Human leg

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The human leg , in the common sense, is the entire lower extremity of the human body, including the legs, thighs and even the pelvic or gluteal regions. However, the definition in human anatomy refers only to the lower extremity extending from the knee to the ankle, also known as crus . Legs are used for standing, and all forms of movement include recreation such as dancing, and are a significant part of a person's mass. Female legs generally have larger pelvic anteversions and tibiofemoral angles, but the femur and tibial are shorter than in men.

Video Human leg

Structure

In human anatomy, the lower leg is part of the lower limb located between the knee and ankle. The thighs are between the hips and knees and form the rest of the lower limb. The term of the lower extremity or "lower extremity" is usually used to describe all the legs. This article generally follows the general usage.

The leg from knee to ankle is called crus or cnemis . The calf is the back, and the tibia or shinbone along with the smaller fibula forms the front of the lower leg.

Evolution has provided the human body with two distinct features: the specialization of the upper extremities for visual manipulation and the development of lower extremities into mechanisms that are specifically adapted for efficient bipedal gait. While the capacity to walk upright is not unique to humans, other primates can only achieve this for a short time and with enormous energy expenditure. Human adaptation to bipedalism is not limited to the feet, but also affects the location of the body's center of gravity, the reorganization of the internal organs, and the shape and biomechanism of the torso. In humans, the double S-shaped vertebral column acts as a shock absorber that shifts the load from the trunk over the load surface of the foot. Human legs are very long and strong as a result of their exclusive specialization to support and move - on orangutans, the leg length is 111% of the stem; in chimpanzees 128%, and in humans 171%. Many leg muscles are also adapted to bipedalism, most gluteal muscles, knee joint extensors, and calf muscles.

Skeleton

The main bone of the leg is the femur (thighbone), the tibia (the shinbone), and the adjacent fibula, and these are all long bones. The patella (kneecap) is a sesamoid bone in front of the knee. Most skeletal frameworks have bony bulges and palpable margins and some serve as anatomical markers that determine the extent of the foot. These are the superior anterior superior iliac spine, the greater trochanter, the superior margin of the medial tibial condyle, and the medial malleolus. The important exceptions to palpation are the hip joint, and the neck and body, or the femoral axis.

Usually, the large joint of the lower limb is parallel in a straight line, representing the mechanical longitudinal axis of the leg, the Mikulicz line. This line extends from the hip joint (or rather the head of the femur), through the knee joint (tibial interondylar eminence), and down to the ankle center (ankle incline, grip-like fork between the medial and lateral malleoli). On the tibial shaft, the mechanical and anatomical axes coincide, but on their femoral shaft deviates 6 Â °, resulting in a femorotibial angle of 174Ã, Â ° in the foot with normal axial alignment. A leg is considered straight when, with the feet put together, the two medial males of the knee and the medial knee touch the knee. Divergences from a normal femorotibial angle are called genu varum if the center of the knee joint is the lateral of the mechanical axis (intermalleolar distance exceeds 3 cm), and the genu valgum if medial to the mechanical axis (intercondylar distance exceeds 5 cm). This condition imposes an unbalanced load on the joints and stretches both the thigh adapter and the kidnapper. Tilt angles are formed between the neck and stem of the femur, (collodiaphysial angle), varying with age - about 150 Â ° in newborns, gradually decreasing to 126-128 Â ° in adults, to reach 120 Â ° in old age. Pathological changes at this angle result in abnormal posture in the limbs: Small angle produces coxa vara and large angles in the coxa valga; the latter usually combined with genu varum and coxa vara lead genu valgum. In addition, the line drawn through the femoral neck is superimposed on the line drawn through the femoral condyle to form an angle, the angle of torque , which allows the movement of the hip joint to be switched to the rotary movement. from the femoral head. An abnormally inflated angle of the torque causes the extremities to change inward and decreases the angle of the extremity outwardly; both cases result in a reduced mobility range.

Muscle

Hip

There are several ways to classify the hip muscles: (1) By location or innervation (the ventral and back divisions of the plexus lining); (2) with development on the basis of their insertion point (posterior group in two layers and anterior groups); and (3) by function (ie extensor, flexor, adductor, and kidnapper).

Some hip muscles also act on the knee joint or on the vertebral joint. In addition, because the area of ​​origin and the insertion of many of these muscles is very broad, these muscles are often involved in several very different movements. In the hip joint, lateral and medial rotation occurs along the axis of the extremities; extension (also called dorsoflection or retroversion) and flexion (anteflection or anteversion) occur along the transverse axis; and kidnappings and adductions occur around the sagittal axis.

The anterior anterior hip muscle is iliopsoas, a group of two or three muscles with a joint insertion on a small trochanter of the femur. The main psoas come from the last vertebra and along the lumbar spine to stretch into the pelvis. Iliacus is derived from the iliac fossa on the pelvic interior side. The two muscles unite to form the iliopsoas muscle that is inserted on the smaller femur trochanter. The minor psoas, present only in about 50 percent of subjects, originate on top of the psoas major to stretch obliquely to the insertion on the interior side of the major muscle.

The posterior back hip muscles are inserted at or just below the major femur trochanter. The tensor fasciae latae extends from the anterior superior iliac spine into the iliotibial canal, pressing the femoral head to the acetabulum but also flexing, spinning in the medial, and abducts to the hip joint. The piriformis originates from the anterior pelvic surface of the sacrum, passes through the larger ischial foramen, and inserts in the posterior aspect of the greater tip of the greater trochanter. In the standing posture it is the lateral rotator, but also helps extend the thighs. Gluteus maximus has the origin between (and around) iliac crest and tail bone from which one part radiates to the iliotibial canal and the other extends to the gluteal tuberosity beneath the major trochanter. Gluteus maximus is primarily an extensor and lateral rotator of the hip joint, and it applies when climbing a ladder or ascending from a sitting position to a standing. Furthermore, the portion inserted into the fascia latae abducts and the part incorporated into the gluteal tuberosity will add the hip. Two deep glutei muscles, gluteus medius and minimus, originate from the lateral side of the pelvis. The medius muscle is shaped like a hat. The anterior fiber serves as the rotator and the medial flexor; posterior fibers as lateral and extensor rotators; and the whole muscle digests the hips. Minus has a similar function and both muscles are fed into the greater trochanter.

The ventral hip muscles function as the lateral rotator and play an important role in controlling the body's balance. Because they are stronger than the medial rotator, in the normal position of the foot, the tops of the legs point outward to get better support. The internus obturator originates in the pelvis on the obturator foramen and its membrane, passes through the lower sciatic foramen, and is introduced to the femoral trochanteric fossa. "Bent" above the sciatic lower notch, which functions as a fulcrum, the muscle forms the strongest lateral rotator of the hip along with the gluteus maximus and quadratus femoris. When sitting with his knees bent, he acts as a kidnapper. The externus obturator has a parallel program with origin that lies on the posterior border of the foramen obturator. It is covered by several muscles and acts as a weak and lateral rotator and adductor. The inferior and superior gemelli represent the marginal head of the obturator and assist this muscle. Three muscles have been referred to as coxae triceps. The quadratus femoris is derived from the ischial tuberosity and fed into the intertrochanteric peak between the trochanters. This flat muscle acts as a strong lateral rotator and thigh adductor.

The thigh adductor muscle is innervated by the obturator nerve, with the exception of pectin receiving fibers from the femoral nerve, and the adductor magnus receiving fibers from the tibial nerve. Gracilis emerges from close to the symphysis pubis and is unique among the adductors that reach past the knee to stick to the medial side of the tibia shaft, thus working on two joints. It shares a distal insertion with sartorius and semitendinosus, the three muscles form anserinus pes. It is the most medial muscle of the adductors, and with its kidnapped thighs its origin can be clearly visible arched under the skin. With an elongated knee, it adds thighs and flexs the hips. Pectinus has an origin in lateral iliopubic eminence for gracilis and, in rectangular shape, extends obliquely to cling to the back of the lower trochanter and down the pectineal line and the proximal portion of the aspera linea of ​​the femur. This is the flexor of the hip joint, and the weak medial adductor and rotator of the thigh. The adductor brevis derives from the inferior ramus of the pubis beneath gracilis and stretches obliquely under the pectineus to the upper third of the aspera linea. Except as an adductor, it is the lateral rotator and weak flexor of the hip joint. The longus adductor has its origin in the superior ramus of the pubis and medial inserts on the middle third of the aspera linea. Especially adductor, it's also responsible for some flexions. Magnus adductor has its origin behind longus and lies deep in it. Her wide stomach is divided into two parts: One is inserted into the aspera linea and the other tendon reaches to the tubercle adductor at the medial side of the distal end of the femur where it forms an intermuscular septum that separates the flexor from the extensor. Magnus is a powerful adductor, especially active when crossing legs. The superior part is the lateral rotator but the inferior part acts as the medial rotator on the flexed leg when it is turned out and also extends the hip joint. The adductor minimus is a subdivision separate from the adductor magnus. Originally forming an anterior portion of the magnus and distal is inserted into the aspera linea above the magnus. Act for adduct and lateral twisting of the femur.

Thigh

Thigh muscles can be classified into three groups according to their location: anterior and posterior muscles and adductors (on the medial side). All adductor except gracilis inserts on the femur and acts on the hip joint, and is functionally qualified as a hip muscle. The majority of thigh muscles, "authentic" thigh muscles, insert in the legs (either tibia or fibula) and act mainly on the knee joint. Generally, the extensor is located on the anterior thigh and the flexor is located posteriorly. Although sartorius flexs the knee, it is ontogenetically considered an extensor because its displacement is secondary.

The largest anterior thigh muscle is the four quadriceps femoral muscles: central rectus femoris, surrounded by three vasti, intermedius vastus, medialis, and lateralis. The rectal femoris is attached to the pelvis with two tendons, while the vasti is inserted into the femur. The four muscles join in a common tendon that is inserted into the patella from where the patellar ligament extends into the tibial tuberosity. The fibers of the medial and lateral vases form two retinacles that stretch past the patella on both sides downward to the tibial condyle. The quadriceps are the extensor of the knee, but the additional rectus femoris flex the hip joint, and the knee articular muscle protects the articular capsule of the knee joint from being bitten during the extension. Sartorius walked superficially and tilted down on the anterior side of the thigh, from the anterior superior iliac spine to the anserinus plank on the medial side of the knee, from where it was later extended to the crastic fascia. Sartorius acts as a flexor of the hips and knees, but, due to its oblique direction, it also contributes to the medial rotation of the foot as one of the anserinus pavement muscles (with bent knees), and the lateral rotation of the hip together.

There are four posterior thigh muscles. Femoris bicep has two heads: The long head begins in the ischial tuberosity along with semitendinosus and acts on two joints. The short head comes from the middle third of the aspera linea on the femur axis and the lateral intermuscular septum of the thigh, and acts on only one joint. The two heads unite to form the biceps that insert on the fibula head. The bicep flexs the knee joint and twists the lateral flexed leg - it is the only lateral rotator of the knee and thus should oppose all medial rotators. In addition, the long head extends the hip joint. Semitendinosus and semimembranosus share their origin with the long head biseps, and both attach to the medial side of the proximal head of the tibia along with gracilis and sartorius to form anserinus pes. The semitendinosus acts on two joints; hip extension, knee flexion, and medial rotation of the foot. Distally, the semimembranosus tendon 'is divided into three parts which are referred to as pesantserus profondus . Functionally, semimembranosus is similar to semitendinosus, and thus produces extension in the hip joint and flexion and medial rotation of the knee. Posterior under the knee joint, the popliteus extends obliquely from the lateral femoral epicondyle to the posterior surface of the tibia. The subpopliteal bursa is located deep within the muscle. Popliteus flexs the knee and medial joints around the legs.

Crus and foot

With popliteus (see above) as a single exception, all the muscles in the legs are attached to the feet and, by location, can be classified into anterior and posterior groups separated from each other by the tibia, fibula, and interosseous membranes. In turn, these two groups can be divided into subgroups or anterior groups composed of extensor and peroneal, and posterior groups of shallow and deep layers. Functionally, the leg muscles are extensor, responsible for dorsiflexion of the foot, or flexor, responsible for plantar flexion. These muscles can also be classified with innervation, the muscles are supplied by the anterior plexus subdivision and supplied by the posterior subdivision. The leg muscles that work on the leg are called extrinsic leg muscles while the leg muscles are located in the foot called intrinsic.

Dorsoflection (extension) and plantar flexion occur around the transverse axis that flows through the ankle joint from the medial malolitus end to the lateral malleolus end. Pronation (eversi) and supination (inversion) occur along the ankle's oblong axis.

Extrinsic

Three of the anterior muscles are extensors. From its origins on the lateral surface of the tibia and the interosseous membrane, the anterior three-sided tibial abdomen extends down the superior and inferior extensor retinacula to the insertion on the plantar side of the medial cuneiform bone and the first metatarsal bone. On an unweighted leg, the anterior tibial dorsal flexs the leg and lifts the medial edge of the foot. On the weight-bearing leg, he pulled his legs toward the legs. Longensor digitorum longus has a wide origin that extends from the lateral condyle of the tibia along the anterior side of the fibula, and the interosseous membrane. At the ankle, the tendon is divided into four that extend in the legs to the dorsal aponeurosis of the last phalanx of the four lateral toes. In unbending legs, the muscles expand the fingers and dorsiflexion of the legs, and in the weight-bearing legs act similar to the anterior tibialis. The hallus extensor hallus is derived from the fibula and the interosseous membrane between two other extensors and, similar to the extensor digitorum, is inserted in the last phalanx of the big toe ("hallux"). The muscle dorsiflexes hallux, and acts similarly to the anterior tibialis in the weight-bearing leg. The two muscles on the lateral side of the foot form a peroneal group. Peroneus longus and brevis are both derived from the fibula and both pass behind the lateral malleolus in which their tendons pass under the peroneal retinacula. Under the legs, longus extends from the lateral to the medial side of the groove, thus strengthening the cross-leg arches. Brevis is attached to the lateral side of the fifth metatarsal tuberosity. Together the two peroneals form the strongest pronator of the foot. The peroneal muscles vary greatly and some variants can sometimes be present.

The three posterior muscles are in superficial layers. The main plantar flexor, commonly referred to as triceps surae, is the soleus, which appears on the proximal side of both leg bones, and gastrocnemius, two heads that appear at the distal end of the femur. These muscles are united in a large terminal tendon, the Achilles tendon, attached to the posterior tubercle of the calcaneus. Plantaris closely follows the lateral gastrocnemius head. The tendon extends between the soleus and the gastrocnemius and is embedded in the medial end of the calcaneus tendon.

In the inner layer, the posterior tibialis has an origin on the interosseous membrane and adjacent bone regions and runs behind the medial malleolus. Under the foot it is divided into thick medial portions attached to the navicular bone and a slightly weaker lateral portion is inserted into the three cuneiform bones. Muscles produce simultaneous plantar flexion and supination in the legs of non-weight-bearing, and approach the heel to the legs. Longus flexion appears distally in the fibula and on the interosseous membrane from which the relatively thick abdominal muscle extends distally. The tendon extends beneath the flexor retinaculum to the sole of the foot and finally attaches to the last phalanx base of hallux. It reinvents hallux and assists in supination. Flexor digitorum longus, finally, comes from the top of the tibia. The tendon goes to the sole of the foot where the fork enters the four terminal tendons attached to the last phalanx of the four lateral toes. It crosses the posterior tibial tendon distally on the tibia, and the tendon of the longus flexor hallusis on the sole of the foot. Indirectly on its part, quadratus plants radiate into it and near the middle phalanx of the tendon through the flexor digitorum brevis tendon. In an unweighted leg, it plantar flex the toes and legs and supinates. In the weight-bearing leg it supports the plantar arch. (For popliteus, see above.)

Intrinsic

The intrinsic muscles of the feet, the muscles in which the stomach is located on the right foot, either dorsal (top) or plantar (singular). On the dorsal side, two extrinsic extensor muscles are long superficial to intrinsic muscles, and their tendons form dorsal aponeurosis in the toes. Extensor and plantar extensor extensions and dorsal interossei radiate into this aponeurosis. The extensor digitorum brevis and extensor hallucis brevis have the same origin on the anterior side of the calcaneus, from which their tendon extends to the dorsal aponeurosis of numbers 1-4. They act to dorsiflex this digit.

The plantar muscle can be divided into three groups associated with three areas: those with large digits, small digits, and territories in between. All of these muscles are covered by thick and dense plantar aponeurosis, which, together with two hard septa, form the space of all three groups. These muscles and their fat tissue function as cushions that radiate weight down. Overall, the foot is a functional entity.

The abductor hallucis extends along the medial edge of the leg, from the calcaneus to the first phalanx base of the first digit and medial sesamoid bone. These are weak kidnappers and flexors, and also help keep the arch of the foot. Lateral to the abductor hallucis is the hallucis brevis flexor, which originates from the medial cuneiform bone and from the posterior tibial tendon. The flexor hallucis has a medial and lateral head which is inserted laterally into the hallucis abductor. This is an important plantar flexor that comes into prominent use in classical ballet (ie for pointe work). The adductor hallucis has two heads; a stronger oblique head arising from laterally and laterally cube-shaped and second and third metatarsal bases; and transverse heads emerging from the distal end of the fifth-third metatarsal. Both heads are inserted in the lateral sesamoid bone of the first digit. The muscle acts as a tensor in the arch of the foot, but it can also add the first digit and the plantar flexs its first phalanx.

The dimini derives from the long plantar ligament and the peroneus longus plantar tendon petal and is inserted in the fifth metatarsal. When present, it acts to plantar to flex the fifth digit and support the plantar arch. The flexor digiti minimi emerges from the base region of the fifth metatarsal and is inserted into the first phalanx base of the fifth digit in which it is usually combined with the abductor of the first digit. Acting for the plantar to flex the last digit. The largest and longest muscle of the little finger is the abductor digiti minimi. Stretching from the lateral process of the calcaneus, with the second attachment on the fifth metatarsal basis, to the first phalanx of the fifth digit, the muscle forms the lateral edge of the sole of the foot. Except for supporting the arch, it is plantar flexing the little finger and also acting as a kidnapper.

The four lumbricales are from the flexor digitorum longus tendon, from which they extend to the medial side of the first phalanx base of the two-five digits. Except for strengthening the plantar arch, they contribute to plantar flexion and move the four digits to the big toe. They, in contrast to the lumbricales of the hand, are rather variable, sometimes none and sometimes more than four are present. The quadratus plantae appears with two slips of the calcaneal plantar margin and is introduced into the tendon of the flexor digitorum longus, and is known as the "plantar head" of this latter muscle. Three plantar interossei appear with their single head on the medial side of the fifth-fifth metatarsal and are inserted at the base of the first phalanx of this digit. Two heads of four dorsal interossees appear on two adjacent metatarsals and join in the intermediate space. Their distal attachment lies on the basis of the proximal faction of the second-fourth digit. The interossei is set with the second digit as the longitudinal axis; the plantar acts as adductor and draws 3-5 to the second digit; while dorsal acts as a kidnapper. In addition, interossei acts as a plantar flexor in the metatarsophalangeal joint. Finally, flexor digitorum brevis emerges from under the calcaneus to enter the tendon on the middle phalanx at 2-4 digits. Because the flexor digitorum longus tendon runs between these tendons, brevis is sometimes called perforatus . The tendons of these two muscles are surrounded by a tendon sheath. Brevis acts to plantar to flex the middle phalanges.

Flexibility

Flexibility can be simply defined as the range of available motion (ROM) provided by a particular joint or group of joints. For the most part, exercises that increase flexibility are done with the intention of increasing overall muscle length, reducing the risk of injury and potentially improving muscle performance in physical activity. Stretching muscles after involvement in physical activity can increase muscle strength, increase flexibility, and reduce muscle pain. If restricted movement is present in the joint, "not enough prolonged" of the muscle, or muscle group, may limit the activity of the affected joint.

Stretching

Stretching before severe physical activity has been considered to improve muscle performance by extending soft tissue beyond its attainable length to increase the range of motion. Many physically active individuals practice this technique as "warming up" to achieve a certain level of muscle preparation for certain sports movements. When stretching, the muscles will feel slightly uncomfortable but not physically torturous.

• Bending plantar: One of the most popular stretching of the lower leg muscles is the heel up, which mainly involves gastrocnemius, soleus, and Achilles tendon. Standing heel raising allows the individual to activate their calf muscles by standing on the step with the toes and forelegs, leaving the heels hanging from the step, and plantar stretch the ankle joint by lifting the heel. This exercise is easily modified by holding on to the closest rails for balance and is generally repeated 5-10 times.
• Dorsoflection: To stretch the anterior muscles of the lower leg, stretching the alternate bone will work well. This movement will stretch the dorsiflexion muscles, especially the anterior tibialis, the longus extusor longus and the extensor digitorum longus, slowly causing the muscles to extend as the weight rests on the ankle joint by using the floor as resistance to the top of the foot. Crossover shin crossovers may vary in intensity depending on the amount of weight applied to the ankle joint as an individual bend in the knee. This stretch is usually held for 15-30 seconds.
• Eversion and inversion: Stretching of eversion and inversion muscles allows a better range of motion to the ankle joint. Elevated elevation and ankle stress will stretch the peroneus and tibilal muscles associated with this movement as it is elongated. Eversion muscles stretch when the ankles become depressed from the starting position. In the same way, the inversion muscle is stretched when the ankle joint becomes high. During this sitting stretch, the ankle joint will remain supported when depressed and raised with the ipsilateral side (same side) to maintain the stretch for 10-15 seconds. This stretch will increase the overall eversion and length of the inversion muscle group and provide more flexibility to the ankle joint for greater range of motion during activity.

Blood supply

The leg artery is divided into series of segments.

In the pelvic area, at the level of the last lumbar vertebra, the abdominal aorta, the continuation of the descending aorta, is divided into a pair of common iliac arteries. This immediately divides into the internal and external iliac arteries, the latter that descends along the medial border of the psoas major to get out of the pelvic area through the vascular lacuna beneath the inguinal ligament.

The artery enters the thigh as a femoral artery that descends the medial side of the thigh to the adductor channel. The canal passes from the anterior to the posterior side of the extremity in which the artery leaves through the adductor hiatus and becomes the popliteal artery. Behind the knee the popliteal artery runs through the popliteal fossa to the popliteal muscle where it is divided into anterior and posterior tibial arteries.

At the lower leg, the anterior tibial enters the extensor compartment near the upper boundary of the interosseous membrane to descend between the anterior tibialis and the extensor hallusis longus. The distal to the superior retinacula and the extensor of the foot becomes the dorsal artery of the foot. The posterior tibial forms a direct continuation of the popliteal artery entering the flexor compartment of the lower leg to descend behind the medial malleolus in which it is divided into medial and lateral plantar arteries, in which the posterior branch causes the fibular artery.

For practical reasons, the lower extremities are subdivided into somewhat arbitrary areas:
The pelvic region is all located on the thigh: anterior, the subinguinal region is limited by the inguinal ligament, sartorius, and pectinus and forms part of the femoral triangle extending far into the longus adductor. Posterior, gluteal region corresponds to the maximus gluteus. The anterior region of the thigh extends from the femoral triangle to the knee and lateral regions to the tensor fasciae latae. The posterior region ends long before the popliteal fossae. The anterior and posterior regions of the knee extend from the proximal region to the tibial tuberosity level. In the lower legs, the anterior and posterior regions extend to malleoli. Behind the malleoli is the lateral and medial retromalleolar region and behind this is the heel region. Finally, the legs are divided into higher back areas and inferior plantar regions.

Vena

Blood vessels are divided into three systems. The vein returns about 85 percent of the superficial blood and veins by about 15 percent. A series of superficial and deep system perforator venous interfaces. In a standing posture, the leg veins must handle tremendous loads as they defy gravity when they return blood to the heart. The venous valve helps to maintain the direction of shallow blood flow within.

Superficial veins:

• Larger saphena vein
• Small saphenous

Vena dalam:

• Femoral vein
• Popliteal vein
• Vena tibia anterior
• Vena tibia posterior
• Fibrous vein

Innervation

Sensory and motor innervation to the lower extremities is supplied by the lumbosacral plexus, formed by the lumbar and sacral spinal lumbar spine with additional contribution of the subcostal nerve (T12) and coccygeal nerve (Co1). Based on distribution and topography, the lumbosacral plexus is divided into lumbar plexus (T12-L4) and sacral plexus (L5-S4); the latter is often subdivided into sciatic and pudendal plexuses:

The lumbar plexus forms laterally intervertebral foramina by the ventral flax of the first four lumbar spinal cord (L1-L4), all of which pass through the major psoas. The large branches of the plexus come out of the muscle to pass sharply downward to reach the abdominal wall and thigh (below the inguinal ligament); with the exception of the obturator nerve passing through the lower pelvis to reach the medial portion of the thigh via the obturator foramen. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.

The iliohypogastric (T12-L1) and ilioinguinal (L1) nerves arise from the psoas major near the origin of the muscle, from which they travel laterally downward to pass anteriorly over the iliac crest between the transversus abdominis and the oblique internal abdomen, and then run over the inguinal ligament. Both nerves secrete muscular branches into these two muscles. Iliohypogastric supplies the sensory branches to the skin of the lateral hips region, and terminal branches eventually penetrate the aponeurosis of the upper abdominal oblique above the inguinal ring to supply the sensory branches to the skin there. Ilioinguinalis exit through the inguinal ring and supply the sensory branches to the skin above the pubic symphysis and the lateral part of the scrotum.

The genitofemoral nerve (L1, L2) leaves the psoas major under two ex neurons, immediately splitting into two branches that descend along the anterior side of the muscle. The sensory femoral branch supplies the skin beneath the inguinal ligament, while the mixed genital branch supplies the skin and muscles around the sex organs. The lateral femoral cutaneous nerve (L2, L3) leaves the major lateral psoas below the previous nerve, goes obliquely and laterally downward over the iliacus, out of the pelvic area near the iliac spine, and supplies the anterior thigh skin.

The obturator nerve (L2-L4) passes medially behind the psoas major to escape from the pelvis through the obturator channel, after which it exits the branch to the external obturator and divides into two passing branches behind and in front of the adductor brevis to supply the motor innervation to all muscle- other adductor muscle. The anterior branch also supplies the sensory nerve to the skin in a small area of ​​the distal medial aspect of the thigh. The femoral nerve (L2-L4) is the largest and longest of the lumbar plexus nerve. It supplies motor innervation to iliopsoas, pectineus, sartorius, and quadriceps; and sensory branches to the anterior thigh, medial lower leg, and posterior leg.

The nerve from the sacral plexus passes behind the hip joint to supply the posterior part of the thigh, most of the lower legs, and the legs. Superior (L4-S1) and the inferior gluteal nerve (L5-S2) conserve gluteus and tensor fasciae latae muscles. The posterior femoral cutaneous (S1-S3) nerve contributes sensory branches to the skin on the posterior thigh. The sciatic nerve (L4-S3), the largest and longest nerve in the human body, leaves the pelvis through the larger foramen of the skiis. The posterior thighs first issue branches to the short head of the biceps femoris and then divide into the tibial nerve (L4-S3) and the common nerve (L4-S2). The fibular nerve continues to descend on the medial side of the biceps femoris, the wind around the fibula neck and entering the front of the lower leg. There it is divided into deep and shallow terminal branches. The superficial branch supplies the peroneal muscles and deep branches into the extensor compartment; both branches reach to the dorsal feet. In the thighs, the tibial nerve releases branches to semitendinosus, semimembranosus, adductor magnus, and the long head of biceps femoris. The nerves then travel straight down the back of the foot, through the popliteal fossa to supply the ankle flexors on the back of the lower leg and then continue downward to supply all the muscles in the soles of the feet. The pudendal (S2-S4) and coccygeal (S5-Co2) nerves supply the pelvic floor muscles and surrounding skin.

The lumbosacral rod is the communication branch that passes between the sacral and lumbar plexus containing the ventral fibers of L4. The coccygeal nerve, the last spinal cord, arises from the sacral hiatus, integrates with the ventral flax of the last two sacral nerves, and forms the coccygeal plexus.

Maps Human leg

Legs and feet lower

The lower legs and ankles should be kept well trained and moved as they are the foundation of the whole body. The lower limb should be strong to balance the weight of the rest of the body, and the gastrocnemius muscles take part in most of the blood circulation.

Exercise

Isometric and default

There are a number of exercises that can be done to strengthen the lower legs. For example, to activate the plantar flexor in the plantar flexor within a person can sit on the floor with the hips flexed, the neutral ankle with the knee fully extended as they alternately push their feet against the wall or platform. This kind of exercise is useful because it hardly causes fatigue. Another form of isometric exercise for the gastrocnemius will sit up the calves that can be performed with or without equipment. One can sit at a table with their feet flat on the ground, and then plantar flex both ankles so that the heel is lifted off the floor and gastrocnemius flexed. Alternative movements can be heel-level exercises with toes supported on elevated surfaces - as opposed movements, this will increase the range of motion. The one-legged legs cause the gastrocnemius muscle to be performed by holding one dumbbell in one hand while using the other for balance, and then standing with one foot on the plate. The next step is plantar flex and keep the knee joint straight or slightly bent. Triceps surae are contracted during this exercise. Stabilization exercises like BOSU squatting balls are also important especially as they help the ankle to adjust to the shape of the ball to balance.

Clinical interests

Lower toe injuries

Lower foot injuries often occur when running or playing sports. About 10% of total injuries involve lower extremities in athletes. The majority of athletes contaminate their ankles, which are mainly caused by the increased load to the legs when they move down the leg or in the ankle position outside. All areas of the foot, which are the front legs, midfoot, and rearfoot, absorb various forces while running and can cause injury as well. Running and various activities can cause stress fractures, tendinitis, musculotendinous injuries, or chronic pain in the lower extremities such as the tibia.

Activity type

Injury to the quadriceps or hamstrings is caused by constant impact of the impact to the foot during activity, such as kicking the ball. When performing this type of movement, 85% of the shock is absorbed into the hamstrings that can cause tension in the muscles.

• Jump - is another risk because if the foot does not land properly after the initial jump, there may be damage to the meniscus in the knee, sprained to the ankle by duration or inverting, or tendon damage Achilles and gastrocnemius if there are too many styles when plantar stretches.
• Lifting weight - like a deep squat that is not done right, is also harmful to the lower limbs, as exercise can cause overextension, or leap, our ligaments in the knee and can cause pain from time to time.
• Walk - the most common activity associated with lower leg injuries. There is constant pressure and pressure that is placed on the feet, knees, and legs when running with the force of gravity. Muscles in the legs or pain in different areas of the foot may be the result of poor biomechanics while running.

Running

The most common injuries in running involve the knee and leg. Various studies have focused on the initial causes of the associated injuries and found that there are many factors that correlate with these injuries. Long-distance runners women who have a history of stress fracture injuries have higher vertical impact strengths than unscathed subjects. The great strength to the lower leg is associated with the force of gravity, and this is correlated with patellofemoral pain or potential knee injury. The researchers also found that the injury related to this run affects the foot as well because runners with previous injuries show more foot and more pronation when running than an unharmed runner. This causes more weight and strength on the medial side of the foot, causing more pressure on the tendons of the feet and ankles (the peroneal tendon). Most of the running injuries are caused by excessive use and those that run at greater distances each week for long duration is the risk of injuring the lower legs.

Prevention tools

Volunteer stretches to the feet, such as wall stretching, the condition of the hamstrings and calf muscles to various movements before their hard work. But a study has shown that the Kinesiology ribbon provides a more promising effect in extended hamstring to produce more fluid movement. Thirty previously injured men showed greater benefits of longer-term hamstring prolongation with Kinesiology bands, or elastic therapy bands. However, they are more advantageous at the beginning of the exercise with voluntary, static or proprioceptive neurosuscular facilitation, which is a special stretching technique for optimizing the range of limb movements. This suggests that stretching helps in the immediate time frame, while the Kinesiology ribbons help in the long term to prevent future injuries. The surroundings and surroundings, such as uneven terrain, can cause the foot to be in an unnatural position, so wearing shoes that can absorb the power from the impact of the ground and allowing it to stabilize the foot can prevent some injuries while running as well. Shoes should be structured to allow for friction-traction on the surface of the shoe, room for different foot strike pressures, or for regular arches that are comfortable for the foot.

Summary

The likelihood of damaging our lower extremities will be reduced by having knowledge of some of the activities associated with lower leg injuries and developing the correct form of walking, such as nothing more than foot pronation or overuse of the foot. Preventive measures, such as recording, stretching, and wearing appropriate footwear, will reduce injury from occurring as well.

Fracture

Foot fractures can be classified according to the involved bone to be:

• Femoral fracture (in the upper leg)

• Crushed Fracture (in the lower leg).

Pain management

Management of low leg and foot pain is essential in reducing further injury development, uncomfortable sensation and restrictive changes in walking and running. Most individuals suffer from various pains in their lower legs and feet due to different factors. Muscle inflammation, tension, tenderness, swelling and muscle tear from excessive muscle or incorrect movement are some of the conditions that athletes and the general public often experience during and after high-impact physical activity. Therefore, a pain management mechanism is recommended to reduce pain and prevent the development of injury.

Plantar fasciitis

Stretching of plantar fasciitis foot is one of the recommended methods for reducing pain caused by plantar fasciitis (Figure 1). To stretch the plantar fascia, while sitting in a chair, place the ankle on the opposite knee and hold a weak toe, slowly pull backward. Stretching should be held for about ten seconds, three times per day

Tibial tibial (shin splint) tension syndrome

Several methods can be used to help control the pain caused by shin splints. Placing ice in the affected area before and after running will help reduce the pain. In addition, using orthotic devices including the neoprene arm (Figure 2) and wearing the right footwear such as the foot arch can help eliminate the condition. Stretching and reinforcing the anterior tibia or medial tibia by performing plantar flexor exercises and dorsi such as calf stretching can also help relieve pain.

Achilles tendinopathy

There are many appropriate approaches to treating pain due to Achilles tendinitis. The main action is to rest. Activities that do not put additional pressure on the affected tendon are also recommended. Wearing an orthotic or prosthesis will provide a cushion and will prevent the affected Achilles tendon from experiencing further stress while walking and performing a therapeutic stretch. Some stretching modalities or eccentric exercises such as toe extension and flexion and calf and heel stretching are useful in reducing pain with patients with Achilles tendinopathy (Figure 4)

Society and culture

Adolescents and adult women in many Western cultures often remove hair from their feet. Taut, tanned, shaved feet are sometimes regarded as a sign of youthfulness and are often considered attractive in this culture.

Men generally do not shave their feet in any culture. However, shaving feet is a generally accepted practice in modeling. It is also quite common in sports where hair removal makes athletes faster by reducing drag; the most common case is competitive swimming. It is also practiced in other sports such as cycling, where skin injuries are common: the absence of growing hair makes nicks, scratches and bruises heal faster due to reduced microbial population on shaved skin.

Picture gallery

See also

• Osteogenesis distraction (leg lengthening)

Note

References

• Chaitow, Leon; Walker DeLany, Judith (2000). Clinical Application of Neuromuscular Technique: Lower Body . Health Sciences Elsevier. ISBN 0-443-06284-6.
• editor-in-law, Lawrence M. Ross, Edward D. Lamperti; author, Michael Schuenke, Erik Schulte, Udo Schumacher. (2006). Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System . Thieme. ISBNÃ, 1-58890-419-9. CS1 maint: Many names: list of authors (links)
• Platzer, Werner (2004). Color Atlas of Human Anatomy, Vol. 1: Locomotor System (5th ed.). Thieme. ISBN: 3-13-533305-1.

External links

• Interactive images in InnerBody

Source of the article : Wikipedia