THE MUSCLES OF THE LOWER LIMB

I. MUSCLES OF THE ILIAC REGION

Consist of a group of three muscles that originate from the lumbar vertebral column (psoas major and
minor) and the ilium (iliacus).

1. PSOAS MAJOR

Origin: the bodies and the costal processes of T12-L5

Insertion:

- Its fibres converge to a tendon which receives on its lateral side the fibres of iliacus, thus forming
iliopsoas muscle; after that, the tendon is attached to the lesser trochanter of the femur.

Innervation: lumbar spinal nerves (L1-L3) – lumbar plexus;

Action: Psoas major acts together with iliacus

2. ILIACUS

Origin: iliac fossa

Insertion: its fibres converge into the lateral side of the strong tendon of psoas major, the muscles then insert
together into the lesser trochanter.

Innervation: femoral nerve

Actions of the iliopsoas muscle:

- flexes the thigh upon the pelvis

- moves forwards the thigh of the swinging limb during walking
- lateral rotation of the thigh
- adduction of the thigh
- those muscles bend the trunk and pelvis forwards against resistance

II. MUSCLES OF THE GLUTEAL REGION

1. GLUTEUS MAXIMUS
- is the largest and most superficial muscle in the gluteal region

Origin:

- the lateral surface of ilium (the posterior gluteal line)

- the posterior surface of sacrum

Insertion:

- the iliotibial tract

- gluteal tuberosity

Innervation: the inferior gluteal nerve (L5-S2)

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Actions:

- Extension of the thigh; adduction of the thigh; lateral rotation of the thigh.
- Maintaining the bipedal posture

2. GLUTEUS MEDIUS

Origin:

- The external lip of iliac crest (3/4 anteriorly)

- The anterior superior iliac spine
- The external surface of ilium (between posterior and anterior gluteal line)

Insertion: the lateral surface of the greater trochanter

Innervation: superior gluteal nerve

Actions:

- Abduction of the thigh

- Lateral rotation of the thigh
- It fixes the pelvis during walking

3. GLUTEAUS MINIMUS

Origin:

- Gluteus minimus lies deep to gluteus medius, arises from the external surface of the ilium
between the anterior and inferior gluteal lines

Insertion: the anterior ridge of greater trochanter

Innervation: superior gluteal nerve

Actions: the same actions as the gluteus medius

4. Piriformis

Origin: the pelvic surface of sacrum and the greater sciatic foramen

Insertion: the upper border of the greater trochanter

Innervation: the sacral plexus (L5-S2)

Actions: abduction, extension and lateral rotation of the thigh

5. Obturator internus

Origin: the internal (medial) surface of the hip bone (around the obturator foramen)

Insertion: the trochanteric fossa (medial surface of greater trochanter)

Innervation: sacral plexus

Action: lateral rotation of the thigh

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 6. Obturator externus

Origin: the external (lateral) surface of ilium, around the obturator foramen.

Insertion: trochanteric fossa

Innervation: obturator nerve

Action: lateral rotation of the thigh

7. Gemellus inferior and gemellus superior

Origin:

- Gemellus inferior: ischial tuberosity

- Gemellus superior: ischial spine

Insertion: trochanteric fossa

Innervation: sacral plexus

Actions: lateral rotation of the thigh

8. Quadratus femoris

Origin: ischial tuberosity

Insertion: the posterior surface of the proximal end of femur

Innervation: sacral plexus

Action: lateral rotation of the thigh

III. MUSCLES OF THE THIGH

- The anterior muscle group: the quadriceps, Sartorius, tensor fasciae latae
- The adductor muscles occupy the region between the quadriceps and the medial margin of the thigh.
- The posterior muscle group, the hamstrings (biceps femoris, semitendinosus, and semimembranosus),
lie behind the adductors.

ANTERIOR COMPARTMENT

1. SARTORIUS
- It is the longest muscle in the body

Origin:

- anterior superior iliac spine.

- It crosses the thigh obliquely then descends to the medial side of the knee.

Insertion:

- medial surface of the proximal end of tibia. On this surface, its tendon together with gracilis and
semitendinosus form a large aponeurosis named “pes anserinus”

Innervation: femoral nerve

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Actions:

- Flexion of the thigh on the pelvis

- abduction, lateral rotation of the thigh
- Flexion of the leg at the knee and medial rotation of the leg.

2. QUADRICEPS FEMORIS

The great extensor muscle of the leg, covers almost all of the front and sides of the femur. It
can be divided into four parts: rectus femoris (arises from the ilium), the other three arise from the shaft of the
femur and surround it from the trochanters to the condyles: vastus lateralis is lateral to the femur, vastus
medialis is medial to it, and vastus intermedius lies in front of the femur.

Origins:

- Rectus femoris: anterior inferior iliac spine

- Vastus lateralis: the lateral lip of linea aspera, anterior surface of greater trochanter, intertrochanteric
line
- Vastus medialis: medial lip of linea aspera, the lower part of intertrochanteric line
- Vastus intermedius: the anterior and lateral surface of the femoral shaft

Insertion:

- The tendons of the four components of quadriceps unite in the lower part of the thigh to form a single
strong tendon attached to the base of the patella (sesamoid bone), and some fibres continue over it to
blend with the patellar tendon.

Innervation: femoral nerve (L1-L4)

Actions:

- Extension of the leg on the thigh

- Flexion of the thigh on the abdomen (rectus femoris)
- Walking: move forwards the swinging leg and fix in extension the leg of the supporting limb. It’s an
important muscle for the bipedal position.

3. TENSOR FASCIAE LATAE

Origin: anterior superior iliac spine

Insertion: it descends and is attached by the iliotibial tract (it is a tendinous tract) on the lateral condyle of tibia.

Innervation: superior gluteal nerve (L4-S1)

Actions:

- extends the knee (stabilizes the knee joint helping to maintain upright posture)
- assist in abduction and flexion of the thigh
- assist in flexion of the leg on the thigh

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 ADDUCTOR COMPARTMENT

Common innervation: obturator nerve!

1. PECTINEUS

Origin: the pectin pubis crest

Insertion: along a line from the lesser trochanter to the linea aspera. (pectineal line)

Innervation: obturator nerve

Actions: adduction, flexion and lateral rotation of the thigh.

2. ADDUCTOR LONGUS

Origin: the external surface of inferior pubic ramus

Insertion: into the middle 1/3 of linea aspera

Innervation: obturator nerve

Actions: Adduction, flexion and lateral rotation of the thigh

3. ADDUCTOR BREVIS

Origin: inferior pubic ramus

Insertion: into the superior 1/3 of linea aspera

Innervation: obturator nerve

Actions: Adduction, flexion and lateral rotation of the thigh

4. ADDUCTOR MAGNUS

Origin: ischial tuberosity, inferior rami of pubis and ischium

Insertion: into the linea aspera, the adductor tubercle on the medial condyle of the femur

Innervation: obturator nerve

Actions: adduction, extension, medial rotation of the thigh

5. GRACILIS

Origin: inferior pubic ramus

Insertion: the upper part of the medial surface of the tibia, forming a part of the pes anserinus

Innervation: obturator nerve

Actions:

- adduction of the thigh

- flexion and medial rotation of the leg

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POSTERIOR COMPARTMENT

- form the proximal lateral and medial margins of the popliteal fossa.

Common innervation: sciatic nerve (L4-S3)!!!

1. SEMITENDINOSUS

Origin: ischial tuberosity

Insertion: the upper part of the medial surface of the tibia forming pes anserinus

Actions:

- Extension of the thigh

- Flexion of the leg
- Medial rotation of the leg

2. SEMIMEMBRANOSUS

Origin: ischial tuberosity

Insertion:

- anterior and posterior surfaces of the medial tibial condyle. Recurrent muscular fibres are attached on
the lateral femoral condyle.

Actions:

- Extension of the thigh

- Flexion of the leg
- Medial rotation of the leg

3. BICEPS FEMORIS

Origin:

- Long head: ischial tuberosity

- Short head: the inferior ½ inside of linea aspera

Insertion: the head of fibula

Actions:

- extension of the thigh

- flexion of the leg on thigh
- lateral rotation of the leg

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 IV. MUSCLES OF THE LEG (CALF)

The muscles of the leg consist of an anterior group of extensor muscles, which produce dorsiflexion
(extension) of the ankle; a posterior group of flexor muscles, which produce plantar flexion (flexion); and a
lateral group of muscles, the fibulares.

ANTERIOR COMPARTMENT

Common innervation: deep fibular nerve (L4-L5)

1. TIBIALIS ANTERIOR

Origin: lateral condyle of tibia, the proximal half of the lateral surface of the tibial shaft

Insertion: first metatarsal bone and the medial cuneiform

Actions:

- dorsal flexion of the foot

- adduction of the foot
- medial rotation of the foot (inversion)
- supports the medial longitudinal arch of the foot

2. EXTENSOR DIGITORUM LONGUS

Origin: lateral condyle of tibia, medial surface of fibula

Insertion: the phalanges of the II-Vth toes

Actions:

- extension of the II-Vth toes

- dorsal flexion of the foot
- abduction of the foot
- lateral rotation of the foot

3. EXTENSOR HALLUCIS LONGUS

Origin: the middle 1/3 of the medial fibular shaft

Insertion: the phalanges of the hallux

Actions:

- extension of the hallux

- dorsal flexion of the foot
- medial rotation of the foot

4. Fibularis tertius

Origin: the inferior half of the medial fibular shaft

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Insertion: the fifth metatarsal bone

Actions: dorsiflexion of the foot, abduction and lateral rotation of the foot (eversion)

LATERAL (FIBULAR) COMPARTMENT

Common innervation: superficial fibular nerve (L5-S1)

1. FIBULARIS LONGUS

Origin: the head and lateral surface of fibula

Insertion: the first metatarsal bone

Actions:

- plantar flexion of the foot

- abduction of the foot
- lateral rotation of the foot (everts the foot)
- supports the longitudinal arch of the foot

2. FIBULARIS BREVIS

Origin: distal lateral surface of the fibular shaft

Insertion: the base of the fifth metatarsal bone

Actions: the same actions as the fibularis longus

POSTERIOR (FLEXOR) COMPARTMENT

Common innervation: tibial nerve

SUPERFICIAL FLEXOR GROUP

1. TRICEPS SURAE

Gastrocnemius + soleus = triceps surae

Gastrocnemius

Origin:

- medial head: posterior surface of the medial femoral condyle

- lateral head: lateral condyle of the femur
- As the muscle descends, the muscle fibres begin to insert into a broad aponeurosis
that develops on its anterior surface

Soleus

Origin: the soleal line on the posterior surface of tibia

Insertion:

- the soleus joins the tendon of gastrocnemius to form the calcaneal tendon (Achilles’s tendon) which is
attached on the calcaneal tuberosity

Actions of triceps surae:

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 - The plantar flexion of the foot
- Adduction of the foot
- Medial rotation of the foot
- The flexion of the leg on the thigh
- Postural role: stabilizes the ankle joint in standing

2. PLANTARIS

Origin: the lateral femoral condyle

Insertion: calcaneal tuberosity

Actions: tenses articular capsule of the knee joint. Has the same actions as the gastrocnemius.

DEEP FLEXOR GROUP

1. FLEXOR DIGITORUM LONGUS

Origin: below the soleal line

Insertion: the plantar surfaces of the distal phalanges of the II-Vth toes

Actions:

- the flexion of the toes

- the plantar flexion of the foot
- adduction and inversion of the foot

2. FLEXOR HALLUCIS LONGUS

Origin: the inferior 2/3 of the posterior surface of fibula

Insertion: the plantar surface of the distal phalanx of the hallux

Actions:

- flexion of hallux
- the plantar flexion of the foot
- adduction and inversion of the foot

3. TIBIALIS POSTERIOR

Origin:

- below the soleal line on tibia

- the superior 2/3 of the posterior surface of the fibula
- the interosseous membrane

Insertion: tarsal bones and the II-IV th metatarsal bones

Actions:

- the plantar flexion of the foot

- adduction and medial rotation of the foot

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 - elevates the longitudinal arch of the foot

4. POPLITEUS
- Popliteus is a flat muscle that forms the floor of the popliteal fossa

Origin: the lateral surface of the lateral femoral condyle

Insertion: above the soleal line on the posterior surface of the tibia

Innervation: tibial nerve

Action: flexion of the leg on the thigh

MUSCLES OF THE FOOT

1. DORSAL COMPARTMENT: extensor hallucis brevis, extensor digitorum brevis

2. PLANTAR COMPARTMENT: abductor hallucis, adductor halluces, flexor hallucis brevis, abductor
digiti minimi, flexor digiti minimi brevis, flexor digitorum brevis, flexor digitorum accessorius and
four lumbrical muscles, dorsal and plantar interossei
- Those muscles assist in maintaining the concavity of the foot.

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