1

KYLE THOMAS P. FRESNIDO, MD.

4TH YR SURGERY RESIDENT
SAN JUAN DE DIOS EDUCATIONAL FOUNDATION INC. HOSPITAL

UE AND LE ANATOMY
 2

UPPER EXTREMITY
TEXT 3

MUSCLES CONNECTING THE UE TO THE THORAX

Innervation Action

Medial and Lateral Adducts arm and

Pectoralis major
Pectoral nerves rotates it medially

Pectoralis minor Medial Pectoral nerve Depresses the shoulder

Subclavius Nerve to subclavius Depresses the clavicle

Draws the scapula

Serratus Anterior Lont Thoracic nerve
forward/ protraction
TEXT 4

THE AXILLA
▸ Pyramidal in shape

▸ Boundaries

▸ Anterior (Pectoral)

▸ Posterior (Scapular)

▸ Medial (Costal)

▸ Lateral (Humeral)

▸ Apex

▸ Base
TEXT 5

THE AXILLA
▸ Pyramidal in shape

▸ Boundaries

▸ Anterior (Pectoral)

▸ Posterior (Scapular)

▸ Medial (Costal)

▸ Lateral (Humeral)

▸ Apex

▸ Base
TEXT 6

THE AXILLA
▸ Contents of the axilla

▸ axillary vein

▸ axillary artery

▸ brachial plexus

▸ Lymph nodes
TEXT 7

ROTATOR CUFF MUSCLES

▸ Supraspinatus

▸ Infraspinatus

▸ Teres Minor

▸ Subscapularis

▸ Function:

▸ Stabilises the shoulder joint

TEXT 8

INTRINSIC MUSCLES OF THE SHOULDER

Nerve supply Action

Supraspinatus Supracapular Abductor
Infraspinatus Suprascapular Lateral Rotator
Teres minor Axillary Lateral Rotator
Subscapularis Upper Subscapular Medial Rotator
Deltoid Axillary Abductor
Teres Major Lower subscapular Medial Rotator
TEXT 9

DISLOCATION VS SEPARATION
▸ Anterior-inferior Dislocation
Dislocation Separation
▸ Common

▸ Weak inferior Displacement of Occurs at the

bones of the Acromioclavicular
▸ Posterior Dislocation
Glenohumeral Joint Joint
▸ Rare
Clavicle is torn from
the acromion
TEXT 10
TEXT 11

INFLAMMATION OF THE ROTATOR CUFF

▸ aka. Rotator cuff tendinitis

▸ inflammation of the Rotator cuff

tendons

▸ Supraspinatus

▸ Pain on the anterior and posterior

shoulder joint during Abduction
TEXT 12

DORSAL SCAPULAR SPACES

▸ Quadrangular space

▸ Triangular space
TEXT 13

QUADRANGULAR SPACE
▸ Boundaries

▸ Above - Teres minor

▸ Below - Teres major

▸ Medial - Long head of Triceps brachia

▸ Lateral - Surgical Neck of Humerus

▸ Contents

▸ Axillary Nerve (Circumflex nerve)

▸ Posterior circumflex humeral vessels

TEXT 14

TRIANGULAR SPACE
▸ Boundaries

▸ Above - Teres minor

▸ Below - Teres major

▸ Laterally - Long head of Triceps brachii

▸ Contents

▸ Circumflex scapular vessels

TEXT 15

MUSCLES OF THE ARM

▸ Anterior compartment

▸ Flexor

▸ Musculocutaneous Nerve

▸ Posterior compartment

▸ Extensor

▸ Radial Nerve
TEXT 16

Compartment Muscle Action

Anterior Coracobrachialis Adducts/flex the arm

Brachialis Main Flexor of Forearm

Main Supinator of Forearm/

Biceps brachii
flex forearm
Posterior Triceps brachii Main extensor of Forearm
TEXT 17
TEXT 18

CUBITAL FOSSA
▸ Contents:

▸ Medial nerve

▸ Brachial artery

▸ Biceps brachii tendon

▸ Radial nerve

▸ Boundaries:

▸ Lateral - Brachioradialis

▸ Medial - Pronator teres

▸ Upper - Horizontal line connecting the epicondyles

▸ Floor - Brachialis and Supinator

TEXT 19

CUBITAL FOSSA
▸ Contents:

▸ Medial nerve

▸ Brachial artery

▸ Biceps brachii tendon

▸ Radial nerve

▸ Boundaries:

▸ Lateral - Brachioradialis

▸ Medial - Pronator teres

▸ Upper - Horizontal line connecting the epicondyles

▸ Floor - Brachialis and Supinator

 TEXT 20

MUSCLES OF THE FOREARM

▸ Flexors

▸ Superficial group

▸ Deep group

▸ Median nerve except FCU and FDP

▸ Medial Epicondyle

▸ Extensors

▸ Superficial group

▸ Deep group

▸ Radial nerve

▸ Lateral Epicondyle
TEXT 21

FLEXOR MUSCLES OF THE FOREARM

Superficial Deep
Pronator teres Flexor pollicis longus
Flexor carpi Radialis Flexor digitorum profundus
Palmaris Longus Pronator Quadratus
Flexor carpi Ulnaris
Intermediate group
Flexor digitorum superficialis
TEXT 22
TEXT 23

EXTENSOR MUSCLES OF THE FOREARM

Superficial Deep
Brachioradialis Abductor pollicis longus
Extensor carpi radialis longus Extensor pollicis brevis
Extensor carpi radialis brevis Extensor pollicis longus
Extensor digitorum Extensor indicis
Extensor digiti minimi Supinator
Extensor carpi ulnaris
Anconeus
TEXT 24
TEXT 25

EPICONDYLITIS

Medial Epicondylitis Lateral Epicondylitis

Golfer’s elbow Tennis elbow

Forced extension and

Repetitive flexion and
flexion of the forearm
pronation
at the elbow
TEXT 26

MUSCLES OF THE HAND

▸ Intrinsic muscles of the hand

▸ Extrinsic muscles of the hand

▸ Thenar muscles

▸ Hypothenar muscles
TEXT 27

Thenar Muscles Hypothenar Muscles

Abductor pollicis brevis Abductor digiti minimi

Flexor pollicis brevis Flexor digiti minimi

Opponens pollicis Opponens digiti minimi

Median Nerve Ulnar nerve

TEXT 28
TEXT 29

INTRINSIC MUSCLES OF THE HAND

Action Nerve

Extends fingers and

Extensor Digitorum Radial nerve
wrist

Palmar interossei (3) ADDUCTS fingers Ulnar nerve

Dorsal interossei (4) ABDUCTS fingers Ulnar nerve

Ulnar nerve- medial

Lumbricales (4) Flexes the MCP joints
Median nerve - Lateral
TEXT 30
TEXT 31
TEXT 32
TEXT 33

EXTRINSIC MUSCLES OF THE HAND

▸ Flexor digitorum superficialis

▸ Flexes the PROXIMAL PIP joints

▸ Flexor digitorum profundus

▸ Flexes the DISTAL PIP joints

TEXT 34

CARPAL TUNNEL
▸ Strong fibrous band that covers the
carpal bones on the palmar side

▸ 10 contents

▸ 9 tendons ( 4 FDP and 4 FDS) and

FPL

▸ 1 nerve ( Median nerve)

TEXT 35

BRACHIAL PLEXUS
TEXT 36
TEXT
ERB-DUCHENNE SYNDROME VS KLUMPKE PARALYSIS
ERB-DUCHENNE
aka. Waiter’s tip deformity
UPPER Brachial plexus injury
Fall on shoulder or difficult delivery
Arm medially rotated and forearm
pronated
Altered sensation to lateral arm,
forearm, thumb and index finger
37
KLUMPKE
aka. claw hand deformity
LOWER Brachial plexus injury
Excessive abduction of arm or stab or
bullet wounds
Weakness of the wrist and finger
flexors of the hand
Altered sensation in the medial hand,
ring and little finger
TEXT 38
TEXT 39
TEXT 40

NERVE INJURY
Long Thoracic weakness in Surgery (thoracic,
Winged scapula
nerve Protraction MRM), stab wound

Thoracodorsal Difficulty in
Surgery
nerve elevating trunk

Dislocation of
weakness in
Axillary nerve humerus, fracture
abduction
to surgical neck
TEXT 41
TEXT 42

NERVE INJURY
Wrist drop
Weakness in Compression of
Saturday night
Radial nerve extension of wrist the Radial nerve in
palsy
and fingers the axilla
Honey moon Palsy

Weakness in Compression of
Musculocutaneous
flexion/supination musculocutaneous
nerve
of forearm nerve
TEXT 43
TEXT 44

NERVE INJURY
Median nerve

Altered sensation; weak

Supracondylar Hand of
Proximal flexion of wrist, lateral
fracture Benediction
fingers and thumb

Carpal tunnel Altered sensation; Ape

syndrome; hand weakness, thumb
Distal
Lunate is adducted and
Dislocation extended
TEXT 45
TEXT 46

NERVE INJURY

Ulnar
nerve

Medial epicondyle Altered sensation;

Proximal
fractures Weakness in flexion

Altered sensation;
Fracture of hook of
Distal weakness in medial 2 Claw hand
Hamate
lumbricales and adduction
TEXT 47
TEXT 48

CARPAL TUNNEL SYNDROME

▸ Entrapment of the median nerve within the carpal tunnel

▸ Burning pain or “PINS and NEEDLES” sensation along the distribution of the
median nerve

▸ Weakness of muscles: lateral half of finger flexors and thenar muscles

▸ Tinel’s sign

▸ no paresthesia over the thenar eminence (palmar cutaneous branch of the

median nerve)
TEXT 49
TEXT 50

BLOOD SUPPLY (ARTERIAL)

▸ Axilllary artery

▸ continuation of the Subclavian artery (1st rib to Teres major)

▸ divided into 3 parts by Pectoralis minor

▸ Continues as Brachial artery

TEXT 51

DIVISION OF THE AXILLARY ARTERY

▸ 1st

▸ Superior thoracic artery

▸ 2nd

▸ Thoracoacromial

▸ Lateral thoracic

▸ 3rd

▸ Subscapular

▸ Ant. Circumflex artery

▸ Post. Circumflex artery

TEXT 52

BLOOD SUPPLY
▸ Axillary artery becomes the Brachial
artery

▸ Brachial Artery divides into the

▸ Ulnar artery

▸ Radial artery

▸ The palmar arch

TEXT 53

BLOOD SUPPLY
▸ Axillary artery becomes the Brachial
artery

▸ Brachial Artery divides into the

▸ Ulnar artery

▸ Radial artery

▸ The palmar arch

TEXT 54

BLOOD SUPPLY
▸ Superficial and deep veins

▸ Basilic vein and Brachial vein becomes the

Axillary vein

▸ Cephalic vein drain into the axillary vein

forming the Subclavian vein
TEXT 55

SKELETAL SYSTEM
▸ Clavicle

▸ first bone to begin ossification

▸ Last bone to complete ossification

▸ Medial 2/3 convex and forward

▸ Lateral 1/3 flattened

▸ Junction is the weakest

TEXT 56

CLAVICULAR FRACTURE
▸ Fall on the shoulder or outstretched hand

▸ Most commonly fractured bone

▸ Medial segment elevated by the pull of the

SCM

▸ Lateral segment displaced downward by

gravity and pull of Deltoid and Pec Major

▸ Brachial plexus injury/ Lower trunk

▸ Hemorrhage from Subclavian vein/artery

TEXT 57

HUMERUS
▸ SURGICAL NECK

▸ AXILLARY nerve or Posterior Circumflex artery

▸ MIDSHAFT

▸ Spiral fractures may affect the RADIAL nerve and

Profunda Brachii artery

▸ SUPRACONDYLAR

▸ MEDIAN nerve may be affected;

▸ MEDIAL EPICONDYLE

▸ ULNAR nerve may be affected

TEXT 58

HUMERUS
▸ SURGICAL NECK

▸ AXILLARY nerve or Posterior Circumflex artery

▸ MIDSHAFT

▸ Spiral fractures may affect the RADIAL nerve and

Profunda Brachii artery

▸ SUPRACONDYLAR

▸ MEDIAN nerve may be affected;

▸ MEDIAL EPICONDYLE

▸ ULNAR nerve may be affected

TEXT 59

HUMERUS
▸ SURGICAL NECK

▸ AXILLARY nerve or Posterior Circumflex artery

▸ MIDSHAFT

▸ Spiral fractures may affect the RADIAL nerve and

Profunda Brachii artery

▸ SUPRACONDYLAR

▸ MEDIAN nerve may be affected;

▸ MEDIAL EPICONDYLE

▸ ULNAR nerve may be affected

TEXT 60

HUMERUS
▸ SURGICAL NECK

▸ AXILLARY nerve or Posterior Circumflex artery

▸ MIDSHAFT

▸ Spiral fractures may affect the RADIAL nerve and

Profunda Brachii artery

▸ SUPRACONDYLAR

▸ MEDIAN nerve may be affected;

▸ MEDIAL EPICONDYLE

▸ ULNAR nerve may be affected

TEXT 61

HUMERUS
▸ SURGICAL NECK

▸ AXILLARY nerve or Posterior Circumflex artery

▸ MIDSHAFT

▸ Spiral fractures may affect the RADIAL nerve and

Profunda Brachii artery

▸ SUPRACONDYLAR

▸ MEDIAN nerve may be affected;

▸ MEDIAL EPICONDYLE

▸ ULNAR nerve may be affected

TEXT 62

RADIUS AND ULNA

▸ Supination and Pronation

▸ Distal and Proximal Radio-ulnar joint

▸ Radial head proximal

▸ Ulnar head Distal

TEXT 63

Colle’s fracture/ Dinner / Silver

Smith Fracture
fork deformity

▸ distal segment
▸ distal segment POSTERIORLY
ANTERIORLY
and SUPERIORLY
Displacement ▸ Distal radial fracture,
▸ Distal radial fracture,
fragment ventrally
fragment dorsally displaced
displaced

MOI Fall on an outstretched hand Fall on the back of the hand

TEXT 64
TEXT 65

CARPAL BONES
Proximal Distal

▸ Scaphoid/
▸ Trapezium
Navicular

▸ Lunate ▸ Trapezoid

▸ Triquetrium/
▸ Capitate
Triquetral

▸ Pisiform ▸ Hamate
TEXT 66

ANATOMICAL SNUFF BOX

▸ Lateral - tendons of EPB and APL

▸ Medial - tendon of EPL

▸ Floor - Scaphoid

▸ Location of pain in Scaphoid fractures

TEXT 67

Carpal Tunnel Syndrome Dupuytren Contracture

Thickening of the synovial sheaths of the Localized thickening and contracture of the
flexor tendons compress the median nerve Palmar aponeurosis

Burning pain/ Pins and needles sensation Starts in the ring finger gradually drawing in
along the distribution of the median nerve the little finger
TEXT 68
TEXT 69

Bennett Fracture Boxer’s Fracture

Oblique fracture of the necks of the

Fracture of the base of the first
fourth or fifth metacarpals with the
metacarpal bone
distal segments displaced proximally

Thumb is forcefully abducted Shortening of the finger

TEXT 70
TEXT 71

DERMATOMES
TEXT 72

TENDON REFLEXES
▸ BICEPS BRACHII TENDON

▸ C5 and C6; flexion of the elbow joint by tapping

the biceps tendon

▸ TRICEPS TENDON

▸ C6, C7 and C8; Extension of the elbow joint by

tapping the triceps tendon

▸ BRACHIORADIALIS TENDON

▸ C5, C6, and C7; supination of the radioulnar joint

by tapping the insertion of the brachioradialis
tendon
 73

LET’S TAKE A BREAK.

K. Fresnido
 74

LOWER EXTREMITY
TEXT 75

LOWER EXTREMITY
▸ Functions

▸ Support weight of the body

▸ Stable foundation for standing, walking, running

▸ Regions
TEXT 76

THIGH
▸ Fascial compartments of the thigh

▸ Anterior

▸ Posterior

▸ Medial
TEXT 77

ANTERIOR COMPARTMENT
▸ Flexors of the Thigh

▸ Extensors of the leg

▸ Femoral nerve

▸ consists of

▸ Iliopsosas - Strongest flexor

▸ Tensor Fascia Lata - Flexion and Medial rotation

▸ Sartorius - Flexion and Lateral rotation

▸ Quariceps femoris
TEXT 78

▸ ASIS - origin of the Sartorius and TFL

▸ AIIS - origin of Rectus femurs

▸ Lesster Trochanter of Femur - common insertion of

the Iliacus and Psoas

▸ Patellar Tendon - common insertion of the quadriceps

▸ Anterior compartment

▸ flexes the thigh at the hip joint, extends the leg at

the knee joint

▸ Rectus Femoris
TEXT 79

MEDIAL COMPARTMENT
▸ Adducts the thigh

▸ Obturator nerve

▸ Consists of

▸ Adductor longus

▸ Adductor brevis

▸ Adductor Magnus

▸ Gracilis
TEXT 80

▸ Linea Aspera of Femur

▸ common insertion of adductor muscles

▸ Adductor tubercle of Femur

▸ Insertion of hamstring part adductor Magnus

TEXT 81

POSTERIOR COMPARTMENT
▸ Extensors of the thigh

▸ Flexors of the leg

▸ Sciatic nerve

▸ Hamstring Muscles

▸ Semitendinosus

▸ Semimembranosus

▸ Biceps Femoris

▸ Adductor Magnus
TEXT 82

▸ Ischial tuberosity - common origin of the

Hamstring muscles

▸ Short head of biceps femurs originates in the

lines aspera and lateral supracondylar ridge of
femur
TEXT 83

FEMORAL TRIANGLE
▸ Boundaries

▸ Superior - Inguinal ligament

▸ Medially - Adductor Longus

▸ Laterally - Sartorius

▸ Floor - Adductor longus, Pectineus, Iliopsosas

▸ Contents

▸ Femoral Nerve

▸ Femoral Artery

▸ Femoral Vein

▸ Lymph vessel
TEXT 84

FEMORAL SHEATH
▸ A funnel shaped fascial compartment

▸ Inferior prolongation of the iliopsoas and

transversals fascia of the abdomen

▸ Compartments

▸ Lateral - femoral artery

▸ Intermediate - Femoral vein

▸ Medial - Femoral Canal

TEXT 85

FEMORAL VEIN CATHETERIZATION

▸ Genitofemoral nerve block

▸ Femoral pulse is palpated midway

between ASIS and Pubis

▸ Femoral vein immediately Medial to it

▸ Two finger breadths below the inguinal

ligament
TEXT 86

FEMORAL HERNIA
▸ Appears as a mass, often tender in the
femoral triangle

▸ Weak area in the anterior abdominal

wall and admits 5th digit
TEXT 87
TEXT 88

ADDUCTOR CANAL
▸ Subsartorial canal

▸ Hunter’s canal

▸ Fascial tunnel in the thigh running from the

apex of the the femoral triangle to the
Adductor hiatus in the tendon of Adductor
Magnus muscle
TEXT 89
TEXT 90

ADDUCTOR CANAL
▸ Boundaries

▸ Anterior - sartorius

▸ Lateral - Vastus Medialis

▸ Posterior and Medial - Adductor longs and magnus

▸ Contents

▸ Femoral artery and vein

▸ Saphenous nerve

▸ Nerve to Vastus medialis

TEXT 91

GLUTEAL REGION
Group Muscle Action
Superficial ▸ Gluteus maximus Extensor of Thigh

▸ Gluteus medius Abductor and Medial rotator

Intermediate
▸ Gluteus minimus of Thigh

▸ Piriformis
▸ Obturator internus
Deep Lateral rotator of Thigh
▸ Superior and inferior Gemelli
▸ Quadratus femoris
TEXT 92
TEXT 93

▸ Outer surface of Ilium - common origin of

Gluteal muscles

▸ Greter trochanter - common insertion

▸ Except

▸ Gluteus maximus - gluteal tuerosity; Iliotibial

tract

▸ Quadratus femoris - Quadrate tubercle

 TEXT 94

SUMMARY
Anterior thigh Flexion of hip Femoral nerve

▸ Sciatic nerve
Posterior thigh Extension of hip ▸ Inferior Gluteal nerve
for Gluteus maximus

Medial thigh Adduction Obturator nerve

▸ Gluteus medius
Abduction Superior Gluteal nerve
▸ Gluteus minimus
TEXT 95

SUMMARY

▸ Gluteus medius
Medial Rotation Superior Gluteal nerve
▸ Gluteus minimus

Piriformis Lateral Rotation Nerve to Piriformis

TEXT 96

LUMBOSACRAL PLEXUS
TEXT 97

▸ Sciatic nerve

▸ Largest nerve in the body

▸ L4 to S3

▸ Supplies no structure in the gluteal area

TEXT 98
TEXT 99

LIGAMENTS OF THE HIP JOINT

▸ Y shaped
Ilio femoral ▸ Resists
hyperextension

▸ Resists hyper
Pubofemoral
abduction

▸ Truingular in shape
Ischiofemoral ▸ Resists internal
rotation
TEXT 100

LIGAMENTS OF THE HIP JOINT

▸ Y shaped
Ilio femoral ▸ Resists
hyperextension

▸ Resists hyper
Pubofemoral
abduction

▸ Truingular in shape
Ischiofemoral ▸ Resists internal
rotation
TEXT 101
TEXT 102

SUPERIOR GLUTEAL NERVE INJURY

▸ Results to weakened abduction of the

thigh by Gluteus medium

▸ Waddling gate

▸ (+) Trendelenburg sigh

TEXT 103

SUPERIOR GLUTEAL NERVE INJURY

▸ Results to weakened abduction of the

thigh by Gluteus medium

▸ Waddling gate

▸ (+) Trendelenburg sigh

TEXT 104

INFERIOR GLUTEAL NERVE INJURY

▸ Weakness in the ability to Laterally

rotate and Extend thigh at hip

▸ Difficulty in climbing stairs and rising

from a chair

▸ Gluteus maximus gait

TEXT 105

SCIATIC NERVE LESIONS

▸ susceptible to damage from IM

injections in Lower Medial quadrant

▸ may be compressed from a posterior

dislocation of femur

▸ L5 and S1 roots are commonly

compressed resulting to pain that
radiates to L5 and S1 dermatomes
TEXT 106

PIRIFORMIS SYNDROME

▸ Piriformis muscle irritates and places

pressure on the sciatic nerve causing
pain on the buttocks and referring pain
along the course of Sciatic nerve

▸ Sciatica
TEXT 107

FEMORAL NERVE INJURY

▸ may be damages in the abdomen by
abscess of the Psoas

▸ stab wound

▸ acetabular fracture

▸ anterior dislocation of the hip

▸ weakness in hip flexion and knee extension

▸ Diminished patellar tendon reflex

▸ Rare
TEXT 108

SAPHENOUS NERVE INJURY

▸ may be damaged during vein stripping

procedures

▸ Pain and paresthesia on skin on the

medial aspect of the leg and foot

▸ no motor loss
TEXT 109

OBTURATOR NERVE INJURY

▸ commonly lesioned in the pelvis

▸ patients unable to adduct the thigh at

the hip

▸ Paresthesia on skin on the medial thigh

TEXT 110

FEMUR
▸ Neck shaft angle

▸ 160 digress - young

▸ 125 - 140 - adult

▸ Coxa Vara

▸ <125 degrees

▸ Coxa Valga

▸ >140 degrees
TEXT 111

FEMORAL NECK FRACTURE

▸ Shortened with lateral rotation

▸ head of femur may undergo Avascular

Necrosis

▸ Pulled up by Quadriceps femoris,

adductors and Hamstring muscles

▸ Subcapital - elderly; women in

menopause

▸ Trochanteric - Young; trauma

TEXT 112

AVASCULAR NECROSIS

▸ Decreased blood supply to the head of

Femur

▸ Traumatic or Atraumatic

▸ Medial femoral circumflex artery is the

major supply

▸ Obturator artery contributes

TEXT 113

DISLOCATION OF HEAD OF FEMUR

▸ Most common posteriorly

▸ Thigh is shortened and Medially rotated

by gluteus medium and minimum

▸ Sciatic nerve may be compressed

▸ Weakness of posterior leg thigh leg

and foot

▸ Paresthesias on posterior and lateral

aspects of leg,
TEXT 114

LEG
▸ Anterior Compartment

▸ Lateral Compartment

▸ Posterior Compartment
TEXT 115

ANTERIOR COMPARTMENT
▸ Muscles

▸ Tibialis anterior

▸ Peroneus Tertius

▸ Extensor digitorum brevis

▸ Extensor digitorum longus

▸ Extensor Hallucis Longus

▸ Nerve : Deep Peroneal Nerve

▸ Action: Dorsiflesion and inversion

TEXT 116

LATERAL COMPARTMENT
▸ Muscles

▸ Peroneus longus

▸ Peroneus brevis

▸ Nerve: Superficial peroneal nerve

▸ Action: Evertion and weak plantarflexion

TEXT 117

POSTERIOR COMPARTMENT
▸ Muscle

▸ Superficial : Gastrocnemius, Plantaris, Soleus

▸ Deep : Popliteus, Flexor digitorum longus,

Flexor Hallucis longus, Tibialis posterior

▸ Nerve: Tibial nerve

▸ Action: Plantar flexion and Inversion

▸ Gastrocnemius and Solerus: Triceps sure

▸ Common insertion : Achilles tendon

TEXT 118

POSTERIOR COMPARTMENT
▸ Muscle

▸ Superficial : Gastrocnemius, Plantaris, Soleus

▸ Deep : Popliteus, Flexor digitorum longus,

Flexor Hallucis longus, Tibialis posterior

▸ Nerve: Tibial nerve

▸ Action: Plantar flexion and Inversion

▸ Gastrocnemius and Solerus: Triceps sure

▸ Common insertion : Achilles tendon

TEXT 119

POPLITEAL FOSSA
▸ Boundaries

▸ Lateral: Biceps femoris above and lateral head of

Gastrocnemius below

▸ Medial: Semitendinosus and semimembranosus

above and medial head of Gastrocnemius below

▸ Contents

▸ Popliteal artery, small saphenous vein, LN

▸ Common Peroneal nerve

▸ Tibial nerve, Genicular branch of Obturator n.

TEXT 120

TENDON REFLEXES
▸ Biceps brachii reflex - C5

▸ Brachioradialis reflex - C6

▸ Triceps brachii reflex - C7

▸ Patellar Tendon reflex - L4

▸ Achilles Tendon reflex - S1

TEXT 121

BLOOD VESSELS
▸ Common Iliac

▸ Internal Iliac

▸ External Iliac

▸ Inferior epigastric

▸ Deep circumflex

▸ Femoral
TEXT 122

BLOOD SUPPLY
▸ External Iliac artery

▸ Inferior epigastric

▸ Femoral

▸ Tibial

▸ Anterior - Dorsalis Pedis

▸ Posterior - Plantar arteries

(medial and lateral)

▸ Plantar Arch
TEXT 123

ARTERIAL PALPATION
▸ Dorsalis Pedis

▸ Medially: tendon of EHL

▸ Laterally: tendone FDL

▸ Landmark: 1st inter metatarsal space

▸ Femoral artery - beneath inguinal ligaments between

ASIS and Symphysis pubis

▸ Popliteal artery - popliteal space with a fully relaxed and

passively flexed knee

▸ Posterior Tibial - behind medial malleolus between

tendons of FDL and FHL