12: Tibia, Fibula, Patella Flashcards
What are bones of the leg?
Tibia & fibula are the bones of the leg, tibia medially & fibula laterally, three joints connect the two (just as the ulna & radius)
Tibia is compared to the …….. in the forearm
radius
Tibia is compared to the radius in the forearm, but how is radius lateral & tibia medial?
Because during the development of the limbs: the upper limb rotates laterally 90 degrees so the radius becomes the lateral bone; the lower limb rotates medially 90 degrees so the tibia becomes the medial bone
Tibia:
1- articulates with … , … , … ?
2- function?
1- Its articulations with femur, talus and fibula
2- transmission of body weight and stability of ankle joint
Fibula function
Slender bone - has no function in weight bearing but provides area for muscle attachment
Superior end of tibia
- medial & lateral condyles
- tibial plateau (articular surface)
- intercondylar eminence
Intercondylar eminence is formed by?
tubercles and fibular articular facet
Shaft of tibia
- 3 borders & surfaces
- tibial tuberosity
- The shaft is thinnest, weakest and poorly vascularized at the junction of middle third with the distal third
- subcutaneous medial surface, anterior border (shin), interosseous border
Inferior end of tibia
- medial malleolus
- inferior articular surface
- fibular notch
What attaches to tibial tuberosity?
Patella ligament
Where does iliotibial tract attach on tibia?
Anterolateral tibial (Gerdy) tubercle
Posterior surface of tibia
Medial condyle shows a groove on its posterior surface, what attaches to it?
Semimembranousus muscle
In what direction does soleal line descend?
Descends lateral to medial (attach soleal muscle)
What structure enters Nutrient foramen? Surgical significance?
Artery enters to supply the tibia. important in graft surgery if you want to remove a piece of bone and graft it somewhere, you have to take the bone with the nutrient artery.
Parts of fibula
What divides the posterior border of fibula into two parts?
Medial crest
Why is it painful when one hits anterior part of leg/tibia?
Bcz immediately deep to the skin (subcutaneous part) & it has periosteum and very rich nerve supply.
(Highly innervated + subcutaneous)
سلايدة مافيها معلومة 🙄
largest sesamoid bone of the body
Patella
Patella is the largest sesamoid bone of the body developed in the tendon of ….?
quadriceps femoris
Location of patella?
Located in front of lower end of femur 1 cm above the knee joint plane
articular surface of patella
Posterior surface is articular in upper ¾ and non-articular in lower ¼
Attachments of patella
- The superior, medial and lateral borders provide attachment for quadriceps tendon
- posterior non-articular area gives attachment to patellar tendon
Ossification centers in patella
Ossifies from several centers which appear from 3 –6 years of age
What is bipartite patella?
Happens when superolateral part of each patella ossifies from separate centers and remain separate from the rest of patella (it is usually bilateral, and may be confused with patellar fractures)
Types of Patellar fractures
a) stable: fractured fragments stay together
b) displaced: fragments move away from one another
c) comminuted: patella breaks into several pieces
d) single: one fracture line
e) open: fragments pierce skin
Most of the posterior surface of patella is articular with …?
femur: femoropatellar joint
Most common area prone to fractures in tibia and why?
Junction of lower 1/3 with upper 2/3 is the narrowest and poorly vascularized region of tibia
This fracture is common due to trauma caused by accidents in which leg hits the dashboard, for example bumper-bumper collision
Compound fractures of tibia (bumper fractures)
Fracture due to extensive walking or running without sufficient warming up
Transverse march (stress) fractures
Severe torsion of the leg (in skiing) lead to ..?
fracture tibia at the junction of upper 2/3 and lower 1/3 of tibial shaft as well as fibula (diagonal fracture)
Fracture through epiphyseal line and inflammation is referred to as ..?
Osgood-Schlatter disease
Osgood-Schlatter disease (slide)
Fibular fractures (site, complications)?
What type of joint is Superior tibiofibular joint? & Movements?
- Plane synovial joint
- Movement- When dorsiflexion of the ankle happens, the fibular
head slides up at the joint
Articular surfaces of Superior tibiofibular joint
Articular surfaces- flat facet of fibular head and a flat facet on
posterolateral aspect of lateral tibial condyle
Ligaments of Superior tibiofibular joint
Ligaments- anterior and posterior ligaments of fibular head
Blood & nerve supply of Superior tibiofibular joint
Blood supply: inferior lateral genicular artery (from popliteal artery) and anterior tibial recurrent artery (anterior tibial artery)
-Nerve supply: common fibular nerve and nerve to popliteus
Superior tibiofibular joint (slide)
What type of joint is Middle tibiofibular join?
Syndesmosis (fibrous joint)
Direction of fibers of Middle tibiofibular join?
Downwards & laterally
Inferior tibiofibular joint
A. Type?
B. Movements
C. Articular surfaces?
A. Syndesmosis (Distal ends of tibia and fibula are interconnected by interosseous, anterior and posterior tibiofibular ligaments)
B. Slight movement while dorsiflexing the ankle joint
C. A rough triangular area on the medial surface of inferior end of fibula articulates with a facet on the lateral aspect of lower end of tibia
Inferior tibiofibular joint
A. Ligaments?
B. Blood & nerve supply?
A. tibiofibular ligament, anterior and posterior tibiofibular ligaments, inferior transverse ligament
B. Perforating branch of fibular artery, and medial malleolar
arteries (branches of anterior and posterior tibial arteries)
Nerves: Deep fibular, tibial and saphenous nerves
Inferior tibiofibular joint (slide)
Add MCQs ‼️‼️
I skipped this slide :)
