Lecture 11: Lower limb bones, hip Flashcards
What are the 3 bones of the hip bone?
1.) illium
2.) ischium
3.) pubis
What does the sacrum articulate superiorly, inferiorly, laterally?
sup: L5
inf: coxxyx
lat: 2 hip bones
What are the lateral surfaces called on the sacrum that articulate with the hip bones?
auricular surface
What does the spinal canal become in the sacrum?
sacral canal
Which surface of the sacrum are the sacral crests located?
posterior
What permits the passage for posterior rami of SI-S4 nerves?
posterior sacral foramina
What permits the passage for the anterior rami of the sacral nerves S1-S4?
anterior sacral foramina
What does L5 vertebrae sit on anteriorly?
sacral promontory
What are the wings of the sacrum known as?
sacral ala
Which structures/arrangement of sacrum and coccyx protects the exiting coccygeal nerve?
sacral cornu (horn)
coccygeal cornu (horn)
Which hip bone is the most superior, thickest and densest?
the illium
Which hip bone is the second largest, still thick and dense qualities, and posterior-inferior? What is it referred to?
ischium, sit bone
Which hip bone is the smallest, sharpest and anterior-inferior? What important muscles attaches to the pubic tubercle of this bone?
pubis, rectus abdominis
What 3 bones are only held together by cartilage prior to adolescence?
illium, ischium, pubis
What is the socket of the hip bone called? Where all 3 bones fuse?
acetabulum
What is the huge hole which sits inferior to the acetabulum? What is its function?
obturator foramen, protection for important nerves and vessels as they travel to the thigh
Important lateral surfaces on the ilium? (6)
1.) the iliac crest
2.) iliac tubercle (tuberculum)
3.) post. gluteal line
4.) ant. gluteal line
5.) inf. gluteal line
6.) supra-acetabular groove (sulcus)
Important internal surface bony landmarks on the ilium? (6)
1.) iliac fossa
2.) auricular surface
3.) iliac tuberosity
4.) arcuate line
5.) iliopectineal (iliopubic) eminence
What are the surfaces called on the hip bone that articulate with the sacrum?
auricular surface
Which space/cup on the hip bone is where the internal organs can sit and be protected?
iliac fossa
What is the important bony, rigid attachment point for many powerful ligaments that support the SI joint?
iliac tuberosity
Which thin, delicate landmark runs down the base of the ilium and helps us divide upper and lower pelvis?
arcuate line
What is the bony, prominent line that acts as attachment point of the ilium to the pubis?
iliopectineal (iliopubic) eminence
Important medial and lateral bony landmarks of the hip bone?
1.) Ant. sup. iliac spine (ASIS-front)
2.) Ant. inf. iliac spine (AIIS- front)
3.) Post. sup. iliac spine (PSIS- back)
4.) Post. inf. iliac spine (PIIS- back)
5.) greater sciatic notch
What are the sharp projections that come off of a parent bone?
spines
What is the thumb-like hole in the ilium? What does it do?
greater sciatic notch, accommodates the passage of the sciatic nerve
Medial/lateral bony landmarks of the ischium bone? (6)
1.) body
2.) ischial spine
3.) greater sciatic notch
4.) lesser sciatic notch
5.) ischial tuberosity
6.) the ischium ramus (inf. border)
Where does the sciatic notch sit?
between the post. inf. iliac spine and ischial spine
What is the arm/bridge on the ischium?
ischial ramus
The ischial tuberosity is only seen on what side of the ischium?
lateral, it is not seen on the medial side
Medial/lateral bony landmarks of the pubic bone?
1.) body
2.) superior ramus
a. pectineal line
b. iliopectineal eminence
3.) inferior ramus
a. ischiopubic ramus
4.) obturator foramen
5.) pubic symphysis
6.) pubic crest
7.) pubic tubercle
Which ramus of the pubis meets with the ilium?
the superior, via the iliopectineal eminence
Which really sharp line is superior to the iliopectineal eminence?
pectineal line
Which bony landmarks border the obturator foramen?
iliopubic (iliopectineal) ramus
ischiopubic ramus
Which is slightly more medial? The pubic crest or the pubic tubercle?
The pubic crest
Bony landmarks of the acetabulum?
1.) rim or margin
2.) acetabular notch
3.) acetabular fossa
4.) lunate surface
5.) acetabular labrum
What is the outer sharp margin and forms the acetabular notch at the bottom of the acetabulum called?
rim or margin
Is the acetabular notch an articulate surface?
No, it serves as an attachment point for ligaments
Where does the head of the femur sit within the acetabulum?
acetabular fossa
What uses the lunate surface as an attachment point?
Acetabular labrum
What improves congruency between acetabulum and the femur?
acetabular labrum
Bony landmarks of the femur?
1.) head
(fovea capitis femoris (fovea of the head)
2.) neck
3.) greater trochanter
(trochanteric fossa)
4.) lesser trochanter
5.) intertrochanteric line
6.) intertrochanteric crest (quadrate tubercle)
What part of the femur sits in the acetabullum?
head
All of the head of the femur is covered in articular cartilage EXCEPT what little divot? Why?
the fovea capitis femoris, it serves as an attachment point for the ligament
What is the head of the femur supported by?
neck
What are the 2 prominent bumps projecting off the neck?
greater (larger) and lesser (smaller) trochanter
What allows us to be bipedal?
The angle of the neck of the femur
When side/s is the lesser trochanter viewed from?
posterior ONLY
What side/s is the greater trochanter viewed from?
both posterior and anterior
What is the divot in the greater trochanter called?
trochanter fossa
On the anterior side, what connects greater trochanter to lesser trochanter?
intertrochanteric line
On the posterior side, What connects greater trochanter to lesser trochanter?
intertrochanteric crest
Which surface of the femur is very smooth?
anterior
What is the thick, prominent ridge that runs down the posterior side of the femur?
linea aspera
The linea aspera gives rise to 2 key features. Which one is on the lateral surface? Which is on the medial surface?
lateral- gluteal tuberosity
medial- pectineal line
How many pectineal lines do we have in the body? Where are they?
2, pubis and femur
What are the ridges that flare out on the distal end of the femur?
supracondylar ridges
What are inferior rounded edges of the femur?
medial and lateral condyle
On each condyle, what are the smaller more prominent ridges?
medial and lateral epicondyle
Are the epicondyles similar sizes? Or quite different like in the humerus?
similar
What is unique about the medial epicondyle?
It has the adductor tubercle- more prominent bump found just superior to medial epicondyle.
Where are the articular surfaces of the condyles? Which is connected? Why? Which is separated? Why?
anterior (connected, makes a shallow depression that will accommodate the knee cap) and posterior (separated-intercondylar fossa, to accommodate the intercondylar eminences)
What surface does the patella (knee cap) articulate with?
anterior surface of the knee
The patella has a rounded superior edge called the __________ and a pointed inferior edge called ___________.
base, apex
Which surface of the patella articulates with the medial and lateral condyles of the femur?
posterior side
Which articulate surface on the patella is smaller?
Lateral
Bony landmarks of the tibia
PROXIMAL END
1.) medial condyle
2.) lateral condyle (fibular facet)
3.) sp. articulate surface
4.) intercondylar eminence
5.) tibial tuberosity
6.) Gerdy’s tubercle
7.) body or shaft (3 borders (ant. med and lat) (3 surfaces (ant, med, post) (soleal line)
DISTAL END
1.) medial malleolus
2.) lateral surface (fibular notch)
3.) interior surface
Which of the leg bones is larges and weight baring?
tibia
The medial and lateral condyles on the proximal end of the tibia match with the condyles of which bone?
femur
Where does the fibula articulate with the tibia?
Just distal to the lateral condyle, on the posterior side of the tibia, called fibular facet
Where does the fibula have articulate surfaces with to form joints?
Tibia and ankle NOT the knee
Between the articular surfaces of the prox. tibia, what are the 2 mountains? Superior extensions?
intercondylar eminences
On the anterior aspect of the tibia, what is the prominent bump between the condyles? Where is this seen?
tibial tuberosity, just distal to the patella
On the lateral aspect of the tibia, there is a flared edge called what? Important attachment point for what?
Gerdy’s tubercle, important powerful muscles of the leg
How is tibia body different from femur?
it is sharp and edgy, femur is smooth and round, tibia is also just subcutaneous
What are the 3 borders of the body of the tibia? Which are easily palpatable?
ant, med. and lat.
anterior and medial (subcutaneous/ medial surface)
Which surfaces of the body of the tibia are covered by muscle?
Anterior and posterior
Which side of the tibia is bounded by deep powerful muscle? What line is found there?
posterior surface, soleal line
The medial malleolus is also known as what?
ankle bone
On the lateral surface of the tibia you will find what notch?
fibular notch, where the fibula will articulate
What are the fibula and tibia connected by?
interosseus membrane
If you need a bone graft, where does it come from?
The shaft of the fibula (and the person can walk with no problems)
What is the point on the head of the fibula?
apex
Are any surfaces of the fibula palpatable?
no
Distally, the fibula has what? That matches up with the medial malleolus of the tibia?
Lateral malleolus
What is the little divot on the distal end of the fibula for a ligament to attach?
malleolar fossa
Where is the articulate point for the bone of the ankle?
Between the lateral malleolus of the fibula and the medial malleolus of the tibia
What are the 3 major regions of the foot complex?
1.) tarsus
2.) metatarsus
3.) phalanges
How many tarsal bones are they?
7
What are in the proximal group of foot bones? (2)
1.) talus
2.) calcaneus
What are in the intermediate group of foot bones? (1)
1.) navicular
What are in the distal group of foot bones?
cuniforms
1.) medial
2.) intermediate
3.) lateral
4.) cuboid
Metatarsals (5) are between which 2 groups?
Cuniforms (distal) and phalanges
What are the different phalanges? What sets #1/big toe apart?
proximal, middle, distal (#1 doesn’t have a middle
What structures does the talus articulate with on its:
1.) superior surface and lateral surface
2.) inferior/posterior surface
3.) anterior surface
1.) distal end of tibia, lateral malleolus, medial malleolus,
2.) calcaneus
3.) navicular
What is the heel bone called?
calcaneus
What are the important articular surfaces of the calcaneus?
1.) superior, middle, anterior
2.) anterior
1.) talus
2.) cuboid
Space where the talus doesn’t quite fit with the calcaneus?
sulcus tali (sinus)
What is the surface of the food that first comes into contact with the ground?
calcaneal tuberosity
What bone may come into contact with the ground if you have a collapsed arch? (deep within the foot)
calcaneal tubercle
On the medial side of the foot, what is the arm that juts out? What does it do?
sustentaculum tali, holds up the talus ensuring it won’t collapse
How many articular surfaces are on the calcaneus medial side for the talus to sit? How many for cuboid?
3 (ant, post, mid)
1 (ant)
What is the part of the bone jutting out on the medial side only called?
sustentaculum tali
On the lateral view, there is small bump called the ___________. It is important for tendons to bend around the foot
fibular (peroneal) tubercle or trochlea
What is the opening between the talus and the calcaneus? What can happen here?
Tarsal sinus, entrapment (tarsal sinus syndrome through compression of tendons)
The navicular bone articulates with:
1.) posteriorly
2.) anteriorly
3.) medial
1.) talus
2.) cuneiform bones
3.) bump that is the navicular tuberosity
Cuboid articulate surfaces:
1.) posteriorly
2.) anteriorly
1.) calcaneus bone
2.) metatarsals (4,5)
How are the cuneiforms named?
How they fall anatomically (med. int. lat)
Articular surfaces of the cuneiforms:
1.) anteriorly
2.) posteriorly
1.) med= 1st toe
int= 2nd toe
lat= 3rd toe
2.) navicular
Which side of the metatarsals are distal?
head
What is the axis of the foot? Add/Abduction happens around which toe?
digit 2
