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Medicine Year 1 - Semester 2 - Part 2 > Bones and Joints of the Lower Limb > Flashcards

Bones and Joints of the Lower Limb Flashcards

1
Q

State the bones of the pelvic girdle

A

Hip bone
Sacrum
Coccyx

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2
Q

State the bones of the lower limbs

A

Femur
Patella
Tibia (medially)
Fibula (laterally)

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3
Q

State the bones of the foot

A

Tarsal bones (x7)
Metatarsal bones (x5)
Phalanges (x14)

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4
Q

Name the 7 Tarsal bones

A

Talus
Calcaneus
Navicular
Cuboid
Medial
Intermediate cuneiform
Lateral cuneiform

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5
Q

State the location of the tibia and fibula

A

Located in the leg

Tibia - medially
Fibula - laterally

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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

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7
Q

Key function of the pelvic girdle

A

Attaches the lower limbs to the axial skeleton

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8
Q

State the bones which fuse to form the hip bone

A

Ilium
Ischium
Pubic bone

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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.

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10
Q

Where do the hip bones articulate ?

A

Pubic Symphysis

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11
Q

State the highest point of the iliac crest

A

At the level of L4 spinous process OR L4/5 disc

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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

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13
Q

State the pelvic joints

A

Pubic Symphysis
Sacro-iliac joint

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14
Q

Describe the pubic symphysis

A

Secondary cartilaginous joint

Supported by superior and arcuate ligaments

Disc between articular surfaces

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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

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16
Q

What is the pubic symphyses supported by ?

A

Supported by superior and arcuate ligaments

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17
Q

What is the sacroiliac joint supported by ?

A

Supported by anterior and posterior sacroiliac and interosseous ligaments

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18
Q

State the ligaments that prevent the sacrum from tilting forwards

A

Sacro-spinous ligament
Sacro-tuberous ligament

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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

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20
Q

Describe tilting of the sacrum forwards

A

S1 rotated downwards
S4 rotated upwards

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21
Q

Function of gateways (i.e. sciatic foramen)

A

Transmit neurovascular bundles

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22
Q

What is found in the greater sciatic foramen ?

A

Sciatic
Gluteal
Pudendal

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23
Q

What is found in the lesser sciatic foramen ?

A

Pudendal

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24
Q

What is found in the obturator foramen (canal) ?

A

Obturator

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25
Q

What is found in the femoral ring ?

A

Femoral

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26
Q

Describe the hip joint

A

Ball and Socket joint
Synovial joint

Very Stable
Limited mobility

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27
Q

Function of the acetabulum

A

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.

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28
Q

Describe a tear to the acetabular labrum

A

The acetabular labrum may tear and cause pain

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29
Q

What is the transverse acetabular ligament ?

A

The labrum bridges across the acetabular notch as the transverse acetabular ligament.

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30
Q

Describe the head of the femur

A

Covered by hyaline cartilage all except for the fovea of the head of femur

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31
Q

Another name for the hip joint

A

Acetabular Femoral Joint

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32
Q

Describe the joint capsule of the hip joint

A

Synovial membrane covers everything except the articular cartilage

It forms a sleeve around the ligament of the head of the femur

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33
Q

State the attachments of the joint capsule of the hip joint

A

Acetabular rim
Transverse acetabular ligament
Intertrochanteric line
Neck of femur

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34
Q

Function of the synovial layers of the joint capsule

A

Sends retinacular fibres medially along the femoral line

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35
Q

Function of capsular ligaments of the hip joint

A

Prevent hyper-extension
Stabilise the joint
Save energy during standing

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36
Q

Zona orbicularis

A

Some deep fibres of the fibrous capsule wind circularly around the neck and form the zona orbicularis

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37
Q

What is the ligament of the head of the femur called ?

A

Ligamentum teres caput femoris

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38
Q

State the hip joint ligaments

A

Ligamentum teres cuput femoris
Zona orbicularis

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39
Q

State the capsular ligaments of the hip

A

Iliofemoral
Pubofemoral
Ischiofemoral

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40
Q

Iliofemoral ligament function

A

Strongest capsular ligament of hip

Prevents hyper-extension of the hip joint during standing

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41
Q

Pubofemoral ligament function

A

Prevents hyper-abduction of hip joint; tightens during abduction and extension of the hip

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42
Q

Ischiofemoral ligament function

A

Weakest capsular ligament of the hip

Prevents excessive internal rotation

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43
Q

Shenton’s line

A

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

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44
Q

Describe the knee joint

State the 2 joints

A

2 JOINTS

Joint between the femur and the tibia

AND

Joint between the patella and the femur

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45
Q

Function of the knee joint

A

Free movement in one plane only

Jonit stability

Weight bearing

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46
Q

What type of joint is the knee joint ?

A

Hinge joint

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47
Q

Features of the knee joint

A

Articular surfaces are reciprocally shaped

Strong collateral ligaments

Muscles are grouped at the sides of the joint where they do not interfere with movement

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48
Q

State some features of the distal femur

A

Medial condyle + epicondyle
Lateral condyle + epicondyle

Patellar surface
Popliteal surface
Intercondylar fossa

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49
Q

State some features of the distal patella

A

Base of patella
Lateral articular surface
Apex of patella

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50
Q

State some features of the proximal tibia

A

Lateral condyle
Medial condyle

Intercondylar tubercles
Tibial tuberosity

51
Q

State some features of the proximal fibula

A

Anterior intercondylar region
Posterior intercondylar region

Medial and lateral tibial plateaus

Intercondylar eminence

52
Q

Describe the knee capsule (fibrous capsule)

A

Attaches to the articular margins
Incomplete anteriorly
Lined by synovial membrane

53
Q

Describe anterior to the knee capsule

A

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
Q

What is the knee capsule reinforced by ?

Tract and Retinacula

A

Reinforced by the iliotibial tract and patellar retinacula from quadriceps.

55
Q

What is the posterior knee capsule reinforced by ?

A

Reinforced by the :

  • Oblique popliteal ligament
  • Arcuate popliteal ligament
56
Q

What is the oblique popliteal ligament ?

A

Expansion of the semimembranous muscle.

57
Q

What is found in the posterior capsule ?

A

There is an opening in the capsule for the tendon of popliteus.

58
Q

What is found around the knee joint ?

A

Bursae

59
Q

What are bursae ?

A

Synovial fluid filled sacs, helping prevent tendons rubbing on bone

OR

Bone and tendons rubbing against superficial structures in the skin.

60
Q

State the bursae found in the knee joint that communicate directly with the articular cavity of the knee joint

A

Suprapatellar bursa (continuous with the joint capsule, found deep to quadriceps)

Popliteal bursa (continuous with the joint capsule, found underneath popliteus tendon)

61
Q

Location of supra patellar bursa

A

Continuous with the joint capsule, found deep to quadriceps

62
Q

Location of the popliteal bursa

A

Continuous with the joint capsule, found underneath popliteus tendon

63
Q

What is a downfall of bursae communicating directly with the articular cavity of the knee joint ?

A

Potential spread of infection
Spread of inflammation

64
Q

State the other bursae found in the knee joint

A

Anserine bursa
Gastrocnemius bursa
Infra patellar bursa (deep and superficial)

65
Q

State the collateral ligaments of the knee joint

A

Lateral (fibular)
Medial (tibial)

66
Q

What is the lateral (fibular) ligament ?

A

A strong cord from lateral femoral epicondyle to the head of fibula.

Separate from the joint capsule, so is an extrinsic ligament.

67
Q

What is the medial (tibial) ligament ?

A

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
Q

Function of the lateral (fibular) ligament

A

Prevents adduction of the leg

69
Q

Function of the medial (tibial) ligament

A

Prevents abduction of the leg

70
Q

Location of the lateral (fibular) ligament

A

Tendon of popliteus is between this ligament and capsule

71
Q

Location of the medial (tibial) ligament

A

Fused to the joint capsule and medial meniscus

72
Q

What happens when you damage the medial collateral ligament ?

A

You are likely to damage the medial meniscus.

73
Q

Why are injuries to the medial collateral ligament and medial meniscus more common than the lateral equivalents ?

A

The lateral ligament meniscus isn’t anchored.
It is a bit more free to more.

74
Q

Lateral meniscus attachments

A

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
Q

What does the tendon of the popliteus muscle attach to ?

A

Tendon of the popliteus muscle attaches to the lateral meniscus

76
Q

Functions of menisci

A

Absorb shock
Decrease friction
Participate in locking of knees
Proprioception

Dissipate the forces/stress on articular cartilage

Increases the congruence of articular surfaces

77
Q

What are menisci ?

A

Crescent shaped fibrocartilage

78
Q

Movement of menisci

A

Move antero-posteriorly during flexion/extension of the knee

79
Q

How are menisci connected ?

A

Interconnected anteriorly by the transverse ligament of the knee

80
Q

Describe the blood supply to the menisci

A

Inner 2/3rds avascualr

Outer 1/3rd partially vascular

81
Q

Problem with menisci

A

As they are made of cartilage, they are mostly a-vascular.

82
Q

Location of the meniscofemoral ligament

A

Extends from the posterior horn of the lateral meniscus to the medial condyle of femur.

83
Q

State the cruciate ligaments

A

Anterior and Posterior cruciate ligaments

84
Q

Function of the cruciate ligaments

A

Named according to their tibial attachment

Act as a pivot for rotatory movements between the bones.

85
Q

Function of the anterior cruciate ligament

A

Prevents anterior movement of tibia and hyperextension

86
Q

Function of the posterior cruciate ligament

A

Prevents posterior movement of the tibia

(as in walking downhill)

87
Q

What is the anterior drawer test ?

A

Sign showing damage to the anterior cruciate ligament

(tibia moves anteriorly too much)

88
Q

What is the posterior drawer test ?

A

Sign showing damage to the posterior cruciate ligament

(tibia moves posteriorly)

89
Q

State the angles of the lower limbs

A

Collodiaphysial angle
Q angle

90
Q

Collodiaphysial angle

A

The angle between the long axes of the neck and shaft of the femur.

  • wider in children
91
Q

Q angle

A

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

  • females have a larger Q
92
Q

Greater Q angle results

A

Lead to a greater risk of knee injury

93
Q

State some features of the distal tibia

A

Fibular notch
Medial malleolus
Inferior articular facet

Groove for flexor hallucis longus
Groove for tibialis posterior

94
Q

State some features of the distal fibula

A

Lateral malleolus
Malleolar fossa
Articular surface

95
Q

What does the ankle joint attach to ?

A

The talus bone of the foot

96
Q

Describe the talus bone

Trochlea - superior articular surface

A

Broad anteriorly: more stable in dorsiflexion

Narrow posteriorly: less stable in plantar flexion

97
Q

What supports the ankle joint ?

A

Capsule and Ligaments

  • Medial (deltoid) ligament
  • Lateral ligament
  • Loos fibrous capsule
98
Q

Describe the location of the ligaments of the ankle

A

(collateral) Ligaments of ankle all originate at malleoli and fan out to tarsal bones

99
Q

Function of the medial (deltoid) ligament

A

Resists dislocation during eversion of the foot

100
Q

Function of the lateral ligament

A

Resists over-inversion, 3 bands:

  • Anterior talofibular
  • Posterior talofibular
  • Fibulocalcaneal
101
Q

State the 3 parts of the lateral collateral ligaments

A
  • Anterior talofibular
  • Posterior talofibular
  • Fibulocalcaneal
102
Q

Sprained ankle

A

Inversion injury of the foot

Land on the lateral border of the foot and foot twists into an inversion position.

103
Q

Why are inversion injuries of the foot more common than eversion injuries ?

A

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
Q

Type of joint at the ankle

A

Hinge joint

Weight bearing

105
Q

Describe movement at the ankle joint

A

Extension - dorsiflexion
Plantar flexion

106
Q

Malleolar fossa

A

Recess between the 2 malleoli, supporting the top of the talus.

107
Q

State the order of the tarsal bones of the foot

A

PROXIMAL ROW:

Talus
Calcaneus

Navicular
Cuboid

DISTAL ROW (medial to lateral):

Medial cuneiform
Intermediate cuneiform
Lateral cuneiform

108
Q

Hindfoot

A

Talus
Calcaneus

109
Q

Midfoot

A

Navicular
Cuboid
Cuneiforms

110
Q

Forefoot

A

Metatarsals
Phalanges

111
Q

State the joints of the foot

A

Transverse tarsal joint
(between head of talus+calcaneus and tails of navicular+cuboid)

Tarsometatarsal joint
(between cuboid+cuneiforms and metatarsals )

112
Q

Movement of distal tibiofibular : syndesmosis

A

NO movement

helps to stabilise the ankle and foot

113
Q

Movement of ankle: hinge joint

A

Plantar flexion and dorsiflexion

114
Q

Movement of intertarsal: plane joints

A

INVERSION AND EVERSION
Subtalar
Talo-navicular
Calcaneo-cuboid

115
Q

State the components of the transverse tarsal joint

A

Talo-navicular
Calcaneo-cuboid

116
Q

Movement of inter metatarsal and tarsometatarsal: plane joints

A

Gliding movements

117
Q

Movement of metatarsophalangeal: condyloid joints

A

Flexion
Extension
Abduction
Adduction

118
Q

Movement of interphalangeal: hinge joints

A

Flexion
Extension

119
Q

Describe the transverse tarsal joint

A

Talo-navicular part of the TCN + CC

Enclosed by joint capsule

120
Q

What are the 2 important ligaments that support the joints and plantar arches ?

A

Long plantar ligament
Spring ligament

121
Q

Function of the spring ligament

(IMPORTANT)

A

Supports the head of the talus and much of the body weight.

aka calcaneonavicular ligament

122
Q

Function of the transverse tarsal joint

A

Assists in inversion / eversion

123
Q

What is the transverse tarsal joint the site for ?

A

Surgical amputation of the foot

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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