bones & joints of thigh & leg Flashcards
how to orient coxal bones
ASIS and pubic tubercles lie in the same frontal plane, ASIS & PSIS lie in the same horizontal plane
features of the acetabulum
lunate surface with hyaline cartilage, acetabular fossa with a fat pad for proprioception and synovial fluid, acetabular labrum (fibrocartilage), acetabular notch
ligaments of the acetabulum
transverse acetabular ligament (bridges the notch, ligamentum teres (transverse acetabular ligament to fovea capitis of femur)
which bony landmarks of the femur are found ONLY posteriorly
intertrochanteric crest, quadrate tubercle, gluteal tuberosity, trochanteric fossa, pectineal line, linea aspera, intercondylar fossa/notch
which bony landmarks of the femur are found ONLY anteriorly
intertrochanteric line, trochlear/intercondylar groove
which tendon is the patella embedded in
quadriceps tendon
patellofemoral joint: how does the patella articulate with the femur
medial and lateral facets of the posterior surface of patella articulate with medial and lateral condyles of the femur
functions of patellofemoral joint
- increases leverage of quadriceps tendon
- centralizes the forces of the 4 quads into one direction of pull
- reduces friction and compression
- contributes to knee joint stability
- provides protection from direct trauma to the femoral condyles when knee is flexed
which bony landmarks of the tibia are only found posteriorly
soleal/oblique line, malleolar groove (for tibialis posterior tendon and flexor digitorum longus tendon)
which bony landmarks of the tibia are only found anteriorly
tibial tuberosity, gerdy’s tubercle (lateral condyle), Pes anserine
which leg bone articulates with the femur
tibia
where on the fibula is the fibular/peroneal groove found
posterior distal end
proximal tib/fib joint: how do the bones articulate
synovial planar/gliding joint. flat facet of fibula head articulates with posterior lateral aspect of lateral condyle of tibia
middle tib/fib joint classification
fibrous, syndesmosis, amphiarthrotic
articulating surfaces of the knee joint (3 joints within a joint)
medial tibiofemoral, lateral tibiofemoral, patellofemoral. single synovial cavity for all 3. modified (complex) hinge joint. biaxial (flexion, axial rotation).
patellofemoral joint classification
synovial, gliding/planar. intercondylar/trochlear groove of femur to posterior patella. thick articular cartilage on both surfaces.
tibiofemoral (medial and lateral) joint classification
synovial, condylar. articulation between medial and lateral femoral and tibial condyles.
extracapsular ligaments of the knee joint
medial and lateral patellar retinacula, patellar ligament, oblique and arcuate popliteal ligaments, medial and lateral collateral ligaments
patellar retinacula (lateral and medial patellar retinaculum) features
extracapsular fibrous expansion that attaches to tibial condyles. stabilizes patella.
patellar ligament
extracapsular. continuation of quadriceps tendon. extends to tibial tuberosity. strengthens anterior joint.
oblique popliteal ligament (attachments)
extracapsular. lateral condyle of femur to medial condyle of tibia. expansion of semimambranosus muscle. strengthens posterior joint capsule.
arcuate popliteal ligament (attachments)
extracapsular. lateral condyle of femur to head of fibula. strengthens posterolateral joint.
tibial collateral ligament (MCL)
extracapsular. flat, triangular band. attaches to the edge of medial meniscus and joint capsule. connects medial femoral condyle to medial shaft of tibia. prevents valgus stress.
fibular collateral ligament (LCL)
extracapsular. connects lateral femoral condyle to fibular head. does not contact meniscus. lateral surface of tib/fib joint. protects knee in flexion and varus stress.
intracapsular ligaments of the knee joint
anterior and posterior cruciate ligaments (ACL, PCL), medial and lateral meniscus, coronary ligament, transverse ligament, posterior meniscofemoral ligament
anterior cruciate ligament (ACL)
intracapsular but extrasynovial. posterolateral from anterior tibia (intercondylar area) to posterior femur (medial surface of lateral condyle). runs obliquely. limits hyperextension of knee. prevents anterior displacement of tibia on femur.
posterior cruciate ligament (PCL)
intracapsular but extrasynovial. runs anteromedial from posterior tibia (intercondylar area) to anterior femur (lateral surface of medial condyle). runs more vertically than ACL. thicker and stronger than ACL. prevents posterior displacement of tibia on femur.
medial and lateral menisci
Fibrocartilage articular discs on tibia. Semi lunar shape but medial is more open (c-shaped) than lateral. Medial meniscus is more fixed, therefore more commonly injured. Provides stability (deepens knee joint). Helps with shock absorption + force distribution. Joint lubrication.
Transverse ligament of knee
Intracapsular. Supports meniscus. Connects anterior horns of medial + lateral menisci
Coronary/meniscotibial ligament
Intracapsular. Supports meniscus. Anchors the lateral rim of each meniscus to the tibia and joint capsule.
Posterior meniscofemoral ligament
Intracapsular. Supports meniscus. Connects lateral meniscus to medial condyle of femur near the PCL
Anterior bursa of knee
Prepatellar, infrapatellar, suprapatellar, semimembranous
Which 3 ligaments are affected by the unhappy triad injury
Acl, mcl, medial meniscus- lateral blow to knee with foot planted.
Q-angle
Frontal plane angle between femur and tibia shafts
Which bones does calcaneus articulate with
Superiorly between calcaneus and talus (subtalar joint). Anteriorly between calcaneus and cuboid (part of transverse tarsal joint)
articular surfaces of calcaneus
Anterior (cuboid), posterior (calcaneal/achilles tendon attaches), superior (3 articular facets for the talus separated by the calcaneal sulcus/ sinus tarsi). Inferior ( weight bearing tuberosity w/ anterior, medial, and lateral tubercle /process). Medial (sustentaculum tali/talar shelf- spring ligament attaches). lateral (peroneal tubercle separates peroneus longus and brevis tendons)
Which bones form the ankle joint
Talus articulates superiorly with tibia and fibula to form the ankle joint.
Which bones does talus articulate with
Navicular @ the head, calcaneus inferiorly, tib/fib superiorly
Which tarsal bone has no muscular attachments and has 60% of its surface covered with articular cartilage
Talus
Describe head of talus
Convex particular surface for the navicular. Rests on sustentaculum tali of calcaneus and spring ligament
Describe neck of talus
plantar surface of talus sulcus. forms tarsal sinus
Describe body of talus
Trochlea/talar dome that articulates with tibia to form ankle joint. Has a posterior process w/ medial and lateral tubercles and a groove for flexor hallucis longus in between. Lateral process for anterior talofibular ligament.
What does navicular articulate with
Head of talus proximally, cuboid laterally, 3 cuneiforms distally
Features of cuboid
Lateral side of foot. Has a deep groove for peroneus longus on inferior surface. Tuberosity on inferior surface.
Plays a role in lateral + transverse foot arches.
What does cuboid articulate with
Calcaneus posteriorly (calcaneocuboid joint). 4th and
5th metatarsals anteriorly. Navicular and lateral cuneiform medically.
What does medial (1st) cuneiform articulate with
1st and 2nd metatarsals, navicular, intermediate cuneiform
What does intermediate cuneiform articulate with
Navicular, base of 2nd metatarsal, medial and lateral cuneiforms
What makes up the “balls of the feet”
Heads of metatarsals
Which metatarsal has a prominent tuberosity on its base
That is a common site for fractures
5th
Which metatarsal is weight bearing and contains 2 sesamoid bones
1st
Which joints make up the ankle joint complex
Talocrural (ankle), subtalar (talocalcaneal), transverse tarsal (choparts)
Distal tibiofibular joint classification
Fibrous, syndesmosis, amphiarthrotic. Fibula notch on tibia articulates with fibula
ligaments of distal tibiofibular joint
interosseous ligament, anterior tibiofibular ligament, transverse tibiofemoral ligament (acts as a labrum)
talocrural joint classification
synovial hinge/mortise, uniaxial. does dorsiflexion/plantar flexion
Ligaments of distal tibiorfibular joint
Interosseous ligament (part of interosseous membrane), anterior and posterior tibiofibular ligament, transverse tibiofibular ligament (acts as a labrum).
