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MSK anatomy > Bones And Joints Of The Proximal Lower Limb > Flashcards

Bones And Joints Of The Proximal Lower Limb Flashcards

1
Q

What composes the pelvis

A

A bony ring formed by the articulation of the left and right innominate (hip) bones and the sacrum

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2
Q

Acetabulum

A

Where the 3 bones of the hip fuse

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3
Q

3 bones of the hip

A

Pubic bone
Ilium
Ischium

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4
Q

What do the hip bones articulate with anteriorly

A

Each other at the pubic symphysis

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5
Q

What do the hip bones articulate with posteriorly

A

The sacrum at the sacroiliac joints

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6
Q

What surrounds the obturator Foramen

A

Superior and inferior pubic rami

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7
Q

Obturator canal

A

A small gap in the membrane and muscles that cover the obturator Foramen that allows vessels and nerves to pass between the pelvis and thigh

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8
Q

Iliac crest

A

Uppermost part of the ilium

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9
Q

2 key bony prominences of the ischium

A

Ischial spine
Ischial tuberosity

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10
Q

Ischial spine

A

Where the Sacrospinous ligament attaches

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11
Q

Ischial tuberosity

A

Where the sacrotuberous ligament attaches as well as muscles of the posterior thigh

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12
Q

Where do muscles of the posterior thigh attach to

A

Ischial tuberosity

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13
Q

What forms the greater and lesser sciatic foramina

A

Greater and lesser sciatic notches of ischium
Sacrotuberous and Sacrospinous ligaments

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14
Q

Function of the greater and lesser sciatic foramina

A

Allow structures to pass between the pelvis and the gluteal region and perineum

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15
Q

What is the long bone of the thigh

A

Femur

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16
Q

Parts of the femur

A

Head
Neck
Shaft
2 condyles at distal end

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17
Q

What does the head of the femur articulate with

A

Acetabulum of the pelvis = hip joint

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18
Q

Location of neck of femur

A

Extends laterally and distally from the head

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19
Q

Greater and lesser trochanters of femur

A

Located distal to neck
Sites of muscle attachment

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20
Q

Intertrochanteric line

A

Between the greater and lesser trochanters on anterior surface of femur

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21
Q

Linea aspera

A

Bony vertical ridge on posterior aspect of shaft of femur
Site of muscle attachment

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22
Q

Gluteal tuberosity

A

Located just inferior to the trochanters in posterior aspect of femur
Site of muscle attachment

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23
Q

What are the sites of muscle attachment on the femur

A

Linea aspera
Gluteal tuberosity
Greater and lesser trochanters

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24
Q

Medial and lateral femoral condyles

A

Distal end of femur
Articulate with the proximal tibia

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25
Q

Adductor tubercle location

A

Superior to the medial femoral condyle

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26
Q

Patella location

A

Anterior to knee joint

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27
Q

What type of joint is the hip joint

A

Synovial ball and socket

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28
Q

Which bones form the hip joint

A

Articulation between the acetabulum of the hip (innominate) bone and the femoral head

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29
Q

Stability of the hip joint

A

Stable as the acetabulum is deep and a good fit between it and the femoral head
Acetabular labrum
Ligaments

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30
Q

Acetabular labrum

A

A rim of fibrocartilage which deepens the acetabulum for even more stability at the hip joint

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31
Q

Ligament of the head of the femur

A

A weak ligament that attaches the femoral head to the centre of the acetabulum

32
Q

Arteries to the hip joint

A

Medial and lateral circumflex femoral arteries

33
Q

What do the medial and lateral circumflex femoral arteries arise mainly from

A

Profunda femoris

34
Q

What do the medial and lateral circumflex femoral arteries give rise to

A

Retinacular arteries

35
Q

Retinacular arteries

A

Run along the neck of the femur to supply the femoral head

36
Q

Which muscles of the thing flex the hip joint

A

Anterior

37
Q

Which muscles of the thing adduct the hip joint

A

Medial

38
Q

Which muscles of the thing extend the hip joint

A

Posterior

39
Q

Which muscles of the thing extend, abduct and rotate the hip joint

A

Gluteal region

40
Q

Which ligaments stabilise the hip joint

A

Iliofemoral
Pubofemoral
Ischiofemoral

41
Q

Which hip ligaments are anterior

A

Iliofemoral
Pubofemoral

42
Q

Which hip ligaments are posterior

A

Ischiofemoral

43
Q

What type of joint is the knee joint

A

Synovial hinge joint

44
Q

Which bones form the knee joint

A

Femoral condyles and tibial condyles

45
Q

Tibial plateaus

A

Flat surface on the most superior aspect of the tibial condyles

46
Q

When is the best fit of the knee joint achieved

A

When knee is extended

47
Q

What helps us stand for long periods of time

A

Femur rotates slightly as the knee reaches full extension
Knee ‘locks’ in place and becomes very stable

48
Q

What muscle is responsible for unlocking the knee and rotating the femur back again

A

Popliteus

49
Q

What contributes to stability of the knee joint

A

Muscles
Tendons
Cartilage
Ligaments
Iliotibial tract

50
Q

Where does the iliotibial tract attach

A

Lateral aspect of tibia

51
Q

Menisci

A

C-shaped cartilage that sit in the tibial plateaus
Wedge-shaped with the thickest part at the periphery and thinnest part in the centre

52
Q

Menisci function

A

Act to deepen the tibial condyles for articulation with the femoral condyles- improving the fit

53
Q

Medial meniscus

A

Attached to the joint capsule along its peripheral margin and is attached to the medial collateral ligament

54
Q

Lateral meniscus

A

Not attached to the lateral collateral ligament (fibular)

55
Q

Which meniscus is more prone to injury

A

Medial if knee is twisted due to attachments

56
Q

Ligaments of the knee

A

Collateral
Cruciate

57
Q

Function of medial and lateral collateral ligaments

A

Support the knee and resist sideways movement of the tibia on the femur

58
Q

What does the medial collateral ligament connect

A

Femur to tibia

59
Q

What does the lateral collateral ligament connect

A

Femur to fibula

60
Q

Attachment of the anterior cruciate ligament

A

Anterior part of intercondylar area of the tibia
Medial aspect of the lateral condyle of the femur

61
Q

Function of anterior cruciate ligament

A

Prevents the tibia moving anteriorly relative to the femur

62
Q

Attachments of the posterior cruciate ligament

A

Posterior part of the intercondylar area of the tibia
Lateral aspect of the medial condyle of the femur

63
Q

Function of posterior cruciate ligament

A

Prevents the tibia moving posteriorly relative to the femur
Important in stability of knee when walking downhill or downstairs

64
Q

Neck of femur fracture

A

A ‘fractured hip’ refers to a fracture of the femoral neck. This is very common in the elderly population and can be caused even by a low energy fall. Osteoporosis is often a contributing factor. Patients typically have pain in the groin and are unable to bear any weight on the affected leg. The typical finding on examination is shortening and external rotation of the affected limb compared to the uninjured limb. The fracture may tear the vessels that supply the femoral head and neck, leading to avascular necrosis of the femoral head.

65
Q

Patellar dislocation

A

Dislocation of the patella is common. Dislocation is almost always lateral because the femur is angled obliquely relative to the tibia and so the angle of the pull of quadriceps is also oblique. The distal fibres of vastus medialis are arranged horizontally and these usually resist lateral movement of the patella. Additionally, the patellofemoral joint has a larger ridge laterally in an attempt to resist to lateral dislocation. Dislocated patellae are relatively easy to relocate and often simply require extension of the leg at the knee, and a small push on the patella.

66
Q

Osteoarthritis of the hip and knee joints

A

Osteoarthritis of the hip joint and knee joint is very common. It causes progressive pain and limited mobility. Hip and knee replacements are two of the most common surgical procedures undertaken in the UK.

67
Q

Posterior dislocation of the hip

A

Dislocation of the hip requires significant force because the joint is very stable. Posterior dislocation of the femoral head tends to occur in car accidents when the knee forcibly impacts the dashboard. The force is transmitted along the femur and the head is forced posteriorly. The acetabulum may fracture. A posterior dislocation risks injury to the sciatic nerve, which is located just behind the hip joint.

68
Q

Meniscal and ligament injuries at the knee

A

The menisci can be torn by twisting injuries of the knee. Tears of the medial (tibial) collateral ligament result from a lateral blow to the knee or twisting injuries. Because it is attached to the medial meniscus, the meniscus may also tear. Anterior cruciate injury is typically also caused when there is a lateral blow to a partially flexed knee. In some cases, all three of these structures can be damaged in a single injury, and this is known as the ‘unhappy triad of the knee’. It is most often seen as a sporting injury, particularly amongst those who play football or rugby. Ligament injuries cause instability of the joint.

69
Q
  1. Which vessels supply blood to the head of the femur? What results if these vessels are disrupted by a fracture of the femoral neck?
A

Medial and lateral circumflex arteries
Artery of Ligamentum teres

-head undergoes avascular necrosis

70
Q
  1. What are the functions of the cruciate ligaments?
A

Stability of the knee
Anterior- resists anterior movement of tibia relative to femur
Posterior- resists posterior movement of tibia relative to femur

71
Q
  1. Which ligaments prevent sideways forces to the knee?
A

Medial and lateral collateral ligaments

72
Q
  1. Which movements of the knee are the anterior and posterior cruciate ligaments supposed to prevent?
A

Anterior - hyperextension
Posterior- hyperflexion

73
Q

What are the names of the two large ligaments on the posterior pelvis? What do that attach to?

A

Sacrospinous ligament- sacrum to spine of ischium
Sacrotuberous ligament - sacrum to Ischial tuberosity

74
Q
  1. What is the name of the foramen formed by the ilium and the sacrospinous ligament?
A

Greater sciatic foramen

75
Q
  1. What is the ‘textbook’ resting position of the lower limb in a patient with a fractured neck of femur?
A

Shortened and laterally rotated

76
Q
  1. What mechanisms resist dislocation of the patella? (Lateral movement)
A

Distal fibres of the vastus medialis are orientated almost horizontally pulling the patella medially
Lateral part of the patella groove of the femur is more prominent than the medial part

77
Q

Why does the knee tend to dislocate laterally

A

Femur is orientated obliquely relative to the tibia
Pull of quadriceps is lateral

MSK anatomy (13 decks)

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