Muscles of the Foot

Muscles of sole of foot, third layer (from below). The flexor

digitorum brevis muscle has been removed, and the quadratus plantae,

abductor hallucis, and digiti minimi muscles have been divided.

Muscles of sole of foot, fourth layer (from below).

The interosseous muscles and the canal for the

tendon of peroneus longus muscle are shown.

1 Tendons of flexor digitorum brevis

muscle

2 Transverse head of adductor hallucis

muscle

3 Abductor digiti minimi muscle

4 Interossei muscles

5 Flexor digiti minimi brevis muscle

6 Opponens digiti minimi muscle

7 Tendon of peroneus longus muscle

8 Quadratus plantae muscle with tendon

of flexor digitorum longus muscle

9 Calcaneal tuberosity

10 Tendons of flexor hallucis longus muscle

(divided)

11 Tendon of flexor digitorum longus muscle

12 Flexor hallucis brevis muscle

13 Oblique head of adductor hallucis muscle

14 Abductor hallucis muscle (cut)

15 Tendon of tibialis posterior muscle

16 Dorsal interossei muscles

17 Plantar interossei muscles

18 Tuberosity of fifth metatarsal bone

19 Tendon of flexor digitorum longus muscle

(crossing of plantar tendons)

20 Long plantar ligament

466 Arteries

Main arteries and nerves of right thigh (anterior aspect).

Sartorius muscle has been divided and reflected. The femoral vein

has been partly removed to show the deep femoral artery.

Notice: the vessels enter the adductor canal to reach the popliteal

fossa.

Main arteries of lower limb, right side

(anterior aspect, schematic drawing).

Arteries 467

1 Femoral artery

2 Profunda femoris artery

3 Ascending branch of lateral circumflex

femoral artery

4 Descending branch of lateral circumflex

femoral artery

5 Lateral superior genicular artery

6 Popliteal artery

7 Lateral inferior genicular artery

8 Anterior tibial artery

9 Peroneal artery

10 Lateral plantar artery

11 Arcuate artery with dorsal metatarsal arteries

12 Plantar arch with plantar metatarsal arteries

13 Medial circumflex femoral artery

14 Profunda femoris artery with perforating

arteries

15 Descending genicular artery

16 Medial superior genicular artery

17 Middle genicular artery

18 Medial inferior genicular artery

19 Posterior tibial artery

20 Dorsalis pedis artery

21 Medial plantar artery

22 Superficial and deep circumflex iliac arteries

23 Femoral nerve

24 Lateral circumflex femoral artery

25 Sartorius muscle (cut and reflected)

26 Rectus femoris muscle

27 Vastus medialis muscle

28 Inguinal ligament

29 Femoral vein (cut)

30 External pudendal artery and vein

31 Adductor longus muscle

32 Great saphenous vein

33 Obturator artery and nerve

34 Gracilis muscle

35 Saphenous nerve

36 Tendinous wall of adductor canal

37 Anterior cutaneous branch of femoral nerve

38 Infrapatellar branch of saphenous nerve

39 Popliteal vein

40 Tibial nerve

41 Medial head of gastrocnemius muscle

42 Biceps femoris muscle

43 Common peroneal nerve

44 Lateral head of gastrocnemius muscle

45 Plantaris muscle

46 Soleus muscle

47 Flexor hallucis longus muscle

48 Spermatic cord

Arteries of the right leg (posterior aspect).

468

1

2

3

4

8

7

7

6

5

4

32

8

31

28

13

22

7

30

Veins

Superficial veins of lower limb, right side

(medio-anterior aspect). The veins have been

injected with red solution.

Medial malleolar region. Dissection of

tibial nerve, posterior tibial vessels, and

great saphenous vein (veins injected with

blue resin).

Main veins of lower

limb, right side

(anterior aspect,

schematic drawing).

1 Superficial epigastric vein

2 Superficial circumflex iliac vein

3 Femoral vein

4 Small saphenous vein

5 External iliac vein

6 External pudendal vein

7 Great saphenous vein

8 Dorsal venous arch

9 Saphenous opening with femoral vein

10 Venous anastomoses of small saphenous

vein with great saphenous vein

11 Patella

12 Penis

13 Medial malleolus

14 Popliteal fossa

15 Perforating veins

16 Lateral malleolus

17 Dorsal digital veins of foot

18 Dorsal venous arch of foot

19 Dorsal metatarsal veins

20 Anterior tibial artery and veins

21 Tibia

22 Posterior tibial artery and veins

23 Fibula

24 Peroneal artery and vein

25 Deep layer of crural fascia

26 Superficial layer of crural fascia

27 Perforating veins I–III (of Cockett)

28 Tibial nerve

29 Arcuate vein

30 Saphenous nerve

31 Medial dorsal cutaneous nerve

(branch of superficial peroneal nerve)

32 Posterior tibial vein

469

30

7

4

7

22

27

21

22

27

7

30

4

7

26

15

11

15

15

Veins

Superficial veins of leg (posterior

aspect; veins injected with blue resin).

Superficial veins of leg. The perforating

veins of Cockett have been dissected (left

side, medial aspect).

Anastomoses between superficial

and deep veins of the leg (schematic

drawing, after Aigner).

Arrows: directions of blood flow.

Veins of leg. The anastomoses between

superficial and deeper veins are dissected

(left side, medial aspect).

Superficial veins on dorsum of foot

(veins injected with blue resin).

470 Nerves

Nerves of lower limb, right side (lateral aspect).

(Schematic drawing.)

Main branches of lumbosacral plexus (ventral aspect).

(Schematic drawing.)

1 Subcostal nerve

2 Iliohypogastric nerve

3 Ilio-inguinal nerve

4 Lateral femoral cutaneous nerve

5 Genitofemoral nerve

6 Pudendal nerve

7 Femoral nerve

8 Obturator nerve

9 Sciatic nerve

10 Lumbar plexus (L1–L4)

11 Sacral plexus (L4–S4) lumbosacral plexus

12 “Pudendal” plexus (S2–S4)

13 Inferior cluneal nerves

14 Posterior femoral cutaneous nerve

15 Common peroneal nerve

16 Tibial nerve

17 Lateral sural cutaneous nerve

18 Medial and lateral plantar nerves

19 Saphenous nerve

20 Infrapatellar branch of saphenous nerve

21 Deep peroneal nerve

22 Superficial peroneal nerve

23 Anterior cutaneous branch of iliohypogastric nerve

24 Lateral cutaneous branch of iliohypogastric nerve

25 Femoral branch of genitofemoral nerve

26 Lateral cutaneous branches of intercostal nerve

27 Anterior cutaneous branches of intercostal nerve

28 Genital branch of genitofemoral nerve

29 Anterior scrotal nerve

1

471

Lumbosacral plexus in situ, right side (medial aspect).

Pelvic organs with peritoneum and part of the levator ani muscle have been removed.

1 Transversus abdominis muscle

2 Iliohypogastric nerve

3 Ilio-inguinal nerve

4 Femoral nerve

5 Lateral femoral cutaneous nerve

6 Obturator nerve

7 Obturator internus muscle

8 Pubic bone (cut edge)

9 Levator ani muscle (remnant)

10 Dorsal nerve of penis

11 Posterior scrotal nerves

12 Adductor longus muscle

13 Gracilis muscle

14 Body of fourth lumbar vertebra

15 Cauda equina

16 Intervertebral disc

17 Sacral promontory

18 Sympathetic trunk

19 Sacrum

20 Lumbosacral trunk

21 Sacral plexus

22 Coccyx

23 Sacrospinous ligament

24 Pudendal nerve

25 Inferior rectal nerves

26 Perineal nerves

27 Subcutaneous fat tissue

of gluteal region

Nerves: Lumbosacral Plexus

472

7

8

9

10

11

12

14

13

15

16

17

1

2

3

4

5

6

Lumbar Part of the Vertebral Canal and Spinal Cord

Lumbar part of vertebral column with pelvis

(sagittal section, medial aspect).

Vertebral canal with spinal cord and root filaments.

Note the high location of the medullary cone. Sacral

plexus and inferior hypogastric plexus are schematically

shown.

1 Eleventh rib

2 Body of third lumbar vertebra

3 Intervertebral disc

4 Body of fifth lumbar vertebra

5 Anterior superior iliac spine

6 Symphysial surface

7 Body of twelfth thoracic vertebra

8 Intervertebral foramen

9 Body of first lumbar vertebra

10 Vertebral canal

11 Spinous process of fifth lumbar vertebra

12 Sacrum (median sacral crest)

13 Promontory (promontorium)

14 Sacrum

15 Arcuate line

16 Coccyx

17 Ischial tuberosity

18 Sympathetic trunk with ganglia

19 Ureter

20 Iliohypogastric nerve (Th12, L1)

21 Ilio-inguinal nerve (L1)

22 Femoral nerve (L2–L4)

23 Genitofemoral nerve (L1, L2)

24 Inferior hypogastric plexus

25 Ductus deferens

26 Urinary bladder

27 Medullary cone of spinal cord

28 Root filaments of spinal nerves

29 Subarachnoid space

(filled with cerebrospinal fluid) (blue)

30 Terminal filament of spinal cord

31 Sacral plexus

32 Pelvic splanchnic nerves (nervi erigentes)

33 Rectum

Lumbar Part of the Vertebral Canal and Spinal Cord 473

Paramedian section of lumbar part of vertebral canal

(MRI scan, dotted line in the schematic drawing below; courtesy

of Prof. Bautz, Erlangen, Germany).

Median section of lumbar part of vertebral canal at the

level of the medullary cone (MRI scan, continuous line in the

schematic drawing below; courtesy of Prof. Bautz, Erlangen,

Germany).

Location of the sections shown above through the

vertebral canal.

1 First lumbar vertebra

2 Root filaments of spinal nerves

3 Sacrum

4 Spinal cord

5 Medullary cone of spinal cord

6 Intervertebral disc between fourth and fifth

lumbar vertebra

7 Fifth lumbar vertebra

474 Spinal Cord with Intercostal Nerves

Spinal cord with intercostal nerves. Inferior thoracic region (anterior aspect). Anterior portion of thoracic vertebrae

removed, dural sheath opened, and spinal cord slightly reflected to the right to display the dorsal and ventral roots.

1 Dura mater

2 Spinal cord

3 Costotransverse ligament

4 Innermost intercostal muscle

5 Vertebral arches (cut surfaces)

6 Eleventh rib

7 Intercostal nerve

8 Collateral branch of intercostal nerve

9 Intercostal nerve (entering the

intermuscular interval)

10 Anterior root filaments

11 Spinal (dorsal root) ganglion

12 Posterior root filaments

13 Arachnoid mater and denticulate ligament

14 Anterior spinal artery

Spinal Cord and Lumbar Plexus 475

Spinal cord and lumbar plexus in situ (anterior aspect).

Organization of spinal cord

segments in relation to the

vertebral column (anterior aspect).

C = cervical; D = thoracic;

L = lumbar; S = sacral segments;

Co = coccygeal bone.

Numbers indicate the related

vertebrae.

1 Conus medullaris

2 Filum terminale

3 Subcostal nerve

4 Iliohypogastric nerve

5 Ilio-inguinal nerve

6 Genitofemoral nerve

7 Lateral femoral cutaneous nerve

8 Femoral nerve

9 Obturator nerve

476 Surface Anatomy of the Lower Limb: Posterior Aspect

Surface anatomy of the right leg (posterior aspect).

Gluteal muscles contracted.

1

2

3

4

5

Cutaneous nerves of the lower limb (posterior aspect).

Dotted lines = border of segments.

1 Iliac crest

2 Sacrum

3 Coccyx

4 Gluteus maximus muscle

5 Dorsal muscles of the leg

6 Iliotibial tract

7 Tendon of semimembranosus

muscle

8 Tendon of biceps femoris

muscle

9 Popliteal fossa

10 Triceps surae muscle

11 Calcaneal or Achilles

tendon

12 Lateral malleolus

13 Superior cluneal nerves

14 Middle cluneal nerves

15 Inferior cluneal nerves

16 Posterior femoral cutaneous

nerve

17 Obturator nerve

18 Saphenous nerve

19 Iliohypogastric nerve

20 Branch of lateral femoral

cutaneous nerves

21 Common peroneal nerve

22 Sural nerve 6

7

8

9

10

11

12

477

Surface anatomy of the right leg (anterior aspect).

1

2

3

4

Cutaneous nerves of the lower limb (anterior aspect).

Dotted lines = border of segments.

1 Iliac crest

2 Anterior superior iliac spine

3 Tensor fasciae latae muscle

4 Quadriceps femoris muscle

5 Iliotibial tract

6 Tendon of biceps femoris

muscle

7 Patella

8 Patellar ligament

9 Tibia

10 Tendon of tibialis anterior

muscle

11 Lateral malleolus

12 Venous network of dorsum

of foot

13 Iliohypogastric nerve

14 Lateral femoral cutaneous

nerve

15 Femoral nerve

16 Common peroneal nerve

17 Superficial peroneal nerve

18 Ilio-inguinal nerve

19 Obturator nerve

20 Saphenous nerve

21 Deep peroneal nerve

5

6

7

8

9

10

11

12

Surface Anatomy of the Lower Limb: Anterior Aspect

478 Thigh: Anterior Region

Cutaneous nerves and veins of thigh (anterior aspect). Cutaneous nerves of lower limb (anterior aspect).

(Schematic drawing.)

Thigh: Anterior Region 479

Cutaneous nerves and veins of thigh (anterior aspect). The

fascia lata and fasciae of the thigh muscles have been removed.

Inguinal nodes with lymphatic vessels

(anterior aspect).

1 Inguinal ligament

2 Superficial circumflex iliac vein

3 Femoral branch of genitofemoral nerve

4 Superficial inguinal lymph nodes

5 Saphenous opening with femoral artery and vein

6 Lateral femoral cutaneous nerve

7 Great saphenous vein

8 Anterior cutaneous branches of femoral nerve

9 Patella

10 Terminal branches of subcostal nerve

11 Terminal branches of iliohypogastric nerve

12 Superficial inguinal ring

13 External pudendal vein

14 Spermatic cord with genital branch of genitofemoral

nerve

15 Penis with superficial dorsal vein of penis

16 Testis and its coverings

17 Saphenous nerve

18 Infrapatellar branch of saphenous nerve

19 Lateral sural cutaneous nerves

20 Intermediate dorsal cutaneous branch of superficial

peroneal nerve

21 Cutaneous branch of obturator nerve

22 Superficial peroneal nerve

23 Medial dorsal cutaneous branch of superficial

peroneal nerve

24 Deep peroneal nerve

25 Femoral nerve

26 Femoral artery

27 Superficial epigastric vein

28 Femoral vein

29 Lateral dorsal cutaneous branch of sural nerve

30 Inguinal nodes (enlarged)

31 Lympathic vessels

32 Sartorius muscle

480 Thigh: Anterior Region

Anterior region of right thigh (anterior aspect). The fascia lata

has been removed, and the sartorius muscle has been slightly

reflected.

Anterior region of right thigh (anterior aspect). The fascia lata

has been removed, and the sartorius muscle has been divided.

1 Anterior superior iliac spine

2 Inguinal ligament

3 Deep circumflex iliac artery

4 Iliopsoas muscle

5 Tensor fasciae latae muscle

6 Femoral nerve

7 Lateral circumflex femoral artery

8 Sartorius muscle

9 Rectus femoris muscle

10 Iliotibial tract

11 Vastus lateralis muscle

12 Anterior sheath of rectus abdominis muscle

13 Inferior epigastric artery

14 Spermatic cord

15 Femoral artery

16 Pectineus muscle

17 Femoral vein

18 Great saphenous vein (divided)

19 Adductor longus muscle

20 Saphenous nerve

21 Muscular branch of femoral nerve

22 Gracilis muscle

23 Vastus medialis muscle

24 Ascending branch of lateral circumflex femoral artery

25 Descending branch of lateral circumflex femoral artery

26 Medial circumflex femoral artery

27 Adductor longus muscle

28 Penis

29 Entrance to adductor canal

30 Vasto-adductor membrane of fascia beneath sartorius muscle

Thigh: Anterior Region 481

Anterior region of right thigh (anterior aspect).

The fascia lata has been removed. Sartorius muscle,

pectineus muscle, and femoral artery have been cut to

display the deep femoral artery with its branches.

The rectus femoris muscle has been slightly reflected.

Anterior region of right thigh (anterior aspect).

The sartorius, pectineus, adductor longus, and rectus

femoris muscles have been divided and reflected.

The greater part of the femoral artery has been

removed.

1 Anterior superior iliac spine

2 Inguinal ligament

3 Tensor fasciae latae muscle

4 Deep circumflex iliac artery

5 Iliopsoas muscle

6 Sartorius muscle (cut)

7 Femoral nerve

8 Lateral circumflex femoral artery

9 Ascending branch of lateral circumflex femoral artery

10 Descending branch of lateral circumflex femoral artery

11 Rectus femoris muscle

12 Vastus medialis muscle

13 Vastus lateralis muscle

14 Femoral vein

15 Pectineus muscle (cut)

16 Femoral artery (cut)

17 Obturator nerve

18 Profunda femoris artery

19 Ascending branch of medial circumflex femoral artery

20 Medial circumflex femoral artery

21 Adductor longus muscle

22 Gracilis muscle

23 Saphenous nerve

24 Distal part of vasto-adductor membrane

25 Rectus femoris muscle with muscular branch of

femoral nerve

26 Adductor longus muscle (divided)

27 Posterior branch of obturator nerve

28 Anterior branch of obturator nerve

29 Point at which perforating artery branches off from

profunda femoris artery

30 Muscular branch of femoral nerve to vastus medialis muscle

482 Gluteal Region

Gluteal region, right side (posterior aspect).

Gluteal region, right side (postero-lateral aspect). Location of

sciatic foramina in relation to the bones (schematic drawing).

1 Iliac crest

2 Gluteus maximus muscle

3 Middle cluneal nerves

4 Anococcygeal nerves

5 Perineal branch of posterior femoral cutaneous nerve

6 Adductor magnus muscle

7 Superior cluneal nerves

8 Position of greater trochanter

9 Inferior cluneal nerves

10 Semitendinosus muscle

11 Posterior femoral cutaneous nerve

12 Long head of biceps femoris muscle

Red lines

1 Spine-tuber line:

the infrapiriform foramen is situated in the middle of

this line

2 Spine-trochanter line:

the suprapiriform foramen is located in the upper third

3 Tuber-trochanter line:

the ischiadic nerve can be found between the middle

and posterior third

Other structures

4 Posterior superior iliac spine

5 Iliac crest

6 Greater trochanter

7 Ischial tuberosity

8 Sacrum

A Suprapiriform foramen

(of greater sciatic foramen)

Superior gluteal artery, vein, and nerve

B Infrapiriform foramen

(of greater sciatic foramen)

Sciatic nerve

Inferior gluteal artery, vein, and nerve

Posterior femoral cutaneous nerve

Internal pudendal artery and vein

Pudendal nerve

C Lesser sciatic foramen

Pudendal nerve

Internal pudendal artery and vein

Gluteal Region 483

Gluteal region, right side (posterior aspect). The gluteus maximus and gluteus medius muscles have been divided and

reflected. Notice the position of the foramina above and below the piriformis muscle and the lesser sciatic foramen.

1 Iliac crest

2 Gluteus maximus muscle (cut)

3 Inferior gluteal nerve

4 Piriformis muscle

5 Muscular branches of inferior gluteal artery

6 Pudendal nerve and internal pudendal artery within the

lesser sciatic foramen (entrance to the pudendal canal)

7 Sacrotuberous ligament

8 Inferior cluneal nerve

9 Inferior rectal nerves

10 Inferior rectal arteries

11 Perforating cutaneous nerve

12 Long head of biceps femoris muscle

13 Gluteus medius muscle (cut)

14 Deep branch of superior gluteal artery

15 Gluteus minimus muscle

16 Superior gluteal nerve

17 Suprapiriform foramen greater sciatic foramen 18 Infrapiriform foramen

19 Tendon of obturator internus and superior gemellus

muscles

20 Posterior femoral cutaneous nerve

21 Inferior gemellus muscle

22 Sciatic nerve

23 Quadratus femoris muscle

24 Tensor fasciae latae muscle

1