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