Bones and Joints of extremities Flashcards
os coxae
the bones of the pelvis, and they are formed by three separate bones that fuse during development.
- the ilium
- ischium
- pubis.
ilium
is the most superior of the bones of the os coxae
ischium
the posteroinferior bone of the os coxae
contains the ischial tuberosity
ischial tuberosity
We bear weight on our ischial tuberosity every time we sit
pubis
the anteroinferior bone of the os coxae
femur
the longest bone in our body
- It is located between the hip and the knee
- contains the trochanter
femoral head
articulates with the acetabulum of the os coxae to form the hip joint.
fovea
the attachment point for the ligament of the head of the femur or the ligamentum teres
greater trochanter and lesser trochanter
are large sites of muscle attachment on the proximal aspect of the bone.
medial and lateral epicondyles of femur
attachment sites on the lateral sides of distal aspect of the femur
medial and lateral condyles of the femur
articulate with the tibia to form the knee joint
patella
a triangular-shaped sesamoid bone that sits within the tendon of the quadriceps muscle
- only articulates with the femur
sesamoid bone
a bone that is located within a tendon
- the patella is an example of this
medial and lateral articular facets of the patella
the posterior surfaces that articulate with the femur
tibia
a bone of the lower leg
- carries most of our weight
- articulates with the talus inferiorly
- this is the medial bone parallel to the fibula
fibula
a bone of the lower leg
- carries at most 12 percent of our weight
- articulates with the talus inferiorly
- this is the lateral bone
medial and lateral tibial condyles
Superiorly they articulate with the femur
- also known as the tibial plateau
lateral malleolus
the lateral protrusion at the ankle of the fibula
medial malleolus
the medial protrusion at the ankle of the tibia
Interosseous membrane
holds together the tibia and fibula
-this is located between the two bones
tarsal bones
- these form posterior aspect of the foot
- seven of them
intertarsal joints
located between the tarsal bones.
tarsometatarsal joints
located between the cuneiforms or cuboid and the metatarsals
metatarsophalangeal joints
located between the metatarsals and the phalanges.
hallux
the first toe
- this has a proximal and a distal phalanx
linea aspera
this is a line on the posterior side of the femur that serves as an attachment site for many muscles
- as it moves inferiorly, it divided into two lines (the lateral supracondylar line and the medial supracondylar line
intercondylar fossa
this is the space between the femurs two condyles at the distal end
sacroiliac joint
- the joint between the sacrum and ilium
- this is a synovial joint
- It is a highly-stable joint capable of only a small amount of gliding movement.
- This is where the lower extremity meets the spinal column
- the large surface area of the articulation site for this joint is what contributes to its stability
pubic symphysis
is located between the right and left pubic bones.
- a thick fibrocartilaginous disc between the two pelvic bones at this location.
- absorbs shock and provides support
coxal hip joint
- a multiaxial ball and socket joint
- this is a joint designed for mobility while remaining stable
- contains the acetabulum
- contains the iliofemoral, ischiofemoral, and pubofemoral ligaments to contribute to the stability of the joint
- also contains the ligamentum teres
ligamentum teres
- this is the ligament to the head of the femur
- contains the artery to the head of the femur
acetabulum
a concave socket on the lateral surface of the hip bone
- a lunate surface
- the ischium, pubis and the illium all contribute to the formation of this
lunate surface
a curved articular surface
acetabular notch
a deep notch in the acetabulum of the hip bone.
is continuous with a circular non-articular depression
patellar surface
The front part of the lower end of femur is named the patellar surface and articulates with the patella
angle of inclination
The angle between the neck of the femur and the long shaft of the femur.
the normal adult has an angle of inclination of 125
this angle alters the movement of the lower limb and thus the kinetic chain
women tend to have a slightly smaller angle due to a wider pelvis
medial and Lateral supracondylar lines
the medial and lateral ridge of the popliteal surface
pes anserine insertion
this is a sit on the medial side of the tiba where tendons insert
gerdy’s tubercle
a smooth facet on the lateral aspect of the upper part of the tibia, just below the knee joint
tibial tuberosity
an elevation on the proximal, anterior aspect of the tibia,
When does the os coxae fuse
this occurs around 13-15 years of age
what is the difference between the bones of the lower limbs and the upper limbs
the bones of the lower limbs are stronger and thicker than the upper limb because these bone need to be able to bare the weight of the body
how does the sacroiliac joint change throughout our lifetime
with pregnancy, the ligaments slacken and this allows for more loose attachment and more movement
with age: adhesions can occur or ossification and this can prevent the joint from moving the way it should
what is important to remember about the greater and lesser sciatic foramen
these are not actually holes in the bone, the bone has the greater and lesser sciatic notches and then ligaments that are attached at these locations then make the structure a foramen
pelvis
this is the sacrum + the os coxae
greater pelvis
this opens up anteriorly and is between the ala of the two illiums
lesser pelvis
this is the inferior portion of the pelvis
- this is mostly surrounded by bone (the pubic bone, the sacrum etc)
pelvic outlet
this is the exit from the lesser pelvis
- this is between the inferior aspect of the pubic bone and the coccyx posteriorly
pelvic inlet
this is the entrance into the lesser pelvis from the greater pelvis and this runs around the pelvic brim
what are differences between male and female pelves
- women have adaptations for childbearing:
- relatively broad and low pelvis
- illia that project father laterally
- less curvature on the sacrum and the coccyx
- wider, more circular pelvic inlet
- enlarged pelvic outlet
- broader pubic angle
(the last four are all to allow for an easier passage of the fetus during childbirth)
coxa valga
this is an angle of inclination that is greater than 125
this could be 140
coxa vara
this is an angle of inclination that is less than 125
this could be 105
kinetic chain
this is referring to how movement at one joint affects the movement at other joints
movements at the hip can affect the way the knee moves or the ankle or the foot with each step
movements of the foot or ankle can also affect the way the knee moves or the hip or even the spinal cord
these are all connected via the kinetic chain and it is important to remember that pain in one location may be due to an altered movement somewhere else.
medial meniscus
sits on top of the medial tibia
- functions to cushion and act as a shock absorber for the knee
- c shaped
lateral meniscus
sits on top of the lateral tibia
- functions to cushion and act as a shock absorber for the knee
- o shaped
medial collateral ligament
- attaches to the medial side of the inferior end of the femur and the medial side of the superior tibia
- prevents movement of the knee joint in the response to valgus forces
- this is tight to the medial joint line and the medial meniscus
- is attached to the articular capsule so it has a better blood supply than the LCL
lateral collateral ligament
-attaches to the lateral side of the inferior end of the femur and the lateral side of the superior tibia
prevents movement of the knee joint in the response to varus forces
- this is further from the joint and inserts on the fibula
anterior cruciate ligament (ACL)
within the joint capsule but not in the synovial capsule
- runs from the inner surface of the lateral femoral condyle, wraps around the PCL, and inserts onto the anterior intercondylar area of the tibia
- prevents anterior movement of the tibia on the femur
- has more stresses place on it than the PCL
posterior cruciate ligament (PCL)
- within the knee joint itself
- runs from the inner surface of the medial femoral condyle to the posterior intercondylar area of the tibia
- prevents posterior movement of the tibia on the femur
- this is stronger and thicker than the ACL
what is the white zone of the meniscus
this is the inner portion that does not have vasculature and when there is a tear or damage here, the surgeon often has to remove the region because it does not heal well without blood supply
what is the red zone of the meniscus
this is the outer portion of the meniscus that has vasculature and this portion heals better so a surgeon can stitch back together
what is the benefit of having the menisci
these deepen the articular surfaces and allow for shock absorption
- they allow for a more rounded surface for the femur to articulate with
valgus forces
- knee bends inward in the coronal plane and opens the medial joint space
- when the lateral aspect of the knee is hit
varus forces
- would result in the knee bending out laterally in the coronal plane and opening of the lateral joint space.
infrapatellar fat pad
this is to provide cushioning and protection around the anterior aspect of the knee
prepatellar bursa
prevents friction over the patella
bursa
there are 12 bursa around the knee
- these are fluid filled sacs that prevent friction and allow for smooth movement of one structure over the other
genu varum
these are when the Knees appear abducted as if a force is being applied to the medial aspect of the knee
this puts more pressure on the LCL and puts more pressure on the medial aspect of the knee as more of the body weight is being place on that side of the knee
genu valgum
these are when the knees appear more adducted as if a force is being applied to the lateral aspect of the knee
this puts more pressure on the MCL and puts more pressure on the lateral aspect of the knee as more of the body weight is being place on that side of the knee
what causes genu valgum or varum
- this is chronic poor alignment and this can affect the kinetic chain
- this is when the femoral head is not centered over the knee joint like we want it to be normally
- this can lead to chronic issues at the knee or along other sections of the kinetic chain
deltoid ligament
this is on the medial side of the ankle
-this is made of several ligaments
- this is a strong ligament that is not prone to injury
anterior talofibular ligament
this is the ligament connecting the fibula to the talus bone on the anterolateral surface
- commonly injured with eversion ankle sprains
- plantarflexion puts most stress on the anterior talofibular ligament and this is the weakest position of the ankle
anterior and posterior tibiofibular ligament
-this connects the tibia and the fibula at the inferior end
calcaneofibular ligament
-this connects the calcaneus and the fibula
talocrural joint
this is the ankle joint
- this is a hinge joint composed of two articulations (between the tibia and talus and the fibula and lateral talus
high ankle sprain
an injury to the tibiofibular ligament
- this can take longer to heel because they are under constant stress everytime we bear weight
why is range of motion is greater with inversion rather than eversion
- the lateral malleolus of the fibula travels further inferiorly than the medial malleolus of the tibia
- this is also why you are more likely to sprain an ankle with inversion rather than eversion
calcaneus
- this is the heel bone
- weight is transferred here and then to the ground
talus
this transfers weight anteriorly from the tibia to toes
- the most important distal tibial joint is between the tibia and the talus
- this articulation is capable of dorsiflexion and plantar flexion but not inversion and eversion
cuboid
on the lateral side; this articulates with the calcaneus
navicular
on the medial side; this articulates with talus and the three cuneiform bones
- this is important for maintaining the arch of the foot
- this has a poor blood supply and doesn’t heal very well or quickly
- common to fracture this and the fracture must be managed appropriately and given time to heal properly
metatarsals
these are the 5 long bones between the instep and the toes that form the distal portion of the foot
- the first three articulate with the 3 cuneiform bones
- the last two articulate with the last two cuneiform bones
all of them articulate with a different proximal phalanx at the distal end
phalanges
there are 14 of these
- the hallux has two and every other toe has three
longitudinal arch
- this is where weight transfer occurs
ligaments and tendons tie the calcaneus to distal portion of the metatarsal - the lateral (calcaneal) portion of the arch carries most of the weight of the body while standing
- medial (talar) portion is more elastic and remains elevated to have the muscles nerves and blood vessels supplying the foot not be squeezed
arches of the foot
these help prevent pinching of muscles, nerves and blood vessels
- spring and lever for walking and running
there are three major arches:
- medial, lateral, transverse
medial
from heel to hallux; this is the highest arch
lateral
from the heel to fifth toe; lowest arch
transverse
perpendicular to other arches; alone distal rows of tarsals
what happens in variations in the arches
- if the arches are higher or lower than they should be they can cause issues in the kinetic chain (changes the biomechanics of the kinetic chain)
- this is particularly true for the medial arch
pes planus
this is flat footed
- a very low medial arch
pes cavus
- this is having a small cave under the food
- this is a higher than normal medial arch
