CH. 1 Functional Anatomy and Biomechanics (Lower Extermity) Flashcards
What is the Osteology of the Hip region?
- Fermur
- Acetabulum of pelvis
Describe the Femur
- Head is 2/3 of a sphere with a depression at its center caller the fovia capitis femoris
- Head is oriented superiorly, anteriorly,a nd medially
- Articular cartilage covers entire head, extept for the fovea capitis
- Angle of inclination normally 115°-125°
- Coxa valga is angle >125°
- Coxa vara is angle <115°
- Femoral neck angles anteriorly 10°-15° from frontal plane to form anterior antetorsion angle
- Antertorsion
- Considered excesive if anterior antetorsion angle >25°-30°
- Retrotorsion
- Considered excessive if anterion antetorsion angle <10°
- Antertorsion
What is the normal angle of inclination?
- 115°-125°
What is considered to be Coxa Valga?
angle > 125°
What is considered to be Coxa Vara?
Angle < 115°
What is the normal femoral neck anterior antetorsion angle?
angle of 10°-15°
What is considered femoral neck Anteversion?
Anterior antetorsion angle 25°-30°
What is considered to be femoral neck Retroversion?
anterior antetorsion angle <10°
Describe the Acetabulum
- Acetabulum faces laterally, inferiorly, and anteriory
- Made of union between ischium, illium, and pubis bones
- Acetabulur fossa
- Center of acetabulum, which is nonarticulating and filled with fat pad for shock absorption
- Acetabulum is not completly covered with cartilage
- Lined with a horseshow-shaped articular cartilage with interruption inferiorly forming acetubular notch
Describe the Arthrology of the Coxofemoral joint
- Synovial joint
- Convex femoral head articulates with concave acetabulum
- Very stable joint due to bony anatomy as well as strength of ligaments and capsule
What are the Noncontractile structures in the Hip region?
- Capsule
- Labrum
- Bursea
- Ligaments
- Iliofemoral
- Ischiofemoral
- Pubofemoral
- Associated nerves and vessels
Describe the Capsule of the Hip joint
- Strong and dense
- Encloses the entire joint
Describe the Labrum of the hip joint
- Tringular shaped, made up of a fibrocartilaginous ring, thickest superiorly
- Attaches to bony rim of acetabulum, bridging acetabular notch
- Serves to deepen acetabulum
- Inner surface is lined with articular cartilage, and outer surface connects to joint capsule
Describe the Iliofermoral ligament (Y ligment or Ligament of Bigelow)
- Two bands, both starting from anterior inferior iliac spine (AIIS)
- Medial running to distal intertrochanteric line
- Lateral running to proximal aspect of intertrochanteric line
- Very strong
- Both bands taut with extension and external rotation
- Lateral band taut with adduction
Describe the Pubofemoral ligament
- Runs from iliopectineal eminence, superior rami of pubis, obturator crest, and obturator membrance, laterally blending with capsule
- Inserts into same point as medial iliofemoral ligament (distal intertrochanteric line)
- Taut with extension, external rotation, and abduction
Describe the Ischiofemoral ligament
- Runs from ischium and posterior acetabulum, superiorly and laterally, blending with zona articularis and attaching to greater trochanter
- Taut with medial rotation, abduction, and extension
Describe the Zona orbicularis
- Runs in a circular pattern around the femoral neck
- Has no bony attachments, but helps to hold head of femur in aceatubulum
Describe the Inguinal ligament
- 12-14 cm long, running from anterior superior iliac crest (ASIS) medially and inferiorly, attaching to the pubic tubercle.
- Forms tunnel for muscles, arteries, veins, and nerves
Describe the Bursae of the Hip
- Subtendinous iliac
- located between hip and os pubis
- Iliopectinal
- between tendons of psoas major, iliacus and capsule
- lies close to femoral nerve
- Ischiofemoral
- between ischial tuberosity and gluteus maximus
- may cause pain in sciatic distribution
- Deep trochanteric
- between gluteus maximus and posterior lateral greater trochanter
- may cause pain with hip flexion and internal rotation due to compression of gluteus maximus
- Superficial trochanteric
- located over greater trochanter
What nerves innervate the hip joint?
- Femoral
- Obturator
- Sciatic
- Superior gluteal
Describe the blood supply of the Hip
- Medial and lateral femoral circumflex supplies proximal femur
- Femoral head is supplied by a small branch off obutrator artery
- Acetabulum is supplied by branches from superior and inferior gluteal arteries
Describe the Biomechanics of the Hip
- Coxofemoral joint arthokinematics/osteokinematics occur in opposite directions due to relationship of convex femoral head moving within concave acetabulum
What is the Osteology of the Knee?
- Femur
- Tibia
- Fibula
- Patella
Describe the Femur
- Femoral condyles are convex in anterior/posterior and medial/lateral planes
- Both femoral condyles are spiral, but lateral one has a longer surface area and medial one descends further inferiorly
Describe the Tibia
- Medial tibial condyle is biconcave, has a larger surface area and is more stable, and therefore less mobile
- Lateral tibial condyle is convex anterior/posterior and concave medial/lateral
- Smaller surface area, more circular, and less stable, therefore more mobile
- Both tibial surfaces are raised where they border intercondylar area
Describe the Patella
- A verticle ridge devides patella into a larger and smaller medial part
- Patella can further be divided by two faint horizontal ridges that divide it into its facets
What is the arthrology of the Knee?
- Tibiofemoral joint
- Patellofemoral joint
- Proximal tibiofibular joint
Describe the Proximal Tibiofibular joint
- Oval tibial facet is flat or slightly convex
- Fibular head has an oval, slightly concave to flat surface
Describe the Tibiofemoral joint
- Synovial hinge joint with two degrees of freedom
- Minimal bony stability thus relies on capsule, ligaments and muscles
Describe the Patellofemoral joint
- Patella articular surface is adapted to patellar surface of femur
- An oblique groove running inferiorly and laterally is the guiding mechanism on femur for patella tracking
- Patellar surface of femur is concave tranversely and convex sagittally, creating its saddle (sellar) shape.
What are the Noncontractile structures in the Knee?
- Ligaments
- Medial collateral (MCL)
- Lateral collateral (LCL)
- Anterior cruciate (ACL)
- Posterior cruciate (PCL)
- Menisci
- Capsule
- Bursae
- Associated nerves and vessels
Describe the Capsule of the Knee
- Tibiofemoral capsule is a fibrous sleeve attached to the distal femur and proximal tibia
- The inner wall is covered by a synovium
- Shaped as a cylinder with a posterior invagination, which posteriorly devides the cavity into medial and lateral halves
- Anterior surface has a window cut out for the patella
- Proximal tibiofubular joint has a fibrous capsule, which is continuous with the knee joint capsule 10% of the time
Describe the Medial Collateral Ligament
- Part of the Tibiofemoral and patellofemoral joint
- Runs from the medial aspect of the medial femoral condyle to the upper end of the tibia
- Posterior fibers blend with capsule
- Runs oblique anteriorly and inferiorly
- Taut in extension and slackened in flexion
- Prevents external rotation
- Provides stability against valgus m=forces
- Runs in the same direction as the anterior cruciate ligament
Describe the Lateral Collateral Ligament
- Part of the Tibiofemoral and patellafemoral joint
- Runs from the lateral femoral condyle to the head on the fibula
- Free of any capsular attachment
- Runs oblique inferiorly and posteriorly in same direction as the posterior cruciate ligament
- Taut in extension and slackened in flexion
- Prevents external rotation
- Provides stability against varus forces