the main » Anatomy of the nose » The structure of the bones of the pelvic girdle. Bones of the free lower limb. Anatomy of the joints of the human lower limbs. Sacroiliac joint, pubic symphysis

The structure of the bones of the pelvic girdle. Bones of the free lower limb. Anatomy of the joints of the human lower limbs. Sacroiliac joint, pubic symphysis

Introduction

Legs or lower limbs bear the brunt of the burden, because they have to perform the functions of support and movement. These are the most powerful of all the muscles of the human body.

The lower limbs are divided into the muscles of the pelvis and the muscles of the free lower limb. The latter group is divided into the muscles of the thigh, lower leg and foot. The pelvic muscles originate from the bones of the pelvis, sacrum and lumbar vertebrae, and also attach to the femur. Their function is to hold the torso in an upright position, flexion, extension in the hip joint and movement of the hip. The muscles of the thigh are divided into three groups: anterior, posterior and medial (leading). These muscles are also involved in keeping the body upright, but their main role is movement. The muscles of the leg are also divided into three groups: anterior, posterior and lateral (lateral). They are responsible for dorsal flexion and plantar extension of the foot, the support functions of the foot and its orientation. The muscles of the foot are similar to the muscles of the hand, divided into 3 groups. In connection with the upright man, they have a special purpose. The main function of the muscles of the foot - ensuring stability in various positions of the foot, flexion, extension and abduction of the fingers.

The purpose of this work is to study the features of the structure of the skeleton, the muscles of the lower limb, their blood supply and innervation.

1. The structure of the bones of the pelvic girdle and free lower limb

Pelvic bone, os plow, (see figure) as a whole bone is present in adults. Up to 14-16 years old, this bone consists of three separate bones connected by cartilage: the iliac, pubic and sciatic. The bodies of these bones on their outer surface form the acetabulum, acetabulum, which is the articular fossa for the femoral head. The acetabulum is deep, circumferentially circumscribed by a high margin, which on its medial side is interrupted by cutting the acetabulum, incisura acetabuli. For articulation with the femoral head in the acetabulum there is a semi-lunar surface, facies lunata, which occupies the peripheral part of the acetabulum. The center of the acetabulum is the fossa of the acetabuli, fossa acetabuli, - rough and somewhat indented. The ileum, os ilium (ilii), consists of two sections: the lower thickened section - the body of the ileum, corpus ossis ilii, participates in the formation of the acetabulum; the upper, extended section - the iliac wing, ala ossis ilii. The iliac wing is a broad curved plate, thinned in the center. To the periphery, the bone plate thickens, expanding fan-like upward, and ends with a convex edge - the iliac crest, crista iliaca. On the iliac crest, there are three rough lines for attaching the wide abdominal muscles: the outer lip, labium externum, inner lip, labium internum, and the intermediate line, linea intermedia. The iliac crest in front and behind has bony protrusions - the upper and lower iliac spines.

Anterior superior iliac spine, spina iliaca anterior superior. Below it, separated by tenderloin, is the lower anterior iliac spine, spina iliaca anterior inferior. At the posterior end of the crest, a protrusion is visible - the upper posterior iliac spine, spina iliaca posterior superior, and slightly below it, the lower posterior iliac spine, spina iliaca posterior interior. On the outer surface of the wing of the Ilium, there are weakly defined three rough lines. Of these, the anterior gluteal line, linea glutealis anterior, is more visible. It is the longest, starts from the upper anterior iliac spine, goes arcuate toward the large sciatic notch of the ischium. The posterior gluteal line, linea glutealis posterior, is much shorter, located below the previous one and is oriented almost vertically. The lower gluteal line, linea glutealis inferior, shorter than other lines, begins between the upper and anterior inferior iliac spine and goes along a gentle arc over the acetabulum to a large sciatic notch. On the inner concave smooth surface of the wing of the Ilium there is a gentle depression - the iliac fossa, fossa iliaca. The lower border of the iliac fossa is the arcuate line, linea arcuata. The beginning of this line is the ear-shaped surface, facies auricularis, its leading edge. This surface is used for articulation with the same surface of the sacrum. The arcuate line extends anteriorly to the iliac-pubic eminence. Above the uviform surface is the iliac tuberosity, tuberositas iliaca, for the attachment of the interosseous ligaments. The pubis, os pubis, has an expanded part - the body and two branches. The body of the pubic bone, corpus ossis pubis, forms the anterior section of the acetabulum. An upper branch of the pubic bone, ramus superior ossis pubis, bearing the ileal-pubic eminence, eminentia iliopubica, located along the fusion line of the pubic bone with the ileum, is sent forward. The front of the upper branch sharply curves downwards and is regarded as the lower branch of the pubic bone, ramus inferior ossis pubis. In the place where the upper branch passes into the lower, in the medial region there is an oval symphysial surface, facies symphysialis, which serves to connect with the pubic bone of the opposite side. On the upper branch of the pubis, about 2 cm from the medial end, there is a pubic tubercle, tuberculum pubicum, from which the pubic crest, crista pubica, extends laterally to the posterior ileal pubic elevation on the lower surface of the upper branch. pubic bone. In the direction backwards and medially the locking groove, sulcus obturatorius, passes for the vessels of the same name and nerve.

The ischium, os ischii (ischium), has a thickened body, corpus ossis ischii, which supplements the acetabulum from below and passes into the branch of the ischial bone, ramus ossis ischii. The body of the sciatic bone is with the branch angle, open to the front. In the corner of the bone forms a thickening - sciatic tuber, tuber ischiadicum. Above this mound, the sciatic spine, spina ischiadica, separates two cuts from the rear edge of the body: the lower - small sciatic notch, incisura ischiadica minor, and the large sciatic notch, incisura ischiadica major, located at the level of the upper edge of the acetabulum. The branch of the sciatic bone is connected to the lower branch of the pubic bone, thus closing the oval obturator opening, the foramen obturatum, the pelvic bone, from below.

Skeleton of the free part of the lower limb

The femur, femur (os femoris), is the largest and longest tubular bone in the human body. (fig. 066) Like all long tubular bones, it has a body and two ends; at the upper proximal end is located the head of the femur, caput ossis femoris, for connection with pelvic bone. The articular surface of the head is directed medially and upwards. In the middle of it is the fossa of the femoral head, fovea capitis femoris, - the place of attachment of the femoral head ligament. The femoral neck, соllum femoris, connects the head with the body and forms an angle of about 130 ° with it. On the border of the neck and body, there are two powerful bony tubercles called spits. The greater trochanter, the trochanter major, is located at the top and laterally, on its medial surface facing the neck, there is a spitting fossa, fossa trochanterica. The trochanter minor spit is located at the lower edge of the neck, medially and posteriorly. In front, both skewers are interconnected by an intertrochanter line, linea intertrochanterica, from the rear, an intertrochanic crest, crista intertrochanterica.

The body of the femur, corpus femoris, is approximately cylindrical in shape, curved convexly anteriorly and as if twisted around its longitudinal axis. The body of the bone is smooth, on the back surface there is a rough line, linea aspera, which is divided into the medial and lateral lips, labium mediale et labium laterale. In the middle of the femur, the lips closely adjoin one another, and they diverge towards the top and bottom. Up lips go to the big and small spits of the femur. The lateral lip significantly expands and thickens, passing the gluteal tuberosity, tuberositas glutea, - the place of attachment of the gluteus maximus muscle. Sometimes gluteal tuberosity acts as a third spit, trochanter tertius. The medial lip extends into a rough comb line, linea pectinea. At the lower end of the femur, both lips gradually move apart from one another, limiting the triangular shape of the popliteal surface, facies poplitea.

The distal end of the femur is enlarged and forms two large rounded condyle, which differ in size and degree of curvature of the articular surfaces. The medial condyle, condylus medialis, is larger than the lateral condylus lateralis. They are located on the same level, since the femur in its natural position is tilted so that its lower end is closer to the median line than the upper one. Both condyles are separated from each other by a deep inter-cracked fossa, fossa intercondylaris. Above the articular surface of the medial condyle is the medial epicondyle, epicondylus medialis. On the lateral side of the same condyle there is a smaller lateral epicondyle, epicondylus lateralis. In front, the articular surfaces of the condyles pass into each other, forming a concave patellar surface, facies patellaris, to which the patella is attached with its back side.

The patella, patella, is a large sesamoid bone enclosed in the quadriceps tendon. The patella is flattened in the anteroposterior direction. Allocate the base of the patella, basis patellae, directed upwards, and the top of the patella facing down, apex patellae. The articular surface, the facies articularis, the patella articulates with the patellar surface of the femur, the anterior surface, the facies anterior, rough and easily palpable through the skin.

The crus, crus, consists of two bones: a medially located tibial bone and a laterally-fibe bone. Both belong to the long tubular bones; in each of them there is a body and two ends. The ends of the bones are thickened and carry surfaces to join with the femur at the top (tibia) and the bones of the foot at the bottom. Between the bones there is an interosseous space of the tibia, spatium interosseum cruris.

Tibia, tibia. In length, this bone occupies the second place in the human skeleton and is the thickest bone of the tibia. The proximal bone end is significantly thickened and has a medial and lateral condyle, condylus medialis et condylus lateralis. The upper articular surface, the facies articularis superior, faces upwards and articulates with the condyles of the femur. The articular surfaces of the tibial condyles are separated by an inter-muscular elevation, eminentia intercondylaris, which consists of two tubercles: the medial inter-muscular tubercle, tuberculum intercondylare mediale, and the lateral inter-muscular tubercle, tuberculum intercondylare laterale. Ahead of the inter-muscular elevation is the anterior inter-mussel field, area intercondylaris anterior, behind the posterior inter-muscular field, area intercondylaris posterior. Below the lateral condyle with its lateral side and somewhat posteriorly, there is the fibular articular surface, facies articularis fibularis, for articulation with the fibula.

The body of the tibia, corpus tibiae, triangular. The anterior margin, margo anterior, is the sharpest, is palpable through the skin, thickens at the top and forms the tibial tuberosity, tuberositas tibiae, to which the quadriceps muscle is attached. The lateral margin is also sharp and faces the fibula, so it is known as the interosseous margin, margo interosseus. The medial margin, margo medialis, is somewhat rounded. In addition to the edges, there are three surfaces in the body of the tibia. The medial surface, the facies medialis, is smooth, lying directly under the skin. The lateral surface, the facies lateralis, and the posterior surface, the facies posterior, are covered with muscles. On the posterior surface of the bone, the rough line of the soleus muscle is visible, the linea musculi solei, which runs from the posterior edge of the lateral condyle downward and medially; here begins the muscle of the same name. Below this line is a large feeding hole leading to a canal distally directed.

The distal end of the tibia is enlarged and approximately quadrangular in shape. On the lateral edge of the distal end of the tibia is the fibular incision, incisura fibularis, for connection with the fibula. On the medial side of the tibia, the medial ankle, malleolus medialis, extends downwards. Behind it is a shallow ankle groove, sulcus malleolaris, for the posterior tibialis muscle tendon here. On the lateral side of the medial ankle is the articular surface of the ankle, facies articularis malleoli, which at an angle passes into the lower articular surface, facies articularis inferior, of the tibia. These surfaces, together with the articular surface of the fibula, are articulated with the talus bone of the tarsus (foot).

Fibula, fibula. This bone is much thinner than the tibial and almost the same length as it. At the proximal thickened end is the head of the fibula, caput fibulae. It highlights the upward tip of the head of the fibula, apex capitis fibulae, and on the medial side is the articular surface of the head of the fibula, facies articularis capitis fibulae, for articulation with the tibia. The head is narrowed downwards and with the help of the fibular neck, collum fibulae, passes into the bone body.

The body of the fibula, corpus fibulae, is trihedral, somewhat twisted along its longitudinal axis, slightly curved in the upper part in the medial direction. The body distinguishes the anterior margin, margo anterior, the posterior margin, margo posterior, and the medial sharp interosseous margin, margo interosseus. Three surfaces are limited to these edges: the lateral surface, the facies lateralis, the posterior surface, the facies posterior, and the medial surface, the facies medialis.

The lower distal end of the fibula is thickened and forms the lateral ankle, malleolus lateralis, which is longer than the medial ankle of the tibia. On the medial surface of the lateral ankle, the smooth articular surface of the ankle, facies articularis malleoli, stands out, to connect with the talus. Behind the articular surface of the ankle is the fossa of the lateral ankle, fossa malleoli lateralis, to which the tendons of the peroneal muscles are attached.

The bones of the foot, ossa pedis, as well as the bones of the hand, are divided into three sections: bones of the tarsus, ossa tarsi, metatarsal bones, ossa metatarsi, and bones of the fingers (phalanges), ossa digitorum (phalanges) (Fig. 068).

The bones of the tarsus, ossa tarsi, include seven spongy bones arranged in two rows. The proximal (posterior) row consists of two large bones: ankle and heel; the remaining five bones of the tarsus form a distal (anterior) row.

The talus, talus, has a body, corpus tali, head, caput tali, and a narrow part connecting them - the neck, collum tali. The body of the talus is the largest part of the bone. Its upper part is a block of the talus, trochlea tali, with three articular surfaces. The upper surface, facies superior, is intended for articulation with the lower articular surface of the tibia.

Two other articular surfaces lying on the sides of the block: the medial ankle surface, the facies malleolaris medialis, and the lateral ankle surface, the facies malleolaris lateralis, are articulated with the corresponding articular surfaces of the tibial and fibula bones. The lateral ankle surface is much larger than the medial and reaches the lateral process of the talus, processus lateralis tali.

Behind the block, the posterior process of the talus, processus posterior tali, departs from the body of the talus. The tendon groove of the long flexor of the toe, sulcus tendinis musculi flexoris hallucis longi, divides this process into the medial tubercle, tuberculum mediale, and the lateral 6 ovule, tuberculum laterale. On the underside of the talus there are three articular surfaces for articulation with the calcaneus: the anterior calcaneal articular surface, facies articularis calcanea anterior; middle calcaneal articular surface, facies articularis calcanea media, and posterior calcaneal articular surface, facies articularis calcanea posterior. Between the middle and posterior articular surfaces, there is a fodder of the talus, sulcus tali. The head of the talus is directed forward and medially. To articulate it with the navicular bone, there is a rounded navicular articular surface, facies articularis navicularis.

The calcaneus, calcaneus, is the largest bone of the foot. It is located under the talus and significantly protrudes from under it. Behind the body of the calcaneus has a tubercle of the calcaneus bent downwards, tuber calcanei. On the upper side of the calcaneus, three articular surfaces are distinguished: the anterior talaric articular surface, the facies articularis talaris anterior, the average talaric articular surface, the facies articularis talaris media, and the posterior articular articular surface, facies articularis talaris posterior. These articular surfaces correspond to the calcaneal articular surfaces of the talus. Between the middle and posterior articular surfaces, there is a sulcus of the calcaneus, sulcus calcanei, which, together with the corresponding sulcus on the talus, forms the tarsal sinus, sinus tarsi, the entrance to which is located on the back of the foot from the lateral side.

From the anterior surface of the calcaneus, a short and fat process extends from the medial side - the support of the talus, sustentaculum tali. On the lateral surface of the calcaneus, the sinus furrow of the long peroneal muscle passes, sulcus tendinis musculi peronei (fibularis) longi. The distal (anterior) end of the calcaneus has a cuboid articular surface, facies articularis cuboidea, for articulation with the cuboid bone.

Scaphoid bone, os naviculare, is located medially, between the talus and three cuneiform bones. The proximal concave surface is articulated with the head of the talus. Distal surface of navicular bone more proximal; it has three articular pads for joining with the sphenoid bones. The tuberosity of the navicular bone, tuberositas ossis navicularis (place of attachment of the posterior tibial muscle) is noticeable at the medial margin. On the lateral side of the navicular bone there may be a non-permanent articular surface for articulation with the cuboid bone.

The wedge-shaped bones, ossa cuneiformia (medial, intermediate and lateral), are located anterior to the navicular bone and are located in the medial part of the foot. Of all the bones, the medial sphenoid bone, os cuneiforme mediale, is the largest, articulated with the base of the first metatarsal bone; intermediate sphenoid bone, os cuneiforme intermedium, with II metatarsal bone; lateral sphenoid bone, os cuneiforme laterale, with III metatarsal bone.

The cuboid bone, os cuboideum, is located on the lateral side of the foot between the calcaneus and the last two metatarsal bones. The joints of these bones have articular surfaces. In addition, on the medial side of the cuboid bone there is an articular platform for the lateral sphenoid bone, and a few posterior and smaller sizes - for articulation with the scaphoid bone. On the lower (plantar) side there is a tuberosity of the cuboid bone, tuberositas ossis cuboidea, in front of which is the sinus furrow of the long peroneal muscle, the sulcus tendinis musculi peronei (fibularis) longi.

The metatarsal bones, ossa metatarsi, are five tubular short bones. The shortest and thickest - I metatarsal bone, the longest - II. As in the metacarpal bones, the body of the metatarsal bone is isolated, - corpus metatarsale, head, caput metatarsale, and base, basis metatrsalis. The bodies of the metatarsal bones have a prismatic shape with a bulge facing in back side. The bases are provided with articular surfaces for articulation with tarsal bones. The head of the first metatarsal bone on the plantar side is divided into two areas, to which the sesamoid bones are attached. The base of the first metatarsal bone forms a joint with a medial sphenoid bone. The bases of the II and III bones articulate with the intermediate and lateral sphenoid bones, and the bases of the IV and V metatarsal bones - with the cuboid bone. On the lateral side of the V metatarsal bone is the tuberosity of the V metatarsal bone, tuberositas ossis metatarsalis V, for the attachment of the short peroneal muscle.

The bones of the fingers (phalanges), ossa digitorum (phalanges), and the feet differ from the bones of the fingers of the hand in their size: they are much shorter. The toes, as well as on the hand, have a proximal phalanx, phalanx proximalis, middle phalanx, phalanx media, and distal phalanx, phalanx distalis. The exception is the thumb (I finger), hallux (digitus primus), the skeleton of which consists of two phalanges: proximal and distal. The phalanges are tubular bones. There are phalanx body, corpus phalangis, phalanx head, caput phalangis, phalanx base, basis phalangis, and two ends. The bodies of the proximal and middle phalanges are somewhat convex to the back. The base of each proximal phalanx has a flattened fossa, which serves to form a joint with the head of the corresponding metatarsal bone. On the basis of the middle and distal phalanges, there are two flat pits separated by a comb for articulation with the phalanx head located more proximally. Each distal (nail) phalanx ends with a tubercle, tuberositas phalangis distalis.

The bones of the tarsus and metatarsus do not lie in the same plane. The talus is located on the heel bone, and the scaphoid bone is above the heel bone and cuboid. The bones of the medial margins of the tarsus are elevated in comparison with its lateral margin. With this interposition of the bones of the foot, its arches are formed, which provide spring support for the lower limb. The arch of the foot has a bulge facing upwards. In fact, the foot rests on the ground only at a few points: behind it is the heel of the calcaneus, in front of the head of the metatarsal bones, mainly II and V. The phalanges only touch the ground slightly.

2. Connection of the lower limb

Sacroiliac joint, articulatio sacroiliaca, paired joint, formed by the ilium and sacrum. The articular articular surfaces, facies auriculares, of the ilium and the sacrum are flat, covered with fibrous cartilage. The articular capsule, capsula articularis, attaches along the edge of the articular surfaces and is tightly stretched. The ligamentous apparatus is represented by strong, tightly stretched fibrous bundles located on the front and rear surfaces of the joint. On the front surface of the joint are ventral sacroiliac ligaments, ligg. sacroiliaca ventralia. They are short bundles of fibers that run from the pelvic surface of the sacrum to the ilium.

On the back of the joint are several ligaments:

Interosseous sacroiliac ligaments, ligg. sacroiliaca interossea, lie behind the sacroiliac joint, in the gap between the bones that form it, and attach their ends to the iliac and sacral tuberosities;

Dorsal sacroiliac ligaments, ligg. sacroiliaca dorsalia, individual bundles of these ligaments, starting from the posterior inferior spine of the Ilium, are attached to the lateral crest of the sacrum along the II-III sacral openings. Others follow from the posterior superior iliac spine downwards and somewhat medially, attaching to the posterior surface of the sacrum in the region of the IV sacral vertebra. The sacroiliac joint belongs to the sedentary joints.

The pelvic bone, in addition to the sacroiliac joint, is connected to the spinal column through a series of powerful ligaments, which include the following:

Sacro-lumpy bundle, lig. sacrotuberale, starts from the medial surface of the sciatic tubercle and, going up and medially, expands fan-shaped, attaching to the outer edge of the sacrum and tailbone. Part of the fibers of this ligament passes to the lower part of the branch of the ischium and, continuing along it, forms the sickle process, processus falciformis;

Sacrospinous ligaments, lig. sacrospinale, starts from spina ischiadica, goes medially and posteriorly and, being located in front of the previous ligament, attaches along the edge of the sacral bone and partly the coccyx. Both ligaments together with the large and small sciatic notches limit two holes: the large sciatic, foramen ischiadicum majus, and the small sciatic, foramen ischiadicum minus. Both of these openings allow muscles as well as vessels and nerves to leave the pelvis;

Ileo-lumbar ligament, lig. iliolumbale, starts from the anterior surface of the transverse processes of the IV and V lumbar vertebrae, goes outwards and attaches to the posterior parts of the crista iliaca and the medial surface of the iliac wing;

Sacrococcygeal junction, junctura sacrococcygea (see junction of the spine).

The pubic symphysis, symphysis pubica, is formed by the hyaline cartilage-covered articular surfaces of the pubic bones, the facies symphysialis, and the fibrous cartilaginous interlocal disk located between them, discus interpubicus. The specified disk grows together with the articular surfaces of the pubic bones and has a sagitally located slit-like cavity in its thickness. In women, the disc is slightly shorter than in men, but thicker and has a relatively large cavity.

The pubic symphysis is fortified with the following bundles:

Upper pubic ligament, lig. pubicum superius, which is on the upper edge of the symphysis and stretched between both tuberculum pubicum;

Arc ligament pubis, lig. arcuatum pubis, which on the lower edge of the symphysis moves from one pubic bone to another.

Locking membrane, membrana obturatoria, consists of bundles of connective tissue fibers, mainly in the transverse direction, which are attached along the edge of the foramen obturatum, performing it all the way, with the exception of sulcus obturatorius. The locking membrane has a number of small holes. She and the muscles starting from it, along with the sulcus obturatorius, restrict the obturator canal, canalis obturatorius, through which the vessels of the same name and nerve pass through it.

3. Muscles of the lower limbs

The muscles of the thigh surround the femur and are divided into an anterior muscle group, which consists mainly of the extensors, the medial group, which includes the adductors, and the posterior muscle group, including the flexors

Front group. Tailor's muscle (m. Sartorius) (Fig. 1, 2, 3, 4) flexes the thigh and shin, simultaneously rotating the thigh outwards, and the thigh inward, providing the ability to throw one's legs over the leg. It is a narrow ribbon, located on the front surface of the thigh and, spiraling down, goes to the front surface. Tailor's muscle is one of the longest muscles of a person. It starts from the upper anterior iliac spine, and is attached to the tibial tuberosity and with separate tufts on the fascia of the tibia.

	Fig. 1. The muscles of the pelvis and thighs (front view): 1 - pear muscle; 2 - small gluteus muscle; 3 - external locking muscle; 4 - quadriceps muscle of thigh; 5 - short adductor muscle; 6 - large adductor muscle; 7 - lateral broad muscle of the thigh; 8 - leading channel
	Fig. 2. The muscles of the pelvis and hips (side view): 1 - large lumbar muscle; 2 - ileal muscle; 3 - pear muscle; 4 - internal locking muscle; 5 - scalloped muscle; 6 - gluteus maximus; 7 - long adductor muscle; 8 - large adductor muscle; 9 - tailor muscle; 10 - thin muscle; 11 - semitendinosus muscle; 12 - the longest rectus muscle of the thigh; 13 - semimembranosus muscle; 14 - medial wide muscle of the thigh; 15 - gastrocnemius muscle
	Fig. 3. The muscles of the pelvis and hips (side view): 1 - the broadest muscle of the back; 2 - external oblique abdominal muscle; 3 - gluteus medius muscle; 4 - gluteus maximus; 5 - tailor muscle; 6 - muscle, which tightens the wide fascia of the thigh; 7 - ileo-tibial tract; 8 - the longest rectus muscle of the thigh; 9 - biceps muscle of thigh: a) long head, b) short head; 10 - lateral broad muscle of the thigh; 11 - gastrocnemius muscle
	Fig. 4. The muscles of the pelvis and thighs (rear view): 1 - gluteus maximus; 2 - large adductor muscle; 3 - ileo-tibial tract; 4 - tendinous jumper of the semitendinuated muscle; 5 - semitendinosus muscle; 6 - biceps muscle of the thigh; 7 - thin muscle; 8 - semimembranosus muscle; 9 - tailor muscle; 10 - plantar muscle; 11 - gastrocnemius muscle: a) the medial head, b) the lateral head

The quadriceps muscle of the thigh (m. Quadriceps femoris) (Fig. 1) consists of four heads and is the largest muscle of a man. With the reduction of all heads, it extends the lower leg, while reducing the rectus femoris muscle, it participates in its flexion.

Located on the anterolateral surface of the thigh, in the lower sections completely goes to the side. Each head has its own starting point. The longest rectus femoris muscle (m. Rectus femoris) (Fig. 2) begins on the inferior iliac spine; the medial broad muscle of the thigh (m. vastus medialis) (Fig. 2, 3) - on the medial lip of the rough femur line; lateral broad muscle of the thigh (m. vastus lateralis) (Fig. 1, 3) - on the greater trochanter, intertrochanteric line, and lateral lip of the rough line of the femur; the intermediate broad muscle of the thigh (m. vastus intermedius) - on the front surface of the femur. All heads grow together, forming a common tendon, which is attached to the top and side edges of the kneecap, bypassing which the tendon falls below and goes into the knee ligament, which is attached to the tibial tuberosity. In the place of attachment of the muscles, there are the patellar pouch (bursa suprapatellaris), the subcutaneous podrenal bag (bursa subcutanea prepatellaris), the subcutaneous podnatserennial bag (bursa subcutanea infrapatellaris) and the deep undergrown bag (bursa infrapatellaris profunda).

The knee joint muscle (m. Articularis genus) tightens the bag knee joint. It is a flat plate and is located on the front surface of the thigh under the intermediate broad muscle of the thigh. The point of its beginning is on the front surface of the lower third of the femur, and the attachment point is on the front and side surfaces of the articular bag of the knee joint.

Medial group. The scalloping muscle (m. Pectineus) (Fig. 2) flexes and leads the hip, rotating it outwards. The flat muscle is quadrangular in shape, starts on the ridge and upper branch of the pubic bone, and is attached on the medial lip of the rough line of the femur below the small skewer.

Thin muscle (m. Gracilis) (Fig. 2, 4) leads the thigh and takes part in flexing the tibia, turning the leg inward. The long flat muscle is located directly under the skin. The point of its beginning is on the lower branch of the pubic bone, and the place of attachment is on the tibial tuberosity. The tendon of the thin muscle grows together with the tendons of the tailoring and semi-tendinous muscles and the fascia of the tibia, forming a superficial goose foot. Here is the so-called goose bag (bursa anserina).

The long adductor muscle (m. Adductor longus) (Fig. 2) causes the thigh to participate in its flexion and rotation outwards. This is a flat muscle, having the shape of an irregular triangle and located on the anteromedial thigh. It starts from the upper branch of the pubic bone and is attached on the middle third of the medial lip of the rough line of the femur. The short adductor muscle (m. Adductor brevis) (Fig. 1) causes the thigh to participate in its flexion and rotation outwards. It is a muscle of a triangular shape, starts on the front surface of the lower branch of the pubic bone, lateral to the thin muscle, and is attached on the upper third of the medial lip of the rough line of the femur.

The large adductor muscle (m. Adductor magnus) (Fig. 1, 2, 4) causes the thigh, partly rotating it outwards. Thick, wide, the most powerful of this group of muscles, which is located deeper than the rest of the adductor muscles. The point of its beginning is on the sciatic hill, as well as on the branch of the sciatic bone and the lower branch of the pubic bone. The attachment site is located on the medial lip of a rough line and medial epicondyle of the femur. In the muscle bundles, several holes are formed which allow blood vessels. The largest of these is called the tendon orifice (hiatus tendineus). Above it is the fascial plate, and between it and the muscle a space of triangular shape is formed, called the lead channel (canalis adductorius) (Fig. 1). The femoral vein, artery and hidden nerve of the lower limb pass through it.

Posterior group The biceps femoris muscle (m. Biceps femoris) (Fig. 3, 4) extends the thigh and bends the lower leg. In the bent position rotates the shin outwards. Passes along the side edge of the upper surface of the thigh. The muscle has one abdomen and two heads. The long head (caput longum) starts from the sciatic hill, the short head (caput breve) - on the lower part of the lateral lip of the rough line of the femur. The abdomen ends with a long narrow tendon, the attachment of which is located on the head of the fibula. Part of the bundles are woven into the fascia of the leg. Near the point of the beginning of the long muscle is the upper bag of the biceps femoris (bursa m. Bicipitis femoris superior). In the area of the tendon is the lower tummymine sac of the biceps femoris (bursa subtendinea m. Bicipitis femoris inferior).

The semi-tendinous muscle (m. Semitendinosus) (Fig. 2, 4) extends the thigh, bends the lower leg, rotates it in the bent position, and also participates in the extension of the trunk. The muscle is long and thin, partly covered by the gluteus maximus, sometimes interrupted by a tendon bridge (intersectio tendinea) (Fig. 4). The point of its beginning is located on the sciatic tubercle, and the place of attachment is on the medial surface of the tibial tuberosity. Separate bundles of muscles are woven into the fascia of the leg, taking part in the formation of a goose foot.

The semi-membranous muscle (m. Semimembranosus) (Fig. 2, 4) extends the thigh and bends the lower leg, rotating it inwards. Passes along the medial edge of the posterior surface of the thigh and partially covers the semitendinosus muscle. The muscle starts from the sciatic hill and is attached at the edge of the medial condyle of the tibia.

The tendon is divided into three bundles, forming a deep goose foot. The external bundle passes into the popliteal fascia, into the posterior ligament of the knee joint.
In the place of the tendon division into separate bundles is located the synovial pouch of the semimembranous muscle (bursa m. Semimembranosi).

4. Blood supply and innervation

Pelvic Muscles:

M. gluteus minimus (small). Source of blood supply: a. glutea superior, a. circumflexi lateralis (from a. profunda femoris). Venous outflow: v. glutea superior, v. profunda femoris.

M. tensor fascia latae (strains of the broad fascia). Source of blood supply, a. glutea superior, a. circumflexi femoris lateralis (from a. profunda femoris). Venous outflow: v. glutea superior, v. profunda femoris.

M. quadratus femoris (square hip mouse). Source of blood supply: a. glutea inferior et a. obturatoria (from a. iliaca interna), a. circumflexi femoris medialis (from a. profunda femoris). Venous outflow: v. glutea inferior, v. obturatoria (in v. iliaca interna).

M. obturatorius extemus (external obturator mouse). Source of blood supply: a. obturatoria, a. circumflexi femoris lat-eralis. Venous outflow: v. obturatoria (vv. profunda femoris).

Thigh muscles:

M. sartorius (tailor's men). Source of blood supply: a. circumflexi femoris lateralis, aa. musculares, a. femoralis, a. genus descendens (from a. femoralis). Venous outflow: v. femoralis.

M. quadriceps femoris. Source of blood supply: a. femoralis, a. profunda femoris, a. circumflexa femoris lateralis. Venous outflow, v. profunda femoris, v. femoralis.

M. articularis genus. Source of blood supply, a. circumflexi femoris lateralis, aa. perforantes (from a. profunda femoris). Venous outflow: v. profunda femoris.

M. quadriceps femoris. Source of blood supply: a. femoralis, a. profunda femoris, a. circumflexa femoris lateralis, Venous outflow: v. profunda femoris femoralis.

M. biceps femoris (biceps) - caput longum (long head); caput breve (short head). Source of blood supply: a. circumflexa femoris medialis, aa. perforantes, a. poplitea Venous outflow: v. profunda femoris.

M. semitendinosus (semitendaline). Source of blood supply: aa. perforantes (from a. profunda femoris). Venous outflow: v profunda femoris.

M. semimembranosus (semi-membranous). Source of blood supply: a. circumflexa femoris medialis, aa. perforantes (from a. profunda femoris), a. poplitea Venous outflow: v. profunda femoris.

M. gracilis (fine muscular). Source of blood supply: a. obturatoria (from a. iliaca interna), a. pudenda externa (from a. femoralis), rr. musculares, aa. femoralis et profundae femoris. Venous outflow: v. obturatoria, v. femoralis.

M. pectineus (ridge muscle). Source of blood supply: a. obturatoria (from a. iliaca interna), a. pudenda externa (iza. femoralis). Venous outflow: v. obturatoria, v. femoralis.

M. adductor longus (long lead). Source of blood supply: a. obturatoria, a. pudenda externa, a. profunda femoris. Venous outflow: v. obturatoria, v. femoralis, v. profunda femoris.

M. adductor brevis (short lead). Source of blood supply: a. obturatoria, aa. perforantes, a. profunda femoris. Venous outflow: v. obturatoria, v. profunda femoris.

M. adductor magnus (large). Source of blood supply: a. obturatoria, aa. perforantes, a. profunda femoris. Venous outflow: v. obturatoria, v. profunda femoris.

Muscles of the leg:

M. tibialis anterior (anterior tibial muscle). Source of blood supply, a. tibialisanterior. Venous outflow: w. tibialesanterior.

M. extensordigitorumlongus (long extensor fingers). Source of blood supply, a. tibialisanterior. Venous outflow: w. tibialesanterior.

M. extensorhallucislongus (long extensor of the big toe). Source of blood supply, a. tibialisanterior. Venous outflow: w. tibialesanterior.

M. tricepssurae (triceps muscle of the leg). Source of blood supply, a. tibialisanterior. Venous outflow: w. tibialesanterior.

M. plantarislongus (plantar long muscle). Source of blood supply, a. poplitea Venous outflow, v. poplitea

M. poplitetis (knee muscle). Source of blood supply, and. poplitea Venous outflow: v. poplitea

M. flexordigitorumlongus (long extensor fingers). Source of blood supply, a. tibialisposterior. Venous outflow, w. tibialesposterior.

M. flexorhallucislongus (long extensor thumb). Source of blood supply, a. tibialis posterior, a. fibularis (from a. tibialis posterior). Venous otdk. w. tibiales posterior.

M. tibialis posterior (posterior tibialis muscle). Source of blood supply, a. tibialisposterior. Venous outflow, w. tibialesposterior.

M. peroneuslongus (long fibular muscle). Source of blood supply, a ..- genus inferior lateralis (from a. Poplitea), a. fibularis (from a. tibialis posterior), a. tibialis anterior. Venous outflow. w. tibiales posteriores et anteriores.

M. peroneus brevis (short malleus muscle). Source of blood supply: a. fibularis, a. tibialis anterior. Venous outflow: vv. tibiales posteriores et anteriores.

Muscles of foot:

M. extensor digitomm brevis (short flexor fingers). Source of blood supply: a. tarsalis lateralis (from a. dorsalis pedis, a. fibularis. Venous outflow, w. tibiales anteriores, w. fibulares.

M. extensor hallucis brevis (short extensor large foot). Source of blood supply: a. dorsalis pedis, a. fibularis. Venous outflow: w. tibiales anteriores, w. fibulares:

M. abductorhallucis (muscle that retracts the thumb). Source of blood supply, a. plantaris medialis. Venous outflow: v. plantares mediales (w. tibiales poteriores).

M. flexor hallucic breves (short flexor large foot clasps). Source of blood supply: a. plantaris medialis, arcus plantaris profundus. Venous outflow, v, plantares mediales et laterales.

M. adductorhallucis (adductor muscle of the thumb). The source of the blood supply, arcus plantaris profundus, aa. metatar-sales plantares. Venous outflow: v. plantares mediales et laterales.

M. abductor digiti minimi. Source of blood supply, a. plantaris lateralis. Venous outflow: v. plantares laterales.

M. flexor digiti minimi (short of the Epic). Source of blood supply, a. plantaris lateralis. Venous outflow: v. plantares laterales.

M. opponensdigitiminimi (opposing muscle). Source of blood supply: a. plantaris lateralis. Venous outflow: v plantares laterales.

M. flexor digitoram brevis (short flexor fingers). Source of blood supply: a. plantares medialis et lateralis. Venous outflow: v. plantares laterales et mediales.

M. quadratus plantae (square muscle soles). Source of blood supply: a. plantaris lateralis. Venous outflow: v. plantares laterales.

M. himbricales (wormheads). Source of blood supply: a. plantares medialis et lateralis. Venous outflow: w. plantares laterales et mediales (in w. tibiales posteriores).

Mm. interossei plantares (interosseous plantar muscles). The source of the blood supply, arcus plantaris profundus, aa. metatar-sales plantares. Venous outflow: v. plantares laterales et mediales.

Mm. interossei dorsales. Source of blood supply: arcus plantaris profundus, aa. metatarsales plantares. Venous outflow: v. plantares laterales et mediales

Innervation - Pelvic Muscles:
. M. gluteus minimus. Source of innervation: n. Gluteus superior.
.M. tensor fascial latae. Source of innervation: n. Gluteus superior.
.M. quadratus femoris. Source of Innervation: n. Ischiadicus.
.M. obturatorius externus. Source of innervation: p. Obturaturius.
. Thigh muscles:
.M. sartorius. Source of innervation: n. Femoralis.
.M. quadriceps femoris. Source of innervation: n. Femoralis.
.M. articularis genus. Source of innervation: n. Femoralis.
.M. biceps femoris
- caput longum. Source of Innervation: n. Ischiadicus, n. tibialis;
- caput breve. Source of Innervation: n. Ischiadicus, n. fibularis communis.
.M. semitendinosus. Source of innervation: n. Tibialis.
.M. semimembranosus. Source of innervation: n. Tibialis.
.M. gracilis Source of innervation: p. Obturatorius.
.M. pectineus. Innervation source: n. Obturatorius, n. fem-moralis.
.M. adductor longus. Innervation source: n, obturatorius.
.M. adductor brevis. Source of innervation: p. Obturatorius.
.M. adductor magnus. Source of innervation: n. Obturatorius, n. Ischiadicus.
Muscles shins:
. M. tibialis anterior. Source of innervation: P. fibularis profundus.
.M. extensor digitorum longus. Source of innervation: P. fibularis proftmdus.
.M. extensor hallucis longus. Source of innervation: P. fibularis profundus.
.M. triceps surae. Source of innervation: n. Tibialis.
.M. plantaris longus. Source of innervation: n. Tibialis.
.M. popliteus. Source of innervation: n. Tibialis.
.M. flexor digitorum longus. Source of innervation: n. Tibialis.
.M. flexor hallucis longus. Source of innervation: n. Tibialis.
.M. tibialis posterior. Source of innervation: n. Tibialis.
.M. peroneus longus. Source of innervation: n. Fibularis superfi-cialis.
.M. peroneus brevis. Source of innervation: P. fibularis superflcialis.
. Muscles of foot:
. M. extensor digitorum brevis. Source of innervation: P. fibularis profundus.
.M, extensor hallucis brevis. Source of innervation: P. fibularis profundus.
.M. abductor hallucis. Source of innervation: p. Plantaris mediales.
.M. flexor hallucis brevis. Source of Innervation: nn. plantaris mediales et lateralis.
-M. adductor hallucis. Source of innervation: p. Plantaris lateralis.
- M. abductor digiti minimi. Source of innervation: p. Plantaris lateralis.
- M. flexor digiti minimi. Source of innervation: p. Plantaris lateralis.
- M. opponens digiti minimi. Source of innervation: p. Plantaris lateralis.
-M. flexor digitorum brevis. Source of innervation: p. Plantaris medialis.
- M. quadratus plantae. Source of innervation: p. Plantaris lateralis.
-M. lumbricales. Source of innervation: I, II - n. Plantaris medialis; III, IV - n. plantaris lateralis.
- Mm. interossei plantares. Source of innervation: p. Plantaris lateralis.
-Mm. interossei dorsales. Source of innervation: p. Plantaris lateralis.

5. Age-related changes in the bones of the lower limb.

The bones of the lower limb develop as secondary.

The pelvic bone develops from 3 primary points of ossification and several (up to 8) additional points. Primary form the iliac bone (appears on the 3rd month of the fetal period), the ischial bone (on the 4th month) and the pubic bone (on the 5th month of the intrauterine period); additional points complement the elevations, grooves, edges of individual bones. In the region of the acetabulum, all 3 bones are first connected by cartilaginous layers, in which later on (by the age of 16-18) additional points of ossification appear. The fusion of all points of ossification occurs at the age of 20-25 years. The pelvis as a whole undergoes changes mainly in relation to size and shape. However, gender differences characteristic of adult women and men begin to differentiate from the age of 8-10 years - the predominance of the height of the pelvis in boys and the width of the pelvis in girls.

The femur develops from 5 ossification centers, of which one is primary, diaphyseal, and 4 secondary. From the primary point (it appears at the beginning of the second month of the prenatal period) the body of the bone is formed. Secondary points occur at different times: at the end of the prenatal period - the point of ossification of the lower epiphysis of the femur, at the end of the first - the beginning of the second year - the point of ossification in the cartilage head of the femur, at 3 years - in the cartilage of the greater trochanter and at the age of 8 years - in the cartilage of the small spit thigh. All these bone formations grow together with the diaphysis of the femoral bone in 16-20 years.

The patella is formed on the basis of cartilage from one point of ossification on the 2nd in girls and on the 4th in boys year of life, the process of ossification ends by the 16th-20th year of life.

The tibia develops from 4 ossification centers: one diaphyseal, which appears in the second month of the prenatal period, and three secondary ones that appear: the upper epiphyseal - in the 9th month of the prenatal period, the lower epiphyseal point - during the first year of life and the third - for tuberosity tibia - in the 13th year of life. The union of all points with the body of the bone occurs in different periods from 16-18 to 20-24 years.

The fibula develops from 3 points of ossification: one primary, diaphyseal, which appears in the middle of the second month of the prenatal period (the body and epiphyses are formed from it); two additional, epiphysarshlh: lower, appearing in the first year of life, and upper - in the 3-5th year of life. The fusion of the epiphyseal points with the body occurs: the lower - at 17-20 years old, the upper - at 19-21 years.

The development of foot bones occurs as follows: the talus develops from a single point of ossification, which appears in the last months of the prenatal period; The process of ossification lasts up to 8 years. The calcaneus is formed from two points of ossification: the primary, the main, appearing in the 6th month of the prenatal period, and the secondary point, appearing by 9 years; this point forms the heel of the calcaneus. The points coalesce by the age of 16-18. Scaphoid bone develops from a single point of ossification, which appears in the 3-5th year of life. The wedge-shaped bones develop each from one point of ossification, while III begins to ossify by the end of the first year, II - at 3 years and I - at 3-4 years. The cuboid bone develops from one point of ossification, which appears more often before birth, less often at the age of 3-6 months. The metatarsus, the number 5 (I-V), develops each of two points of ossification: primary and secondary, secondary. The main point appears in the II-V bones at the beginning of the 3rd month, in the I bone - at the end of the same month of the prenatal period, secondary points of ossification are formed by 4 years and grow together by 17 years in girls and 20 in boys. Phalanges develop from two points of ossification, the main one, which appears in the period from the 3rd to the 9th month of the prenatal period, and the secondary, arising by the 4th year, and their union occurs in the period from 15 to 20 years.

Conclusion

Skeleton lower limbs subdivided into the skeleton of the free limb and the skeleton of the belt of the lower limbs (pelvic girdle). The skeleton of the free lower extremity consists of the femur, two bones of the tibia — tibia and tibia, the skeleton of the foot — the tarsal bones (7 short spongy bones), the tarsus (5 short tubular bones) and phalanges of the fingers (short tubular bones; in the first finger 2 phalanges, in the remaining fingers, 3 phalanxes).

In connection with the upright walking skeleton of the lower extremities has features:

bones more massive than in upper limb, as the legs have a large load in the upright position of the body;
hip joint is durable because the head of the femur is covered around the bone cushion formed by the pelvic bone;
the foot has a vaulted structure that provides cushioning when walking.

Bibliography

Lyutyen Drekol-Rohen. Anatomical atlas. Functional systems of man. M., 2004.
Milovazorov M.I. Anatomy and human physiology. M., 2001.
Prives MG, Lysenkov N.K., Bushkovich N.I. Human anatomy. M., Medicine, 1995.
Shevkunenko V.N. Atlas of peripheral nervous and venous systems. M., 1999.

Full-text search:

Main\u003e Abstract\u003e Medicine, health

Introduction 2

1. The structure of the bones of the pelvic girdle and free lower limb 3

2. Connection of the lower limb 14

3. Muscles of the lower limb 16

4. Blood supply and innervation 21

5. Age changes bones of the lower limbs. 27

Conclusion 29

Bibliography 30

Introduction

Legs or lower limbs bear the brunt of the burden, because they have to perform the functions of support and movement. These are the most powerful of all the muscles of the human body.

The purpose of this work is to study the features of the structure of the skeleton, the muscles of the lower limb, their blood supply and innervation.

1. The structure of the bones of the pelvic girdle and free lower limb

Pelvic bone, os plow, (see figure) as a whole bone is present in adults. Until the age of 14-16, this bone consists of three separate bones connected by cartilage: the iliac, pubic and sciatic. The bodies of these bones on their outer surface form the acetabulum, acetabulum, which is the articular fossa for the femoral head. The acetabulum is deep, circumferentially bounded by a high margin, which on its medial side is interrupted by cutting the acetabulum, incisura acetabuli. For articulation with the femoral head in the acetabulum there is a semi-lunar surface, facies lunata, which occupies the peripheral part of the acetabulum. The center of the acetabulum is the fossa of the acetabuli, fossa acetabuli, - rough and somewhat indented. The ileum, os ilium (ilii), consists of two sections: the lower thickened section - the body of the ileum, corpus ossis ilii, participates in the formation of the acetabulum; the upper, extended section - the iliac wing, ala ossis ilii. The iliac wing is a broad curved plate, thinned in the center. To the periphery, the bone plate thickens, expanding fan-like upward, and ends with a convex edge - the iliac crest, crista iliaca. On the iliac crest, there are three rough lines for attaching the wide abdominal muscles: the outer lip, labium externum, inner lip, labium internum, and the intermediate line, linea intermedia. The iliac crest in front and behind has bony protrusions - the upper and lower iliac spines.

Anterior superior iliac spine, spina iliaca anterior superior. Below it, separated by tenderloin, is the lower anterior iliac spine, spina iliaca anterior inferior. At the posterior end of the crest, a protrusion is visible - the upper posterior iliac spine, spina iliaca posterior superior, and slightly below it, the lower posterior iliac spine, spina iliaca posterior interior. On the outer surface of the wing of the Ilium, there are weakly defined three rough lines. Of these, the anterior gluteal line, linea glutealis anterior, is more visible. It is the longest, starts from the upper anterior iliac spine, goes arcuate toward the large sciatic notch of the ischium. The posterior gluteal line, linea glutealis posterior, is much shorter, located below the previous one and is oriented almost vertically. The lower gluteal line, linea glutealis inferior, shorter than other lines, begins between the upper and anterior inferior iliac spine and goes along a gentle arc over the acetabulum to a large sciatic notch. On the inner concave smooth surface of the wing of the Ilium there is a gentle recess - the iliac fossa, fossa iliaca. The lower border of the iliac fossa is the arcuate line, linea arcuata. The beginning of this line is the ear-shaped surface, facies auricularis, its leading edge. This surface is used for articulation with the same surface of the sacrum. The arcuate line extends anteriorly to the iliac-pubic eminence. Above the uviform surface is the iliac tuberosity, tuberositas iliaca, for the attachment of the interosseous ligaments. The pubis, os pubis, has an expanded part - the body and two branches. The body of the pubic bone, corpus ossis pubis, forms the anterior section of the acetabulum. An upper branch of the pubic bone, ramus superior ossis pubis, bearing the ileal-pubic eminence, eminentia iliopubica, located along the fusion line of the pubic bone with the ileum, is sent forward. The front of the upper branch sharply curves downwards and is regarded as the lower branch of the pubic bone, ramus inferior ossis pubis. In the place where the upper branch passes into the lower, in the medial region there is an oval symphysial surface, facies symphysialis, which serves to connect with the pubic bone of the opposite side. On the upper branch of the pubis, about 2 cm from the medial end, there is a pubic tubercle, tuberculum pubicum, from which the pubic crest, crista pubica, extends laterally to the posterior ileal pubic elevation on the lower surface of the upper branch. pubic bone. In the direction backwards and medially the locking groove, sulcus obturatorius, passes for the vessels of the same name and nerve.

Skeleton of the free part of the lower limb

The femur, femur (os femoris), is the largest and longest tubular bone in the human body. (fig. 066) Like all long tubular bones, it has a body and two ends; at the upper proximal end is the head of the femur, caput ossis femoris, for connection with the pelvic bone. The articular surface of the head is directed medially and upwards. In the middle of it is the fossa of the femoral head, fovea capitis femoris, - the place of attachment of the femoral head ligament. The femoral neck, соllum femoris, connects the head with the body and forms an angle of about 130 ° with it. On the border of the neck and body, there are two powerful bony tubercles called spits. The greater trochanter, the trochanter major, is located at the top and laterally, on its medial surface facing the neck, there is a spitting fossa, fossa trochanterica. The trochanter minor spit is located at the lower edge of the neck, medially and posteriorly. In front, both skewers are interconnected by an intertrochanter line, linea intertrochanterica, from the rear, an intertrochanic crest, crista intertrochanterica.

The patella, patella, is a large sesamoid bone enclosed in the quadriceps tendon. The patella is flattened in the anteroposterior direction. The base of the patella, basis patellae, is pointed upward, and the top of the patella is turned down, apex patellae. The articular surface, the facies articularis, the patella articulates with the patellar surface of the femur, the anterior surface, the facies anterior, rough and easily palpable through the skin.

The distal end of the tibia is enlarged and approximately quadrangular in shape. At the lateral edge of the distal end of the tibia is the fibular incision, incisura fibularis, for connection with the fibula. On the medial side of the tibia, the medial ankle, malleolus medialis, extends downwards. Behind it is a shallow ankle groove, sulcus malleolaris, for the posterior tibialis muscle tendon here. On the lateral side of the medial ankle is the articular surface of the ankle, facies articularis malleoli, which at an angle passes into the lower articular surface, facies articularis inferior, of the tibia. These surfaces, together with the articular surface of the fibula, are articulated with the talus bone of the tarsus (foot).

The bones of the foot, ossa pedis, as well as the bones of the hand, are divided into three sections: the bones of the tarsus, ossa tarsi, metatarsal bones, ossa metatarsi, and bones of the fingers (phalanges), ossa digitorum (phalanges) (Fig. 068).

The metatarsal bones, ossa metatarsi, are five tubular short bones. The shortest and thickest - I metatarsal bone, the longest - II. As in the metacarpal bones, the body of the metatarsal bone is isolated, - corpus metatarsale, head, caput metatarsale, and base, basis metatrsalis. The bodies of the metatarsal bones have a prismatic shape with a bulge facing the back. The bases are provided with articular surfaces for articulation with tarsal bones. The head of the first metatarsal bone on the plantar side is divided into two areas, to which the sesamoid bones are attached. The base of the first metatarsal bone forms a joint with a medial sphenoid bone. The bases of the II and III bones articulate with the intermediate and lateral sphenoid bones, and the bases of the IV and V metatarsal bones - with the cuboid bone. On the lateral side of the V metatarsal bone is the tuberosity of the V metatarsal bone, tuberositas ossis metatarsalis V, for attaching the short peroneal muscle.

The bones of the tarsus and metatarsus do not lie in the same plane. The talus is located on the heel, and the scaphoid is above the calcaneus and cuboid. The bones of the medial margins of the tarsus are elevated in comparison with its lateral margin. With this interposition of the bones of the foot, its arches are formed, which provide spring support for the lower limb. The arch of the foot has a bulge facing upwards. In fact, the foot rests on the ground only at a few points: behind it is the heel of the calcaneus, in front of the head of the metatarsal bones, mainly II and V. The phalanges only touch the ground slightly.

2. Connection of the lower limb

On the back of the joint are several ligaments:

The pelvic bone, in addition to the sacroiliac joint, is connected to the spinal column through a series of powerful ligaments, which include the following:

Sacrococcygeal junction, junctura sacrococcygea (see junction of the spine).

The pubic symphysis is fortified with the following bundles:

Upper pubic ligament, lig. pubicum superius, which is on the upper edge of the symphysis and stretched between both tuberculum pubicum;

Arc ligament pubis, lig. arcuatum pubis, which on the lower edge of the symphysis moves from one pubic bone to another.

3. Muscles of the lower limbs

	Fig. 1. The muscles of the pelvis and thighs (front view): 1 - pear muscle; 2 - small gluteus muscle; 3 - external locking muscle; 4 - quadriceps muscle of thigh; 5 - short adductor muscle; 6 - large adductor muscle; 7 - lateral broad muscle of the thigh; 8 - leading channel
	Fig. 2. The muscles of the pelvis and hips (side view): 1 - large lumbar muscle; 2 - ileal muscle; 3 - pear muscle; 4 - internal locking muscle; 5 - scalloped muscle; 6 - gluteus maximus; 7 - long adductor muscle; 8 - large adductor muscle; 9 - tailor muscle; 10 - thin muscle; 11 - semitendinosus muscle; 12 - the longest rectus muscle of the thigh; 13 - semimembranosus muscle; 14 - medial wide muscle of the thigh; 15 - gastrocnemius muscle
	Fig. 3. The muscles of the pelvis and hips (side view): 1 - the broadest muscle of the back; 2 - external oblique abdominal muscle; 3 - gluteus medius muscle; 4 - gluteus maximus; 5 - tailor muscle; 6 - muscle, which tightens the wide fascia of the thigh; 7 - ileo-tibial tract; 8 - the longest rectus muscle of the thigh; 9 - biceps muscle of thigh: a) long head, b) short head; 10 - lateral broad muscle of the thigh; 11 - gastrocnemius muscle
	Fig. 4. The muscles of the pelvis and thighs (rear view): 1 - gluteus maximus; 2 - large adductor muscle; 3 - ileo-tibial tract; 4 - tendinous jumper of the semitendinuated muscle; 5 - semitendinosus muscle; 6 - biceps muscle of the thigh; 7 - thin muscle; 8 - semimembranosus muscle; 9 - tailor muscle; 10 - plantar muscle; 11 - gastrocnemius muscle: a) the medial head, b) the lateral head

The knee joint muscle (m. Articularis genus) tightens the knee joint bag. It is a flat plate and is located on the front surface of the thigh under the intermediate broad muscle of the thigh. The point of its beginning is on the front surface of the lower third of the femur, and the attachment point is on the front and side surfaces of the articular bag of the knee joint.

The large adductor muscle (m. Adductor magnus) (Fig. 1, 2, 4) causes the thigh, partly rotating it outwards. Thick, wide, the most powerful of this group of muscles, which is located deeper than the rest of the adductor muscles. The point of its beginning is on the sciatic hill, as well as on the branch of the sciatic bone and the lower branch of the pubic bone. The attachment site is located on the medial lip of a rough line and medial epicondyle of the femur. In the muscle bundles, several holes are formed that allow blood vessels to pass through. The largest of these is called the tendon orifice (hiatus tendineus). Above it is the fascial plate, and between it and the muscle a space of triangular shape is formed, called the lead channel (canalis adductorius) (Fig. 1). The femoral vein, artery and hidden nerve of the lower limb pass through it.