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Regions of the lower limb

Similar to the rest of the human body, the lower limb is divided into smaller regions that help physicians describe, diagnose and treat pathologic conditions of the lower limb. The lower limb has an anterior and posterior surface. Each surface consists of a several regions that have their own anatomical boundaries and contents which include muscles, bones and neurovascular structures of the lower limb.

The regions of the lower limb are usually named on the basis of major bones or joints of the corresponding region. The main regions include the gluteal, hip, femoral, knee, leg, talocrural and foot regions. According to some authors, the hip region may be viewed as a subregion of the gluteal region and therefore may not be classified as a separate region of the lower limb.

This article will describe the anatomy and contents of the regions of the lower limb.

Key points about the regions of the lower limb
Definition  The lower limb is divided into distinct regions in order to help physicians describe, diagnose and treat pathologic conditions of the lower limb
Gluteal region Boundaries:
Superior: Iliac crest
Inferior: Gluteal sulcus
Landmarks
: Gluteal sulcus, intergluteal cleft
Main contents
: Bony pelvis and ligaments, gluteal muscles, sciatic nerve
Hip region Boundaries:
Anterior: Anterior superior iliac spine
Posterior: Posterior margin of greater trochanter
Main contents
: Hip joint
Femoral region Boundaries:
Anterosuperior: Inguinal ligament
Posterosuperior: Gluteal sulcus
Inferior: Superior border of knee region
Subregion
: Femoral triangle
Main contents
: Femur, quadriceps femoris muscles, adductor muscle group, ischiocrural muscles, femoral triangle (femoral nerve, femoral artery, femoral vein, lymphatics), sciatic nerve
Knee region Boundaries:
Superior: Distal end of femoral region
Inferior: Proximal end of leg
Subregion
: Popliteal fossa
Main contents
: Knee joint, popliteal fossa (popliteal artery, popliteal vein, tibial nerve, common fibular nerve)
Leg region Boundaries:
Superior: Distal end of knee region
Inferior: Proximal end of talocrural region
Main contents
: Tibia, fibula, anterior, posterior and lateral muscles of the leg, anterior tibial artery, posterior tibial artery, tibial nerve, common fibular nerve, deep fibular nerve, superficial fibular nerve
Talocrural region Boundaries:
Superior: Distal end of leg region
Inferior: Proximal end of foot region
Subregions
: Medial and lateral retromalleolar regions
Main contents
: Medial and lateral malleoli
Foot region Boundaries:
Superior: Distal end of talocrural region
Subregions
: Tarsus, metatarsus, phalanges
Main contents
: Tarsal bones (x7), metatarsal bones (x5), phalanges (x14), lateral, medial and central muscles of foot
Contents
  1. Gluteal region
    1. Contents
  2. Femoral region
    1. Contents
  3. Knee region
    1. Contents
  4. Leg region
    1. Contents
  5. Talocrural region
    1. Contents
  6. Foot region
    1. Contents
  7. Sources
+ Show all

Gluteal region

The gluteal region is the most proximally located region on the posterior surface of the lower limb. It marks the large transition zone between the posterior trunk and lower limb. Specifically, the gluteal region is the prominence situated posterior to the pelvis which extends from the iliac crest superiorly to the gluteal sulcus (fold of the buttock) inferiorly and as far as the posterior margin of the greater trochanter of the femur laterally. Some anatomy textbooks identify the hip region as a component of the gluteal region. However, frequently these two regions are distinguished separately. Whatever the classification may be, the hip region is always located lateral to the gluteal region and contains the hip joint and surrounding ligaments.

The gluteal muscles (gluteus maximus, medius and minimus as well as the tensor fascia latae muscle) form the bulk of the gluteal region. Separating the buttocks from each other is a groove known as the intergluteal cleft (natal cleft).

Contents

The gluteal region is composed of the bony pelvis, muscles, ligaments and associated neurovasculature. 

Muscles of the gluteal region can be organized into superficial and deep layers. Superficial muscles of the gluteal region consist of the three large overlapping gluteus maximus, medius and minimus muscles and the tensor fasciae latae muscle

Deep muscles of the gluteal region consist of a series of smaller muscles (piriformis, obturator internus, superior and inferior gemelli, and quadratus femoris) which lie beneath the inferior half of the gluteus maximus muscle. 

Stabilizing the bony pelvis are a number of ligaments which lie within the gluteal region. The three main ligaments of the gluteal region include the posterior sacroiliac, sacrotuberous and sacrospinous ligaments which aid in stabilizing the hip bones, sacrum and coccyx

One of the main neurovascular structures of this area is the large sciatic nerve, which exits the pelvic region to enter the gluteal region through the greater sciatic foramen

Femoral region

The femoral or thigh region is the region of the lower limb located between the hip and knee joints. The superior border of the femoral region is represented by the imaginary line that traverses the inguinal ligament anteriorly and quadratus femoris muscle and gluteal fold posteriorly. This line demarcates the femoral region from the abdominal wall and gluteal region.

Contents

The thigh houses the largest bone of the human body, the femur. Surrounding the femur are the large muscles of the thigh which are grouped by fasciae and intermuscular septa into three compartments: the anterior, posterior and medial compartments of the thigh. The muscles of the femoral region include the quadriceps femoris muscle anteriorly, the adductor muscle group medially and the hamstring muscles posteriorly. 

Within the anterior thigh region, there is a small triangular sub-region known as the femoral triangle, also known as the femoral trigone. The femoral triangle is located on the anteromedial aspect of the thigh and is bordered by the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially. Contents of the femoral triangle, from lateral to medial include the femoral nerve, femoral artery, femoral vein, and the femoral lymph nodes, which are more commonly known as the inguinal lymph nodes

Posteriorly, the sciatic nerve continues from the gluteal region to enter the posterior thigh.

Learn more about the anatomy of the femur with our quizzes and labeling activities. 

Knee region

The knee region (genual region) encompasses the knee joint. This region begins superiorly at the distal end of the femoral region and extends inferiorly to the proximal border of the leg. It has both an anterior and posterior surface.

Contents

The knee region is mainly composed of the knee joint which is formed by the articulations between the distal femur, proximal tibia and patella. While the fibula does not take part in the formation of the knee joint, the head of the fibula is included as a component of the knee region. 

The posterior surface of the knee region is marked by a diamond shaped fossa known as the popliteal fossa, which is also known as the popliteal region. The popliteal fossa is a fat filled space bounded superiorly by the tendons of the hamstring muscles and inferiorly by the  tendons of the gastrocnemius muscle. The popliteal region houses the popliteal artery and vein as well as the two main nerves of the leg: the tibial and common fibular nerves.

Leg region

The leg is the part of the lower limb located between the knee and ankle joint.

Contents

The bony framework of the leg consists of the tibia medially and the fibula laterally. Muscles of the leg are divided into anterior, posterior and lateral groups. Muscles of the posterior group (gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor hallucis longus, flexor digitorum longus) mainly plantarflex and invert the foot and flex the toes, while muscles of the anterior group (tibialis anterior, extensor digitorum longus, extensor hallucis longus and fibularis tertius) collectively dorsiflex and invert the foot at the ankle joint and extend the toes. The lateral group of muscles (fibularis longus and fibularis brevis) function to evert the foot. 

Neurovascular structures of the leg include the anterior and posterior tibial arteries and anterior and posterior tibial veins as well as the tibial, common fibular, superficial fibular and deep fibular nerves.

Talocrural region

The talocrural region is marked by the ankle joint and is therefore also known as the ankle region. It is bounded superiorly by the distal border of the anterior and posterior leg and by the proximal border of the dorsal region of the foot anteroinferiorly and by the proximal border of the heel of the foot (calcaneus) posteroinferiorly.

Contents

The anterior talocrural region is defined by the distal ends of the tibia and fibula which form the bony protrusions of the ankle region known as the medial and lateral malleoli, respectively. Between them is the most proximal bone of the foot, the talus

The posterior talocrural region is similarly marked by the medial and lateral malleoli, which are separated by the calcaneal tendon which is commonly referred to as the Achilles tendon. Between the calcaneal tendon and both malleoli are two small subregions known as the medial and lateral retromalleolar regions.

Tendons of the anterior, posterior and lateral leg muscles pass through the talocrural region to insert onto the foot. Important vessels (anterior and posterior tibial artery, anterior and posterior tibial vein, deep fibular nerve and tibial nerve) also pass through this region to supply and drain structures of the foot.

Foot region

The foot is the region distal to the ankle joint and is subdivided into the tarsus, metatarsus, and phalanges (or toe bones). The superior surface of this region is called the dorsum of the foot and the inferior surface, in contact with the ground, is the sole or plantar region of the foot.

Contents

The tarsus refers to the cluster of seven tarsal bones which include the calcaneus, talus, navicular, cuboid and the medial, intermediate and lateral cuneiform bones

The metatarsal region of the foot is formed by the five metatarsal bones. The metatarsal bones are numbered from I to V. Each metatarsal has a head at the distal end, an elongated shaft in the middle, and a proximal base. 

The phalanges are the bones of the toes. Each toe has three phalanges (proximal, middle and distal phalanges) except for the great toe, which only has a proximal and distal phalanx. Similar to the metatarsals, the phalanges also consist of a head, shaft and base. 

The muscles contained in the foot can be subdivided into plantar and dorsal groups. The dorsal group is comprised of only two muscles, while the plantar muscles are further subdivided into three groups; lateral, central, and medial.

A terminal branch of the anterior tibial artery, dorsalis pedis traverses the dorsum of the foot alongside the deep fibular nerve to supply structures of this area. Posteromedially, a neurovascular bundle containing the posterior tibial artery and vein and tibial nerve curves around the medial malleolus to enter the sole of the foot.

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