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  <head>
    <title>076-03 Lower-limb osteology, joints, muscles, vessels, nerves, and gait integration</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Lower limb anatomy and gait">
      <outline text="Support over mobility">
        <outline text="Supports weight, absorbs impact, propels, balances"/>
        <outline text="More constrained joints, more robust bones"/>
        <outline text="Aligned force from pelvis to foot"/>
      </outline>
      <outline text="Hip joint">
        <outline text="Acetabulum deepened by labrum"/>
        <outline text="Iliofemoral ligament resists hyperextension">
          <outline text="Upright standing with little muscle activity"/>
        </outline>
        <outline text="Head ligament artery matters mainly in children"/>
        <outline text="Retinacular branches from medial circumflex femoral">
          <outline text="Injured in intracapsular fracture"/>
          <outline text="Avascular necrosis and non-union"/>
        </outline>
        <outline text="Posterior dislocation through a flexed hip">
          <outline text="Can injure the sciatic nerve"/>
        </outline>
        <outline text="Hip pain refers to groin, thigh, knee"/>
      </outline>
      <outline text="Gluteal region and thigh">
        <outline text="Gluteus maximus extends, externally rotates hip"/>
        <outline text="Gluteus medius, minimus stabilise pelvis in stance">
          <outline text="Superior gluteal injury: contralateral pelvic drop"/>
        </outline>
        <outline text="Piriformis divides greater sciatic foramen">
          <outline text="Sciatic nerve usually exits below, varies"/>
        </outline>
        <outline text="Anterior compartment: femoral nerve">
          <outline text="Patella increases quadriceps moment arm"/>
        </outline>
        <outline text="Medial adductors: obturator nerve"/>
        <outline text="Hamstrings mainly tibial division">
          <outline text="Short head of biceps: common fibular"/>
          <outline text="Extend hip, flex knee, decelerate swing"/>
        </outline>
      </outline>
      <outline text="Femoral triangle and adductor canal">
        <outline text="Lateral to medial: nerve, artery, vein, lymphatics">
          <outline text="Femoral sheath excludes the nerve"/>
          <outline text="Femoral canal is a hernia site medial to vein"/>
        </outline>
        <outline text="Profunda femoris supplies the thigh"/>
        <outline text="Femoral artery through hiatus becomes popliteal">
          <outline text="Saphenous nerve does not pass the hiatus"/>
        </outline>
        <outline text="Great saphenous anterior to medial malleolus"/>
        <outline text="Small saphenous behind lateral malleolus"/>
      </outline>
      <outline text="Knee">
        <outline text="Femoral condyles roll and glide on flat plateaus"/>
        <outline text="Menisci deepen, distribute load, absorb shock">
          <outline text="Medial meniscus firmly attached, less mobile"/>
        </outline>
        <outline text="Cruciates resist anterior and posterior translation"/>
        <outline text="Tibial collateral resists valgus, blends with capsule"/>
        <outline text="Fibular collateral resists varus, separate from meniscus"/>
        <outline text="Terminal extension locks, popliteus unlocks"/>
        <outline text="Popliteal artery lies deepest in the fossa">
          <outline text="Reduced dislocation may hide vascular injury"/>
        </outline>
      </outline>
      <outline text="Leg compartments">
        <outline text="Anterior: dorsiflexion, deep fibular nerve">
          <outline text="Anterior tibial artery becomes dorsalis pedis"/>
        </outline>
        <outline text="Lateral: eversion, superficial fibular nerve"/>
        <outline text="Common fibular nerve at fibular neck">
          <outline text="Compression causes foot drop"/>
        </outline>
        <outline text="Superficial posterior plantarflex via calcaneal tendon"/>
        <outline text="Deep posterior flex toes, invert, support arches"/>
        <outline text="Tarsal tunnel behind medial malleolus">
          <outline text="Tibial-nerve compression"/>
        </outline>
      </outline>
      <outline text="Ankle and foot arches">
        <outline text="Mortise most stable in dorsiflexion">
          <outline text="Wider anterior talus engages mortise"/>
        </outline>
        <outline text="Lateral ligaments and strong deltoid ligament"/>
        <outline text="Subtalar joints adapt to terrain"/>
        <outline text="Talus: no muscle attachments, vulnerable supply"/>
        <outline text="Talar head is keystone of medial arch"/>
        <outline text="Lateral arch lower and more rigid"/>
        <outline text="Windlass mechanism tightens plantar aponeurosis"/>
      </outline>
      <outline text="Lumbosacral plexus">
        <outline text="Lumbar plexus forms within psoas">
          <outline text="Lateral femoral cutaneous: meralgia paraesthetica"/>
        </outline>
        <outline text="Sciatic nerve: tibial and common fibular divisions"/>
        <outline text="Superior gluteal abductors, inferior gluteus maximus"/>
        <outline text="Pudendal nerve supplies perineum"/>
        <outline text="Deep fibular senses first web space"/>
      </outline>
      <outline text="Gait integration">
        <outline text="Stance and swing phases alternate">
          <outline text="Double support disappears in running"/>
        </outline>
        <outline text="Hip abductors stabilise pelvis in stance"/>
        <outline text="Quadriceps control knee flexion after contact"/>
        <outline text="Plantarflexors restrain tibia, generate push-off"/>
        <outline text="Dorsiflexors control lowering, clear toes"/>
        <outline text="Deficits create compensations elsewhere"/>
        <outline text="Linked kinetic chain, not one joint"/>
      </outline>
    </outline>
  </body>
</opml>
