Bone and Joints of the Lower Limb

Question 1

What makes up the Pelvic Girdle

Answer 1

Hip bones, sacrum and coccyx

Question 2

What are the three bones of hip bone?

Answer 2

Illium, Ischium and Pubic bones Add photo

Question 3

What are the functions the Pelvic Girdle

Answer 3

It attaches the lower limb to the axial skeleton, transfers the body weight to the lower limb, provides an almost rigid ring for wight bearing and child birth, supports the pelvic organs and provides muscles attachment for limb movement.

Question 4

What are the pelvic joints and describe a bit about them

Answer 4

Pubic symphysis - secondary cartilagenous joint which is supported bye the arcuate ligaments Sacro-iliac joint - Synovial joint supported by the anterior and posterior sacro-illiac and interosseous ligaments (Very limited movement)

Question 5

What is the function of the sacrospinous and sacrotuberous ligaments

Answer 5

• Prevents the sacrum from tilting forwards and they convert the sciatic notches into greater and lesser foramen (allows for passage of nerves and vessels)

Question 6

What are the four different gateways and what runs through them

Answer 6

Greater Sciatic foramen - Sciatic nerve and gluteal neurovascular bundle Obturator canal - Obturator neurovascular bundle Gap between inguinal ligament and pelvic bone - Femoral neurovascular bundle The lesser sciatic foramen - Internal Pudendal neurovascular bundle

Question 7

Look at the features of the proximal femur

Answer 7

see images of lunate, acetabulum, intertrochanteric line and crest

Question 8

Describe features of the acetabulum

Answer 8

• Deep socket, the rim is raised by the acetabular labrum which then bridges across the acetabular notch as the transverse acetabular ligament

Question 9

Describe some features of the hip bone joint capsule

Answer 9

It attaches to the; acetabular rim, transverse acetabular ligament, intertrochanteric line and neck of femur - Synovial membrane forms a sleeve for the ligament of head of femur. - Synovial layers of the capsule sends retinacular fibres medially along the femoral neck towards the head.

Question 10

What is the function of the ligaments around the hip bone

Answer 10

Prevent overextension, stabalize the joint and save energy during standing

Question 11

What is the function of the Zona Orbicularis

Answer 11

It is a ring like structure which connects the fibrous capsule to the neck of the femur and prevents dislocation

Question 12

What are some of the ligaments of the hip joint capsule

Answer 12

Iliofemoral (strongest) - Prevents hyperextension during standing Pubofemoral - Prevents overabduction of hip joint; tightens during abduction and extension of hip Ischiofemoral - weakest

Question 13

What is Shenton’s line?

Answer 13

Add image. If fractured or dislocated this line becomes disrupted

Question 14

Look at the main features of the distal femur, patella and proximal tibia and fibula.

Answer 14

Look at images

Question 15

Describe some of the features of the knee joint capsule

Answer 15

It is incomplete because anteriorly the fibrous capsule is replaced by the quadriceps tendon (patellar ligament) and the patella and fat pads on either side of the patella ligament

Question 16

Posteriorly, what is the fibrous capsule augmented by?

Answer 16

Oblique popliteal ligament - expansion of the semimembranous membrane. Arcuate popliteal ligament.

Question 17

What are the main bursae of the knee joint?

Answer 17

Suprapatellar bursa, popliteal bursa, anserine bursa (pes bursa) and the gastrocnemius bursae

Question 18

What are the collateral ligaments of the knee joint?

Answer 18

Lateral (fibular) - Prevents adduction of the leg

Medial (tibial) - Fused to joint capsule and medial meniscus. Prevents abduction of the leg. Injures to this is more common

Question 19

What are the Meninsci and what are their functions?

Answer 19

Two cresent-shaped fibrocartilage (medial and lateral meniscus) Functions - Increase match of articular surfaces, dissipate the forces on articular cartilage, absorb shock, decrease friction, participate in locking of the knees, proprioception.

Question 20

Where are the horns of the menisci attached? and how are they interconnected? How do they move?

Answer 20

• Attached to intercondylar areas of tibial plateau. - Interconnected anteriorly by transverse ligament of knee - Move antero-posteriorly during flexion/extension

Question 21

Describe some of the features of the medial and lateral meniscus?

Answer 21

Medial Meniscus - Attached round its margin to the joint capsule and medial collateral ligament Lateral Meniscuc - Attached to joint capsule but not lateral collateral ligament. Tendon of popliteus muscle attached to lateral meniscus.

Question 22

What is the role of the meniscofemoral ligaments

Answer 22

Extend from posterior horn of lateral meniscus to medial condyle of femur

Question 23

Describe some features of the cruciate ligaments

Answer 23

• Named due to tibial attachment - Anterior cruciate ligament prevents anterior movement of tibia and hyperextension - Posterior cruciate ligament - prevents posterior movement of tibia (when walking down hill) (google image)

Question 24

What is the collodiaphysial angle?

Answer 24

Angle between the long axes of the neck and shaft of femur (normally wider in babies anyways). The types are Coxa vara (small), normal and Coxa valga (large angel)

Question 25

What is the Q angle

Answer 25

The angel between the anatomical axis of the femur and that of the tibia

Question 26

What are the bones of the ankle joint?

Answer 26

Tibia, Fibula and talus. Calcaneus is not considered part of the ankle

Question 27

Describe the collateral ligaments of the ankle

Answer 27

Medial (deltoid) ligaments - Resists dislocation during eversion of foot Lateral ligament - resists over inversion (injury to this ligament is what is known as a sprained ankel)

Question 28

Describe the bones of the foot

Answer 28

• Proximal row; Talus and Calcaneous - Distal row (M to L); Medial cuneiforn, intermediate cuniform, lateral cuniform and cuboid and navicular. Also metatarsals and phalanges.

Question 29

What are the joints and movements of the foot?

Answer 29

• Distal tibiofibular (syndesmosis) - no movement - Ankle - Planterflexion or dorsiflexion Intertarsel (plane joints) - Subtalar, -Transverse tarsal joint (Talo-calcaneo-navicular and calcaneo-cuboid) which do inversion and eversion. - Tarsometatarsal and intermetatarsal (plane) -gliding joints - metatarsophalangeal (condyloid) - flexion,extension, abduction and adduction - Interphalangeal (hinge) - flexion and extension

Question 30

Describe some of the features of the transverse tarsal joint

Answer 30

Two important ligaments support the joints and planter arches; Long plantar ligament and spring ligament (prevents flat foot)

Question 31

Describe features of the plantar arches

Answer 31

They all absorb and distribute downward forces. - Medial longitudinal arch made pf calcaneous, talus, navicular, all cuneiforms and 3 medial metatarsals - Lateral longitudinal arch - Calcaneus, cuboid and 4th and 5th metatarsal - Transverse arch - cuniforms and cuboid

Question 32

What is the site for surgical amputation of foor?

Answer 32

Transverse tarsal joint