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Represents the upper two-thirds of a line joining:
Midinguinal point: midway between ASIS and pubic symphysis.
Adductor tubercle: lower end of the tendon of adductor magnus.
Upper one-third: Lies in the femoral triangle.
Middle one-third: Lies in the adductor canal.
Lower one-third: Represents the region of descending genicular and saphenous branches.
Draw after marking the femoral artery.
Joins two points on femoral artery:
Point 1: 3.5 cm below midinguinal point.
Point 2: 10 cm below midinguinal point.
Course: Slightly convex laterally in its upper part.
Mark by joining:
Junction of middle and lower thirds of thigh — 2.5 cm medial to midline on back of thigh.
Midline of back of knee.
Midline of back of leg at tibial tuberosity level.
Lies deep in popliteal fossa, dividing into anterior and posterior tibial arteries.
Join:
Posterior superior iliac spine (PSIS) and apex of greater trochanter.
Artery enters gluteal region at junction of upper and middle thirds of this line.
Mark:
PSIS, greater trochanter, and ischial tuberosity.
Artery emerges just medial to the sciatic nerve at midpoint between greater trochanter and ischial tuberosity.
Join:
A point 2.5 cm below the medial side of the head of fibula.
A point midway between the two malleoli.
The artery runs downwards and slightly medially along this line.
Join:
Midline of back of leg at tibial tuberosity level.
Midpoint between medial malleolus and tendocalcaneus.
The artery passes obliquely downwards and medially in the calf.
Join:
A point midway between the two malleoli.
A point at the proximal end of the first intermetatarsal space.
Pulse felt lateral to the tendon of extensor hallucis longus.
Join:
Midpoint between medial malleolus and heel prominence.
Navicular bone, midway between heel and root of great toe.
Direction: Runs toward the first interdigital cleft.
Start at medial malleolus level; draw a curve towards the base of 5th metatarsal, then medially across the sole to join the deep plantar branch forming the plantar arch.
Formed by the lateral plantar artery (main contributor) and the deep plantar branch of dorsalis pedis artery.
Lies opposite the bases of the metatarsals, convex forwards, crossing from lateral to medial side of the sole.
It supplies digital branches to the toes.
Marking is the same as the femoral artery, except:
Upper point → 1 cm medial to the midinguinal point.
Lower point → 1 cm lateral to the adductor tubercle.
The vein lies:
Medial to the artery at the upper end.
Posterior to it in the middle.
Lateral to it near the lower end.
Easily visible on the living subject.
Surface marking can be made by joining:
Medial end of the dorsal venous arch on dorsum of foot.
Anterior surface of medial malleolus.
Medial border of tibia at junction of upper two-thirds and lower one-third.
Adductor tubercle.
Below the saphenous opening in the thigh.
The vein ascends in front of the medial malleolus and drains into the femoral vein at the saphenous opening.
Surface marking line passes through:
Lateral end of the dorsal venous arch.
Behind the lateral malleolus.
Lateral to tendocalcaneus above the malleolus.
Centre of popliteal fossa.
It drains the lateral border of foot, heel, and back of leg and opens into the popliteal vein.
Join two points:
1.2 cm lateral to the midinguinal point.
2.5 cm vertically below that first point.
Lies lateral to femoral artery in femoral triangle.
Marked by joining:
A point 2.5 cm lateral to the midpoint between posterior superior iliac spine (PSIS) and ischial tuberosity.
Continues downward to a point midway between the greater trochanter and ischial tuberosity (site of emergence).
Runs down in the posterior thigh, deep to gluteus maximus.
Continuation of the sciatic nerve in the popliteal fossa.
Marked by a line from:
Centre of popliteal fossa → to midpoint between medial malleolus and tendocalcaneus.
Runs deep to soleus and supplies the posterior compartment of leg and sole of foot.
Branch of sciatic nerve.
Marked by joining:
Upper point: Junction of middle and lower thirds of thigh, lateral side.
Lower point: Neck of fibula, where it winds around the bone.
Divides into superficial and deep peroneal nerves.
Injury → foot drop due to loss of dorsiflexors and evertors.
Point 1: On the lateral aspect of the neck of the fibula.
Point 2: In front of the ankle, midway between the two malleoli, where it divides into medial and lateral branches.
The medial branch runs to the first interosseous space.
Relation to anterior tibial artery:
Upper & lower thirds: Lateral to the artery.
Middle third: Anterior to the artery.
Point 1: On the lateral aspect of the neck of the fibula.
Point 2: On the anterior border of peroneus longus, at the junction of upper two-thirds and lower one-third of the leg.
At the lower point, the nerve pierces the deep fascia and divides into medial and lateral branches supplying the dorsum of the foot.
Marked similar to the medial plantar artery.
Lies lateral to the artery.
Course: From midpoint between medial malleolus and heel → towards the navicular bone, ending in the direction of the first interdigital cleft.
Marked similar to the lateral plantar artery.
Lies medial to the artery.
Course: From medial malleolus, curves across the sole to the base of the fifth metatarsal, then turns medially to form the plantar arch.
Centre: Lies 4 cm below and 4 cm lateral to the pubic tubercle.
Shape and size: About 2.5 cm long and 2 cm broad.
Orientation: Long axis directed downwards and laterally.
Anatomical importance: It transmits the great saphenous vein, superficial epigastric, superficial circumflex iliac, and superficial external pudendal vessels, and is covered by the cribriform fascia.
Location: Lies deep to the inguinal ligament.
Surface marking: Represented by a horizontal line 1.25 cm long over the inguinal ligament, placed 1.25 cm medial to the midinguinal point.
Significance:
Medial boundary of the femoral canal, through which femoral hernia may protrude.
Contains lymphatics and a lymph node (Cloquet’s node).
Description: A thick band of deep fascia at the front of the lower leg.
Extent:
Laterally: From the anterior border of the triangular subcutaneous area of fibula.
Medially: To the lower part of the anterior border of the tibia.
Shape: About 3 cm broad vertically.
Function:
Holds the tendons of tibialis anterior, extensor hallucis longus, and extensor digitorum longus in position as they cross the ankle joint.
Prevents bowstringing during dorsiflexion.
Shape: Y-shaped structure with three parts.
Attachments:
Stem: From the anterior part of the upper surface of the calcaneum to a point medial to the tendon of extensor digitorum longus on the dorsum of foot.
Upper band: From the medial end of the stem to the anterior border of the medial malleolus.
Lower band: From the medial end of the stem to the medial side of the foot, continuing into the sole.
Function:
Stabilizes the extensor tendons over the dorsum of foot during movement.
Location: On the medial side of the ankle.
Extent:
From the medial malleolus → to the medial side of the heel, running downwards and backwards.
Breadth: About 2.5 cm.
Structures passing deep to it (anteroposteriorly) — Mnemonic: “Tom, Dick, ANd Harry”
Tibialis posterior
Digitorum longus (flexor)
Artery (posterior tibial)
Nerve (tibial)
Hallucis longus (flexor)
Function: Keeps flexor tendons close to the ankle and prevents bowstringing during plantarflexion.
Normal AP radiograph shows:
Femoral head fitting into the acetabulum.
Shenton’s line: Smooth curve along the inferior border of superior pubic ramus and medial border of femoral neck (interrupted in dislocation).
Neck-shaft angle: ~125° in adults.
Trabecular pattern: Radiating from femoral head — tension and compression trabeculae forming an intersecting pattern.
Clinical relevance:
Used to identify fracture neck of femur and congenital dislocation of hip.
Radiographic features:
Femoral condyles, tibial plateau, patella, and joint space clearly visible.
In lateral view: Patella anterior to femur, joint cavity forming an open angle.
Suprapatellar pouch may be outlined in effusion.
Clinical relevance:
Loss of joint space → osteoarthritis.
Displaced patella → ligament or tendon injury.
Osteochondritis dissecans visible as irregular subchondral lucencies.
AP view: Shows tarsal bones, metatarsals, and phalanges in alignment.
Lateral view: Demonstrates longitudinal arches (especially the medial arch).
Oblique view: Best for joints between tarsal and metatarsal bones.
Clinical relevance:
Flat foot (pes planus): Flattened medial arch.
Clubfoot (talipes): Medial deviation and plantar flexion deformity.
Fractures of metatarsals (e.g., Jones fracture) clearly seen on oblique view.
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