Introduction to lower limb and hip Flashcards
bones of the lower limb
• Gluteal region – Innominate – Proximal femur • Thigh – Femur • Leg – Tibia – Fibula • Foot – Tarsals – Metatarsals – Phalanges
joints of the lower limb
• Hip joint • Sacroiliacjoint • Pubicsymphysis • Kneejoint • Ankle joint • Intertarsaljoints • Tarsometatarsal joints • Metatarsophalangealjoints • Interphalangealjoints
innervation of the lower limb
• Gluteal region – Sacral plexus (L4-S4) • Anterior thigh – Femoral nerve • Medial thigh – Obturator nerve • Posterior thigh – Sciatic nerve & bb • Leg (anterior, posterior & lateral) – Sciatic nerve bb • Foot (dorsal & plantar) – Sciatic nerve bb
classification of the hip joint
– DIARTHROIDAL – MULTIAXIAL – SYNOVIAL • BALL AND SOCKET
bones of the hip joint
• Femur • Innominate Bone – Ilium – Ischium – Pubis
articular surfaces of the hip joint
• Femur – Femoral Head • Hip Bone – Acetabulum – Weight-bearing Is By Ilium • Note: Acetabular Labrum: – Surrounds rim, enhancing its depth. Helps prevent dislocation
ligaments of the hip joint
• CAPSULAR: – ILIO-FEMORAL – ISCHIO-FEMORAL – PUBO-FEMORAL • INTRACAPSULAR – TRANSVERSE ACETABULAR LIGAMENT
iliofemoral ligament
– “Y” SHAPED – FROM ANTERIOR INFERIOR ILIAC SPINE – TO: – 1) UPPER PART OF TROCHANTERIC LINE – 2) LOWER PART OF TROCHANTERIC LINE – BECOMES TIGHT IN EXTENSION
acetabular labrum
anatomy of hip joint
Fibrous capsule
– Strong And Dense Tube-like
– Attached To Labrum Medially & Femur Laterally • Inter-trochanteric Line Anteriorly
• Neck Before Troch.Crest Posteriorly
– Tends To Be “Spiralled” Around The Joint
• Some Deep Fibrespass Circularly Around The Joint “Zona Orbicularis” Enhancing The Strength Of The Joint
zona orbicularis
pubofemoral ligament
– Triangular In Shape
– From Superior Ramus Of The Pubis & Pubic Part Of Acetabular Rim
– Attaches To Inferior Part Of Trochanteric Line Blended With Iliofemoral Ligament
– Becomes Tight In Extension
ischiofemoral ligament
– Arises From Ischial Portion Of The Acetabular Rim
– Attaches To Neck Of Femur Below Greater Trochanter
– Becomes Tight In Extension
transverse ligament
- Bridges The Acetabular Notch Forming A “Tunnel” For Blood Vessels
- Completes The Acetabular Labrum • Gives Rise To The Ltf (Lhf)
Ligamentum Teres Femoris (Ligament Of Head Of Femur)
– Is A Misnomer - Not A Ligament As Such
– Is A Tube, Housing A Branch Of The Obturator Artery
– Arises From Transverse Ligament – Attaches To Fovea Capitus
disarticulated hip
synovial membrane
– Lines The Internal Surface Of The Fibrous Capsule
– Lines That Portion Of The Neck Which Is Within The Capsule
– Lines The Ligamentum Terres Femoris – Lines The Fat Pad In Base Of Cup
blood supply of hip
• Branches Of:
– Medial & Lateral Femoral Circumflex
– Superior Gluteal
– Inferior Gluteal
– Artery To Head - Branch Of The Obturator Artery
nerve supply of hip
• Branches Of:
– Femoral Nerve
– Obturator Nerve
– Superior Gluteal Nerve – Sciatic Nerve
axial view
SIJ classification
– Synovial Plane Joint
– Note: Irregular Surface
– Note: Is Not Really Freely Moving
– Note: Becomes Fibrous With Age
• Cavity Becomes Obliterated (At Least In Part) By Fibro-cartilaginous Fibres)
SIJ bones involved
- Auricular Surface Of Adjacent Iliums
- Lateral Surfaces Of The Sacrum
• Note:
– Irregular “Interlocking Surfaces”
SIJ ligaments
• Interosseous Ligaments
– Occupy Space Above And Behind The Joint Cavity
– Are Very Strong - Are The Chief Bond Between The Two Bones
Anterior SIJ ligaments
• Anterior Sacroiliac Ligament:
– Thin Broad Sheet Of Transverse Fibres Covering Whole Anterior Aspect Of The Joint.
• Iliolumbar Ligament*
– Strong & Triangular
• Connects Tip Of L5 Trans. Process To The Iliac Crest
• Anterior Fibres Blend Into Anterior Sacro Iliac Ligament
posterior SIJ ligaments
- Interosseous Sacroiliac Ligament
- Posterior Sacroiliac Ligament
– Short Transverse Fibres From Lateral Sacral Crest (2-3 Tubercles) To Ilium
– Long Vertical Fibres Joining Sacral Crest (3-4 Tubercles) To Posterior Iliac Spines. They Blend With Sacrotuberous Fibres
sacrospinous ligament
• Is Thin And Triangular
– Attached Laterally By Its Apex To Ischial Spine
– Attached Medially By Base To Lateral Margins To Sacrum And Coccyx. Fibres Mingle With Sacrotuberous Ligament
sacrotuberous ligament
• Attached
– Widely To Dorsal Surface Of Sacrum And Coccyx
– By Broad Base To Posterior Iliac Spines
– Runs Downwards And Laterally To Superior Medial Aspect Of Ischial Tuberosity
