Bones And Joints Of Lower Limb Flashcards
Where does the head of the femur articulate with the pelvis?
Acetabulum
Which 2 parts come together to form the linea aspera?
Pectineal line and gluteal tuberosity
Is the linea aspera on the anterior or posterior femur?
Posterior
Is the intertrochanteric crest on the anterior or posterior femur?
Posterior
Which side of the distal femur is the adductor tubercle on?
Medial side
The medial malleolus is formed from which bone?
Tibia
The lateral malleolus is formed from which bone?
Fibula
Name the proximal tarsals
Talus
Calcaneus
Name the intermediate tarsal
Navicular
Name the distal tarsals
Cuboid
3 Cuneiforms
How many tarsal do we have per foot?
7
Where does the greater sciatic foramen run?
Down the lateral aspect of the ilium and round the posterior of the acetabulum
What is the Pes Anserinus?
Conjoined tendons of 3 muscles that insert on the anterior, medial, proximal tibia
3 muscles: sartorius, gracilis and semitendinosus
What shape is the ligament to the head of the femur?
Triangular
What is special about the ligament of the head of the femur?
Contains small arterial blood supply to the head of the femur
Which 3 parts of the pelvis come together at the acetabulum?
Ilium
Ischium
Pubis
What do we call the part of the acetabulum where it is incomplete inferiorly?
Acetabular notch
Which ligament supports the inferior part of the acetabulum?
Transverse acetabular ligament
Which 3 ligaments reinforce the joint capsule of the hip?
Iliofemoral
Pubofemoral
Ischiofemoral
Describe the iliofemoral ligament
Y shaped One of the strongest ligaments in the body Ilium to intertrochanteric line Prevents hyperextension Reinforces anterior and superior portion
Describe the pubofemoral ligament
Attaches to pubic bone and femur
Protects anteriorly
Prevents over abduction
Describe the ischiofemoral ligament
Posterior
Weakest of the 3
Ischium to the femur
Limits extension
Of the quadriceps, which is the only one that can exert an affect on the hip?
Rectus femoris
Name the main hip flexors
Iliopsoas
Rectus femoris
Sartorius
Name the adductors of the hip
Adductor magnus Adductor longus Adductor brevis Pectineus Gracilis Obturator externus
Which nerves supply the hip joint and at which faces?
Femoral nerve = anterior
Nerve to quadratus femoris = posterior
Obturator nerve = inferior
Gluteal superior nerve = superior
What is the major source of blood supply to the hip?
Medial circumflex femoral artery
Lateral circumflex femoral artery
What is the minor blood supply to the hip?
Obturator artery via ligament of head of femur
Which type of femoral fractures are more likely to result in avascular necrosis?
Intra capsular
Define ankylosis
Stiffness of a joint due to abnormal adhesion
What is between the condyles of the femur anteriorly and posteriorly?
Anterior = shallow depression for patella articulation Posterior = deep notch: intercondylar fossa
Which condyle of the femur takes more weight when the knee is locked?
Medial condyle
Where is the adductor tubercle of the femur?
At the medial epicondyle
Describe the menisci of the knee
Crescenteric plates of fibrocartilage
Thicker at the edges
Attached to intercondylar areas, attached to joint capsule and anteriorly connected by transverse ligament of the knee
Why do we need knee menisci?
Act as shock absorbers
Deepen surface for articulation
How does the lateral meniscus of the knee vary from the medial meniscus?
Almost O shaped
More mobile than the medial meniscus
Attachments to the tibia are closer together
Less likely to tear
Why is a meniscal tear more likely to heal if it is on the edge?
Menisci have better outer blood supplies so a tear on the periphery is more likely to heal
Which ligaments of the knee are intra capsular?
Cruciates (anterior and posterior)
Which ligament of the knee strengthens the capsule?
Oblique popliteal ligament
How do we remember the course of the cruciates?
PAMs APLs
Describe the anterior cruciate ligament
Weaker than posterior
Relatively poor blood supply
Limits hyperextension
Describe the posterior cruciate ligament
Stronger than anterior
Limits hyperflexion
Main stabiliser in weight bearing when knee is flexed
Which muscle unlocks the knee?
Popliteus
Describe the ‘Unhappy Triad’ of damage at the knee
Injury to medial collateral ligament, medial meniscus and anterior cruciate ligament
How do we test for cruciate damage?
Anterior and posterior draw sign
How does the patella usually dislocate?
Laterally
Which are the 3 bursae in which bursitis commonly occurs at the knee?
Supra-patellar
Pre-patellar
Superficial infra-patellar
Which bursa is inflamed in ‘housemaid’s knee’?
Pre-patellar
Which bursa is inflamed in clergyman’s knee?
Superficial infra-patellar
Define avulsion
Fragment of bone pulled from main body by tendon or ligament
When might ischial tuberosity avulsion occur?
In sports needing rapid contration and relaxation of the hamstrings
eg. Sprinting
Where is the gluteal tuberosity of the femur?
Posterior, lateral
Where is the pectineal line of the femur?
Posterior, medial
What attaches to the intercondylar fossa of the femur?
Cruciate ligaments
What is the main blood supply to the head of the femur?
Medial circumflex artery
Where does the patella ligament attach?
Tibial tuberosity
What is the innervation of the hip?
Anterior: femoral and obturator nerves
Posterior: superior gluteal nerve and nerve to quadratus femoris
What are the main medial rotators of the thigh?
Semimembranosus
Semitendinosus
What are the main lateral rotators of the thigh?
Gluteus maximus
Biceps femoris
(The larger muscles laterally rotate the thigh)