NEUROMUSCULAR SYSTEMS OF THE LOWER MEMBER

NEUROMUSCULAR SYSTEMS OF THE LOWER MEMBER

AUTHOR: Abel Renovell Blasco.
Physiotherapist
Ephysiotherapy Webmaster

INTERNAL PLANTAR NERVE
GLOBAL FUNCTION:
- Statics: Maintain the external arch.
- Dynamics: Movement of the 1rst finger and impulsor effect.

MUSCLE	ORIGIN	INSERTION	FUNCTION
SHORT FLEXOR OF THE 1RST FINGER	1rst wedge	1ª phalanx of the 1º finger.	Flexor of the 1º finger.
SEPARATOR OF THE 1º FINGER	Internal condyle of the calcaneous	1ª phalanx of the 1º finger	Separates the 1º finger
LUMBRICAL 1º	Tendon of the 2º finger of the large flexor.	Dorsum of the proximal Proximal phalanx of the 2º finger and tendon of this finger of the large flexor.	To bend the 1st phalanx and to extend the 2nd and the 3rd of the 1rst finger.
SHORT FLEXOR DIGITORUM.	Calcaneous	Medial phalanxes of the last tour fingers.	To bend the medial phalanxes of the last tour fingers.

EXTERNAL PLANTAR NERVE
GLOBAL FUNCTION:
- Statics: They maintain the osseous arches of the 3 support points
- Dynamics: They maintain the force from the external part of the foot to the internal part.

MUSCLE	ORIGIN	INSERTION	FUNCTION
DORSAL INTEROSSEOUS: There are 4 of them.	In the two metatarsals of the corresponding interosseous space. The 2nd toe has 1 internal and 2 external. The 3rd and the 4th external.	External side of the proximal phalanxes of the 2nd toe, 3rd and 4th toe.	To bend the primer phalanx and to extend the other two. To separate the toes.
PLANTAR INTEROSSEOUS: there are 3: in the 3rd, 4th and 5th toe.	In the internal surface of the corresponding metatarsal.	Internal side of the proximal phalanxes of the corresponding toe	To bend the first phalanx and to extend the other two. To approximate the toes.
SHORT FLEXOR OF THE 5TH TOE	Large and basic plantar ligament of the 5th metatarsal.	External side of the proximal phalanx of the 5th toe.	Separador anf flexor of the 5thtoe.
OPONENT OF THE 5TH FINGER	Large and basic ligament of the 5th metatarsal.	External rim of the 5th metatarsal.	Oponent of the 5º toe
SEPARATOR OF THE 5TH TOE	External tuberosity of the calcaneous.	Proximal phalanx of the 5th toe.	Separador and flexor of the 5th toe.
APROXIMATOR OF THE DEL 1º TOE. (Transvers fascicle)	Head of the 2º,3º,4º and 5º metatarsal	Proximal phalanx of the l 1º toe.	Aproximates the 1º toe.
APROXIMATOR OF THE 1º TOE. (Oblique fasciculus)	Cuboides	Proximal phalanx of the 1º toe.	Aproximates the 1º toe.
CUADRATUS PLANTAE	Tuberosity of the calcaneous	Tendon of the large flexor of the toes.	Corrects the direction of the tendon of the largee flexor of the toes and helps it to bend
2º, 3º and 4º LUMBRICAL	Tendons of the 3º, 4º and 5º toe of the profound common flexor.	Back of the phalanxes and the proximal tendons of the common extensor muscle of the 3º, 4º and 5º toe.	To bend the 1rst phalanx and to extend the 2nd and the 3rd

Sciatic of the internal popliteal
GLOBAL FUNCTION:
- Statics: To maintain the osseous arches.
- Dynamics: Transmission of charges

MUSCLE	ORIGIN	INSERTION	FUNCTION
LARGE FLEXOR OF THE 1RST FINGER	Posterior surface and rim of the fibula	Distal Phalanx of the 1rst finger	Flexor of the 1rst finger, plantar flexor and supinator. Strenghtens the articulation of the ankle.
TIBIALIS POSTERIOR	Interosseous membrabe, tibial and fibula	Scaphoid bone and 1rst wedge	Plantar flexor and supinator. Sustains the plantar arch.
LARGE COMMON FLEXOR OF THE TOES	Posterior surface of the tibial	Distal phalanxes of the 2nd and 5th toe	To bend the toes and the sole. Sustains the plantar arch.
POPLITEAL	Posterior external surfaxe of the external condyle of the femur	Posterior surface of the tibial above the oblique line	Directs the external condyle backwards
SOLEUS (TRÍCEPS SURAL)	Posterior surface, external border and head of the fibula.	Through the Achilles tendon and the posterior tuberosity of the calcaneous.	Plantar flexion and supination.
GEMELO INTERNO (TRÍCEPS SURAL)	Surface postero-externa del cóndilo interno del fémur	Achilles tendon	To bend the knee
SURAL TRICEPS	Posterior-external surfaxe of the external condyle of the femur	Achilles tendon	To bend the knee
PLANTARIS	Interior surface of the external condyle of the femur	Achilles tendon or directly in the calcaneous.	To bend the knee. Contributes to the emptying of the popliteal vein by positioning itself on top of it.

EXTERNAL SCIATIC POPLITEAL NERVE
GLOBAL FUNCTION:
- Dynamics: Dorsiflexion of the ankle when supporting the foot. Direct the point of the foot outwards. The global function of the anterior tibial nerve is to extend the toes and to twist the ankle

MUSCLE	ORIGIN	INSERTION	FUNCTION
MUSCULAR CUTANEOUS NERVE OR FIBULAR NERVE
SHORT LATERAL FIBULAR	External surface of the fibula	Styloid process of the metatarsal	Extensión y pronaciñon del pie
LARGE LATERAL FIBULAR	Anterior external surface of the fibula	Base of the 1º metarsal	Extensión y pronaciñon del pie
ANTERIOR TIBIAL NERVE
ANTERIOR TIBIAL	External surface of the tibial and the interosseous membrane	First metatarsal and 1rst wedge	Flexión dorsal del pie.
LARGE EXTENSOR OF THE 1RST TOE	Interosseous membrana and tibial	Distal phalanx of the 1rst toe	Extensión del dedo 1º y flexión dorsal del pie.
EXTENSOR DIGITORUM LONGUS	Internal surface of the fibula	Distal phalanx of the 2nd and 5th finger	Flexión dorsal del pie y extiende del 2º al 5º dedo
ANTERIOR FIBULAR	Lower third of the fibula and interosseous membrane	External surface of the 5º metarsal	Extensión del pie y pronación
SHORT COMMON EXTENSOR	Dorsal and external surface of the calcaneous	Tendons of the common extensor of the 1rst until the 4rth toe	Extensión from the 1rst until the 4rth toe

INTERNAL SCIATIC POPLITEAL NERVE OF THE THIGH OR GREAT SCIATIC
GLOBAL FUNCTION:
Righting of the pelvis and flexion of the knee. Drivers when walking.

MUSCLE	ORIGIN	INSERTION	FUNCTION
STRAIGHT PIECE OF THE MAJOR APPROXIMATOR	Sciatic tuberosity	Tubérculo del gran APPROXIMATOR.	Aproxima el muslo y extiende la articulación coxo femoral. Transmite las fuerzas
SEMIMEMBRANOSUS	Sciatic tuberosity	2 tendones a la tuberosidad interna de la tibia y otro a la capsula articular of the knee	Flexor y APPROXIMATOR de la cadera y flexor of the knee y rotación externa de la pierna
SEMITENDINOSUS	Sciatic tuberosity	Tuberosidad superior de la tibia	Flexor y APPROXIMATOR de la cadera y flexor of the knee y rotación externa de la pierna
FEMORAL BICEPS SHORT PORTION	Linea aspera of the femur	Head of the fibula	To bend the knee and external rotation of the leg
FEMORAL BICEPS LARGE PORTION	Sciatic tuberosity	Head of the fibula	To bend the knee and external rotation of the leg

LUMBO SACRAL PLEXUS NERVE
GLOBAL FUNCTION:
- Deep muscles: Active ligaments of the hip joint.
- Superficial muscles: each muscle has a specific action.

MUSCLE	ORIGIN	INSERTION	FUNCTION
DEEP MUSCLES
VASTUS INTERMEDIUS	Sciatic tuberosity	Posterior intertrochanterial line	Approximation and internal rotation of the hip. Compacts the fémur against the cotyloid
INTERNAL OBTURATOR	Internal surface of the obturador hole	Digital recess	Adductor and external rotator of the hip
SUPERIOR GEMELLUS	External surface of the sciatic spinal	Tendon of the internal obturator	Adductor and external rotator of the hip
INFERIOR GEMELLUS	Sciatic tuberosity	Tendon of the internal obturator	Adductor and external rotator of the hip
PYRAMIDAL	Anterior surface of the sacral	Vértice del trocanter mayor	Adductor y rotador externo e interno de la cadera
SUPERFICIALES
MINOR GLUTEAL	External iliac fossa until the anterior gluteal line	Vertex of the major trochanter	Adductor, flexor y internal rotator of the hip
MEDIAN GLUTEAL	External iliac fossa between the anterior and posterior gluteal line	External surface of the major trochanter	Adductor, flexor y internal rotator of the hip
TENSOR OF FASCIA LATA	Anterior-superior spinal iliac	Through the lower part of the tensor of the fascia lata until the external tuberosity of the tibial	Flexion, extensión and rotation of the knee. Flexion, adduction and rotation of the hip.
MAJOR GLUTEAL	Posterior base of the sacral, coccyx, posterior-superior and posterior-inferior iliac spinals	Fascia lata and linea aspera	Righting of the rachis. Adduction, extensión and external rotation of the thigh

OBTURATOR NERVE
GLOBAL FUNCTION:
Intermedian action between the 1rst amd 2nd phase of walking. External rotation and approximation of the hip.

MUSCLE	ORIGIN	INSERTION	FUNCTION
BENT PART OF THE MAJOR APPROXIMATOR	Sciatic tuberosity y rama isquiopubiana	Linea aspera of the femur	Adductor and flexor of the femur
MINOR APPROXIMATOR	Pubis	Linea aspera of the femur (superior third)	Adductor and flexor of the femur
MEDIAN APPROXIMATOR	Pubic spinal	Linea aspera of the femur (middle third)	Adductor and flexor of the femur
INTERNAL RECTUS OF THE THIGH	Pubic spinal nearby the pubic symphysis	Internal tibial plateau	Abductor and flexor of the thigh y flexor del muslo
EXTERNAL OBTURATOR	External surface of the obturator hole	Digital recess of the femur	Adductor and external rotator of the femur
PECTINEUS	Pectineus crest of the pubis	Linea pectinea of the linea aspera	Abductor and external rotator of the femur

CRURAL NERVE
GLOBAL FUNCTION:
Final phase of the intermedian movements between the 1rst and 2nd phase of walking

MUSCLE	ORIGIN	INSERTION	FUNCTION
ILIAC PSOAS (PSOAS MAJOR)	Intervertebral bodies and intervertebral disks of ribs D11 and L4. Costal process of lumbar vertebrae	Trochanter minor	Flexor and external rotator of the hip
ILIAC PSOAS (ILIAC)	Internal iliac fossa	Trochanter minor	Flexor and external rotator of the hip
CRURAL (CUADRICEPS FEMORIS)	Anterior surface of the femur	Tendon of the patella	Extensor of the knee
VASTUS INTERNUS (CUADRICEPS FEMORIS)	Internal lip of the linea aspera	Tendon of the patella	Extensor of the knee
VASTUS EXTERNUS (CUADRICEPS FEMORIS)	External lip of the linea aspera	Tendon of the patella	Extensor of the knee
RECTUS ANTERIOR (CUADRICEPS FEMORIS)	Anterior-inferior iliac spinal	Tendon of the patella	Extensor of the knee and flexor of the hip
SUBCRURAL	Anterior surface of the femur	Articular capsule of the knee	Traction of the knee capsule
SARTORIUS	Iliac anterior-superior spinal	Superior-internal surface of the tibial	Adduction, flexion and external rotation of the hip. Flexion and internal rotation of the knee