Pierre Lemelin, Ph.D.

Functional and Clinical Anatomy of Lower Limb

ANAT 403–The Human Body

Goals: (1) Understand the anatomical and functional aspects of human bipedal walking.
(2) Integrate this knowledge with clinical reasoning.

I. Bipedal Walking: Differences Between Chimpanzees and Humans

• 400cc vs 1400cc brain size

• Canine teeth are bigger (males)
• Posture
foramen
magnum

magnum
noninteri secondary
pframen
posterior
more
headisaheadofcolordosi

www
at hip
joint
femoralligament
onesingh willpullback g g
kyphosis
primary tovertical

Iowa
at feet
hip kneejoints gastrocnemius
sound
farther awayfrom willlrickin
bounce
midline backto
urtica
* Differences in the location of the center of mass and its position relative to the head,
vertebral column, and lower limb joints.

1
 A. Lumbar vertebrae Human chimpanzee

B. Pelvis body issignificantly

bigger andhipjoint ismuch
distanceb w sacroiliac

f
in a bigger
estbodyismuch bigger
Amore coronalposition

fI
iliaccrests lesurgluteals contribute
areoriented in montemedialnotation

11
asaggtalplane
Clesserguiteals

facritia jointismoreextensive
abduction

ilium acetabulum iliacpillar is quite

C. Femur translate
weighttohip
joint thick
1 femoral
head
1 isproportionatelylarger

I carryingangle

is
I isdifferent
obliquein

1Inimpanne

valgus're
knee
brings closerto
a
much
longer

D. Foot inchimps
grasping
forclimbing

no
abducted

moreofa
saddleshape
I
allowingG
moment
increased

2
 walks and runs
r andtheirdiff types
II. Bipedal Walking: Biomechanical Aspects of Human Gait
Walk minifoot ontheground
Runhasanaerial phase
aspeedb rstridelengthand r f mis
ramana

1effecta limbdecreases
length
increases the
CG rise thenfalls
at
stride 2steps
stride: support phase + swing phase
longer
loot
allowsfortherelease
of PE to KE
P efficiency

keeppelvisinertposition
via
abduction
ist
excessive
prevents futon
forward
athipjoint
mostmusclesoflower
i
limb an usedduring support
phasetorestrictmotion
Ettore
ÉÉÉÉh bucking

Ky q dauerate forward
mestrike
before
momentumright

resists
a It
exussindositeon
p
to toe off
mainlytibialis
anterior
pants immediatecollapse
rapidplantarflexonBAD
toe
prevents from draggingdining
phase
swing c aorsitlex.in

* Difference the action and the functional role of a muscle

3
 III. Bipedal Walking: Clinical Aspects of Human Gait

A. Injury to superior gluteal nerve = Trendelenburg gait

lessergluteal m

B. Injury to femoral nerve = buckling of knee joint during the support phase
landatmidsupportto preventbucking orwillusetheirhand tolocktime
C. Injury to tibial nerve = short stepping, leaning backward gait will in extension
alsoaffectcalfmuscles
sowon'tcollapseforward athipuoint willrotateinjurednotlaterallyshiftsplantar
fusionthat pants doscollapsetolateralcompa
D. Injury to common peroneal (fibular) nerve = loss of all muscles of the anterior and
lateral compartments as well as sensation on the dorsum of foot.

* Most commonly injured nerve of the lower limb; ability to dorsiflex the foot is lost =
foot-drop and “high-stepping” gait.
toefirstthenheel
preventsslapthatwouldcomeif they
heelstruck

4
IV. Clinical Aspects of the Knee Joint

internal
aspectof
g lateral
internalaspect of
andy medialcondyle

5
 ft

mammsm.in
rips le
meniscus
fpI tan
crush
lateral
meniscus

* “Unhappy” triad: injury and rupture of the anterior cruciate ligament, tibial (= medial)
collateral ligament, and medial meniscus.

V. Clinical Aspects of the Ankle Joint

* Tearing of the anterior talofibular ligament (and sometime calcaneofibular ligament)

when the weight bearing foot lands on its lateral side and is forced into inversion.
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 21 for Valdez
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