Blood supply and nerve supply of

muscles of lower limb and their

functions

❖ The 62 lower extremity bones consist of 10 hip and leg, 14 ankle

and 38 foot bones.
❖ The 10 hip and leg bones are the innominate or hip bone, femur,
tibia, fibula, and patella (kneecap) on each side.
❖ The 14 ankle bones are the talus, calcaneus (heel bone),
navicular, cuboid, internal cuneiform, middle cuneiform, and
external cuneiform on each side.
❖ The 38 foot bones are the 10 metatarsals and 28 phalanges (toe
bones).

Hip bone
➢ Hip bone is a large irregular bone. It is made up of three parts. These are
the ilium (superiorly), pubis and the ischium.
➢ The three parts are joined to each other at a cup-shaped hollow, called
the acetabulum.
➢ The pubis and ischium are separated by a large oval opening
called the obturator foramen.
 Hip bone

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 Ilium
➢ The ilium or flank forms the upper expanded plate like part of the hip
bone.
➢ Its lower part forms the upper two-fifths of the acetabulum.

❖ Muscles of ilium

❖ Fascia lata
• The fascia lata is the deep fascia of the thigh. It encloses the thigh
muscles and forms the outer limit of the facial compartments of the
thigh, which are internally separated by intramuscular septa.
• Origin : outer lip of anterior iliac crest and anterior superior iliac
spine(ASIS).
• Insertion: iliotibial tract
• Blood supply : The fascia lata is pierced by :
1. The superficial iliac circumflex artery
2. The superficial epigastric artery
• Nerve supply : 1.Ilioingual nerve.
2.Femoral branch of the genitofemoral nerve.

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3.Medial, intermediate and lateral femoral cutaneous nerves..
4.Cutaneous branch of the obturator nerve
• Function: The fascia lata surrounds the tensor fasciae latae
muscle. It is a fibrous sheath that encircles the thigh
subcutaneously. This encircling of the muscle allows the muscles
to be bound together tightly.

❖ Tensor fascia latae

• The tensor fasciae latae is a muscle of the thigh. Together with the
gluteus Maximus, it acts on the iliotibial band and is continuous
with the iliotibial tract, which attaches to the tibia.
• Origin: TFL originates from Anterior superior iliac spine and
anterior part of iliac crest.
• Insertion : iliotibial tract
• Blood supply : The tensor fasciae latae muscle is vascularized
by the ascending branch of lateral circumflex femoral artery .
• Nerve supply : The innervation is supplied by the superior
gluteal nerve (L4-S1) a branch Of sacral plexus.
• Function: The main task of the tensor fasciae latae is to
sustain tension of the iliotibial tract. As the femoral shaft meets
the pelvis, an angled pressure from above imposes a high bending
strain to the femur.
➢ Both the hip abductors and the tensor fasciae latae counteract the
pressure on the opposite side and help stabilize the bone.
➢ Furthermore, the activation of the muscle leads to
an abduction, flexion and internal rotation of the hip joint.

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 ❖ Extensor oblique muscle

• The external oblique muscles are located on the outer surface of

the sides of the abdomen, on each side of the rectus abdominis.
• The muscles extend from the lower ribs to the pelvis. The external
oblique muscles are responsible for the twisting of the trunk.
• Origin: The muscle originates from the outer lip of the
anterior iliac crest and the anterior superior iliac spine. Distally its
fibers attach to the fascia lata- a deep fascia surrounding the entire
thigh musculature.
• Insertion: anterior two-third of the outer lip of iliac crest.
• Blood supply : The tensor fasciae latae muscle is vascularized
by the ascending branch of lateral circumflex femoral artery.
• Nerve supply : The innervation is supplied by the superior
gluteal nerve (L4-S1) a branch of sacral plexus.
• Function : The external oblique functions to pull the chest
downwards and compress the abdominal cavity, which increases
the intra-abdominal pressure as in a valsalva maneuver.
• It also performs ipsilateral (same side) side-bending and
contralateral (opposite side) rotation.

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 ❖ Sartorius muscle
• The sartorius muscle is the longest muscle in the entire human
body. It is a long, thin, band-like muscle found in the anterior
region of the thigh.
• Origin: Anterior superior iliac spine.
• Insertion: the medial side of the proximal tibia.
• Blood supply : As sartorius is such a long muscle, it comes as
no surprise that it requires extensive vascular supply from several
sources:
1.The proximal third may receive its vascular supply from the
branches of the femoral, deep femoral, lateral circumflex femoral
arteries and/or artery of quadriceps.
2.The middle third is supplied by branches of the femoral artery.
3.The distal third receives blood supply from the femoral artery and
descending genicular artery.
• Nerve supply : the femoral nerve L2 and L3
• Function: The sartorius muscle can move the hip joint and the
knee joint, but all of its actions are weak, making it a
synergist muscle.
• At the hip, it can flex, weakly abduct, and laterally rotate the thigh.
• At the knee, it can flex the leg; when the knee is
flexed, sartorius medially rotates the leg.
• Turning the foot to look at the sole or sitting cross-legged
demonstrates all four actions of the sartorius.

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 ❖ Lattissimus dorsi
• The latissimus dorsi is the largest muscle in the upper body.
• Origin : Just behind the highest point of the outer lip of the iliac
crest.
• Insertion: floor of the intertubercular groove of the humerus.
• Blood supply : The latissimus muscle is supplied by the
thoracodorsal artery, and branch of the subscapular artery. A
nerve, the thoracodorsal, and vein accompany the artery.
➢ The latissimus muscle blood supply is via the subscapular artery,
a branch of the axillary artery.
• Function : Depress,adducts,extends and internally rotates the
shoulder.

❖ Transverse abdominis
• Transverse abdominis muscle, is a muscle layer of the
anterior and lateral (front and side) abdominal wall which is deep
to (layered below) the internal oblique muscle. It is thought by
most fitness instructors to be a significant component of the core.
• Origin : anterior two-third of the inner lip of the iliac crest.
• Insertion : xiphoid process, linea alba, pubic crest.
• Blood supply : the posterior intercostal and subcostal
arteries, superior and inferior epigastric arteries, superficial and
deep circumflex arteries and posterior lumbar arteries.

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• Nerve supply : The terminal branches of the lower five
intercostal nerves and the subcostal nerve, that arise from the
lower six thoracic spinal nerves (T7-T12).
• Additionally, the iliohypogastric and ilioinguinal nerves (L1)
contribute to the nervous supply of this muscle.
• Function : It is involved in moving the trunk, but also stabilizes
the vertebral column, creates tension of the anterior body wall and
increases the intraabdominal pressure upon contraction.

❖ Fascia transversalis
• The transversalis fascia is a thin aponeurotic membrane which
lies between the inner surface of the transverse abdominal muscle
and the parietal peritoneum.
• Origin : It originates broadly from the anterior portion of the
iliac crest, lateral half of the inguinal ligament, and
thoracolumbar fascia.
• Insertion : inner lip of iliac crest.
• Blood supply : The inferior epigastric artery and vein, which
arise from the external iliac vessels just proximal to their passage
under the inguinal ligament, supply the inferior portion of the
rectus muscles and run superiorly until they anastomose with the
superior epigastric vessels.
• Function : Below the arcuate line, the transversalis
fascia forms the posterior sheath alone.
➢ With attachments to the posterior margin of the inguinal ligament,
it contributes to the formation of the femoral sheath, contributes

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 the internal spermatic fascia, and becomes the only layer
contributing to the inguinal floor.

❖ Fascia iliaca
• The iliac fascia, is a fascia in the region of the ilium of the pelvis.
• It is bound superolaterally by the iliac crest and merges medially
with the fascia overlying the psoas muscle.
• Origin : anterior to the iliacus muscle.
• Insertion : anterior two-third of inner lip of iliac crest.

❖ Quadratus lumborum
• The Quadratus lumborum muscle, informally called the QL, is a
paired muscle of the left and right posterior abdominal wall.
• It is the deepest abdominal muscle, and commonly referred to as
a back muscle. Each is irregular and quadrilateral in shape.
• Origin : posterior one third of inner lip of iliac crest.

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• Insertion : Inferior border of 12th rib and L1-L5.
• Blood supply : Branches of the subcostal artery.
➢ Branches of the lumbar arteries.
➢ The lumbar branch of the iliolumbar artery.
➢ The arteria lumbalis ima from the median sacral artery.
• Nerve supply : Subcostal nerve (T12).
• Iliohypogastric and Ilioinguinal nerve (both from L1).
• Branches from the ventral rami (L2 and L3).
• Function : Quadratus Lumborum fixes the 12th rib to
stabilize diaphragm attachments during inspiration.
➢ Lateral flexes the vertebral column.
➢ Extends lumbar vertebrae.
➢ It forms with the contralateral Tensor fascia lata and Gluteus
medius a lateral myofascial sling which aims to
maintain frontal plane stability of the pelvis.

❖ Internal oblique muscle

• The abdominal internal oblique muscle, also internal oblique
muscle or interior oblique, is an abdominal muscle in
the abdominal wall that lies below the external oblique muscle and
just above the transverse abdominal muscle.
• Origin : intermediate area of iliac crest.

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• Insertion : inferior borders of the 10th through 12th ribs and
the linea alba.
• Blood supply : The internal oblique is supplied by the lower
intercostal nerves, as well as the iliohypogastric nerve and the
ilioinguinal nerve.
• Nerve supply : The internal oblique is supplied by the lower
intercostal nerves, as well as the iliohypogastric nerve and the
ilioinguinal nerve.
• Function : Together with the other abdominal muscles,
the internal abdominal oblique is important for movements of the
trunk, maintaining normal abdominal tension, and increasing
intra-abdominal pressure.
➢ The internal oblique performs two major functions. Firstly as
an accessory muscle of respiration, it acts as an antagonist
(opponent) to the diaphragm, helping to reduce the volume of
the chest cavity during exhalation.
➢ Secondly, its contraction causes ipsilateral rotation and side-
bending. It acts with the external oblique muscle of the opposite
side to achieve this torsional movement of the trunk.

❖ Erector spinae
• The erector spinae is not just one muscle, but a group of muscles
and tendons which run more or less the length of the spine on the
left and the right, from the sacrum or sacral region and hips to the
base of the skull.

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• They are also known as the sacrospinalis group of muscles.
• It is made up of 3 muscles:
1. Medially by Spinalis
2. Centrally by logissimus
3. Laterally by iliocostalis
• Origin : Spinous processes of T9-T12 thoracic vertebrae,
medial slope of the dorsal segment of iliac crest.
• Insertion : spinous processes of T1 and T2 thoracic vertebrae
and the cervical vertebrae.
• Blood supply : lateral sacral artery.
• Nerve supply : posterior branch of spinal nerve.
• Function : The function of the spinal erectors is to move the
vertebral column.
➢ Bilateral contraction of these muscles extends the spine, while
unilateral contraction causes lateral flexion (ipsilateral).
➢ They also help to maintain posture by steadying the spine on the
pelvis during walking.

❖ Rectus Femoris
• The rectus femoris muscle is one of the four quadriceps
muscles of the human body.
• The rectus femoris is situated in the middle of the front of
the thigh ,it is fusiform in shape.
• Origin : The upper half of the anterior inferior iliac spine.
• Insertion : inserts into the patellar tendon as one of the
four quadriceps muscles.
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• Blood supply : descending branch of the lateral femoral
circumflex artery.
• Nerve supply : femoral nerve.
• Function : All four quadriceps are powerful extensors of
the knee joint. They are crucial in walking, running, jumping
and squatting.
• Because the rectus femoris attaches to the ilium, it is also
a flexor of the hip.

❖ Gluteus maximus
• gluteus maximus is the main extensor muscle of the hip.
• It is the largest and outermost of the three gluteal muscles and
makes up a large part of the shape and appearance of each side of
the hips.
• Its thick fleshy mass, in a quadrilateral shape, forms the
prominence of the buttocks.
• Origin : Gluteal surface of ilium , lumbar fascia, sacrum,
sacrotuberous ligament.
• Insertion : Greater trochanter of the femur and iliotibial tract.
• Blood supply : The gluteus maximus muscle is vascularized
by the muscular branches of the inferior gluteal and superior
gluteal arteries, the branches of the internal iliac artery.
• Nerve supply : Gluteus maximus receives its innervation
from the inferior gluteal nerve (root value L5-S2).
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• Function : The main functions of the gluteus maximus muscle
are:-
➢ the extension and external rotation of the thigh at the hip joint.
➢ Additionally, its superior part can produce thigh abduction, while
the inferior part causes the thigh adduction

❖ Gluteus medius
• The gluteus medius, one of the three gluteal muscles, is a broad,
thick, radiating muscle. It is situated on the outer surface of
the pelvis.
• Origin : Gluteal surface of ilium, under gluteus maximus from
the area between the anterior and posterior gluteal lines.
• Insertion : Lateral aspect of greater trochanter of femur.
• Blood supply : superior gluteal artery.
• Nerve supply : superior gluteal nerve(L4, L5, S1 nerve
roots).
• Function : The anterior part acting alone helps to flex and
internally rotate the hip.
➢ The posterior part acting alone helps to extend and externally
rotate the hip.
➢ The anterior and posterior parts working together abduct the hip
and stabilize the pelvis in the coronal plane.

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 ❖ Gluteus minimus
• The gluteus minimus is a small triangular muscle located deep in
the posterior region of the hip, spanning from the gluteal surface
of the ilium to the proximal end of the femur.
• It belongs to the group of gluteal muscles, along with
the gluteus maximus, gluteus medius and tensor fasciae latae.
• Origin : Gluteal surface of ilium between anterior and inferior
gluteal lines.
• Insertion : Anterior aspect of greater trochanter of femur.
• Blood supply : Superior gluteal artery, trochanteric
anastomosis.
• Nerve supply : the superior gluteal nerve (L4-S1), a branch
of the sacral plexus.
• Function : Gluteus minimus acts in synergy with
the gluteus medius to produce the movements on the hip joint, the
internal rotation and abduction of the thigh.

❖ Piriformis
• The piriformis is a small muscle located deep in the buttock,
behind the gluteus maximus.
• It runs diagonally from the lower spine to the upper surface of the
femur, with the sciatic nerve running underneath or through the
muscle.
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• Origin : Below the inferior gluteal line the rectus femolis arises
from the groove above the acetabulum.
• Insertion : Greater trochanter.
• Blood supply : inferior gluteal, superior gluteal and internal
pudendal arteries, all branches of the internal iliac artery.
• Nerve supply : Nerve to the piriformis(L5, S1, and S2).
• Function : Lateral Rotation of the hip when it is extended
(that is when in standing).
➢ Abduction of the hip when it is flexed.Aids slightly in tilting
pelvis laterally.
➢ Also aids in tilting pelvis posteriorly by pulling the sacrum down
towards the thigh.

❖ Obturator internus
• The obturator internus (OI) is a hip muscle that originates deep
within the pelvis, wraps out and inserts on the posterior aspect of
the head of the femur (the thigh bone).
• Origin : pelvic surface
• Insertion : Medial aspect of the greater trochanter.
• Blood supply : inferior gluteal artery.
• Nerve supply : Nerve to obturator internus (L5, S1, S2).

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• Function :The main function is to rotate the leg externally and has a
major role in stabilizing the head of the femur into the hip socket.

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 Pubis
➢ It forms the anteroinferior part of the hip bone and the
anterior one-fifth of the acetabulum, forms the anterior
boundary of the obturator foramen.
➢ It has:
a. A body anteriorly.
b. A superior ramus superolaterally.
c. An inferior ramus inferolaterally.

❖ Muscles of pubis
❖ Cremaster muscle
• The cremaster muscle is a muscle that covers the testis and
the spermatic cord.
• Origin : internal oblique muscle.
• Insertion : Tunica Vaginalis of testis.
• Blood supply : The cremaster muscle is supplied by the
cremaster artery which is a branch of inferior epigastric artery.
• Nerve supply : The cremaster muscle is innervated from the
genital branch of the genitofemoral nerve. It receives distinctly
different innervation and vascular supply in comparison to the
internal oblique.
• Function : The cremaster muscle lowers and raises the testis
in order to control its temperature. When a man enters an
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 environment with a colder temperature, the muscle causes the
testis to move against the body. The more the testis presses
against the body, the less it is exposed to the cold air.

❖ Rectus abdominis

• The rectus abdominis muscle, also known as the "abdominal

muscle", is a paired muscle running vertically on each side of the
anterior wall of the human abdomen, as well as that of some other
mammals.
• There are two parallel muscles, separated by a midline band of
connective tissue called the linea alba.
• Origin : Crest of pubis.
• Insertion : costal cartilages of ribs 5-7 Xiphoid process of
sternum.
• Blood supply : mainly by the superior epigastric
(continuation of the internal thoracic) and inferior epigastric
arteries (internal iliac branch) which run along the internal surface
of the muscle.
• Nerve supply : Intercostal nerves (T6-T11), Subcostal nerve
(T12).
• Function : Rectus abdominis flexes the trunk anteriorly.
➢ Moreover, working together with other abdominal muscles, this
muscle compresses the abdominal viscera and increases the
intra-abdominal pressure, which has an important function in
processes such as forced breathing, labor, defecation and
micturition.

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 ❖ Pyrimidalis
• Pyrimidalis is a paired triangular muscle of the anterior abdominal
wall found on each side of the linea alba.
• Pyramidalis belongs to the anterior abdominal muscles, together
with the rectus abdominis muscle.
• Origin : Pubic crest.
• Insertion : Linea alba.
• Blood supply : Blood supply to the pyramidalis muscle
comes from branches of the inferior epigastric artery.
• Nerve supply : subcostal nerve, which is the anterior ramus
of spinal nerve T12.
• Function : The pyramidalis, when contracting, tenses the linea
alba.

❖ Adductor longus
• In the human body, the adductor longus is a skeletal
muscle located in the thigh.
• Origin :anterior surface of the body of the pubis in the angle
between the crest and symphysis.
• Insertion : middle third of linea aspera.
• Blood supply : deep femoral artery.
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• Nerve supply : anterior branch of obturator nerve.
• Function : Its main actions is to adduct and laterally rotate the
thigh; it can also produce some degree of flexion/anteversion.

❖ Gracilis
• The gracilis muscle is the most superficial muscle on the medial
side of the thigh.
• It is thin and flattened, broad above, narrow and tapering below.
• Origin : on the anterior surface of the body from the margin of
symphysis, and from the inferior ramus.
• Insertion : tibia.
• Blood supply : medial circumflex femoral artery.

• Nerve supply : The gracilis is innervated by the anterior

branch of the obturator nerve that arises from the lumbar plexus.
• Function : Gracilis acts on the hip and knee joints, resulting in
several movements:-Strong leg flexion and medial (internal)
rotation around the knee joint when the knee is in a semiflexed
position.
➢ Weak thigh flexion and adduction around the hip joint, simply
aiding the other, more powerful thigh adductors.

❖ Adductor brevis

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• The adductor brevis is a muscle in the thigh situated immediately
deep to the pectineus and adductor longus.
• It belongs to the adductor muscle group. The main function of
the adductor brevis is to pull the thigh medially.
• Origin : anterior surface of the body of the pubis lateral to the
origin of gracillis.
• Insertion : Linea aspera of femur (medial lip).
• Blood supply : deep femoral artery.
• Nerve supply : The adductor brevis is innervated dually by
the anterior and posterior branches of the obturator nerve.
• Function : The muscle is primarily known as a hip adductor.
➢ It also functions as a hip flexor. Whether it acts to rotate the femur
laterally or medially is dependent on position.

❖ Obturator externus
• Obturator externus muscle is a flat, triangular, paired muscle of
the gluteal region.
• It is found on the anterior aspect of the obturator foramen, attached
to the obturator membrane and the adjacent margin of the
obturator foramen.
• Origin : the anterior surface of the body of the pubis near the
margin of the obturator foramen.
• Insertion : trochanteric fossa of the femur.
• Blood supply : Obturator and medial circumflex femoral
arteries.

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• Nerve supply : Obturator externus is innervated by the
posterior branch of the obturator nerve (L3 and L4), originating
from the lumbar plexus.
• Function : The mechanical model demonstrated that the
primary action of the obturator externus muscle was to externally
rotate the femur when the hip was in neutral position and flexed at
90°.
➢ Its secondary function was as an adductor when the hip was in
flexion.

❖ Levator ani
• The levator ani is a broad muscular sheet located in the pelvis.
• Together with the coccygeus muscle and their associated fascias
it forms the pelvic diaphragm.
• The levator ani is collection of three muscles: puborectalis,
pubococcygeus, and iliococcygeus.
• Origin : the middle part of the posterior surface of the body of
the pubis.
• Insertion : Inner surface of coccyx, levator ani of opposite
side, and into structures that penetrate it.
• Blood supply : Inferior gluteal artery.

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• Nerve supply : The levator ani muscles are mostly
innervated by the pudendal nerve, perineal nerve and acting
together.
• Function : The levator ani muscles are responsible for
"wagging" the tail in tailed quadrupeds.
➢ These muscles are not as strong in the human, as tail-wagging is
more demanding than the support function that the muscles serve
in humans.

❖ Pectineus muscle
• The pectineus muscle, is a flat, quadrangular muscle,
situated at the anterior (front) part of the upper and medial
(inner) aspect of the thigh.
• The pectineus muscle is the most anterior adductor of the
hip.
• Origin : the whole length of the pectineal line of pubis.
• Insertion : pectineal line of femur.
• Blood supply : Obturator artery.
• Nerve supply : Femoral nerve, sometimes obturator nerve.
• Function : It is one of the muscles primarily responsible
for hip flexion.
➢ It also adducts the thigh.

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 ❖ Psaos minor

• The psoas minor is a long, slender skeletal muscle which, when

present, is located anterior to the psoas major muscle.
• Origin : Lateral surface bodies f T12 and L1 vertebrae and
intervening intervertebral disc.
• Insertion : Pectineal line and iliopubic eminence.
• Blood supply : The psoas minor is supplied by the four
lumbar arteries (inferior to the subcostal artery) and the lumbar
branch of the iliolumbar artery.
• Nerve supply : Anterior ramus of nerve L1.

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• Function : The psoas minor is a weak flexor of the lumbar
vertebral column.

Attachments on pubic crest

Ischium
➢ The ischium forms the posteroinferior part of the hip
bone, and the adjoining two-fifths of the acetabulum.
➢ It forms the posterior boundary of the obturator

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 foramen. The ischium has a body and a ramus .

❖ Muscles of ischium
❖ Superior gemilli
• The superior gemellus muscle is the higher placed gemellus
muscle that arises from the outer (gluteal) surface of the ischial
spine, and blends with the upper part of the tendon of the internal
obturator.
• Blood supply : inferior gluteal artery.
• Nerve supply : L5, S1, and S2.
• Function : acts as a part of the triceps coxae muscle group to
produce external (lateral) rotation and abduction of the thigh.
➢ The movement produced by contraction of this muscle group is
dependent upon the position of the leg.

❖ Inferior Gemilli
• Inferior gemellus is a small, paired muscle located in the
deep gluteal region of the lower extremity.
• It is part of a larger, tricipital (three-headed) muscle complex
called triceps coxae (triceps of the hip) which also includes
the superior gemellus and obturator internus muscles.
• Origin : ischial tuberosity

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• Insertion : Medial surface of greater trochanter of femur (via
tendon of obturator internus).
• Blood supply : Medial circumflex femoral artery.
• Nerve supply : Nerve to quadratus femoris (L4/5, S1).
• Function : The gemellus inferior is an important muscle that
connects the upper legs to the pelvic region.
➢ This muscle enables the rotation of the thigh in a lateral, or
outward, motion.

❖ Quadratus femoris
• The quadratus femoris is a flat, quadrilateral skeletal muscle.
• Located on the posterior side of the hip joint, it is a strong
external rotator and of the thigh, but also acts to stabilize the
femoral head in the acetabulum.
• Blood supply : femoral surface of Ischium.
• Nerve supply : Nerve to quadratus femoris (L4-S1).
• Function : it stabilizes the hip joint by keeping the head of the
femur in place and produces external rotation of the thigh in the
hip joint when the lower limb is in the anatomical position.
➢ it can assist in the production of
both abduction and adduction movements of the leg.

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 ❖ Biceps femoris

• The biceps femoris is a muscle of the thigh located to the

posterior, or back.
• As its name implies, it has two parts, one of which (the long head)
forms part of the hamstrings muscle group.
• Blood supply : It has two heads of origin:
1.the long head arises from the lower and inner impression on the
posterior part of the tuberosity of the ischium.
2.the short head, arises from the lateral lip of the linea aspera
between the adductor magnus and vastus lateralis extending up
almost as high as the insertion of the gluteus Maximus.
• Nerve supply : long head: tibial nerve
short head: common fibular nerve
• Function : In general, the biceps femoris muscle acts on both
the knee and hip joints.
➢ Although, due to its attachments, the short head of this muscle
acts only on the knee joint while the long head acts on both. When
acting on the hip joint, biceps femoris produces the movement of
hip extension.

❖ Adductor magnus

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• The adductor magnus muscle is a large triangular muscle of the
lower limb, with its apex situated on the hip bone, and its base on
the linea aspera of the femur.
• It is situated both in the posterior and medial fascial
compartments of the thigh.
• It is a composite muscle consisting of two parts, the adductor part
and the hamstring part, also called the ischiocondylar part.
• Origin : The adductor part: arises from the outer surface of the
inferior pubic ramus and the ischial ramus.
• The hamstring: part originates from the inferolateral side of the
ischial tuberosity.
• Insertion : Adductor part: Gluteal tuberosity, linea aspera
(medial lip), medial supracondylar line .
➢ Ischiocondylar part: Adductor tubercle of femur.
• Blood supply : Deep femoral artery, Femoral, popliteal and
genicular arteries.
• Nerve supply : Adductor part: Obturator nerve (L2-L4)
➢ Ischiocondylar part: Tibial division of sciatic nerve (L4)
• Function : On the medial side (closest to the middle) of the
thigh, the adductor magnus muscle creates the shape of a large
triangle.

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➢ As an adductor, it contracts and pulls the hip towards the body's
midline. This action is a fundamental part of walking, sprinting,
and a variety of other bipedal motions.

Attachment of ischial tuberosity

Femur
➢ The femur (Latin thigh) or thighbone is the longest and the
strongest bone of the body.

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➢ Like any other typical bone it has two ends upper and lower, and

shaft.

Femur

❖ Muscles of femur

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 ❖ Vastus intermedius
• The vastus intermedius arises from the front and lateral surfaces
of the body of the femur.
• Its fibers end in a superficial aponeurosis, which forms the deep
part of the quadriceps femoris tendon.
• It is one of the four muscles that form the quadriceps femoris
muscle.
• Origin : upper three fourth of the anterior and lateral surfaces
of the shaft of the femur.
• Insertion : : Tibial tuberosity and patella by Quadriceps
tendonquadriceps tendon.
• Blood supply :
• Blood supply : The blood supply to
the vastusintermedius comes from the artery of the quadriceps
and deep femoral artery.
• Nerve supply : The Vastus Intermedius muscle is innervated
by a branch of the Femoral nerve, originating from lumbar nerve 2,
3, and 4 nerve roots.
• Function : The main function of the vastus intermedius is
extension of the knee.

• Vastus lateralis

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• The vastus lateralis also called the ''vastus externus'' is the
largest and most powerful part of the quadriceps femoris, a
muscle in the thigh.
• Origin : the upper part of the intertrochanteric line, anterior and
inferior aspects of the greater trochanter, the lateral margin of the
gluteal tuberosity, and the upper half of the lateral lip of the linea
aspera.
• Insertion : Tibial tuberosity via patellar ligament, patella ,
lateral condyle of tibia.
• Blood supply : Vastus lateralis receives its blood supply
from three sources:
➢ The superior medial artery, which is a branch of the lateral
circumflex femoral artery.
➢ The inferior medial artery, a branch of the artery of the quadriceps.
➢ The lateral artery, which is actually the first perforator of the deep
femoral artery.
• Nerve supply : The vastus lateralis muscle is innervated by
the muscular branches of the femoral nerve (L2, L3, and L4).
• Function : The specific task of the vastus lateralis muscle is to
extend the lower leg and allow the body to rise up from a
squatting position.

❖ Vastus medialis

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• The vastus medialis is a muscle present in the anterior
compartment of thigh, and is one of the four muscles that make
up the quadriceps muscle.
• Origin : The vastus medialis arises from the lower part of
intertrochanteric line, the spiral line, medial lip of the linea aspera,
and the medial supracondylar line.
• Insertion : quadriceps tendon.
• Blood supply : femoral artery.
• Nerve supply : femoral nerve.
• Function : It is involved in knee extension, along with the
other muscles which make up the quadriceps muscle.
➢ The vastus medialis also contributes to correct tracking of the
patella.

❖ Plantaris
• Plantaris is long, thin muscle extending behind the knee and into
the sural region (calf) of the posterior leg.
• It forms, together with gastrocnemius and soleus, the superficial
group of the posterior compartment of the leg.
• The muscle belly is variable both in thickness and length.
• Origin : the lateral end of lateral supracondylar line of the femur.
• Insertion : Achilles tendon.
• Blood supply : Plantaris has a dual blood supply:

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➢ Superficially it receives blood from the lateral sural artery, a branch
of the popliteal artery.
➢ Its deep surface is supplied by the superior lateral genicular
artery, which also stems from the popliteal artery.
• Nerve supply : Plantaris is innervated by the tibial nerve,
which is a branch of the sciatic nerve. The tibial nerve arises from
the S1 and S2 spinal nerves.
• Function : There is a level of disagreement about the function
of the plantaris muscle. Due to its attachments, it is involved in
plantar flexion of the foot at the ankle joint and in knee flexion at
the knee joint. In reality, however, it weakly assists the
gastrocnemius and soleus muscles to perform these two
movements.

❖ Gastrocnemius
• The gastrocnemius muscle is a superficial two-headed muscle
that is in the back part of the lower leg of humans.
• It runs from its two heads just above the knee to the heel, a three
joint muscle.
• Origin : proximal to articular surfaces of lateral condyle of
femur and medial condyle of femur.
• Insertion : tendo calcaneus(achilles tendon) into mid-
posterior calcaneus.

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• Blood supply : lateral and medial sural arteries, which are
direct branches of the popliteal artery.
• Nerve supply : The gastrocnemius is innervated by the
ventral rami of S1 and S2 spinal nerves, carried by the tibial
nerve into the posterior compartment of the leg.
• Function : The gastrocnemius is a powerful plantar flexor of
the foot at the talocrural joint.
➢ It also flexes the leg at the knee. The actions of gastrocnemius are
usually considered along with soleus, as the triceps surae group.
➢ They are the chief plantar flexors of the foot.
➢ The muscles are usually large and powerful. Gastrocnemius
provides the force behind propulsion for walking, running and
jumping.

❖ Articularis genu
• The articularis genus is a small skeletal muscle located anteriorly
on the thigh just above the knee.
• Origin : the anterior surface of the lower part of the body of the
femur.
• Insertion : the synovial membrane of the knee-joint.
• Blood supply : It is supplied by the lateral femoral
circumflex artery.
• Nerve supply : It is innervated by branches of the femoral
nerve (L2-L4).

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• Function : Articularis genus pulls the suprapatellar bursa
superiorly during extension of the knee, and prevents
impingement of the synovial membrane between the patella and
the femur.

Attachment of anterior aspect of femur

38
 Attachment on posterior aspect of femur

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 Patella
➢ The patella is the largest sesamoid bone in the body, developed in
the tendon of the quadriceps femoris.
➢ It is situated in front of the lower end of the femur about 1 cm
above the knee joint.

❖ Muscles of patella

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➢ The superior border or base provides insertion to the rectus
femoris in front and to the vastus intermedius behind.
➢ The lateral border provides insertion to vastus lateralis in its
upper one-third or half.
➢ The medial border provides insertion to the vastus medialis in its
upper two-thirds.

Tibia
➢ The tibia (Latin shinbone) is the medial and larger bone of the leg.
➢ It is homologous with the radius of the upper limb.
➢ it connects the knee with the ankle bones.

❖ Muscles of tibia
❖ Tibialis antererior
• The tibialis anterior is a muscle in humans that originates along
the upper two-thirds of the lateral (outside) surface of the tibia and
inserts into the medial cuneiform and first metatarsal bones of
the foot.
• It acts to dorsiflex and invert the foot. This muscle is mostly
located near the shin.
• Origin : the upper two third of the lateral surface of the shaft of
the tibia.
• Insertion : Medial cuneiform and the base of first
metatarsal bone of the foot.

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• Blood supply : Anterior tibial artery.
• Nerve supply : Deep peroneal (fibular) nerve, branch of
common peroneal (fibular) nerve (L4, L5, S1).
• Function : Tibialis anterior dorsiflexes the foot at the
talocrural joint and inverts it at the subtalar joint.
➢ It plays an important role in the activities of walking, hiking and
kicking the ball by stabilizing the ankle joint as the foot hits the
floor and pull it clear of the ground as the leg continues moving.

❖ Semitendinuous
• Semitendinosus is a fusiform muscle of the posterior compartment
of thigh.
• Along with semimembranosus and long head of biceps femoris it
comprises a group called the hamstring muscles with which it
shares these three common features:
➢ They all attach between the ischial tuberosity of pelvis and bones
of the leg.
➢ They cross both hip and joints on their course and act on them.

➢ They are all innervated by the tibial division of sciatic nerve.

• Origin : the ischial tuberosity of pelvis.

• Insertion : Proximal end of tibia below medial condyle via pes
anserinus.
• Blood supply : First perforating branch of deep femoral
artery, medial femoral circumflex artery, inferior gluteal artery and
inferior medial geniculate artery.

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• Nerve supply : First perforating branch of deep femoral
artery, medial femoral circumflex artery, inferior gluteal artery and
inferior medial geniculate artery.
• Function : Attaching between the hip and leg
the semitendinosus produces movements on both hip and knee
joints producing thigh extension, internal rotation, pelvis
stabilization (hip joint), leg flexion and internal rotation (knee
joint).

❖ Soleus
• The soleus is a powerful muscle in the back part of the lower leg
(the calf).
• It runs from just below the knee to the heel, and is involved in
standing and walking.
• Origin : fibula, medial border of tibia (soleal line).
• Insertion : tendo calcaneus.
• Blood supply : popliteal artery, posterior tibial
artery, peroneal artery.
• Nerve supply : tibial nerve, specifically, nerve roots L5–S2.
• Function : The soleus' function is closely related to that of the
gastrocnemius muscle.
➢ Together, they constitute a chief plantar flexor - their contraction
results in the plantar flexion of the upper ankle joint, enabling the
lifting of the heel against gravity when walking or jumping.

❖ Popletius

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• Popliteus is the muscle of the leg. Its deepest muscle of the knee
joint which forms the floor of the popliteus fossa.
• It is the only muscle in the posterior (back) compartment of the
lower leg that acts just on the knee and not on the ankle.
• Its a thin, flat ,triangular shape muscle.
• Origin : the lateral condyle of the femur.
• Insertion : the posterior surface, into the triangular area above
the soleal line.
• Blood supply : Inferior medial and lateral genicular arteries
(popliteal artery), posterior tibial recurrent artery, posterior tibial
artery, nutrient artery of tibia.
• Nerve supply : Tibial nerve (L4-S1)
• Function : With the tibia fixed in position,
the popliteus muscle acts on its origin and laterally rotates the
femur on the tibia.
• This movement “unlocks” the knee and allows flexion to occur.
• During the open chain (swing) phase of the gait cycle, the foot is
above the ground and the tibia is free to move.

❖ Flexor digitorum longus

• Flexor digitorum longus is a thin muscle that belongs to the deep
posterior muscles of the leg.
• Origin : Posterior surface of tibia (inferior to soleal line).
• Insertion : Plantar surface; base of the distal phalanges of the
four lesser toes.
• Blood supply : Flexor digitorum muscle is supplied by
branches of the posterior tibial artery, which is a terminal branch
of the popliteal artery.

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• Nerve supply : flexor digitorum longus muscle is innervated
by branches of the tibial nerve (root value L5, S1 and S2) which is
a branch of sciatic nerve.
• Function : Due to its attachments, flexor digitorum
longus performs its action in four different joints; talocrural (ankle
joint), talocalcaneal (subtalar joint), metatarsophalangeal and
interphalangeal joints.
• The main function of this muscle is the flexion of the foot and
toes.

❖ Tibialis posterior
• The tibialis posterior is the most central of all the leg muscles, and
is located in the deep posterior compartment of the leg.
• It is the key stabilizing muscle of the lower leg.
• Origin : Posterior surface of tibia, posterior surface of fibula and
interosseous membrane.
• Insertion : Tuberosity of navicular bone, all cuneiform bones,
cuboid bone, bases of metatarsal bones 2-4.
• Blood supply : branches of the posterior tibial artery, which
stems the popliteal artery. These branches include
the fibular and medial plantar arteries.
• Nerve supply : Tibialis posterior is innervated by the tibial
nerve which arises from the L4 and L5 spinal nerves. The tibial
nerve is the larger of the two branches of the sciatic nerve.
• Function : Tibialis posterior is involved in movements at two
different joints, as follows:
➢ Plantar flexion of the foot at the talocrural (ankle) joint.
➢ Inversion of the foot at the subtalar joint.

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 ❖ Superior extensor retinaculum
• The superior extensor retinaculum of the foot(transverse crural
ligament) is the upper part of the extensor retinaculum of
foot which extends from the ankle to the heelbone.
• Origin : Proximal half of) medial surface of fibula, lateral tibial
condyle, interosseus membrane.
• Insertion : Distal and middle phalanges of digits 2-5.
• Blood supply : The leg portion of the muscle is supplied by
two arteries of the leg : the proximal part is supplied by the anterior
tibial artery, while the distal part receives blood from the fibular
artery.
• Nerve supply : The extensor digitorum longus is innervated
by the deep fibular nerve (L5, S1), a branch of the common fibular
nerve.
• Function : Metatarsophalangeal and interphalangeal joints 2-5:
Toe extension,Talocrural joint: Foot dorsiflexion,Subtalar joint:
Foot eversion.

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 Attachments on the anterior aspect of tibia

47
 Attachment on the posterior aspect of the tibia

48
 Fibula
➢ The fibula (Latin clasp/pin) is the lateral and smaller bone of the leg.
It is very thin as compared to the tibia.
➢ It is homologous with the ulna of the upper limb.
➢ It forms a mortice of the ankle joint.

Anterior aspect Posterior

aspect

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 ❖ Muscles of fibula

❖ Extensor hallucis longus

• The extensor hallucis longus is a thin muscle, situated between

the tibialis anterior and the extensor digitorum longus, that
functions to extend the big toe and dorsiflects the foot, and
assists with foot eversion and inversion.
• Origin : from the posterior half of middle two-fourths of fibula.
• Insertion : Inserts on the dorsal side of the base of the distal
phalanx of the big toe.
• Blood supply : anterior tibial artery.
• Nerve supply : deep fibular nerve deep peroneal nerve, L5
(L4-S1).
• Function : Like the name suggests, the
main function of extensor hallucis longus muscle is the extension
of the big toe (hallux).
➢ This action happens in both metatarsophalangeal and
interphalangeal joints of hallux. This extension is a crucial
movement in walking and running.

❖ Peroneus tertius
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• The Peroneus Tertius muscle also called the Fibularis Tertius is
one the 3 peroneal muscles (peroneus longus, peroneus brevis).
• It is absent in 5% to 17% of the human white population.
• Origin : lower one fourth of the fibula.
• Insertion : base of the 5th metatarsal.
• Blood supply : anterior tibial artery.
• Nerve supply : deep fibular nerve.
• Function : Its action is that of weak dorsiflexion of the ankle
joint and to evert the foot at the ankle joint.

❖ Flexor hallucis longus

• Flexor hallucis longus is a powerful muscle located on the
posterior aspect of the fibular below the deep fascia of the calf.
• In its own synovial sheath, the tendon passes downwards, deep to
the flexor retinaculum, crossing the posterior ankle joint, lateral
to flexor digitorum longus.
• Origin : lower three fourth of the posterior surface between the
medial crest and the interosseus border.
• Insertion : Plantar surface; base of distal phalanx of hallux.
• Blood supply : muscular branch of Peroneal artery and
peroneal branch of the posterior tibial artery.
• Nerve supply : tibial nerve, S2 & S3 .
• Function : Similar to the flexor digitorum longus and tibialis
posterior muscles, the flexor hallucis longus muscle functions to
plantar flex and invert the foot. However, it is unique in that it also
functions to flex the great toe and helps supinate the ankle.

51
 ❖ Peroneus longus
• the peroneus longus (also known as fibularis longus) is a
superficial muscle in the lateral compartment of the leg, and acts
to evert and plantarflex the ankle.
• This muscle, the longest and most superficial of the
three peroneus muscles.
• Origin : upper one-third of the lateral surface, and posterior half
of the middle one-third of fibula.
• Insertion : First metatarsal, medial cuneiform.
• Blood supply : fibular (peroneal) artery.
• Nerve supply : Superficial fibular (peroneal) nerve.
• Function : plantarflexion, eversion, support arches.

❖ Peroneus brevis
• The peroneus brevis muscle, also known as the
fibularis brevis muscle, is a muscle in the lateral compartment of
the leg.
• It lies deep/medial to the adjacent peroneus longus, and is a
shorter and smaller muscle.
• Origin : the anterior half of middle one-third of the lateral
surface , and the whole of lower one-third.
• Insertion : Fifth metatarsal.
• Blood supply : Fibular artery (peroneal artery).
• Nerve supply : Superficial fibular nerve.
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• Function : The muscle assists in weak plantarflexion and
eversion of foot.

❖ Superior peroneal retinaculum

• The superior peroneal retinaculum is one of two fibrous bands
that bind the peroneus longus and peroneus brevis muscle
tendons that run over the ankles lateral side.

• Origin : the lower part of the posterior margin of triangular area

on the anterior border.
• Insertion : the lateral malleolus and extends to the lateral
aspect of the calcaneus and the deep fascia of the leg.
• Function : the superior peroneal retinaculum creates a fibro-
osseous (composed of both fibers and bone) tunnel from the
retromalleolar groove, working to prevent peroneal subluxation, a
condition in which the peroneal tendons snap out of place.

Tarsals
➢ The tarsus is made up of seven tarsal bones, arranged in two
rows.

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➢ In the proximal row, there is the talus above, and the calcaneus
below.
➢ In the distal row, there are four tarsal bones lying side by side.
From medial to lateral side these are the medial cuneiform, the
intermediate cuneiform, the lateral culeiform and the cuboid.
➢ Another bone, the navicular, is interposed between the talus and
the three cuneiform bones. In other words, it is interposed
between the proximal and distal rows.
➢ The tarsal bones are much larger and stronger than the carpal
bones because they have to support and distribute the body
weight. Each tarsal bone is roughly cuboidal in shape, having six
surfaces.

Tarsals

❖ Muscles of tarsals

❖ Extensor digitorum brevis

• Extensor digitorum brevis is a thin muscle found on the dorsum of
the foot.

54
• This region contains the dorsal compartment of the foot, which
houses extensor digitorum brevis and extensor hallucis brevis.
• These muscles are covered by the deep dorsal fascia of foot.
• Extensor digitorum brevis projects anteriorly to the lateral
malleolus and passes over the lateral aspect of the
calcaneocuboid joint.
• Origin : The extensor digitorum brevis is a thin muscle of the
foot that originates from three locations: 1. anterior part of the
superolateral surface of calcaneus. 2.the talocalcaneal
interosseous ligament. 3.the stem of the inferior extensor
retinaculum of ankle.
• Insertion : Extensor digitorum longus tendons of toes 2–4.
• Blood supply : Fibular artery, anterior tibial artery, dorsalis
pedis artery.
• Nerve supply : Deep fibular/peroneal nerve (L5, S1).
• Function : The extensor digitorum brevis muscle receives
signals from the deep fibular nerve. It controls the movements of
the all toes except the smallest toe.

❖ Inferior extensor retinaculum

• The inferior extensor retinaculum of the foot(cruciate crural
ligament, lower part of anterior annular ligament) is a Y-shaped
band placed in front of the ankle-joint, the stem of the Y being
attached laterally to the upper surface of the calcaneus.
• it is directed medialward as a double layer, one lamina passing in
front of, and the other behind, the tendons of the peroneus
tertius and extensor digitorum longus.

55
• Attachment : The lateral part of the nonarticular area on the
anterior part of the dorsal surface.
• Function : They function to stabilise tendons as
the muscles to which they attach contract to cause movement.

❖ Abductor hallucis
• Abductor hallucis is a fusiform muscle located superficially and
medially in the foot.
• Following the classification of plantar foot muscles from
superficial to deep, abductor hallucis comprises the first (most
superficial) layer of muscles along with the flexor digitorum brevis
and abductor digiti minimi.
• Origin : the medial process of the calcaneal tuberosity, plantar
aponeurosis and the superficial layer of flexor retinaculum.
• Insertion : base of proximal phalanx of great toe.
• Blood supply : The blood supply for abductor hallucis
muscle comes from two arteries: Medial plantar artery, a branch
of posterior tibial artery and First plantar metatarsal artery, a
branch of lateral plantar artery.
• Nerve supply : the medial plantar nerve (root value S1 - S3),
the larger of the two terminal branches of the tibial nerve.
• Function : Metatarsophalangeal joint 1: Toe abduction, toe
flexion; Support of longitudinal arch of foot.

56
 ❖ Flexor retinaculum
• The flexor retinaculum (transverse carpal ligament, or anterior
annular ligament) is a fibrous band on the palmar side of the hand
near the wrist.
• It arches over the carpal bones of the hands, covering them and
forming the carpal tunnel.
• Attachment : medial tuburcle of plantar surface of calcaneus.
• Function : prevent 'bowstringing' of tendons as they pass the
tibiotalar joint. It forms the roof of the tarsal tunnel.

❖ Flexor digitorum brevis

• Flexor digitorum brevis is situated lateral to abductor digiti minimi
and medial to abductor hallucis muscles.
• This muscle runs deep to the thick layer of the plantar
aponeurosis. Its tendons run medially to the common plantar
digital nerves and vessels.
• Origin : Medial process of calcaneal tuberosity, plantar
aponeurosis and intermuscular septum.
• Insertion : Middle phalanges of digits 2-5.
• Blood supply : Medial and lateral plantar arteries and plantar
arch, plantar metatarsal and plantar digital arteries.
• Nerve supply : Medial plantar nerve (S1-S3).
• Function : Metatarsophalangeal joints 2-5: Toe flexion and
supports longitudinal arch of foot.
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 ❖ Abductor digiti minimi
• The abductor digiti minimi is a muscle which lies along
the lateral (outer) border of the foot and is in relation by its medial
margin with the lateral plantar artery, vein and nerves.
• Origin : lateral tuburcle of plantar surface of calcaneous.
• Insertion : Fifth toe or phalanges.
• Blood supply : Lateral plantar artery.
• Nerve supply : Lateral plantar nerve.
• Function : Its function is flexion and abduction of the fifth
(little) toe at the metatarsophalangeal joint.

Metatarsals
➢ The metatarsus is made up of 5 metatarsal bones, which are
numbered from medial to lateral side.
➢ Each metatarsal is a miniature long bone and has the following
parts: shaft ,base and head.

❖ Muscle of metatarsals

58
 ❖ Flexor digiti minimi brevis
• The flexor digiti minimi brevis (foot) is a muscle that is located on
the outer edge of the foot bones.
• It begins at the fifth metatarsal (the bone behind the bones of the
pinky toe) and sheath of the peroneus longus muscle, located in
the sole of the foot.
• Origin : Base of metatarsal bone 5, long plantar ligament.
• Insertion : Base of proximal phalanx of digit 5.
• Blood supply : There are three main vessels that supply
flexor digiti minimi brevis:
• Anterior tibial artery, via its two branches; arcuate and lateral tarsal
arteries
• Posterior tibial artery, via lateral plantar artery.
• Nerve supply : Superficial branch of lateral plantar nerve.
• Function : Flexion and adduction of the fifth toe.

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 Phalanges

➢ There arc 14 phalanges in each foot;2 for the great toe and 3 for each of the
other toes.

60
➢ As compared to the phalanges of the hand, these are much smaller in size,
and the shafts particularly of first row are compressed from side to side.
Otherwise their arrangement and features are similar in two limbs.

❖ Muscles of phalanges
❖ Lumbricals
• The lumbricals are four small skeletal muscles, accessory to the
tendons of the flexor digitorum longus and numbered from the
medial side of the foot;
• they arise from these tendons, as far back as their angles of
division, each springing from two tendons, except the first. So the
first lumbricle is unipenate and second, third and fourth are
bipenate..
• Origin : Medial borders of long flexor tendons.
• Insertion : Proximal phalanges and extensor tendons of the 4
lateral toes.
• Blood supply : Medial and Lateral plantar arteries.
• Nerve supply : the medial plantar nerve while the remaining
three lumbricals are supplied by the lateral plantar nerve.
• Function : Flexes metatarsophalangeal joints, extends
interphalangeal joints.

❖ Plantar interosseus

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• The plantar interosseous muscles are part of the fourth and
deepest layer of muscles in the sole of the foot.
• There are three plantar interossei and they are smaller than the
dorsal interossei.
• Origin : Metatarsals, long plantar ligament.
• Insertion : Medial side of Proximal phalanges of 3rd to 5th
toe.
• Blood supply : Plantar Artery, and Dorsal Metatarsal A.
• Nerve supply : the lateral plantar nerve. The lateral plantar
nerve is a branch from the tibial nerve, which originally branches
off the sciatic nerve from the sacral plexus.
• Function : The plantar interossei have several functions:
adduct the third, fourth and fifth toes to the axis of the second toe.
➢ facilitate extension of the interphalangeal joints and flexion of the
metatarsophalangeal joint.

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 Dorsal aspect of skeleton of foot

63