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MUSCLES OF GLUTEAL REGION/THIGH/LEG
DR MANOJ KUMAR SINGH1ST YR PG
PHYSICAL MEDICINE AND REHABILITATION
Muscles of the Gluteal Region:
MUSCLES OF ANTERIOR COMPARTMENT OF LEG
TIBIALIS ANTERIOR
EXTENSOR HALLUCIS LONGUS
EXTENSOR DIGITORUM LONGUS
PERONEUS TERTIUS
EXTENSOR DIGITORUM BREVIS
TIBIALIS ANTERIORORIGIN : Tibia :- lateral condyle U2/3 lateral surface of shaft Inter osseous membrane
INSERTION : Medial cuneiform :- infro medial surface 1st MT :- Base
N/S : Deep peroneal nerve ACTION : Dorsiflexion at foot Inverter of foot Maintain medial longitudinal arch of foot
EXT HALLUCIS LONGUS
ORIGIN : Fibula :-middle 2/4 shaft post surface
INSERTION : Distal phalynx of great toe :-Dorsal surfaceN/S : Deep peroneal nerve ACTION : Dorsi flexion of foot Extensin of MTP , Keep leg verticle while walking on uneven ground
EXTENSOR DIGITORIUM LONGUS ORIGIN : Tibia :- Lateral condyle Fibula :- U ¼ whole side Middle :- anterior half Interosseous membraneINSERTION : Middle and distal phalanges of 2nd and 5th toe Muscle divide into 4 tendons for 2ndto 5th toe Each tendon is joined on lateral side by tendon of ext digitobrevis and form dorsal digital expantion
N/S : Deep peroneal nerve
ACTION : Dorsiflexion of foot Extends MTP ,IP5 of 2nd and 5th toe
PERONEUS TERTIUS
ORIGIN : Fibula :- L/4 medial surface shaft
INSERTION : 5th MT – medial surface of dorsal surface
N/S : Deep peroneal nerve ACTION : Dorsiflexion and inverter of foot
EXTENSOR DIGITORIUM BREVIS
N/S : Deep peroneal nerve
ACTION : EHB :- Extends MTP of great toe Other extends MTP ,IP5 OF 2ND ,3RD,4TH toes
ORIGIN : Calcaneus anterior surface INSERTION : Proximal phalynx of 1st – 4th toes Muscle divides into 4 tendons for medial 4th toe medial most part of muscle called as extensor hallucis brevis Lateral 3 tendons join lateral side of EDL for dorsal digital expansion of 2nd ,3RD ,4th
toe
2 MUSCLES OF LATERAL SIDE OF LEG
PERONEUS LONGUS
PERONEUS BREVIS
PERONEUS LONGUS
ORIGIN : Fibula :- Head of fibula Lateral surface of shaft Medial 1/3 of fibula INSERTION : Medial cuneaform same as T.ant 1st MT N/S : Superior peroneal nerveACTION : Evertor of foot Maintains lateral longitdinal transerve arch
PERONEUS BREVIS
• ORIGIN : Fibula :- L/3 Lateral surface of shaft
• INSERTION : 5th MT
• N/S : Superficial peroneal nerve
• ACTION : Evertor of foot
MUSCLES OF MEDIAL SIDE OF LEG
• SARTORIUS • GRACILIS• SEMITENDANOSUS
SUPERFICIAL MUSCLES OF BACK OF LEG
. GASTROCNEMIUS
. SOLEUS
. PLANTARIS
GASTROCNEMIUSORIGIN : Medial Head :- medial condyle of femur popliteal surface of femur capsule of knee joint Lateral head :- lateral condyle of femur lateral supracondylar line capsule of kneeINSERTION : Calcaneous :- Tendons of gastrocnemius fuses with soleus for tendon achilis inserted on M/3 of posteior surface of calcaneous
N/S : Tibial nerve S1,S2 ACTION : Plantar flexion foot imp for walking Flexor of knee
SOLEUSORIGIN : Tibia :- soleal line and m/3 of post surface of shaft Fibula :- Base of head U/4 post surface of shaft INSERTION : Calcaneous:- Tendon of gastorcnemus fuses with tendon of soleus form tendon achillis inserted on M/3 of posteior surface of calcaneousN/S : Tibial nerve S1/S2ACTION : PLANOR FLEXION OF FOOT
PLANTARISORIGIN : FEMUR : Lateral condyle Oblique popliteal line INSERTION : Calcaneous:- posteior surface of calcaneum medial to TAN/S : Tibial nerve S1/S2ACTION : Plantar is rudimentary Accessory to gastrocnemeus Importance of
DEEP MUSCLES OF BACK OF LEG
. POPLITEUS
. FLEXOR HALLUCIS LONGUS
. FLEXOR DIGITORUM LONGUS
. TIBIALIS POSTERIOR
POPLITEUS
ORIGIN : Femur :- Lateral condyle Lateral meniscusINSERTION : Tibia :- post surface shaft of tibia above soleal lineN/S : Tibial nerve ACTION : Unlocking of knee by lateral rotations of femur on tibia bigining of flexion
FlEXOR HALLUCIS LONGUSORIGIN : Fibula :- lower ¾ post surface
INSERTION : Distal phalynx of big toe
N/S : Tibial nerve ACTION : Flexion of distal phalnx of great toe
FLEXOR DIGITORIUM LONGUSORIGIN : Tibia :-U/3post surface below soleal lineINSERTION : Distal phalanx of 2nd -5th toe Muscle divides into 4 tendons for lateral 4 toes N/S : Tibial nerveACTOIN : Flexor of digital phalanx 2-5th toes Plantar flexon of foot at ankle
TIBIALIS POSTERIORORIGIN : Tibia :- u2/3 posterior surface below soleal line Fibula :- Posterior surface of fibula INSERTION : Tuberosity of navicular bone and tarsal bones except talus Insert extends to 2nd ,3rd,4th,MT at baseN/S : Tibial nerve ACTION : Plantar flexion at ankle Inversion at foot at subtalar joint Maintains medial longitudinal arch
Muscles producing movements at hip joint
Movement Chief muscles Accessory muscles
Flexion Psoas major and iliacus Pectinius,rectus femoris,and sartorius,adductors(mainly adductor longus )participate in early stagesExtension Gluteus maximus and ---------------------------- Hamstrings Adduction Adductor longus,brevis,magnus Pectinius and gracilis
Abduction Glutei medius and minimus Tensor fascia lata and sartorius
Medial rotation TFL,anterior fibres of G.Med,G.Min ------------------------------ Lateral rotation 2obturators,2gemelli,and quadratus Piriformis,gluteus maximus, femoris sartorius
Muscles producing movement at knee joint
Movement Principal muscles Accessory muscles
Flexion Biceps femoris Gracilis Semitendinosus Sartorius Semimembranosus Popliteus
Extension Quadriceps femoris TFL
Medial rotation PopliteusOf flexed leg Semimembranosus Sartorius Semitendinosus Gracilis
Lateral rotation Biceps femoris ------------------------Of flexed leg
Muscles producing movements at ankle joint
Movement Principal muscles Accesory muscles
Dorsiflexion Tibialis anterior Extensor digitorum longus Extensor hallucis longus
Peroneus longus
Plantarflexion Gastrocnemius Plantaris Soleus Tibialis posterior Flexor hallucis longus Flexor digitorum longus
Muscles producing movement of inversion and eversion
Movement Principal muscles Accesssory muscles
Inversion Tibialis anterior Flexor hallucis longus Tibialis posterior Flexor digitorum longus
Eversion Peroneus longus Peroneus tertius Peroneus brevis