Bony Prominences of Clinical Importance in the lower limb

Question 1

What are the iliac crests and what is there significance

Answer 1

• Highest points of the left and right iliac bones.
• Signify the highest anatomical points in the lower limb.

Question 2

What is the name of the imaginary plane that horizontally joins the iliac crests

Answer 2

• Supracrestal plane

Question 3

What vertebral level is signified by the supracrestal plane and what are the clinical implications (3) at this levels

Answer 3

• Approximately L4 (can vary), L3/L4 intervertebral disc
• Lumbar puncture can be carried out safely at this level.
• Epidural anaesthesia can be administered
• Determining sites for aspiration of bone marrow

Question 4

What is the clinical significance of the greater trochanter (3)

Answer 4

• Important in examinations of the lower limb.
• Signifies change in direction of bone from neck to shaft
• Landmark for hip joint, joint capsule, extra capsular ligaments

Question 5

What is the clinical significance of the neck of the femur (1)

Answer 5

• Transfers body weight from head to shaft.

Question 6

Clinical significance of ASIS

Answer 6

• McBurney’s Point - 1/3 of the length of the straight line between ASIS and umbilicus
• Incision for appendectomy is made here as it is the most common location for base of apendix

Question 7

What can happen to the lateral cutaneous nerve of the thigh due to the inguinal ligament and what are the effects of this

Answer 7

• Compression of the lateral cutaneous nerve.
• Painful patch of numbness.
• Known as meralgia paraesthetica

Question 8

What are the structures that pass deep to the inguinal ligament

Answer 8

• Contents of femoral triangle
• Lateral cutaneous nerve of thigh
• Psoas major, Iliacus, Pectineus (floor of femoral triangle)

Question 9

What are the bony landmarks of the knee

Answer 9

• Femur
• Patella
• Tibia

Question 10

What are the bony landmarks of the ankle joint

Answer 10

• Medial Malleolus
• Lateral malleolus
• Pott’s fracture