Anatomy lecture 11: Lower Limb Bones Flashcards
Posterior sacral foramina:
provide passage for posterior rami of S1-S4 nerves.
Laterally the sacrum articulates with:
Two hip bones for form the sacroiliac joint (auricular surfaces).
Vertebral foramina:
sacral canal
Sacral hiatus:
laminae of the 5th sacral vertebrae fail to meet in the midline.
Sacral crests:
prominent boney ridges on the posterior surface of the sacrum, above the sacral hiatus
(Represents remnants of spinous, articular, and transverse processes of the embryonic segments)
Posterior sacral foramina:
4 pairs:
provide passage for posterior rami of S1-S4 nerves.
The anterior surface of the sacrum:
Anterior foramina: on each side for the passage of the sacral nerves S1-S4
Sacral promontory
Sacral Ala
-Formation of pelvic inlet (Superior aperture)
Coccyx:
4 fused vertebral segments & coccygeal cornu
Two processes arising from the first coccygeal segment toward the sacrum and articulate with the sacral cornu to form the sacrococcygeal joints.
Coccygeal Cornu
Hip bone:
ilium pubis, ischium
Ilium external surface features:
24) Iliac crest
29) iliac tubercle (tuberculum)
35) posterior gluteal line
34) Anterior gluteal line
33) Inferior gluteal line
19) Supra-acetabular groove (sulcus)
Gives attachment to the reflected surface head of the rectus femoris muscle:
Supra-acetabular groove (sulcus)
Ilium internal surface features:
27) Iliac crest
21) iliac fossa
23) Auricular surface for sacrum
22) iliac tuberosity: attachment for posterior sacroiliac ligaments
13) Arcuate line
14) iliopectineal (iliopubic) eminence
25) Anterior superior Iliac spine (ASIS)
30) Posterior superior iliac spine (PSIS)
39) greater sciatic notch
Ischium:
36) body: posterior part of the acetabulum
38) Ischial spine
39) Greater sciatic notch
40) lesser sciatic notch
41) Ischial tuberosity
37) Ischial ramus
Pubis:
9) Body
7) Superior ramus
12) Pectineal line
14) Iliopectineal eminence
8) Inferior ramus
5) Obturator foramen: can find the obturator groove (15) that will turn into obturator canal by the attachment of the obturator membrane to the margins of the obturator foramen.
41) Pubic symphysis
11) Pubic crest
10) Pubic tubercle
Acetabulum:
-rim or margin
-acetabular labrum
4) acetabular notch: converted into a foramen (acetabular foramen) by the transverse acetabular ligament.
2) acetabular fossa
3) lunate surface
-acetabular labrum
Proximal Femur:
12) head: fovea capitus femoris; attachment to the ligamentum teres femoris
2) neck
16) greater trochanter
18) lesser trochanter
14) intertrochanteric line
15) intertrochanteric crest: middle is the quadrate tubercle
Middle Femur:
The body/shaft:
6) linea aspera(two lips): prolonged superiorly by 9, & 11. Inferiorly by two supracondylar ridges (making up 24)
9) gluteal tuberosity
11) pectineal line
24) Popliteal surface
Distal Femur:
19) Medial condyle
20) Lateral condyle
21) patellar surface: separates the condyles
22) Intercondylar fossa (notch)
25) medial epicondyle: larger
27) lateral epicondyle: broader
26) adductor tubercle: on top of medial epicondyle
Patella:
sesamoid bone, developed in the tendon of the quadriceps femoris.
Has an anterior, posterior, three borders and an apex
Anterior surface: rough longitudinal striae, covered by the tendon expansion of quadriceps femoris, separated from the skin by a bursa.
Posterior surface: separated into two facets by a vertical ridge, corresponds to the groove of the femur. Lateral facet is broader and deeper.
Borders: attachment to the quadriceps femoris tendon from rectus femoris, & vastus intermedialis
Apex: attachment to the patellar ligament
Articulation: articulates with the femur
Tibia:
2) medial condyle
3) lateral condyle: fibular facet; Gerdy’s tubercle: where ITB inserts
2 & 3) superior articular facets
4) Intercondylar eminence
11) tibial tuberosity
1) body/shaft: ant., med., lat. & ant., med., post.(15) & soleal line (17)
Distal end:
19) medial malleolus
21) fibular notch (lateral surface)
-Inferior surface: articulates with talus
Fibula:
Lateral side of tibia
Proximal end:
1) head: articular surface for lateral condyle of tibia
3) apex
4) body/shaft (3 borders & 3 surfaces)
11) Medial (interosseous border): attachment to interosseous membrane
6) Lateral surface
-posterior border
Distal end:
13) lateral malleolus
15) malleolar fossa: attachment to the posterior talofibular ligament
Foot:
3 parts: tarsus (7 bones), metatarsus
& digits
Talus:
Superior surface: articulates w/ inferior surface of tibia
Inferior surface: articulates w/ posterior and middle calcaneal surfaces separated by sulcus Tali.
Sulcus tali: lies above a similar groove on upper surface forming sinus tarsi (canal) with has interosseous talocalcaneal ligament.
Head: anterior articular surface and navicular articular surface
Medial surface: medial malleolus
Lateral surface: lateral malleolus
Calcaneus:
largest of tarsal bones:
lower and back part of the foot
Superior surface: 3 articular facets for talus
calcaneal sulcus: Lies below a similar one on the undersurface of the talus forming the sinus tarsi for the lodgment of the interosseous talocalcaneal ligament.
Plantar surface of calcaneus:
Inferior or plantar surface bound posteriorly by calcaneal tuberosity.
Makes up the lateral and medial processes.
Calcaneal tubercle also here: attachment for ligaments
Medial surface of calcaneus:
horizontal eminence: sustentaculum tali: below is a groove for the flexor hallucis longus tendon
Anterior or cuboidal articular surface: articulates with cuboid bone
Lateral surface: two oblique grooves separated by a ridge, fibular (peroneal) tubercle or trochlea
Navicular bone:
situated at the medial side of the tarsus: between talus and cuneiform
Anterior surface: articulates with three cuneiform bones
Posterior surface: articulates with head of talus
Medial surface: has round tuberosity
Cuboid bone:
lateral side of the foot, in front of the calcaneus, and behind the fourth and fifth metatarsal bones
Cuneiforms:
Three bones:
-medial cuneiform
-intermediate cuneiform
-lateral cuneiform
(numbered 1-3 from medial to lateral)
Metatarsus:
made up of 5 bones:
numbered medial to lateral.
Each bone has a base, shaft, and head
5th metatarsal bone recognized by a rough eminence, the tuberosity, on the lateral side of its base.
The phalanges:
correspond and number and general arrangement with the hand.
Each has a base, shaft and head.
distal phalanges have distal tuberosities.
Foot axis:
passes through the 2nd toe and metatarsal bone. abduction and adduction of the foot is relative to the second toe.
Fascia Lata:
deep fascia of the thigh.
tough fibrous sheath that invests the thigh like a sleeve. Thickened laterally forming the ITB.
Invests the TFL between its two layers and acts as the tendon for this muscle.
Superficial gluteal muscles:
Glut max
Glut med
Glut min
TFL
Tensor Fascia Latae:
O: Lateral ASIS & anterior iliac crest
I: Tibia (Gerdy’s tubercle) via ITB
A: abduction, flexion, medial rotation, anterior pelvic tilt, tenses ITB to support femur on tibia during standing
N: Superior gluteal nerve
Gluteus Maximus:
O: posterior iliac crest, sacrum, coccyx, sacrotuberous ligament
I: ITB, gluteal tuberosity of femur
A: Knee stability in extension, abduction, adduction, lat. rotation, posterior pelvis tilt, and extension
N: Inferior gluteal nerve
Gluteus Medius:
O: External surface of ilium between the anterior and posterior gluteal lines
I: Lat. surface of greater trochanter
A: abduction, flexion, med. rotation, extension, and lat. rotation of thigh
N: Superior gluteal nerve
Gluteus Minimus:
O: Gluteal surface of ilium, between anterior and inferior gluteal lines
I: anterior surface of greater trochanter
A: abd., flexion, extension, lat. rotation, & med. rotation @ hip joint
N: Superior gluteal nerve
Trendelenburg sign & gait:
glut minimus
Deep gluteal muscles:
Piriformis
Superior and inferior gemellus
Obturator internus
Quadratus femoris
Obturator externus
Piriformis:
O: Anterior sacrum
I: Superior border of greater trochanter
A: Lat. rotation, and abduction
N: Nerve to piriformis (from sacral plexus)
Piriformis syndrome:
When sciatic nerve gets pinched by piriformis muscle
Superior Gemellus:
O: Ischial spine
I: Medial surface of the greater trochanter
A: Lat. rotation, & abduction
N: Nerve to obturator internus (from sacral plexus)
Obturator Internus:
O: inner surface of obturator membrane
I: Medial surface of the greater trochanter
A: Lat. rotation, abduction
N: Nerve to obturator internus (from sacral plexus)
Inferior Gamellus:
O: Ischial tuberosity
I: medial surface of greater trochanter
A: Lat. rotation, abduction
N: Nerve to quadratus femoris (from sacral plexus)
Quadratus Femoris:
O: Ischial tuberosity
I: Quadrate tubercle of femur
A: Lat. rotation, & adduction
N: Nerve to quadratus femoris (from sacral plexus)
Obturator Externus:
O: Outer surface of the obturator membrane
I: Trochanteric fossa
A: Lateral Rotation & adduction
N: Obturator N. from lumbar plexus
Thigh compartments:
Anterior: extensor
Medial: adductor; innervated by the obturator nerve (except pectineus(femoral) & adductor magnus (obturator & tibial)
Posterior: Flexor
Biceps femoris:
Posterior compartment:
O:
-long head; Ischial tuberosity
-Short head; linea aspera
I:
-head of fibula
-Lateral condyle of tibia
A: Flex (entire muscle), ext. (long head), lat. rotation of leg @ knee
N: Tibial N. (long head) & common fibular; peroneal (short head)
Semitendinosus:
Posterior compartment:
O: Ischial tuberosity
I: Proximal part of medial surface of shaft of tibia
A: flex. @ knee, Ext. of leg, Med. rotation @ knee
N: Tibial N.
Semimembranosus:
Posterior compartment:
O: Ischial tuberosity
I: Posterior aspect of medial condyle of tibia
A: flex. @ knee, ext. of thigh, med. rotation @ knee (when flexed)
N: Tibial N.
Hamstring muscle notes:
Biceps known as lateral hamstring & ST and SM as the medial hamstrings.
Shortening of the hamstring and its effect on LBP (lower back pain)
