1. LOWER LIMB ANATOMY
We will try to review the anatomy of the lower limb with a more familiar and practical approach then we have been used to. We will do our best to keep in mind that we are addressing technicians / orthoprosthetists and their work related for this part of the theory.

2. LOWER LIMB ANATOMY OSTEOLOGY ARTHROLOGY MYOLOGY PHYSIOLOGY
Bones of the body
ARTHROLOGY
Junctions of bones in the body & joints elements [ligaments, tendons, fibrocartilaginous structure (shock absorber), capsule synovial (lubrication)]
MYOLOGY
Muscles
PHYSIOLOGY
Movements at the joints

3. OSTEOLOGY_LOWER LIMB

4. FOOT BONES (26 Bones+2 Sesamoids)
The human foot is composed of 26 individual bones divided in 3 groups
TARSAL (7 bones)
Calcaneus
Talus
Cuboid
Navicular
3 Cuneiforms
METATARSAL (5 bones)
5 Metatarsals
PHALANGES (14 bones):
3 for the 2nd, 3rd, 4th and 5th
2 for the 1st
& 2 Sesamoids

5. FOOT BONES (26 Bones+2 Sesamoids)
Talus
Calcaneus
Cuboid
Navicular
Cuneiforms
Metatarsals
Distal Phalanx
Middle Phalanx
Proximal phalanx
DORSAL VIEW

6. FOOT BONES (26 Bones+2 Sesamoids)
Navicular
Cuneiforms
Phalanges
Talus
Looking at the foot from under, at least on this drawing, it become very clear that two of the most prominent bones or part of bone are: the proximal head of the fifth metatasal and medially the Navcular. Although these two bony references are not much use in prosthetic they are used for arch support and other orthoses.
Calcaneus
Cuboid
Metatarsals
PLANTAR VIEW

7. FOOT BONES (26 Bones+2 Sesamoids)
Talus
Navicular
Cuneiforms
Metatarsals
Cuboid
Phalanges
Calcaneus
LATERAL VIEW

8. FOOT BONES (26 Bones+2 Sesamoids)
Talus
Calcaneus
Cuneiforms
Navicular
Metatarsals
Phalanges
MEDIAL VIEW

9. Midtarsal (Transverse tarsal) (Preserve the Talus & Calcaneum)
SOME FAMILIAR FOOT AMPUTATIONS
Tarsometatarsal
Lisfranc Amputation
Midtarsal (Transverse tarsal)
(Preserve the Talus & Calcaneum)
Chopart Amputation
more an ankle amputation then a foot amputation, we are including it with the foot part because part of the calcaneum is fixed to the tibia/peroneusluding the Pirogoff
As prosthetist we do come across those two types of amputation which do give problem to fit

10. SQUELETTON OF A CHOPART AMPUTATION
more an ankle amputation then a foot amputation, we are including it with the foot part because part of the calcaneum is fixed to the tibia/peroneusluding the Pirogoff
LATERAL VIEW

11. SHIN (LEG) BONES: TIBIA & FIBULA
POSTERIOR VIEW
ANTERIOR VIEW

12. SHIN'S (LEG) BONES: TIBIA & FIBULA
The Tibia, the main shin bone is connected with:
- the femur at the upper extremity.
- the fibula and the talus at the lower extremity.
The Fibula, located on the lateral aspect of the shin is jointed with:
- the tibia proximally
- the tibia and talus distally.
Reminder :
The Fibula is not part of the knee joint
ANTERIOR VIEW

13. Important anatomical shin bony references for the ortho
Tibial plateau
Head of fibula
Medial tibial flare
Gerdi tubercle
Tibial tuberosity
Tibial crest
Is the fibula part of the knee joint?
Medial Malleolus
Lateral Malleolus
ANTERIOR VIEW

14. Other anatomical shin bony terminologies
The upper epiphysis :
Tibial Spines
Tibial plateau
Glenoïd Areas
medial and lateral
Is the fibula part of the knee joint?
ANTERIOR VIEW

15. Other anatomical shin bony terminologies
The lower epiphysis :
Is the fibula part of the knee joint?
ANTERIOR VIEW

16. SOME FAMILIAR ANKLE AMPUTATIONS
Pirogoff
Pirogoff Amputation
Syme
Syme Amputation

17. THIGH'S BONE: FEMUR
POSTERIOR VIEW
ANTERIOR VIEW

18. Important anatomical thigh bony references + others terminologies
Femur head
Femur neck
Greater trochanter
Lesser trochanter
Adductor tubercle
The three in red are not palpable, therefore not usable as references but are a must know.
Lateral epicondyle
Medial epicondyle
Lateral condyle
Medial Condyle
Anterior view

19. Important anatomical thigh bony references + others terminologies
Femur head
Greater trochanter
Lesser trochanter
Linea aspera:
important muscle insertion area.
Intercondylar Fossa
Adductor tubercle
Medial epicondyle
Lateral epicondyle
Medial condyle
Lateral condyle
POSTERIOR VIEW

20. Others anatomical thigh bony terminologies
Upper extremity :
upper epiphysis
Corpus tibiae
Patellar surface
Lower extremity :
lower epiphysis
ANTERIOR VIEW

21. PATELLA: NO SHIN NOR THIGH BONE
The patella is small flat triangular shape bone with 2 sides:
- a posterior side jointed to the femur.
an anterior side on which the Quadriceps Femoris tendon is inserted.
Patella base
(on top)
Patella apex
(on bottom)
ANTERIOR VIEW

22. PATELLA: NO SHIN NOR THIGH BONE
Articulation areas to the femur Condyles
Patella base
Patella apex
POSTERIOR VIEW

23. KNEE: WHERE TIBIA, FEMUR & PATELLA MEET
Patella base
ANTERIOR VIEW
POSTERIOR VIEW
SAGITAL CUT VIEW

24. THE THREE PELVIC (COXAL) BONES: ILIUM, PUBIS & ISCHIUM
Iliac bone
Pubic bone
Ischial bone
ANTERIOR VIEW

25. Important hip bony references for the ortho + others terminologies
Iliac crest
Cavity Cotyloïd
Antero Superior
Iliac Spine
( ASIS)
Pubic Tubercle
Ischial tuberosity
ANTERIOR VIEW

26. Important hip bony references for the ortho + others terminologies
Iliac crest
Antero Superior
Iliac Spine
( ASIS)
Postero Superior
Iliac Spine
( PSIS)
Antero Inferior
Iliac Spine
( AIIS)
Postero Inferior
Iliac Spine
( PIIS)
Cavity Cotyloïd
Ischial tuberosity
Ischiopubic ramus
LATERAL VIEW: RIGHT HIP BONE

27. HIP: WHERE FEMUR & COXAL BONES MEET
OPEN JOINT VIEW
ANTERIOR VIEW
POSTERIOR VIEW

28. ARTHROLOGY of LOWER LIMB

29. ANKLE JOINT 3 BONES Medial Malleolus Lateral malleolus
Tibia
Fibula
Medial Malleolus
15 to 20 mm higher then the lateral malleolus
Lateral malleolus
located more posterior than Medial malleolus
Talus
CORONAL SECTION VIEW

30. Three lateral ligaments of the ankle joint
Anterior talofibular
ligament
Posterior talofibular
ligament
Calcaneofibular
ligament
LATERAL VIEW

31. Parts of medial (deltoid) ligaments of the ankle joint
1-Posterior Tibiotalar
2-Tibionavicular
3-Tibiocalcaneal
MEDIAL VIEW

32. KNEE JOINT
This is the largest joint of the body, it allows forward progression of the body, and acts as a shock absorber.
It is composed of:
The junction of three bones
Tibia, Femur & Patella
Four main ligaments
Lateral (Fibular) collateral ligament
Medial (Tibial) collateral ligament
Anterior cruciate ligament
Posterior cruciate ligament
Two meniscus
Lateral meniscus ("O" shape)
Medial meniscus ("C" shape)

33. Meniscus Main Functions
Distribute the weight bearing forces over a larger area.
Increase the knee stability.
Posterior
Cruciate
Ligament
Anterior
Cruciate
ligament
Lateral Condyle
Medial Condyle
Lateral Meniscus
("O" shape)
Medial Meniscus
( "C" shape)
POSTERIOR VIEW

34. Meniscus Over Tibia Anterior Cruciate ligament Lateral Tibial Condyle
Medial Tibial
Condyle
Lateral Meniscus
("O" shape)
Medial Meniscus
( "C" shape)
Posterior
Cruciate
Ligament
TRANVERSAL VIEW

35. ANTERIOR VIEW (FEMUR FLEXES 90°)
KNEE: INSIDE VIEW
Femur
Anterior
Cruciate
ligament
Posterior
Cruciate
Ligament
Medial Condyle
Lateral Condyle
Medial Meniscus
( "C" shape)
Lateral Meniscus
("O" shape)
Tibia
Head of fibula
ANTERIOR VIEW (FEMUR FLEXES 90°)

36. Some important knee references & terminologies for the ortho
Quadriceps femoris
Tendon
Medial
Condyle
Patellar
Ligament
Bursa
Medial (tibial) collateral ligament
Tibial
Tuberosity
ANTERO-MEDIAL VIEW

37. Some important knee terminologies for the ortho + others term.
Adductor Magnus
Tendon
Lateral head of
Gastrocnemius
Femur
Medial head of
Gastrocnemius
Semi Membranosus
Lateral (fibular) collateral ligament
Popliteus
Ligamentum
Popliteum
Medial (tibial) collateral ligament
Tibia
Fibula
POSTERIOR VIEW

38. HIP JOINT
OPEN JOINT VIEW
ANTERIOR VIEW
POSTERIOR VIEW

39. HIP JOINT
Meeting of two bones (femur and illiac bone) attached with 5 ligaments .
The illiac bone is composed of 3 bones:
illium
ischium
the pubis
The acetabulum, cavity concave is located at the junction of
these three bones, and connected to the spheric head of femur.
The head of femur is rotating inside the acetabulum.
The 5 ligaments ensuring the connection between the femur and
the illiac bone:
the transverse acetabular ligament
the ligament of the head of the femur (ligamentum Teres)
the iliofemoral ligament ( Y-ligament)
the pubofemoral ligament
the ischiofemoral ligament

40. HIP JOINT Head of femur Acetabulum Neck of the femur Ligamentum Teres
Great trochanter
Ischial Tuberosity
OPEN JOINT VIEW

41. HIP JOINT Antero Inferior Iliac Spine Pubofemoral Ligament Iliofemoral
(Y) Ligament
Great trochanter
Ischial Tuberosity
Lesser trochanter
ANTERIOR VIEW

42. HIP JOINT Acetabular Rim Ischiofemoral Ligament Great trochanter
Ischial Tuberosity
Lesser trochanter
POSTERIOR VIEW

43. MYOLOGY of LOWER LIMB

44. MYOLOGY of SHIN Peroneus Longus Tibialis anterior Extensor Digitorum
ANTERIOR VIEW

45. MYOLOGY of SHIN Triceps Surae
Gastrocnemius
Lateral head
Medial head
&
Soleus
Popliteus
Peroneus
Longus
Tibialis
Posterior
Flexor
Digitorum
Longus
Calcaneal
(Achilles)
Tendon
POSTERIOR VIEW

46. MYOLOGY of SHIN Gastrocnemius Lateral head Gastrocnemius Medial head
Peroneus
Longus
Soleus

47. MYOLOGY of THIGH & HIP

48. ANTERIOR THIGH MUSCLES Vastus Intermedius is (Behind Rectus Femoris)
Tensor of
Fascia Lata
Pectineus
Gracilis
Sartorius
Adductors
Longus
Magnus
Quadriceps
Rectus Femoris
Vastus Lateralis
Vastus Medialis
Vastus Intermedius is (Behind Rectus Femoris)

49. Vastus Intermedius is (Behind Rectus Femoris)
QUADRICEPS MUSCLES
Rectus
Femoris
Vastus Medialis
Vastus
Lateralis
Vastus Intermedius is (Behind Rectus Femoris)

50. ADDUCTORS MUSCLES AdductorMagnus Adductor Brevis Adductor Longus

51. ANTERIOR HIP MUSCLES Iliopsoas
Minor
Iliopsoas
Iliacus
Psoas Major
Pectineus
Tensor of
Fascia Lata
Adductor
Longus
Sartorius
Gracilis

52. POSTERIOR THIGH MUSCLES (HAMSTRING)
Medial Hamstring
Semitendinosus
Semimembranosus
Lateral Hamstring
Biceps Femoris
Long Head
Short Head
Gracilis

53. POSTERIOR HIP MUSCLES (GLUTEUS) & others
Gluteus Maximus
(Origin)
Gluteus Medius (Origin)
Piriformis
Gluteus Minimus
Obturator
Internus
Gluteus Medius (Ending)
Gemellus
Superior
Inferior
Quadratus Femoris
Gluteus
Maximus
(Ending)