Bone

Anterior View:

Posterior View:
 Greater Sciatic Foramen

Boundaries
Antlat: greater sciatic notch of ilium
Postmed: sacrotuberous ligament
Inf: sacrospinous ligament and ischial spine
Sup: ant sacroiliac ligament

Contents
Above Piriformis: sup gluteal vessels
sup gluteal nerve
Below Piriformis: inf gluteal and int pudendal vessels
inf gluteal, pudendal, sciatic, post femoral
cutaneous nerves; nerves to obturator internus and
quadratus femoris

Lesser Sciatic Foramen

Boundaries
Front: tuberosity of ischium
Above: spine of ischium and sacrospinous ligmanet
Behind: sacrotuberous ligament

Contents
Tendon of obturator internus
Int pudendal artery and vein
Pudendal nerve

The Hip Joint

Type: multiaxial ball and socket; synovial

Articulating Surfaces: head of femur (2/3 of sphere), acetabulum (accommodates >1/2 femoral surface in
lunate surface)
Acetabular Labrum: increases depth of acetabulum
Capsule: strong; attaches to edge of acetabulum and transverse acetabular ligament; anteriorly attached to
intertrochanteric line and root of greater trochanter, posteriorly attached to neck proximal to greater
trochanter; some reflects back as retinaculum that carries blood vessels to head and neck
Ligaments:
1) Iliofemoral – strong, anterior, AIIS and acetabular rim  intertrochanteric line; prevents over-
extension
2) Pubofemoral – iliopubic eminence and pubic part of acetabular rim  iliofemoral ligament;
strengthen inf and ant joint; prevents overabduction
3) Ischiofemoral – posterior; ischial acetabular rim  neck of femur; prevents hyperextension
4) Ligament of head of femur – intracapsular; of little importance; acetabular notch  fovea;
contains branch of obturator artery
Anterior aspect strengthen by ligaments, posterior by muscles

Pelvic Ligaments

Sacrotuberous: sacrum and ischial tuberosity

Sacrospinous: sacrum and ischial spine
Inguinal: ASIS and pubic tubercle
Knee Joint

Type: synovial, hinge

Movements: flexion and extension, rotation; knee locks 2Y to MED ROTATION OF FEMUR on tibia;
popliteus unlocks knee by laterally rotating femur
Articulations: 1) Femorotibial (lateral and medial) – femoral and tibial condyles
2) Femoropatellar
Fibular IS NOT involved
Strength: from muscles (esp. vastus medalis) > ligaments
Capsule: attaches to femur (just above condyles), tibial plateau;
has an opening just post to lat tibial condyle for popliteus to pass through where
it is prolonged inflate over popliteus to head of fibula (arcuate popliteal lig); ant
part is formed by quads tendon
Synovial membrane: posteriorly it reflects into intercondylar region covering
cruciates
Continuous with: suprapatellar, popliteus, anserine and gastrocnemius bursae
Artery: genicular anastomosis (from femoral, popliteal, ant and post recurrent
branches of ant tibial recurrent and circumflex fibular arteries). Intra-articular
components supplied by middle genicular branch of popliteal.
Nerve: femoral, tibial, common fibular, obturator, saphenous
Menisci: wider externally; attached to intercondylar tibia; coronary ligaments extend from menisci to tibial
condyles
1) Medial – C-shaped; broader posteriorly; adheres to surface of TCL therefore less mobile
2) Lateral – nearly circular; smaller; more moveable

Ligaments:
EXTRACAPSULAR
 1 Patellar – distal part of quads tendon; from apex of patella to tibial tuberosity; receives medial and
lateral patellar retinacula from vastus medialis and lateralis
2 Fibular collateral – cord like; 5cm; extracapsular; strong; lat epicondyle of femur to lat fibular
head; tendon of popliteus passes deep to it, separating it from lat meniscus
3 Tibial collateral – weaker flat band; intracapsular; med epicondyle of femur to med condyle of
tibia; fibres firmly attached to medial meniscus

INTRA-ARTICULAR
Cruciates WIND on in rotation, and UNWIND on ex rotation; maintain contact of femur with tibia
during flexion

1-Anterior cruciate – weaker; from ANT

INTERCONDYLAR TIBIA  sup, post, lat  POST
LAT CONDYLE OF FEMUR; limits POST
MOVEMENT OF FEMUR ON TIBIA
Tightens on knee extension
Factoid: inf fibres of vastus medialis stabilize patella
when knee extended;
2-Posterior cruciatePCL stabilizes
– stronger; knee
from when knee
POST
flexed
INTERCONYLAR TIBIA  sup, ant, med  ANT
Suprapatellar
MED CONYLE bursaOFascends
FEMUR;5cm+limits
above patella
ANT
There is no activeOF
MOVEMENT rotation
FEMUR of extended
ON TIBIA knee
Synovial membrane does not cover back of PCA
3-Popliteal tendon
Ankle Joint expansion of tendon of semimembranosus;
a)oblique:
from med tibial condyle to lat femoral condyle,
Medial: blending with joint capsule b)arcuate: from post fibular
head to post knee joint

Lateral:
Type: hinge, synovial
Articulating Surfaces: tibia, fibula, trochlea of talus
Capsule: synovial membrane can extends superiorly to IO ligament
Ligaments:
1) Lateral ligament of the ankle:
a. Anterior talofibular ligament: flat, weak band; lat malleolus  neck of talus
b. Posterior talofibular ligament: thick, strong; malleolar fossa  lat tubercle of talus
c. Calcaneofibular ligament: round cord; lat malleolus  lat calcaneus
2) Deltoid ligament: medial malleolus  talus, calcaneus, navicular; stabilizes during eversion
Artery: malleolar branch of fibular, ant and post tibial arteries
Nerve: tibial and deep fibular
Factoid: most stable during dorsiflexion

SubTalar (Talocalcanean) Joint

Type: synovial
Articulating Surfaces: body of talus (concave), sup calcaneus (convex)
clinical subtalar jt also contains talocalcaneal part of talocalcaneonavicular jt
Capsule: weak
Ligaments: med, lat ad post talocalcanean ligament
interosseous talcocalcanean ligament (anterior) – strong, within tarsal sinus
Movement: inversion and eversion

Talocalcaneonavicular Joint

Type: synovial, ball and socket

Articulating Surfaces: head of talus, post navicular, sup surface of plantar calcaneonavicular (spring) lig,
sustentaculum tali, calcaneus
Capsule: blends with interosseous talocalcanean ligament posteriorly
Ligaments: dorsal talonavicular ligament
spring ligament (sustentaculum tali (talar shelf)  postinf navicular bone) – supports talus,
maintains longitudinal arch

Talus

Calcaneus
Calcaneal Tendon
15cm long; continuation of aponeurosis formed halfway down calf; inserts on calcaneal tuberosity; fibres
spiral 90deg (gastrocnemius fibres attach laterally, soleal medially)
Subcutaneous calcaneal bursa

Arches of Foot
 Longitudinal

Medial part: higher; calcaneus,

talus (keystone), navicular, 3
cuneiforms, 3 MT’s
Lateral part: flatter; calcaneus,
cuboid, lat 2 MT’s

Support: tibialis anterior,

fibularis longus, flexor hallicus
longus, spring and plantar
ligament, plantar aponeurosis

Transverse

Bones: cuboid, cuneiforms,

bases of MT’s

Support: tibialis anterior and

fibularis longus

Areas
Saphenous Opening
Opening in fascia lata inf to med inguinal ligament; suplatinf margin formed by falciform ligament
(attaches to inguinal ligament); gt saphenous vein passes through suplaterally to enter femoral vein. Post
wall lies ant to pectineus.

Femoral Triangle
Boundaries
Superior: inguinal ligament (inf margin of ex oblique aponeurosis)
Medial: med border of adductor longus
Lateral: med border of sartorius
Floor: iliopsoas (lateral), pectineus (medial), adductor longus
Roof: fascia lata and cribiform fascia, sub cut tissue, skin

Contents
Femoral nerve
Femoral sheath: femoral artery, vein and inguinal lymph
Lat cutaneous nerve, femoral branch of genitofemoral nerve

Ileopectineal arch splits area post to inguinal ligament into 2

Femoral sheath: formed by transversalis and iliopsoas fascia; 3 compartments
1) Lateral - artery
2) Intermediate - vein
3) Medial = femoral canal; allows femoral vein to expand; femoral ring = base; can contain lymph
node of Cloquet
Factoid - femoral branch of genitofemoral nerve lies within femoral sheath but pierces it anteriorly to
supply skin overlying femoral triangle
- mid-inguinal point is half way between ASIS and pubic symphysis
- femoral pulse is 2-3cm inf to midpoint of inguinal ligament
- femoral nerve is midway between ASIS and pubic tubercle
- long saphenous vein joins femoral vein within triangle

Adductor Canal

Course: From apex of femoral triangle to

adductor hiatus

Contents: femoral artery and vein, saphenous

nerve, nerve to vastus medialis
NOT FEMORAL NERVE

Boundaries:
ant and lat – vastus medialis
floor – adductor longus and magnus
medial – adductor longus and magnus,
sartorius
roof – fascia, sartorius
Popliteal Fossa

Boundaries

Upper: semimembranosus
biceps femoris
Lower: gastrocnemius
plantaris
Floor: popliteus (inf), capsule (mid),
femur (sup)
Roof: skin and Popliteal fascia

Deeply, sup boundary by med and lat

supracondylar lines

Contents
Small saphenous vein entering popliteal vein
Popliteal artery and vein
Tibial and common fibular nerve
- tibial is largest, most superficial
Post cut nerve of thigh
Lymph nodes and vessels

Factoids
Popliteal artery is deep to popliteal vein which is
deep to nerves
Skin overlying popliteal fossa supplied by post
cut nerve of thigh
Posterior to Medial Malleolus
Tom Dick And Very Nervous Harry
Tibialis posterior tendon
Flexor Digitorum Longus tendon
Posterior tibial Artery
Posterior tibial Vein
Tibial Nerve
Flexor Hallicus longus tendon

Muscles
Muscles Inserting Onto Greater Trochanter

Gluteus medius and minimus (maximus goes to

iliotibial tract)
Gemellus superior and inferior
Obturator internus and externus
Piriformis
Quadratus femoris

Gluteal Region
Gluteus Maximus
Course: post gluteal line, post sacrum and coccyx, sacrotuberous ligament  iliotibial tract, gluteal
tuberosity of femur
Action: extends and laterally rotates thigh
Nerve: inf gluteal
Artery: sup and inf gluteal

Gluteus Medius
Course: ext ilium between post and ant gluteal lines  greater trochanter of femur
Action: abduct and medially rotates thigh
Nerve: sup gluteal
Artery: sup gluteal

Gluteus Minimus
Course: ext ilium between ant and inf gluteal lines  greater trochanter of femur
Action: abducts and medially rotates thigh
Nerve: sup gluteal
Artery: sup gluteal

Piriformis
Course: ant sacrum  upper greater trochanter of femur
Action: laterally rotates and abducts thigh
Nerve: S1 – 2
Artery:
Factoid: passes through greater sciatic foramen

Superior Gemellus
Course: ischial spine  obturator internus tendon
Action: laterally rotates femur
Nerve: nerve to obturator internus
Artery: inferior gluteal

Inferior Gemellus
Course: ischial tuberosity  obturator internus tendon
Action: laterally rotates femur
Nerve: nerve to quadratus femoris
Artery: inferior gluteal

Obturator Internus
Course: internal obturator membrane and margin of obturator foramen med greater trochanter above
trochanteric fossa
Action: laterally rotates and abducts thigh
Nerve: nerve to obturator internus
Artery: obturator

Obturator Externus
Course: external obturator membrane and sup and inf pubic rami  trochanteric fossa of femur
Action: laterally rotates thigh
Nerve: obturator
Artery: obturator

Quadratus Femoris
Course: lat ischial tuberosity  quadrate line of femur below intertrochanteric crest
Action: laterally rotates thigh
Nerve: nerve to quadratus femoris
Artery: inf gluteal

Posterior Thigh
Semimembranosus
Course: upper lateral ischial tuberosity  med condyle of tibia
Action: Extends thigh, flexes knee
Nerve: tibial
Artery: deep femoral

Semitendinosus
Course: lower, med ischial tuberosity (common tendon with biceps femoris)  med tibia (via pes
anserinus)
Action: extends thigh, flexes knee
Nerve: tibial
Artery: deep femoral
Factoid: pes anserinus is common insertion for gracilis, sartorius and semitendinosus

Bicep femoris
Long head: ischial tuberosity  head of fibula and lat condyle of tibia
Short head: lat lip of linea aspera  head of fibula and lat condyle of tibia
Action: extends thigh, flexes knee
Nerve: long head – tibial nerve
short head – common fibular nerve
Artery: deep femoral

Medial Thigh
Adductor Magnus
Course: ischiopubic ramus and ischial tuberosity  linea aspera and adductor tubercle of femur
Action: adducts, flexes and medially rotates thigh
ischiocondylar part: extends thigh
Nerve: post division of obturator nerve
ischiocondylar part: tibial nerve
Artery: obturator, deep femoral, medial femoral circumflex

Gracilis
Course: pubic symphysis and inf pubic ramus  med tibia (via pes anserinus)
Action: adducts, flexes and medially rotates thigh, flexes knee
Nerve: ant division of obturator nerve
Artery: obturator

Adductor Brevis
Course: inf pubic ramus  pectineal line and linea aspera
Action: adducts, flexes and medially rotates thigh
Nerve: ant division of obturator nerve
Artery: obturator, deep femoral

Adductor Longus
Course: med sup pubic ramus  lower 2/3 linea aspera of femur
Action: adducts, flexes and medially rotates thigh
Nerve: ant division of obturator nerve
Artery: obturator, deep femoral

Anterior Compartment of Thigh

Iliacus
Course: iliac fossa and crest, ala of sacrum  lesser trochanter of femur
Action: flexes thigh
Nerve: femoral
Artery: iliolumbar
Factoid: inserts with psoas major via iliopsoas tendon

Iliopsoas
Course: iliac fossa, bodies and transverse processes of lumbar vertebrae  lesser trochanter of femur
Action: flexes thigh, flexes lumbar
Nerve: L2-4, femoral
Artery: iliolumbar

Pectineus
Course: pectin of pubis  pectineal line of femur
Action: adducts, flexes, and medially rotates thigh
Nerve: femoral and ant division of obturator – DUAL NERVE SUPPLY
Artery: med femoral circumflex

Sartorius
Course: ant sup iliac spine  med tibia (pes anserinus)
Action: flexes, abducts and laterally rotates thigh, flexes knee
Nerve: femoral
Artery: lat femoral circumflex, saphenous

Quadriceps Femoris
1) Rectus Femoris
 a. Straight head: ant inf iliac spine  patellar ligament (patella and tibial tuberosity)
b. Reflected head: sup rim of acetabulum  patellar ligament
2) Vastus Intermedius: ant lat femur  patella
3) Vastus Lateralis: lat IM septum, lat linea aspera and gluteal tuberosity  patella and med patellar
retinaculum
4) Vastus Medialis: med IM septum, med linea aspera  patella and med patellar retinaculum
Action: extends knee (all), flexes thigh (rectus femoris)
Nerve: femoral
Artery: lat circumflex femoral (all), perforating branches of deep femoral (vastus medialis)

Anterior Compartment Leg

Tibialis Anterior
Course: lat tibial condyle and upper lat tibia  med medial cuneiform and 1st MT
Action: dorsiflexes and inverts foot
Nerve: deep fibular
Artery: ant tibial
Factoid: ant tibial artery lies lateral to this

Extensor Digitorum Longus

Course: lat condyle of tibia, ant fibula, lat IO membrane  extensor expansions lat 4 toes
Action: extends MTP, PIP and DIPJ lat 4 toes
Nerve: deep fibular
Artery: ant tibial
Factoid: ant tibial artery lies medial to this

Extensor Hallicus Longus

Course: med ½ ant fibula and IO membrane  base DP GT
Action: extends MTP and IPJ GT
Nerve: deep fibular
Artery: ant tibial

Fibularis Tertius
Course: distal ant fibula  dorsum shaft 5th MT
Action: everts foot
Nerve: deep fibular
Artery: ant tibial

Lateral Compartment Leg

Boundaries:
Lat surface fibula
Ant and post IM septa
Deep fascia leg
Superior fibular retinaculum

Fibularis Brevis
Course: lower 1/3 lat fibula 
tuberosity base 5th MT
Action: plantar flexes and everts foot
Nerve: sup fibular
Artery: fibular

Fibularis Longus
Course: upper 2/3 lat surface fibula
 past groove on ant-inf aspect of
cuboid  deep to intrinsic muscles of
foot  med cuneiform and base 1st
MT
Action: plantar flexes and everts foot
Nerve: superficial fibular
Artery: fibular

Tendons are posterior to lat malleous,

through sup fibular retinaculum (from
lat malleolus to calcaneus)

Posterior Compartment Leg

SUPERFICIAL
 Gastrocnemius
Medial head: above medial femoral condyle
 dorsum of calcaneus via calcaneal tendon
Lateral head: above lateral femoral condyle
 dorsum of calcaneus via calcaneal tendon
Action: flexes knee, plantar flexes foot
Nerve: tibial
Artery: sural, post tibial

Soleus
Course: post head and upper shaft fibula,
soleal line tibia  calcaneus via Achille’s
tendon
Action: plantar flexion
Nerve: tibial
Artery: post tibial

Plantaris
Course: above lat femoral condyle 
calcaneus medial to calcaneal tendon
Action: flex knee, plantar flexion
Nerve: tibial
Artery: popliteal

DEEP
 Flexor Hallicus Longus
Course: lower 2/3 post fibula  base DP GT
Action: flexes MTP and PIPJ GT, plantar
flexes foot
Nerve: tibial
Artery: fibular, tibial
Factoid: important in ‘push off’

Flexor Digitorum Longus

Course: mid ½ post tibia  bases DP digits
Action: flexes MTP, PIP and DIPJ, plantar
flexes foot
Nerve: tibial
Artery: tibial

Tibialis Posterior
Course: IO membrane, postmed fibula, postlat
tibia  tuberosity of navicular and med
cuneiform, MT’s
Action: plantar flexes and inverts foot
Nerve: tibial
Artery: fibular, tibial

Popliteus
Course: lat condyle femur  post tibia above
soleal line
Action: flexes knee, med rotate femur
Nerve: tibial
Artery: popliteal
Factoid: unlocks knee to initiate flexion of
knee; lies immediately deep to popliteal art;
may attach to lat meniscus

Muscles of the Foot

1ST LAYER
 1. Abductor Hallicus
Course: med tuberosity of calcaneus, flexor retinaculum, plantar
aponeurosis  med base PP gt toe
Action: abducts GT, flexes MTPJ
Nerve: medial plantar
Artery: med plantar

2. Flexor Digitorum Brevis

Course: med tuberosity of calcaneus, plantar aponeurosis, IM septum 
base MP 2-5
Action: flexes MTP and PIPJ 2-5
Nerve: med plantar
Artery: med and lat plantar
Factoid: splits to allow passage of flexor digitorum longus

3. Abductor digiti minimi

Course: med and lat tuberosity of calcaneus, plantar aponeurosis, IM
septum  lat base PP 5th digit
Action: abducts LT, flexes MTPJ
Nerve: lat plantar nerve
Artery: lat plantar

2ND LAYER
 1. Quadratus Plantae
Course: med plantar surface of calcaneus  postlat
tendon of flexor digitorum longus
Action: flexes lat 4 digits
Nerve: lat plantar

2. Lumbricals
Course: tendons of FDL  med expansion
Action: flex PIP, extend MIP and DIP
Nerve: med plantar (med 1), lat plantar (lat 3)

3. Flexor Digitorum Longus

Course: mid ½ post tibia  bases DP digits
Action: flexes MTP, PIP and DIPJ, plantar flexes foot
Nerve: tibial
Artery: tibial

4. Flexor Hallicus Longus

Course: lower 2/3 post fibula  base DP GT
Action: flexes MTP and PIPJ GT, plantar flexes foot
Nerve: tibial
Artery: fibular, tibial
Factoid: important in ‘push off’

3RD LAYER
 1. Flexor Hallicus Brevis
Course: cuboid, lat cuneiform, med 1st MT  med PP
GT, lat PP GT
Action: flexes MTPJ GT
Nerve: med plantar
Artery: med plantar
Factoid: tendons of insertion contain sesamoid bone

2. Adductor Hallicus
Oblique head: bases of MT 2-4  lat side base PP GT
Transverse head: heads of MT 3-5  lat side base PP
GT
Action: adducts GT
Nerve: lat plantar (deep branch)
Artery: plantar arterial arch
Factoid: plantar arterial arch passes sup to oblique head
of adductor hallucis

3. Flexor Digiti Minimi Brevis

Course: base 5th MT  lat base PP LT
Action: flexes MTPJ LT
Nerve: lat plantar
Artery: lat plantar

4TH LAYER
Extensor Digitorum Brevis
Dorsal Interosseous (4)
Course: suplat calcaneus  extensor expansion toes 1-
Course: shafts MT  base PP
4
Action: abduct 2-4; flex MTPJ and extend IPJ
Action: extends toes 1-4
Nerve: lat plantar (deep branch)
Nerve: deep fibular
Artery: dorsal metatarsal
Artery: dorsalis pedis
Plantar Interossei (3)
Extensor Hallicus Brevis
Course: bases and med sides MT  med bases of P
Course: suplat calcaneus  dorsum of base PP GT
Action: adducts digits, flex MTPJ
Action: extends GT
Nerve: lat plantar
Nerve: deep fibular
Artery: dorsalis pedis
 MUSCLE ATTACHMENTS

ARTERIES
Blood Supply to Hip
Trochanteric anastomosis (gter trochanter): descending sup gluteal
inf gluteal
ascending branches of med and lat circumflex femoral
Cruciate anastomosis (lesser trochanter): descending branch of inf gluteal
ascending branch of 1st perforating artery
transverse branches of med and lat circumflex femoral

Femoral Artery
Continuation of ex iliac beginning at femoral triangle 
descends on iliopsoas, pectineus and adductor longus 
enters adductor canal (vein lies post to artery, saphenous
nerve ant to artery)  pass through adductor hiatus 
becomes popliteal artery
Factoid: bisects femoral triangle

Profunda Femoris
Arises from lat side of fem art within fem triangle, 4cm inf to inguinal ligament  runs lat to fem art 
passes posterior leaving fem triangle between pectineus and adductor longus  descends post to adductor
longus
Branches: perforating branches – perforate adductor magnus to post and lat compartments of thigh
circumflex femoral – med branch – passes between iliopsoas and pectineus; supplies blood to head
and neck of femur
lat branch – passes deep to sartorius and rectus femoris

Popliteal Artery
Popliteal

Begins when femoral artery passes

through adductor hiatus of adductor
magnus Passes inferolaterally through
fossa  Divides at inf border of popliteus
 ant and post tibial arteries
Starts medial to tibial nerve, ends lateral
to it. Popliteal vein lies between the two
Gives off sural arteries to supply
gastrocnemius

Branches form genicular anastomosis

1) Inf lat genicular
2) Inf med genicular
3) Sup lat genicular
4) Sup med genicular
5) Mid genicular

Also contribute to anastomosis:

Descending genicular branch of

femoral art

Descending branch of lat

femoral circumflex art

Ant tibial recurrent branch of ant

tibial art
Anterior Tibial Artery
Begins at inf border of popliteus  passes anteriorly
through IO membrane  descends on ant surface of IO
membrane between EHL and TA with deep fibular nerve 
changes name to dorsalis pedis
Give off ant and post tibial recurrent arteries at knee;
malleolar arteries over med and lat malleoli
Accompanied by ant tibial vein

Posterior Tibial Artery

Begins at distal border of popliteus as popliteal artery passes
deep to tendinous arch of soleus and gives off fibular artery
 accompanied by tibial nerve  runs post to medial
malleolus  runs between tendons of FHL and FDL 
divides into med and lat plantar arteries
Gives off tibial nutrient artery
Accompanied by deep tibial vein

Fibular Artery
Arises from post tibial artery inf to distal border of popliteus
and tendinous arch of soleus  descends to med side of
fibula within FHL
Branches: nutrient artery of fibula
perforating branch – pierves IO membrane
lat calcaneal branch  heel
lat malleolar branch

Dorsalis Pedis Artery

Continuation of ant tibial artery. Travels deep to extensor
hallicus longus in ankle  lies lat to tendon of EHL  ends
when divides to form 1st dorsal metatarsal and deep plantar
artery
Joins lat plantar artery to form plantar arch
VEINS
Femoral Vein
Ascends through adductor canal, passing
from postlat to fem art to posterior 
femoral canal  becomes ex iliac vein.
Receives greater saphenous vein in
femoral triangle

Popliteal Vein

Begins at distal border of popliteus as post

tibial and ant tibial veins meet  peroneal
vein drains into it
Lies in sheath with popliteal artery,
passing from med to lat side of artery
Becomes femoral vein as passes through
adductor hiatus
Small saphenous vein drains in in
popliteal fossa

Med and lat plantar veins form post tibial

and fibular veins POST TO MED AND
LAT MALLEOLI
 Great Saphenous Vein
Formed by union of dorsal vein of gt toe and
dorsal venous arch  ascends ANTERIOR TO
MEDIAL MALLEOLUS  POST TO MEDIAL
CONDYLE OF FEMUR  passes through
saphenous opening in fascia lata  enters
femoral vein in femoral triangle
Accompanied by saphenous nerve

Small Saphenous Vein

Formed by union of dorsal vein of lt toe and
dorsal venous arch ascends POST TO LAT
MALLEOLUS  along lateral border of
calcaneal tendon  penetrates deep fascia 
between 2 heads of gastrocnemius ascends 
enters popliteal vein
Accompanied by sural nerve

NERVES

Clunial Nerve
Superior, middle and inferior clunial nerve – supply skin over iliac crest

Superior Gluteal Nerve

Course: runs between gluteus medius and minimus with deep branch of sup gluteal artery
Supplies: gluteus medius and tensor of fascia lata
Lesion: loss of abduction at hip

Inferior Gluteal Nerve

Course: runs through greater sciatic foramen (inf to Piriformis, deep to gluteus maximus and sup to sciatic
nerve) with inf gluteal vessels
Supplies: gluteus maximus
Lesion: loss of extension of hip

Sciatic Nerve

Course: formed at inf border of Piriformis; most lateral structure

coming through greater sciatic foramen  runs inflat under
gluteus maximus midway between greater trochanter and ischial
tuberosity  rests on ischium  passes post to obturator
internus, quadratus femoris and adductor magnus  travels in
thigh deep to biceps femoris

Accompanied by post femoral cutaneous nerve and inf gluteal

artery

Branches: tibial and common fibular nerve

Supplies: post thigh muscles, all muscles of leg and foot, most
skin of leg and foot

Lesion: loss of all motor except adduction and flexion of thigh

and extension of knee
loss of sensation lower leg and foot

Surface marking: midpoint between ischial tuberosity and gter

trochanter  apex of popliteal fossa

Pudendal Nerve
Most medial structure to exit greater sciatic foramen inf to Piriformis  enters perineum through lesser
sciatic foramen

Femoral Nerve
 Splits into superficial (R) and deep (L)
groups

Sup: 2 muscular, 2 cutaneous

Deep: 2 muscular, 2 cutaneous

Course: descends through psoas major  down between psoas major and iliacus  deep to inguinal
ligament midpoint  splits into ant and post divisions  through femoral triangle where separated from
femoral artery by portion of psoas major
Anterior division: anterior cutaneous branch (intermediate and medial cutaneous)
muscular branches – to pectineus and sartorius
Posterior division: saphenous – accompanies femoral artery and vein in adductor canal  becomes
superficial by passing between sartorius and gracilis  skin and fascia on
antmed knee, leg and foot
muscular branches – to quads
articular branches – to knee and hip
Factoid: largest branch of lumbar plexus)
comes from POSTERIOR divisions of anterior rami

Obturator Nerve
From ventral divisions of L2-4  descends through
psoas major  pierces psoas fascia, crosses sacroiliac
joint, passes lat to in iliac vessels and ureter  leaves
pelvis through obturator foramen  divides into ant
and post branches which are separated by obturator
externus then adductor brevis

Supplies: obturator externus, pectineus, adductor

longus, adductor brevis, gracilis, adductor magnus, and
med thigh

Tibial Nerve
Formed at bifurcation of sciatic nerve at top of popliteal
fossa where it lies medial to vessels  passes between 2
heads of gastrocnemius deep to tendinous arch of soleus
with post tibial vessels  descends in post compartment of
leg deep to soleus on tibialis posterior  lies between
tendons of FHL and FDL POSTERIOR TO MEDIAL
MALLEOLUS  terminates as med and lat plantar nerves

Gives branches in fossa – gastrocnemius, soleus, plantaris,

popliteus. Also supplies tibialis posterior, FDL, FHL
Med plantar – supplies AbH, FDB, 1st lumbrical, medial
sole of foot and med 3.5 toes
Lat plantar – supplies quadratus plantae, FDM, AdH, IO,
AbDM and 3 lumbricals, lat sole and lat 1.5 toes

Med sural cutaneous (joined by sural communicating

branch from fibular  sural nerve)  skin of inf leg and lat
foot

Lesion: loss of flexion of toes and inversion of foot; loss of

sensation sole of foot

Common Fibular Nerve

From dorsal branches L4+5, S1+2  begins at top of
popliteal fossa  Follows med border of biceps femoris in
lat popliteal fossa  Passes superficial to lat head of
gastrocnemius  passes between soleus and fibularis
longus  Winds around post neck of fibula runs deep to
fibularis longus  Divides into superficial and deep fibular
nerve
Lesion: loss of extension toes and foot; loss of sensation lat
lower leg and upper foot

Before division: articular branch to knee

lat sural cutaneous – postlat calf
Superficial Fibular Nerve
Begins between fibularis longus and fibula  runs between fibular
muscles and EDL  pierces deep fascia to become superficial at
lower 1/3 leg  divides into medial and intermediate dorsal
cutaneous nerve
Supplies: fibularis longus and brevis; skin of distal ant leg and
dorsum of foot
Action: everts foot

Deep Fibular Nerve

Arises between fibularis longus and neck of fibula  accompanies
ant tibial artery between tibialis anterior and EDL  pierces ant
crural intermuscular septum and EDL  runs deep to EDL 
descends ant to IO membrane with ant tibial artery between TA and
EHL  divides into lateral and medial terminal branch at ankle
Supplies: skin of 1st webspace, tibialis anterior, EDL, fibularis
tertius, EHL, ankle
Action: dorsiflexion, extension toes

Sural Nerve
Formed by medial sural cutaneous and peroneal anastomotic
branches  passes down with small saphenous vein, near lat
margin of tendocalcaneus, behind lat malleolus. Becomes lat
dorsal cutaneous nerve