proximal phalanx
Abductor Digiti processes of Abducts and flexes Lateral plantar n.
of 5th toe (lateral
Minimi calcaneal the PIP of 5th toe (S2, S3)
side)
tuberosity

SECOND LAYER: 2 Muscles, 2 Tendons of Muscles of the Leg

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Quadratus Medial & lateral Lateral border of Offsets oblique Lateral Plantar n.
Plantae calcaneus: Calcaneal the long flexor pull of flexor (S2, S3)
tuberosity tendons digitorum longus
to flex the toes
Lumbricals (4)
1st medial side of Long Proximal phalanx Medial plantar n.
flexor tendons and extensor Flexion of MTP, (S2, S3)
2nd, 3rd, 4th 2nd, 3rd and 4th – LFT expansion of toe II extension of IP Lateral plantar n.
of II to IV As above for toes joints (S2, S3)
III-V

• includes the tendons of flexor digitorum longus and flexor hallucis longus

THIRD LAYER: 3 Muscles

Muscle Name Origin(s) Insertion(s) Action(s) Innervation
Flexor Hallucis Cuboid, lateral Medial and lateral
Brevis cuneiform, medial side of the Flexes the MTP Medial Plantar n.
Medial & Lateral 1st metatarsal, long proximal phalanx joint of hallux (S2, S3)
Heads plantar ligament of hallux
Adductor Hallucis
Oblique Head: Bases of Lateral side of the Adducts hallux,
metatarsals II-IV base of the helps maintain Lateral Plantar n.
proximal phalanx transverse arch of (S2, S3)
Transverse Head: MTP joints of digits of hallux the foot
III-V
 Base of 5th Lateral base of the
Flexor Digiti Flexes the MTP
metatarsal, long proximal phalanx
Minimi Brevis joint of toe V
plantar ligament of toe V

FOURTH LAYERS: 2 Muscles and 2 Tendons of Muscles from the Leg

Muscle Name Origin(s) Insertion(s) Action(s) Innervation

Adduct digits
Medial base of
III-V, flex MTP
Plantar Interossei Medial base of proximal phalanges and Lateral Plantar n.
and extend IP
(3) metatarsals III-V extensor expansion of (S2, S3)
joints of digits
digits III-V
III-V

1st and 2nd on either

side, the base of the 1st
phalanx of digit II, 3rd Abducts the
Dorsal Interossei Adjacent sides of Lateral Plantar n.
and 4th on the lateral toes, flexes
(4) metatarsals I-V (S2-3)
side of the proximal MTP joints
phalanx of toes III and
IV