Adductor Thigh Musculature

Note: The muscles in this group may also receive blood from obturator artery. 

Adductor longus

• Origin: anterior surface of pubis, just inferior to the pubic tubercle

• Insertion: medial lip of linea aspera on middle half of femur

• Action:

  1. adducts thigh

  2. flexes thigh

  3. may laterally rotate thigh at the hip

• Blood: muscular branches of femoral artery

• Nerve: obturator nerve, L2,3,4

Adductor brevis

• Origin: body & inferior ramus of pubis

• Insertion: superior portion of linea aspera

• Action:

  1. adducts thigh (major)

  2. aids in flexion of thigh

  3. may laterally rotate thigh at the hip

• Blood: muscular branches of femoral artery

• Nerve: obturator nerve, L2,3,4

Adductor magnus

• Origin:

  1. anterior fibers: inferior pubic ramus

  2. oblique fibers: ischial ramus

  3. posterior fibers: ischial tuberosity

• Insertion:

  1. proximal 1/3 of linea aspera

  2. adductor tubercle

• Action:

  1. adducts the thigh

  2. posterior fibers also extend and laterally rotate thigh

• Blood:

  1. muscular branches of profunda femoris

• Nerve:

  1. anterior fibers: obturator nerve, L2,3,4

  2. posterior fibers: tibial nerve of sciatic bundle, L4,5

Gracilis

• Origin: body of pubis & inferior pubic ramus

• Insertion:

  1. medial surface of proximal tibia, inferior to tibial condyle

  2. contributes to the pez anserine

• Action:

  1. adducts thigh

  2. flexes knee

  3. medially rotates tibia

• Blood: obturator artery

• Nerve: obturator nerve, L2,3,4

Obturator externus

• Origin:

  1. medial surface of obturator foramen

  2. external surface of obturator membrane

• Insertion: trochanteric fossa of femur

• Action:

  1. laterally rotates thigh

  2. assists in flexion of hip joint

• Blood: obturator artery

• Nerve: obturator nerve, L2,3,4

Anterior Thigh Musculature

Sartorius

• Origin: anterior superior iliac spine (ASIS)

• Insertion:

  1. upper medial surface of body of tibia

  2. contributes to pez anserine

• Action:

  1. flexes hip and knee

  2. laterally rotates thigh if flexed at the hip

• Blood:

  1. muscular branches of profunda femoris artery

  2. saphenous branch of descending genicular artery

• Nerve: branches of femoral nerve, L2,3

Rectus femoris

• Origin:

  1. anterior head: anterior inferior iliac spine (AIIS)

  2. posterior head: ilium just above the acetabulum

• Insertion:

  1. common quadriceps tendon into patella

  2. tibial tuberosity via patellar ligament

• Action:

  1. extends knee

  2. flexes hip

• Blood: lateral femoral circumflex artery

• Nerve: branches of femoral nerve, [L2],3,4

Vastus lateralis

• Origin:

  1. greater trochanter

  2. lateral lip of linea aspera

  3. lateral intermuscular septum

• Insertion:

  1. common quadriceps tendon into patella

  2. tibial tuberosity via patellar ligament

• Action:

  1. extends knee

  2. can abnormally displace patella

• Blood: lateral femoral circumflex artery

• Nerve: branches of femoral nerve, [L2],3,4

Vastus intermedius

• Origin: anterior lateral aspect of the femoral shaft

• Insertion:

  1. common quadriceps tendon into patella

  2. tibial tuberosity via patellar ligament

• Action: extends knee

• Blood: lateral femoral circumflex artery

• Nerve: branches of femoral nerve, [L2],3,4

Vastus medialis

• Origin:

  1. intertrochanteric line of femur

  2. medial aspect of linea aspera

• Insertion:

  1. common quadriceps tendon into patella

  2. tibial tuberosity via patellar ligament

• Action: extends knee

• Blood:

  1. muscular branches of profunda femoris artery

  2. saphenous branch of descending genicular artery

• Nerve: branches of femoral nerve, [L2],3,4

Articularis genus

• Origin:

  1. distal portion of anterior femoral surface, close to the knee

  2. off the deep fibers of the vastus intermedius

• Insertion: synovial membrane of the knee joint

• Action:

  1. pulls the synovial membrane of the knee superior with knee extension

  2. prevents impingement of the synovial membrane between patella and the femur

• Blood: lateral femoral circumflex artery

• Nerve: branches of femoral nerve, L3,4

Psoas major

• Origin:

  1. transverse processes of L1-L5

  2. vertebral bodies of T12-L4 and the intervening intervertebral discs

• Insertion: iliopsoas tendon to the lesser trochanter of the femur

• Action:

  1. hip flexion

  2. lateral rotation

• Blood: muscular branches of medial femoral circumflex artery

• Nerve: ventral rami, L1,2,3

Illiacus

• Origin: inner surface of upper iliac fossa

• Insertion: iliopsoas tendon to the lesser trochanter of the femur

• Action:

  1. powerful hip flexion

  2. lateral rotation

• Blood: muscular branches of medial femoral circumflex artery

• Nerve: femoral nerve, L3,4

Pectineus

• Origin:

  1. pectineal line of the pubis

  2. superior pubic ramus

• Insertion:

  • the pectineal line of the femur

  • (just below the lesser trochanter on the posterior aspect of the femur)

• Action:

  1. flexes hip

  2. adducts thigh

  3. medially rotates thigh

• Blood: muscular branches of medial femoral circumflex artery

• Nerve:

  • femoral nerve, L3,4 OR

  • obturator nerve, L2,3,4 OR

  • femoral L3,4 and accessory obturator L3,4

  Posterior Leg Musculature

   

   

  Gastrocnemius

  • Origin:

    1. medial head: just above medial condyle of femur

    2. lateral head: just above lateral condyle of femur

  • Insertion: calcaneus via lateral portion of calcaneal tendon

  • Action:

    1. plantarflex the ankle

    2. knee flexion (when not weight bearing)

    3. stabilizes ankle & knee when standing

  • Blood:

    1. sural branches of popliteal artery

    2. muscular branches of peroneal artery

    3. posterior tibial artery

  • Nerve: tibial nerve, S1,2

  Soleus

  • Origin:

    1. upper fibula

    2. soleal line of tibia

  • Insertion: calcaneus via medial portion of calcaneal tendon

  • Action: plantarflex the foot

  • Blood:

    1. sural branches of popliteal artery

    2. muscular branches of peroneal artery

    3. posterior tibial artery

  • Nerve: tibial nerve, S1,2

  Plantaris

  • Origin: above the lateral head of gastrocnemius on femur

  • Insertion: calcaneus, medial to calcaneal tendon, or blending with the calcaneal tendon

  • Action: like a weak gastrocnemius

  • Blood:

    1. sural branches of popliteal artery

    2. muscular branches of peroneal artery

    3. posterior tibial artery

  • Nerve: tibial nerve, S1,2

  Popliteus

  • Origin:

    1. lateral femoral condyle

    2. arcuate popliteal ligament

    3. lateral meniscus

    4. knee joint capsule

  • Insertion: posterior tibial surface above the soleal line

  • Action:

    1. insertion fixed: laterally rotates femur on tibia & unlocks knee

    2. origin fixed: medially rotates tibia on femur & unlocks knee

  • Blood: sural branches of popliteal artery

  • Nerve: tibial nerve, L5,S1

  Flexor digitorum longus

  • Origin:

    1. posterior surface of tibia

    2. crural fascia

  • Insertion: plantar surface of bases of the 2-5th distal phalanges

  • Action:

    1. primarily flexes 2nd - 5th toes

    2. weak plantarflexor

    3. weak inversion & adduction of foot

  • Blood:

    1. peroneal artery

    2. posterior tibial artery

  • Nerve: tibial nerve, L5,S1

  Tibialis posterior

  • Origin:

    1. posterior, proximal tibia

    2. interosseous membrane

    3. medial surface of fibula

  • Insertion:

    1. navicular tuberosity (principle)

    2. all 3 cuneiforms (plantar surface)

    3. bases of 2nd-4th metatarsals

    4. cuboid

    5. sustentaculum tali of calcaneus

  • Action:

    1. stabilizes ankle

    2. inversion & adduction of foot

    3. prevents hyperpronation while in gait

    4. weak plantarflexion of ankle

  • Blood:

    1. peroneal artery

    2. posterior tibial artery

  • Nerve: tibial nerve, L5,S1

  Flexor hallucis longus

  • Origin:

    1. posterior, inferior 2/3 of fibula

    2. interosseous membrane

    3. crural fascia & posterior intermuscular septum

  • Insertion: plantar surface of distal phalanx of hallux

  • Action:

    1. flexes big toe (hallux)

    2. weak plantarflexion of the foot

    3. weak inversion & adduction of foot

  • Blood:

    1. peroneal artery

    2. posterior tibial artery

  • Nerve: tibial nerve, L5,S1,2

  Anterolateral Leg Musculature

   

   

  Peroneus longus

  • Origin:

    1. head of the fibula

    2. proximal 2/3 of lateral fibula

    3. adjacent intermuscular septum

  • Insertion:

    1. plantar surface of cuboid

    2. base of 1st & (2nd) metatarsal

    3. plantar surface of medial cuneiform

  • Action:

    1. eversion & abduction of the foot

    2. weak plantarflexion of the foot at the transverse tarsal joint

  • Blood: muscular branches of the peroneal artery

  • Nerve: superficial peroneal nerve, L4,5,S1

  Peroneus brevis

  • Origin:

    1. distal 2/3 of lateral fibula

    2. posterior and anterior intermuscular septum

  • Insertion: tuberosity on lateral aspect of base of 5th metatarsal

  • Action:

    1. eversion & abduction of the foot

    2. weak plantarflexion of foot

  • Blood: muscular branches of the peroneal artery

  • Nerve: superficial peroneal nerve, L4,5,S1

  Tibialis anterior

  • Origin:

    1. lateral tibial condyle

    2. proximal 2/3 of anteriolateral surface of tibia

    3. interosseous membrane

    4. anterior intermuscular septum & crural fascia

  • Insertion:

    1. medial & plantar surface of base of 1st metatarsal

    2. medial & plantar surface of the cuneiform

  • Action:

    1. strongest dorsiflexor

    2. inverts & adducts the foot

  • Blood: anterior tibial artery

  • Nerve: deep peroneal nerve, L4,5,S1

  Extensor hallucis longus

  • Origin:

    1. medial aspect of the fibula

    2. interosseous membrane

    3. crural fascia

  • Insertion: dorsal surface of base of proximal and distal phalanx of hallux

  • Action:

    1. extends distal phalanx of big toe

    2. weak dorsiflexor

    3. weak inversion & adduction

  • Blood: anterior tibial artery

  • Nerve: deep peroneal nerve, L4,5,S1

  Extensor digitorum longus

  • Origin:

    1. lateral condyle of the tibia

    2. upper anterior surface of fibula

    3. interosseous membrane

    4. crural fascia

  • Insertion:

    • dorsal surface of the bases of the middle & distal phalanxes of the 2nd-5th rays

    • (via 4 tendons and giving a fibrous expansion)

  • Action:

    1. extends the lateral 4 toes

    2. weak dorsiflexor & everts foot

  • Blood: anterior tibial artery

  • Nerve: deep peroneal nerve, L4,5,S1

  Peroneus tertius

  • Origin:

    1. distal 1/3 of anterior fibula

    2. distal & lateral aspect of extensor digitorum

  • Insertion: dorsal surface of base of 5th metatarsal

  • Action:

    1. extends the 5th toe

    2. weak dorsiflexor & everts foot

  • Blood: anterior tibial artery

  • Nerve: deep peroneal nerve, L4,5,S1

  Foot Musculature

   

   

  Abductor hallucis

  • Origin:

    1. medial process of calcaneal tuberosity

    2. flexor retinaculum

    3. plantar aponeurosis

    4. medial intermuscular septum

  • Insertion: medial aspect of base of proximal phalanx of hallux

  • Action:

    1. flexes the big toe (primary action)

    2. may assist in abduction of big toe

  • Blood: medial plantar artery

  • Nerve: medial plantar nerve, L5,S1

  Flexor digitorum brevis

  • Origin:

    1. medial process of calcaneal tuberosity

    2. plantar aponeurosis

  • Insertion:

    • both sides of the bases of the middle phalanx of rays 2-5

    • (each of the 4 tendons splits forming tunnel for FDL)

  • Action: flexes toes 2-5

  • Blood: medial plantar artery

  • Nerve: medial plantar nerve, L5,S1

  Abductor digiti minimi

  • Origin:

    1. lateral & medial processes of the calcaneal tuberosity

    2. plantar aponeurosis

    3. lateral intermuscular septum

  • Insertion: lateral aspect of base of proximal phalanx of 5th ray

  • Action:

    1. abducts 5th toe

    2. aids in flexing

  • Blood: lateral plantar artery

  • Nerve: lateral plantar nerve, S1,2

  Abductor ossis metatarsi quinti

  • Origin: from fibers of abductor digiti minimi

  • Insertion: into the 5th metatarsal

  • Action: abducts the 5th ray

  • Blood: lateral plantar artery

  • Nerve: lateral plantar nerve, S1,2

  Quadratus plantae

  • Origin:

    1. medial head: medial calcaneus

    2. lateral head: lateral calcaneus & long plantar ligament

  • Insertion:

    • lateral margin of tendon of flexor digitorum longus (FDL)

    • may send slips into the distal tendons

  • Action:

    1. assists FDL in flexing the distal phalanxes of 2nd-5th toes

    2. corrects FDL from pulling toes medially

  • Blood: lateral plantar artery

  • Nerve: lateral plantar nerve, S1,2

  Lumbricals

  • Origin: from tendons of FDL:

    1. 1st: medial aspect of tendon to 2nd ray

    2. 2nd-4th: two heads between the tendons in which they lie

  • Insertion: extensor tendons of EDL on dorsal foot

  • Action:

    1. flex proximal phalanges at MTP

    2. extend middle & distal phalanges at IP

  • Blood:

    1. 1st: medial plantar artery

    2. 2nd-4th: lateral plantar artery

  • Nerve:

    1. 1st: medial plantar nerve, L5,S1

    2. 2nd-4th: lateral plantar nerve, S1,2

  Flexor hallucis brevis

  • Origin:

    1. medial aspect of the cuboid

    2. lateral cuneiform

  • Insertion:

    1. medial aspect of base of proximal phalanx of hallux

    2. lateral aspect of base of proximal phalanx of hallux

  • Action: flexes hallux at MTP

  • Blood: medial plantar artery

  • Nerve: medial plantar nerve, L5,S1

  Adductor hallucis

  • Origin:

    1. oblique head: base of 2nd-4th metatarsals & long plantar ligament

    2. transverse head: deep transverse metatarsal ligament & plantar ligaments at MTP joints

  • Insertion: lateral aspect of base of proximal phalanx of hallux

  • Action:

    1. adduction of hallux at MTP

    2. flexes hallux at MTP

  • Blood: lateral plantar artery

  • Nerve: lateral plantar nerve, S1,2

  Flexor digiti minimi brevis

  • Origin:

    1. base of 5th metatarsal

    2. digital sheath of peroneus longus

  • Insertion: lateral aspect of base of proximal phalanx of 5th ray

  • Action: flexes the 5th toe at MTP

  • Blood: lateral plantar artery

  • Nerve: lateral plantar nerve, S1,2

  Plantar interossei (3 muscles)

  • Origin: medial aspect of 3rd-5th metatarsals (each muscle has a single head)

  • Insertion: medial aspect of base of proximal phalanx of the same ray (of 3rd-5th rays)

  • Action:

    1. adduct toes 3-5

    2. flex toes 3-5 at MTP

  • Blood: lateral plantar arch

  • Nerve: lateral plantar nerve (deep branch), S1,2

  Dorsal interossei (4 muscles)

  • Origin: from both metatarsals between which they lie

  • Insertion: base of proximal phalanx closest to the axis of the foot (2nd ray)

  • Action:

    1. abduct toes 2-4

    2. flexes toes 2-4 at MTP

  • Blood: lateral plantar arch

  • Nerve: lateral plantar nerve (deep branch), S1,2

  Extensor hallucis brevis

  • Origin:

    1. upper anterolateral calcaneus

    2. inferior extensor retinaculum

  • Insertion: base of proximal phalanx of hallux

  • Action: extends hallux

  • Blood: dorsalis pedis artery

  • Nerve: deep peroneal nerve, L4,5

  Extensor digitorum brevis

  • Origin:

    1. upper anterolateral calcaneus

    2. inferior extensor retinaculum

  • Insertion: middle & distal phalanges of 2nd-4th rays (via EDL)

  • Action: extends 2nd-4th rays

  • Blood: dorsalis pedis artery

  • Nerve: deep peroneal nerve, L4,5