Bones and Joints of the Lower Limb Flashcards
1
Q
State the bones of the pelvic girdle
A
Hip bone
Sacrum
Coccyx
2
Q
State the bones of the lower limbs
A
Femur
Patella
Tibia (medially)
Fibula (laterally)
3
Q
State the bones of the foot
A
Tarsal bones (x7)
Metatarsal bones (x5)
Phalanges (x14)
4
Q
Name the 7 Tarsal bones
A
Talus
Calcaneus
Navicular
Cuboid
Medial
Intermediate cuneiform
Lateral cuneiform
5
Q
State the location of the tibia and fibula
A
Located in the leg
Tibia - medially
Fibula - laterally
6
Q
Function of the pelvic girdle
A
Transfers the body weight to the lower limbs.
Provides an almost rigid, complete ring for weight bearing and child birth.
Supports the pelvic organs
Provides muscle attachment for limb movements
7
Q
Key function of the pelvic girdle
A
Attaches the lower limbs to the axial skeleton
8
Q
State the bones which fuse to form the hip bone
A
Ilium
Ischium
Pubic bone
9
Q
Give a brief description of the hip bone
A
Tri-radiate cartilage between the 3 parts of the hip bone.
Cartilage is visible radiologically, but ossifies by LATE TEENS.
10
Q
Where do the hip bones articulate ?
A
Pubic Symphysis
11
Q
State the highest point of the iliac crest
A
At the level of L4 spinous process OR L4/5 disc
12
Q
Describe the orientation of the pelvic girdle
A
Anterior superior iliac spine is on the same coronal plane as the pubic tubercle and pubic crest
13
Q
State the pelvic joints
A
Pubic Symphysis
Sacro-iliac joint
14
Q
Describe the pubic symphysis
A
Secondary cartilaginous joint
Supported by superior and arcuate ligaments
Disc between articular surfaces
15
Q
Describe the sacroiliac joint
A
Synovial anteriorly
Fibrous posteriorly
Supported by anterior and posterior sacroiliac and interosseous ligaments
Iliolumbar ligament
Extremely limited movement
16
Q
What is the pubic symphyses supported by ?
A
Supported by superior and arcuate ligaments
17
Q
What is the sacroiliac joint supported by ?
A
Supported by anterior and posterior sacroiliac and interosseous ligaments
18
Q
State the ligaments that prevent the sacrum from tilting forwards
A
Sacro-spinous ligament
Sacro-tuberous ligament
19
Q
Function of the sacrospinous and sacrotuberous ligaments
A
Prevent the sacrum from tilting forwards
Support the sacroiliac joint
Convert the sciatic notches into greater and lesser sciatic foramina for the passage of nerves and vessels
20
Q
Describe tilting of the sacrum forwards
A
S1 rotated downwards
S4 rotated upwards
21
Q
Function of gateways (i.e. sciatic foramen)
A
Transmit neurovascular bundles
22
Q
What is found in the greater sciatic foramen ?
A
Sciatic
Gluteal
Pudendal
23
Q
What is found in the lesser sciatic foramen ?
A
Pudendal
24
Q
What is found in the obturator foramen (canal) ?
A
Obturator
25
What is found in the femoral ring ?
Femoral
26
Describe the hip joint
Ball and Socket joint
Synovial joint
Very Stable
Limited mobility
27
Function of the acetabulum
Deep socket, weight bearing, stable
Cartilage over lunate surface
The rim is raised by the acetabular labrum
The labrum bridges across the acetabular notch as the transverse acetabular ligament.
28
Describe a tear to the acetabular labrum
The acetabular labrum may tear and cause pain
29
What is the transverse acetabular ligament ?
The labrum bridges across the acetabular notch as the transverse acetabular ligament.
30
Describe the head of the femur
Covered by hyaline cartilage all except for the fovea of the head of femur
31
Another name for the hip joint
Acetabular Femoral Joint
32
Describe the joint capsule of the hip joint
Synovial membrane covers everything except the articular cartilage
It forms a sleeve around the ligament of the head of the femur
33
State the attachments of the joint capsule of the hip joint
Acetabular rim
Transverse acetabular ligament
Intertrochanteric line
Neck of femur
34
Function of the synovial layers of the joint capsule
Sends retinacular fibres medially along the femoral line
35
Function of capsular ligaments of the hip joint
Prevent hyper-extension
Stabilise the joint
Save energy during standing
36
Zona orbicularis
Some deep fibres of the fibrous capsule wind circularly around the neck and form the zona orbicularis
37
What is the ligament of the head of the femur called ?
Ligamentum teres caput femoris
38
State the hip joint ligaments
Ligamentum teres cuput femoris
Zona orbicularis
39
State the capsular ligaments of the hip
Iliofemoral
Pubofemoral
Ischiofemoral
40
Iliofemoral ligament function
Strongest capsular ligament of hip
Prevents hyper-extension of the hip joint during standing
41
Pubofemoral ligament function
Prevents hyper-abduction of hip joint; tightens during abduction and extension of the hip
42
Ischiofemoral ligament function
Weakest capsular ligament of the hip
Prevents excessive internal rotation
43
Shenton's line
Line drawn along the superior pubic ramus continuing along the head and neck of the femur.
If this line is jaded, it is indicative of a fracture
44
Describe the knee joint
| State the 2 joints
2 JOINTS
Joint between the femur and the tibia
AND
Joint between the patella and the femur
45
Function of the knee joint
Free movement in one plane only
Jonit stability
Weight bearing
46
What type of joint is the knee joint ?
Hinge joint
47
Features of the knee joint
Articular surfaces are reciprocally shaped
Strong collateral ligaments
Muscles are grouped at the sides of the joint where they do not interfere with movement
48
State some features of the distal femur
Medial condyle + epicondyle
Lateral condyle + epicondyle
Patellar surface
Popliteal surface
Intercondylar fossa
49
State some features of the distal patella
Base of patella
Lateral articular surface
Apex of patella
50
State some features of the proximal tibia
Lateral condyle
Medial condyle
Intercondylar tubercles
Tibial tuberosity
51
State some features of the proximal fibula
Anterior intercondylar region
Posterior intercondylar region
Medial and lateral tibial plateaus
Intercondylar eminence
52
Describe the knee capsule (fibrous capsule)
Attaches to the articular margins
Incomplete anteriorly
Lined by synovial membrane
53
Describe anterior to the knee capsule
Anteriorly, the fibrous capsule is replaced by the quadriceps tendon (patellar ligament)
The patella and fat pads on either side of the patellar ligament.
54
What is the knee capsule reinforced by ?
| Tract and Retinacula
Reinforced by the iliotibial tract and patellar retinacula from quadriceps.
55
What is the posterior knee capsule reinforced by ?
Reinforced by the :
- Oblique popliteal ligament
- Arcuate popliteal ligament
56
What is the oblique popliteal ligament ?
Expansion of the semimembranous muscle.
57
What is found in the posterior capsule ?
There is an opening in the capsule for the tendon of popliteus.
58
What is found around the knee joint ?
Bursae
59
What are bursae ?
Synovial fluid filled sacs, helping prevent tendons rubbing on bone
OR
Bone and tendons rubbing against superficial structures in the skin.
60
State the bursae found in the knee joint that communicate directly with the articular cavity of the knee joint
Suprapatellar bursa (continuous with the joint capsule, found deep to quadriceps)
Popliteal bursa (continuous with the joint capsule, found underneath popliteus tendon)
61
Location of supra patellar bursa
Continuous with the joint capsule, found deep to quadriceps
62
Location of the popliteal bursa
Continuous with the joint capsule, found underneath popliteus tendon
63
What is a downfall of bursae communicating directly with the articular cavity of the knee joint ?
Potential spread of infection
Spread of inflammation
64
State the other bursae found in the knee joint
Anserine bursa
Gastrocnemius bursa
Infra patellar bursa (deep and superficial)
65
State the collateral ligaments of the knee joint
Lateral (fibular)
Medial (tibial)
66
What is the lateral (fibular) ligament ?
A strong cord from lateral femoral epicondyle to the head of fibula.
Separate from the joint capsule, so is an extrinsic ligament.
67
What is the medial (tibial) ligament ?
A broad, flat band from the medial femoral epicondyle to the tibial condyle.
An intrinsic ligament, as it is fused to the joint capsule and medial meniscus.
68
Function of the lateral (fibular) ligament
Prevents adduction of the leg
69
Function of the medial (tibial) ligament
Prevents abduction of the leg
70
Location of the lateral (fibular) ligament
Tendon of popliteus is between this ligament and capsule
71
Location of the medial (tibial) ligament
Fused to the joint capsule and medial meniscus
72
What happens when you damage the medial collateral ligament ?
You are likely to damage the medial meniscus.
73
Why are injuries to the medial collateral ligament and medial meniscus more common than the lateral equivalents ?
The lateral ligament meniscus isn't anchored.
It is a bit more free to more.
74
Lateral meniscus attachments
The lateral meniscus is attached to the joint capsule but NOT to the lateral collateral ligament.
Tendon of the popliteus muscle attaches to the lateral meniscus
75
What does the tendon of the popliteus muscle attach to ?
Tendon of the popliteus muscle attaches to the lateral meniscus
76
Functions of menisci
Absorb shock
Decrease friction
Participate in locking of knees
Proprioception
Dissipate the forces/stress on articular cartilage
Increases the congruence of articular surfaces
77
What are menisci ?
Crescent shaped fibrocartilage
78
Movement of menisci
Move antero-posteriorly during flexion/extension of the knee
79
How are menisci connected ?
Interconnected anteriorly by the transverse ligament of the knee
80
Describe the blood supply to the menisci
Inner 2/3rds avascualr
Outer 1/3rd partially vascular
81
Problem with menisci
As they are made of cartilage, they are mostly a-vascular.
82
Location of the meniscofemoral ligament
Extends from the posterior horn of the lateral meniscus to the medial condyle of femur.
83
State the cruciate ligaments
Anterior and Posterior cruciate ligaments
84
Function of the cruciate ligaments
Named according to their tibial attachment
Act as a pivot for rotatory movements between the bones.
85
Function of the anterior cruciate ligament
Prevents anterior movement of tibia and hyperextension
86
Function of the posterior cruciate ligament
Prevents posterior movement of the tibia
(as in walking downhill)
87
What is the anterior drawer test ?
Sign showing damage to the anterior cruciate ligament
(tibia moves anteriorly too much)
88
What is the posterior drawer test ?
Sign showing damage to the posterior cruciate ligament
(tibia moves posteriorly)
89
State the angles of the lower limbs
Collodiaphysial angle
Q angle
90
Collodiaphysial angle
The angle between the long axes of the neck and shaft of the femur.
- wider in children
91
Q angle
The angle between the anatomical axis of the femur and that of the tibia
- females have a larger Q
92
Greater Q angle results
Lead to a greater risk of knee injury
93
State some features of the distal tibia
Fibular notch
Medial malleolus
Inferior articular facet
Groove for flexor hallucis longus
Groove for tibialis posterior
94
State some features of the distal fibula
Lateral malleolus
Malleolar fossa
Articular surface
95
What does the ankle joint attach to ?
The talus bone of the foot
96
Describe the talus bone
| Trochlea - superior articular surface
Broad anteriorly: more stable in dorsiflexion
Narrow posteriorly: less stable in plantar flexion
97
What supports the ankle joint ?
Capsule and Ligaments
- Medial (deltoid) ligament
- Lateral ligament
- Loos fibrous capsule
98
Describe the location of the ligaments of the ankle
(collateral) Ligaments of ankle all originate at malleoli and fan out to tarsal bones
99
Function of the medial (deltoid) ligament
Resists dislocation during eversion of the foot
100
Function of the lateral ligament
Resists over-inversion, 3 bands:
- Anterior talofibular
- Posterior talofibular
- Fibulocalcaneal
101
State the 3 parts of the lateral collateral ligaments
- Anterior talofibular
- Posterior talofibular
- Fibulocalcaneal
102
Sprained ankle
Inversion injury of the foot
Land on the lateral border of the foot and foot twists into an inversion position.
103
Why are inversion injuries of the foot more common than eversion injuries ?
You're much more likely to land on the lateral (outside of the foot)
The lateral malleolus sticks down a bit further than the medial malleolus, preventing eversion.
104
Type of joint at the ankle
Hinge joint
Weight bearing
105
Describe movement at the ankle joint
Extension - dorsiflexion
Plantar flexion
106
Malleolar fossa
Recess between the 2 malleoli, supporting the top of the talus.
107
State the order of the tarsal bones of the foot
PROXIMAL ROW:
Talus
Calcaneus
Navicular
Cuboid
DISTAL ROW (medial to lateral):
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
108
Hindfoot
Talus
Calcaneus
109
Midfoot
Navicular
Cuboid
Cuneiforms
110
Forefoot
Metatarsals
Phalanges
111
State the joints of the foot
Transverse tarsal joint
(between head of talus+calcaneus and tails of navicular+cuboid)
Tarsometatarsal joint
(between cuboid+cuneiforms and metatarsals )
112
Movement of distal tibiofibular : syndesmosis
NO movement
helps to stabilise the ankle and foot
113
Movement of ankle: hinge joint
Plantar flexion and dorsiflexion
114
Movement of intertarsal: plane joints
INVERSION AND EVERSION
Subtalar
Talo-navicular
Calcaneo-cuboid
115
State the components of the transverse tarsal joint
Talo-navicular
Calcaneo-cuboid
116
Movement of inter metatarsal and tarsometatarsal: plane joints
Gliding movements
117
Movement of metatarsophalangeal: condyloid joints
Flexion
Extension
Abduction
Adduction
118
Movement of interphalangeal: hinge joints
Flexion
Extension
119
Describe the transverse tarsal joint
Talo-navicular part of the TCN + CC
Enclosed by joint capsule
120
What are the 2 important ligaments that support the joints and plantar arches ?
Long plantar ligament
Spring ligament
121
Function of the spring ligament
(IMPORTANT)
Supports the head of the talus and much of the body weight.
aka calcaneonavicular ligament
122
Function of the transverse tarsal joint
Assists in inversion / eversion
123
What is the transverse tarsal joint the site for ?
Surgical amputation of the foot
