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Functional Anatomy of Lower Extremity
Jason M. Lewis, MD; Nicole Z. Spence, MD; Rafael Vazquez, MD
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TERMINOLOGY

  • Abbreviations

    • Iliohypogastric nerve (IH-N)
    • Ilioinguinal nerve (II-N)
    • Genitofemoral nerve (GFN)
    • Lateral femoral cutaneous nerve (LFCN)
    • Femoral nerve (FN)
    • Posterior femoral cutaneous nerve (PFCN)
    • Sciatic nerve (SN)
    • Common peroneal nerve (CPN)
    • Deep peroneal nerve (DPN)
    • Superficial peroneal nerve (SPN)
    • Tibial nerve (TN)
  • Definitions

    • Lower extremity is lower appendage extending from hip to toes

GROSS ANATOMY

  • Anatomic Boundaries

    • Bones of Lower Extremity

      • Muscles of Anterior Thigh Compartment (Flexors)

        • Muscles of Medial Thigh Compartment (Adductors)

          • Muscles of Posterior Thigh Compartment

            • Muscles of Anterior Leg Compartment

              • Muscles of Lateral Leg Compartment

                • Muscles of Superficial Posterior Leg Compartment

                  • Muscles of Deep Posterior Leg Compartment

                    • Muscles of Foot

                      INNERVATION of LOWER EXTREMITY

                      • Lumbar Plexus (L1-L4)

                        • Lumbosacral Trunk (L4-S1)

                          • Sacral Plexus (S1-S4)

                            • Cutaneous Innervation

                              CLINICAL IMPLICATIONS

                              • Analgesia of Lower Extremity

                                Selected References

                                1. Brazill JM et al: Nerves in bone: evolving concepts in pain and anabolism. J Bone Miner Res. 34(8):1393-406, 2019
                                2. Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
                                3. Tran J et al: Anatomical study of the innervation of anterior knee joint capsule: implication for image-guided intervention. Reg Anesth Pain Med. 43(4):407-14, 2018
                                4. Nencini S et al: The physiology of bone pain. How much do we really know? Front Physiol. 7:157, 2016
                                5. Karmakar MK et al: High-definition ultrasound imaging defines the paraneural sheath and the fascial compartments surrounding the sciatic nerve at the popliteal fossa. Reg Anesth Pain Med. 38(5):447-51, 2013
                                6. Andersen HL et al: Injection inside the paraneural sheath of the sciatic nerve: direct comparison among ultrasound imaging, macroscopic anatomy, and histologic analysis. Reg Anesth Pain Med. 37(4):410-4, 2012
                                7. Awad IT et al: Posterior lumbar plexus block: anatomy, approaches, and techniques. Reg Anesth Pain Med. 30:143–9, 2005
                                8. Sim IW et al: Anatomy and anaesthesia of the lumbar somatic plexus. Anaesth Intensive Care. 32:178–87, 2004
                                9. Standring S et al: Pelvic girdle and lower limb. In Standring S et al: Gray's Anatomy: The Anatomical Basis of Clinical Practice. Edinburgh New York: Elsevier Churchill Livingstone, 2005.
                                10. Horner G et al: Innervation of the human knee joint and implications for surgery. Clin Orthop Relat Res. 221-6, 1994
                                11. Hurrell DJ: The nerve supply of bone. J Anat. 72(Pt 1):54-61, 1937
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                                References
                                Tables

                                Tables

                                TERMINOLOGY

                                • Abbreviations

                                  • Iliohypogastric nerve (IH-N)
                                  • Ilioinguinal nerve (II-N)
                                  • Genitofemoral nerve (GFN)
                                  • Lateral femoral cutaneous nerve (LFCN)
                                  • Femoral nerve (FN)
                                  • Posterior femoral cutaneous nerve (PFCN)
                                  • Sciatic nerve (SN)
                                  • Common peroneal nerve (CPN)
                                  • Deep peroneal nerve (DPN)
                                  • Superficial peroneal nerve (SPN)
                                  • Tibial nerve (TN)
                                • Definitions

                                  • Lower extremity is lower appendage extending from hip to toes

                                GROSS ANATOMY

                                • Anatomic Boundaries

                                  • Bones of Lower Extremity

                                    • Muscles of Anterior Thigh Compartment (Flexors)

                                      • Muscles of Medial Thigh Compartment (Adductors)

                                        • Muscles of Posterior Thigh Compartment

                                          • Muscles of Anterior Leg Compartment

                                            • Muscles of Lateral Leg Compartment

                                              • Muscles of Superficial Posterior Leg Compartment

                                                • Muscles of Deep Posterior Leg Compartment

                                                  • Muscles of Foot

                                                    INNERVATION of LOWER EXTREMITY

                                                    • Lumbar Plexus (L1-L4)

                                                      • Lumbosacral Trunk (L4-S1)

                                                        • Sacral Plexus (S1-S4)

                                                          • Cutaneous Innervation

                                                            CLINICAL IMPLICATIONS

                                                            • Analgesia of Lower Extremity

                                                              Selected References

                                                              1. Brazill JM et al: Nerves in bone: evolving concepts in pain and anabolism. J Bone Miner Res. 34(8):1393-406, 2019
                                                              2. Tran DQ et al: Lower extremity regional anesthesia: essentials of our current understanding. Reg Anesth Pain Med. ePub, 2019
                                                              3. Tran J et al: Anatomical study of the innervation of anterior knee joint capsule: implication for image-guided intervention. Reg Anesth Pain Med. 43(4):407-14, 2018
                                                              4. Nencini S et al: The physiology of bone pain. How much do we really know? Front Physiol. 7:157, 2016
                                                              5. Karmakar MK et al: High-definition ultrasound imaging defines the paraneural sheath and the fascial compartments surrounding the sciatic nerve at the popliteal fossa. Reg Anesth Pain Med. 38(5):447-51, 2013
                                                              6. Andersen HL et al: Injection inside the paraneural sheath of the sciatic nerve: direct comparison among ultrasound imaging, macroscopic anatomy, and histologic analysis. Reg Anesth Pain Med. 37(4):410-4, 2012
                                                              7. Awad IT et al: Posterior lumbar plexus block: anatomy, approaches, and techniques. Reg Anesth Pain Med. 30:143–9, 2005
                                                              8. Sim IW et al: Anatomy and anaesthesia of the lumbar somatic plexus. Anaesth Intensive Care. 32:178–87, 2004
                                                              9. Standring S et al: Pelvic girdle and lower limb. In Standring S et al: Gray's Anatomy: The Anatomical Basis of Clinical Practice. Edinburgh New York: Elsevier Churchill Livingstone, 2005.
                                                              10. Horner G et al: Innervation of the human knee joint and implications for surgery. Clin Orthop Relat Res. 221-6, 1994
                                                              11. Hurrell DJ: The nerve supply of bone. J Anat. 72(Pt 1):54-61, 1937