Understanding the Anatomy of the Lower Limb: Nerves and Veins
School
Rabbinical College of America**We aren't endorsed by this school
Course
MANA 20141
Subject
Nursing
Date
Dec 10, 2024
Pages
2
Uploaded by tsybwur
Nerves related to bone The common fibular branch of the sciatic nerve curves laterally around the neck of the fibula when passing from the popliteal fossa into the leg (Fig. 6.20). The nerve can be rolled against bone just distal to the attachment of biceps femoris to the head of the fibula. In this location, the nerve can be damaged by impact injuries, fractures to the bone, or leg casts that are placed too high. Superficial veins Large veins embedded in the subcutaneous (superficial) fascia of the lower limb (Fig. 6.21) often become distended (varicose). These vessels can also be used for vascular transplantation. Common fibular nerve (neck of fibula) Superficial branch Deep branch Fig. 6.20 Nerves related to bone. Conceptual overview ° Key points The most important superficial veins are the great and small saphenous veins, which originate from the medial and lateral sides, respectively, of a dorsal venous arch in the foot. The great saphenous vein passes up the medial side of the leg, knee, and thigh to pass through an opening in deep fascia covering the femoral triangle and join with the femoral vein. w The small saphenous vein passes behind the distal end of the fibula (lateral malleolus) and up the back of the leg to penetrate deep fascia and join the popliteal vein posterior to the knee. Great saphenous vein Small saphenous vein Lateral malleolus Lateral marginal vein Medial marginal vein Dorsal venous arch Fig. 6.21 Superficial veins. 525
Lower limb Bony pelvis The external surfaces of the pelvic bones, sacrum, and coccyx are predominantly the regions of the pelvis associ- ated with the lower limb, although some muscles do origi- nate from the deep or internal surfaces of these bones and from the deep surfaces of the lumbar vertebrae, above (Fig. 6.22). Each pelvic bone is formed by three bones (ilium, ischium, and pubis), which fuse during childhood. The ilium is superior and the pubis and ischium are antero- inferior and posteroinferior, respectively. The ilium articulates with the sacrum. The pelvic bone is further anchored to the end of the vertebral column (sacrum and coccyx) by the sacrotuberous and sacrospi- nous ligaments, which attach to a tuberosity and spine on the ischium. The outer surface of the ilium, and the adjacent surfaces of the sacrum, coccyx, and sacrotuberous ligament, are associated with the gluteal region of the lower limb and Tuberculum of iliac crest provide extensive muscle attachment. The ischial tuberos- ity provides attachment for many of the muscles in the posterior compartment of the thigh, and the ischiopubic ramus and body of the pubis are associated mainly with muscles in the medial compartment of the thigh. The head of the femur articulates with the acetabulum on the lateral surface of the pelvic bone. Hium The upper fan-shaped part of the ilium is associated on its inner side with the abdomen and on its outer side with the lower limb. The top of this region is the iliac crest, which ends anteriorly as the anterior superior iliac spine and posteriorly as the posterior superior iliac spine. A prominent lateral expansion of the crest just posterior to the anterior superior iliac spine is the tuberculum of iliac crest. The anterior inferior iliac spine is on the anterior margin of the ilium, and below this, where the ilium fuses with the pubis, is a raised area of bone (the iliopubic eminence). Horizontal plane through top of iliac crest Anterior abdominal wall lliac crest LIV spine Anterior gluteal line Anterior superior iliac spine Inguinal ligament Anterior inferior iliac spine lliopubic eminence Pubic tubercle Pubis Acetabulum Ischium 526 Fig. 6.22 External surface of the bony pelvis. Lateral view. Posterior gluteal line LA Posterior superior iliac spine Sacrum Inferior gluteal line Sacrotuberous ligament Sacrospinous ligament Ischial spine Ischial tuberosity