Introduction to lower limb and hip

Question 1

bones of the lower limb

Answer 1

• Gluteal region – Innominate – Proximal femur • Thigh – Femur • Leg – Tibia – Fibula • Foot – Tarsals – Metatarsals – Phalanges

Question 2

joints of the lower limb

Answer 2

• Hip joint • Sacroiliacjoint • Pubicsymphysis • Kneejoint • Ankle joint • Intertarsaljoints • Tarsometatarsal joints • Metatarsophalangealjoints • Interphalangealjoints

Question 3

innervation of the lower limb

Answer 3

• 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

Question 4

classification of the hip joint

Answer 4

– DIARTHROIDAL – MULTIAXIAL – SYNOVIAL • BALL AND SOCKET

Question 5

bones of the hip joint

Answer 5

• Femur • Innominate Bone – Ilium – Ischium – Pubis

Question 6

articular surfaces of the hip joint

Answer 6

• Femur – Femoral Head • Hip Bone – Acetabulum – Weight-bearing Is By Ilium • Note: Acetabular Labrum: – Surrounds rim, enhancing its depth. Helps prevent dislocation

Question 7

ligaments of the hip joint

Answer 7

• CAPSULAR: – ILIO-FEMORAL – ISCHIO-FEMORAL – PUBO-FEMORAL • INTRACAPSULAR – TRANSVERSE ACETABULAR LIGAMENT

Question 8

iliofemoral ligament

Answer 8

– “Y” SHAPED – FROM ANTERIOR INFERIOR ILIAC SPINE – TO: – 1) UPPER PART OF TROCHANTERIC LINE – 2) LOWER PART OF TROCHANTERIC LINE – BECOMES TIGHT IN EXTENSION

Question 9

acetabular labrum

Answer 9

Question 10

anatomy of hip joint

Answer 10

Question 11

Fibrous capsule

Answer 11

– 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

Question 12

zona orbicularis

Answer 12

Question 13

pubofemoral ligament

Answer 13

– 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

Question 14

ischiofemoral ligament

Answer 14

– Arises From Ischial Portion Of The Acetabular Rim

– Attaches To Neck Of Femur Below Greater Trochanter

– Becomes Tight In Extension

Question 15

transverse ligament

Answer 15

• Bridges The Acetabular Notch Forming A “Tunnel” For Blood Vessels
• Completes The Acetabular Labrum • Gives Rise To The Ltf (Lhf)

Question 16

Ligamentum Teres Femoris (Ligament Of Head Of Femur)

Answer 16

– 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

Question 17

disarticulated hip

Answer 17

Question 18

synovial membrane

Answer 18

– 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

Question 19

blood supply of hip

Answer 19

• Branches Of:
– Medial & Lateral Femoral Circumflex
– Superior Gluteal
– Inferior Gluteal
– Artery To Head - Branch Of The Obturator Artery

Question 20

nerve supply of hip

Answer 20

• Branches Of:
– Femoral Nerve
– Obturator Nerve
– Superior Gluteal Nerve – Sciatic Nerve

Question 21

axial view

Answer 21

Question 22

SIJ classification

Answer 22

– 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)

Question 23

SIJ bones involved

Answer 23

• Auricular Surface Of Adjacent Iliums
• Lateral Surfaces Of The Sacrum

• Note:
– Irregular “Interlocking Surfaces”

Question 24

SIJ ligaments

Answer 24

• Interosseous Ligaments

– Occupy Space Above And Behind The Joint Cavity

– Are Very Strong - Are The Chief Bond Between The Two Bones

Question 25

Anterior SIJ ligaments

Answer 25

• 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

Question 26

posterior SIJ ligaments

Answer 26

• 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

Question 28

sacrospinous ligament

Answer 28

• 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

Question 29

sacrotuberous ligament

Answer 29

• 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