7.6 Appendicular Muscles of the Pelvic Girdle and Lower Limbs

Learning Objectives

By the end of this section, you will be able to:

  • Identify the appendicular muscles of the pelvic girdle and lower limb
  • Identify the movement and function of the pelvic girdle and lower limb

The appendicular muscles of the lower body position and stabilize the pelvic girdle, which serves as a foundation for the lower limbs. Comparatively, there is much more movement at the pectoral girdle than at the pelvic girdle. There is very little movement of the pelvic girdle because of its connection with the sacrum at the base of the axial skeleton. The pelvic girdle has less range of motion because it was designed to stabilize and support the body.

 

Muscles of the Thigh

What would happen if the pelvic girdle, which attaches the lower limbs to the torso, were capable of the same range of motion as the pectoral girdle? For one thing, walking would expend more energy if the heads of the femurs were not secured in the acetabula of the pelvis. The body’s center of gravity is in the area of the pelvis. If the center of gravity were not to remain fixed, standing up would be difficult as well. Therefore, what the leg muscles lack in range of motion and versatility, they make up for in size and power, facilitating the body’s stabilization, posture, and movement.

Most muscles that insert on the femur (the thigh bone) and move it, originate on the pelvic girdle. The psoas major and iliacus make up the iliopsoas muscle. Some of the largest and most powerful muscles in the body are the gluteal muscles or gluteal group. The gluteus maximus is the largest; deep to the gluteus maximus is the gluteus medius, and deep to the gluteus medius is the gluteus minimus, the smallest of the trio (Figure 7.16 and Table 7.11).

The tensor fascia latae is a thick, squarish muscle in the superior aspect of the lateral thigh. It acts as a synergist of the gluteus medius in abducting the thigh, and as a synergist of the iliopsoas in flexing the thigh. It also helps stabilize the lateral aspect of the knee by pulling on the iliotibial tract (band), making it taut. Deep to the gluteus maximus, the piriformis, obturator internus, obturator externus, superior gemellus, inferior gemellus, and quadratus femoris laterally rotate the femur at the hip. These muscles are often grouped together and referred to as the deep lateral rotator muscle group.

The pectineus, adductor longus, adductor brevis, adductor magnus, and gracilis are muscles in the medial compartment of the thigh with the gracilis originating most medially and the pectineus originating most laterally. The muscles in the medial compartment of the thigh are responsible for adducting the femur at the hip. The pectineus flexes the femur at the hip as well. The pectineus is located in the femoral triangle, which is formed at the junction between the hip and the leg and also includes the femoral nerve, the femoral artery, the femoral vein, and the deep inguinal lymph nodes. The adductor longus, adductor brevis, and adductor magnus can both medially and laterally rotate the thigh depending on the placement of the foot. The adductor longus flexes the thigh, whereas the adductor magnus extends it. The strap-like gracilis additionally flexes the leg at the knee (Table 7.12).

 

Figure 7.16 Hip and Thigh Muscles The large and powerful muscles of the hip that move the femur generally originate on the pelvic girdle and insert into the femur. The muscles that move the lower leg typically originate on the femur and insert into the bones of the knee joint.

Table 7.11 – Gluteal Region Muscles that Move the Femur

Prime mover

Origin

Insertion

Movement

Iliopsoas group

Psoas major

T12, L1-5

Lesser trochanter of femur

Hip flexion, external rotation

Iliacus

Iliac fossa; iliac crest

Lesser trochanter of femur

Hip flexion, external rotation

Gluteal group

Gluteus maximus

Dorsal ilium; sacrum; coccyx

Gluteal tuberosity of femur; iliotibial band

Hip extension, external rotation, abduction

Gluteus medius

Iliac crest

Greater trochanter of femur

Hip abduction

Pelvic stability in weight bearing

Gluteus minimus

Ilium

Greater trochanter of femur

Hip abduction

Tensor fascia latae

Anterior superior iliac spine

Iliotibial band

Assists with hip flexion and hip abduction

Lateral rotators

Piriformis

Anterolateral surface of sacrum

Greater trochanter of femur

Hip external rotation

Obturator internus

Inner surface of obturator membrane; greater sciatic notch; margins of obturator foramen

Greater trochanter of femur

Hip external rotation

Obturator externus

Outer surface of obturator membrane; pubic and ischium; margins of obturator foramen

Trochanteric fossa of femur

Hip external rotation

Superior gemellus

Ischial spine

Greater trochanter of femur

Hip external rotation

Inferior gemellus

Ischial tuberosity

Greater trochanter of femur

Hip external rotation

Quadratus femoris

Ischial tuberosity

Trochanteric crest of femur

Hip external rotation

Adductors

Gracilis

Pubis near pubic symphysis

Tibial shaft at pes anserine

Hip adduction

Knee flexion

Adductor longus

Pubis near pubic symphysis

Linea aspera

Hip adduction

Adductor brevis

Body of pubis; inferior ramus of pubis

Linea aspera, more proximal than adductor longus

Hip adduction

Adductor magnus

Pubic ramus; ischial tuberosity

Linea aspera of femur gluteal tuberosity; adductor tubercle of femur

Hip adduction and extension

Pectineus

Pectineal line of pubis

Proximal medial shaft of femur, just inferior to lesser trochanter

Hip adduction and flexion

Table 7.12 – Thigh Muscles that Move the Femur, Tibia, Fibula

Prime mover

Origin

Insertion

Movement

Anterior compartment of thigh

Rectus femoris

Anterior inferior iliac spine

Patella; tibial tuberosity

Knee extension

Hip flexion

Vastus lateralis

Greater trochanter; intertrochanteric line; linea aspera

Patella; tibial tuberosity

Knee extension

Vastus medialis

Linea aspera; intertrochanteric line

Patella; tibial tuberosity

Knee extension

Vastus intermedius

Proximal shaft of femur

Patella; tibial tuberosity

Knee extension

Sartorius

Anterior superior iliac spine

Medial aspect of proximal tibia

Hip flexion, abduction and external rotation

Knee flexion

Posterior compartment of thigh

Biceps femoris

Ischial tuberosity; linea aspera; distal femur

Head of fibula; lateral condyle of tibia

Knee flexion

Hip extension and external rotation

Semitendinosus

Ischial tuberosity

Upper medial tibial shaft

Knee flexion

Hip extension and internal rotation

Semimembranosus

Ischial tuberosity

Medial condyle of tibia

Knee flexion

Hip extension and internal rotation

The muscles of the anterior compartment of the thigh flex the hip and extend the knee. This compartment contains the quadriceps femoris group, which actually comprises four muscles that extend and stabilize the knee. The rectus femoris is on the anterior aspect of the thigh, the vastus lateralis is on the lateral aspect of the anterior thigh, the vastus medialis is on the medial aspect of the anterior thigh, and the vastus intermedius is between the vastus lateralis and vastus medialis and deep to the rectus femoris. The tendon common to all four is the quadriceps tendon, which inserts into the patella and continues below it as the patellar ligament. The patellar ligament attaches to the tibial tuberosity. In addition to the quadriceps femoris, the sartorius is a band-like muscle that extends from the anterior superior iliac spine to the medial side of the proximal tibia. This versatile muscle flexes the leg at the knee and flexes, abducts, and laterally rotates the leg at the hip. This muscle allows us to sit cross-legged. It is the longest muscle in the human body.

The posterior compartment of the thigh includes muscles that flex the leg and extend the thigh. The three long muscles on the back of the knee are the hamstring group, which flexes the knee. These are the biceps femoris, semitendinosus, and semimembranosus. The tendons of these muscles form the popliteal fossa, the diamond-shaped space at the back of the knee.

 

Muscles That Move the Feet and Toes

Similar to the thigh muscles, the muscles of the leg are divided by deep fascia into compartments, although the leg has three: anterior, lateral, and posterior (Figure 7.17 and Table 7.13).

 

Figure 7.17 Muscles of the Lower Leg The muscles of the anterior compartment of the lower leg are generally responsible for dorsiflexion, and the muscles of the posterior compartment of the lower leg are generally responsible for plantar flexion. The lateral and medial muscles invert, evert, and rotate the foot.

 

Table 7.13 – Muscles that Move the Feet and Toes

Prime mover

Origin

Insertion

Movement

Anterior compartment of the leg

Tibialis anterior

Anterior shaft of tibia; interosseous membrane

First metatarsal; medial cuneiform

Ankle dorsiflexion

Foot inversion

Extensor hallucis longus

Anteromedial fibular shaft; interosseous membrane

Distal phalanx of big toe

Big toe extension

Ankle dorsiflexion

Extensor digitorum longus

Lateral condyle of tibia; interosseous membrane

Middle and distal phalanges of toes 2-5

Toe extension toes 2-5

Ankle dorsiflexion

Lateral compartment of the leg

Fibularis longus

Upper portion of lateral fibula

First metatarsal; medial cuneiform

Ankle plantarflexion

Foot eversion

Fibularis brevis

Lateral shaft of distal fibula

Fifth metatarsal

Ankle plantarflexion

Foot eversion

Posterior compartment of the leg: superficial muscles

Gastrocnemius

Medial and lateral condyles of femur

Posterior calcaneus

Ankle plantarflexion

Knee flexion

Soleus

Posterior shaft of tibia and fibula; interosseous membrane

Posterior calcaneus

Ankle plantarflexion

Plantaris

Posterior femur above lateral condyle

Calcaneus or Achilles tendon

Ankle plantarflexion

Knee flexion

Tibialis posterior

Posterior shaft of tibia and fibula; interosseous membrane

Plantar surfaces of navicular; metatarsals 2-4

Ankle plantarflexion

Foot inversion

Supports medial longitudinal arch

Posterior compartment of the leg: deep muscles

Popliteus

Lateral condyle of femur; lateral meniscus

Proximal medial tibia

Knee flexion

“Unlocks” the knee from full extension

Flexor digitorum longus

Posterior tibia

Distal phalanges of toes 2-5

Toe flexion toes 2-5

Ankle plantarflexion

Flexor hallucis longus

Midshaft of fibula; interosseous membrane

Distal phalanx of big toe

Big toe flexion

Ankle plantarflexion

The muscles in the anterior compartment of the leg: the tibialis anterior, a long and thick muscle on the lateral surface of the tibia, the extensor hallucis longus, deep to the tibialis anterior, and the extensor digitorum longus, lateral to the tibialis anterior. All three muscles contribute to ankle dorsiflexion – raising the front of the foot when they contract. Thick bands of connective tissue called the superior extensor retinaculum (transverse ligament of the ankle) and the inferior extensor retinaculum, hold the tendons of these muscles in place during dorsiflexion.

The lateral compartment of the leg includes two muscles: the fibularis longus (peroneus longus) and the fibularis brevis (peroneus brevis). Both of these muscles contribute to foot eversion.

The superficial muscles in the posterior compartment of the leg all insert onto the calcaneal tendon (Achilles tendon), a strong tendon that inserts into the calcaneal bone of the ankle. The muscles in this compartment are large and strong and keep humans upright. The most superficial and visible muscle of the calf is the gastrocnemius. Deep to the gastrocnemius is the wide, flat soleus. The plantaris runs obliquely between the two; some people may have two of these muscles, whereas no plantaris is observed in about seven percent of other cadaver dissections. There are four deep muscles in the posterior compartment of the leg as well: the popliteus, flexor digitorum longus, flexor hallucis longus, and tibialis posterior.

The foot also has intrinsic muscles, which originate and insert within it (similar to the intrinsic muscles of the hand). These muscles primarily provide support for the foot and its arch, and contribute to movements of the toes (Figure 7.18 and Table 7.14). The principal support for the longitudinal arch of the foot is a deep fascia called plantar aponeurosis, which runs from the calcaneus bone to the toes (inflammation of this tissue is the cause of “plantar fasciitis,” which can affect runners). The intrinsic muscles of the foot consist of two groups. The dorsal group includes only one muscle, the extensor digitorum brevis. The second group is the plantar group, which consists of four layers, starting with the most superficial.

 

image
Figure 7.18 Intrinsic Muscles of the Foot The muscles along the dorsal side of the foot (a) generally extend the toes while the muscles of the plantar side of the foot (b, c, d) generally flex the toes. The plantar muscles exist in three layers, providing the foot the strength to counterbalance the weight of the body. In this diagram, these three layers are shown from a plantar view beginning with the bottom-most layer just under the plantar skin of the foot (b) and ending with the top-most layer (d) located just inferior to the foot and toe bones.
Table 7.14 – Intrinsic Muscles of the Foot

Prime mover

Origin

Insertion

Movement

Dorsal group

Extensor digitorum brevis

Calcaneus; extensor retinaculum

Extensor expansion toes 2-5

Toe extension toes 2-5

Plantar group (layer 1)

Abductor hallucis

Calcaneal tuberosity; flexor retinaculum

Proximal phalanx of big toe

Big toe adduction and flexion

Flexor digitorum brevis

Calcaneal tuberosity

Middle phalanx of toes 2-4

Toe flexion toes 2-4

Abductor digiti minimi

Calcaneal tuberosity

Proximal phalanx of middle toe

Toe abduction and flexion toe 5

Plantar group (layer 2)

Quadratus plantae

Medial and lateral sides of calcaneus

Tendon of flexor digitorum longus

Toe flexion toes 2-5

Lumbricals

Tendons of flexor digitorum longus

Medial side of proximal phalanx toes 2-5

Extension at interphalangeal joint and flexion at metatarsophalangeal joint toes 2-5

Plantar group (layer 3)

Flexor hallucis brevis

Lateral cuneiform; cuboid

Base of proximal phalanx of big toe

Big toe flexion

Adductor hallucis

Bases of metatarsals 2-4

Base of proximal phalanx of big toe

Big toe adduction and flexion

Flexor digiti minimi brevis

Base of metatarsal 5

Base of proximal phalanx of toe 5

Toe flexion toe 5

Plantar group (layer 4)

Dorsal interossei

Sides of metatarsals

Both sides of toe 2; for other toes the extensor expansion on side opposite of toe 2

Toe abduction and flexion

Plantar interossei

Side of each metatarsal that faces toe 2

Extensor expansion on side facing toe 2

Toe abduction and flexion toes 3-5

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