Lower Body Ligaments, Bursa, and Joints Flashcards
Trochanteric Bursa
Between glute max fibres and the greater trochanter
Ischial Bursa
Between inferior part of glute max and the ischial tuberosity
Inguinal Ligament
From ASIS to pubic tubercle
Formed by the inferior margin of abdominal muscles
A thickened fibrous band or ‘retinaculum’)
Sacroiliac Joint
B/w the auricular surfaces and tuber-sixties of the sacrum and ilium
What classification is the sacroiliac joint?
Compound (combination of two)
- Plane (synovial); b/w auricular surfaces
- Syndesmosis (fibrous joint); b/w tuberosities
What movement does the sacroiliac joint have?
Slight gliding movements (shearing)
Slight rotary movements resulting in:
- Nutation
- Counternutation
Amount of movement limited by interlocking joint surfaces and strong surrounding ligaments
What ligaments are involved in the sacroiliac joint?
Interosseous sacroiliac ligaments
Sacrotuberous ligament
Sacrospinous ligament
Interosseous sacroiliac ligaments
Approx 10cm of dense regular connective tissue between tuberosities of the sacrum and ilium
Sacrotuberous Ligament
From posterior ilium, sacrum and coccyx to ischial tuberosity
Sacrospinous Ligament
From lateral sacrum and coccyx to ischial spine
Pubic symphysis
B/w symphyseal surfaces of the bodies of the two pubic bones
What classification is the pubic symphysis?
Secondary cartilaginous
- Contains a fibrocartilaginous disc often thicker in women than men
What ligaments are involved in the pubic symphysis joint?
Superior pubic ligament
Inferior pubic ligament
Tendons of the abdominal muscles strengthen joint anteriorly
Which ligaments form the greater and lesser sciatic foramen?
Sacrospinous ligament and sacrotuberous ligament
Which 3 ligaments make up the hip joint?
Iliofemoral
Pubofemoral
Ischiofemoral
Iliofemoral Ligament
Y-shaped ligament
Restricts hyperextension
PA: ilium part of acetabular rim
DA: intertrochanteric line
Pubofemoral Ligament
Reinforces the capsule inferiorly and anteriorly
Restricts abduction and hyperextension of the hip
PA: pubic bone
DA: blends with the medial part of the iliofemoral ligament
Ischiofemoral Ligament
Reinforces the capsule posteriorly, spirals up and over the femoral neck
Restricts hyperextension of the hip joint
PA: ischial part of the acetabular rim
DA: medial to the base of the greater trochanter
Hip Joint Blood supply
Medial and lateral circumflex femoral arteries
Artery to the head of the femur (travels via ligament of head of femur to fovea of femoral head)
Hip Joint - Innervation
Femoral nerve, Obturator nerve, Superior gluteal nerve
Hip Joint Movements
flexion/extension
abduction/adduction
circumduction
external/internal rotation
Compare the ROM available at your GH joint to your hip joint. Which has greater ROM and why?
GH ROM is greater as the Hip joint has more ligaments
Iliofemoral ligament, pubofemoral ligament, ischiofemoral ligament
Which direction of movement does each of the hip ligaments prevent?
hyperextension
What is the benefit of relying on hip ligaments for postural support?
Provides stability without the excessive use of muscles
Which collateral ligaments are in the knee?
lateral and medial collateral ligament
Which cruciate ligaments are in the knee?
anterior and posterior ligament
Collateral ligaments of knee - basics
- external knee ligamnets
- become taught when knee is fully extended
- become slack when knee flexed
- limit medial & lateral movement of knee
Cruciate ligament
ACL, PCL
within intercondylar area of femur
poor blood supply = poor healing
Cross over each other obliquely
- Wind around each other during medial
rotation of the tibia: limiting it to 10
degrees
- They unwind during lateral rotation,
therefore greater range of motion can
occur: 60 degrees lateral rotation
Menisci
- crescent-shaped plates of fibrocartilage
- located on superior articular surface of tibia
- wedge shaped: thicker at outside margin, thinner the middle
- several ligamentous attachments to tibia
Lateral Meniscus
- Circular (almost)
- smaller than the medial meniscus, more mobile
- separated from LCL by popliteus tendon
- less likely to get damaged
Medial Meniscus
- C-shaped
- firmly attached to MCL
- well fixed, less mobile than lateral meniscus
- attachment to MCL and reduced mobility results in more likely to get damaged
Menisci - Function
They deepen the tibial surface, therefore increase knee joint congruence
- Reduce friction in the joint
- Act as a shock absorber
- Distribute force between the bony surfaces
Lateral Collateral Ligament
- fibular collateral ligament
- cord like, very strong
- from the lateral epicondyle of the femur to the fibular head
- popliteus tendon runs deep to this ligament, separates it from the lateral meniscus
medial collateral ligament
- tibial collateral ligament
- strong, flat, a thickening of fibrous capsule
- from medial epicondyle of femur to medial condyle of tibia
- attached to medial meniscus
- weaker than the lateral collateral ligament (more often damaged)
Patellar tendon
- continuation of quadriceps tendon from apex of patella to tibial tuberosity
- known as patella ligament, may be included in external knee ligaments
Anterior Cruciate Ligament
- weaker than PCL
- most common cruciate ligament injured
- injured during hyperextension
- arises from anterior intercondylar area of tibia
- passes posteriorly, superiorly and laterally
- attaches to posterior part of medial side of lateral femoral condyle
Posterior Cruciate Ligament
Suprapatellar bursa
extends 5cm superior to the patella. Continuous with
synovial capsule
Subcutaneous prepatellar bursa
b/w skin & patella
Subcutaneous infrapatellar bursa
b/w skin & tibial tuberosity
Deep Infrapatellar bursa
b/w patella tendon and anterior tibia
Infrapatellar fat pat
Collection of fat cells located posterior to patellar tendon and anterior to the capsule
◆ Highly innervated – can be a source of knee pain
◆ Fat pad injury can occur due to repetitive microtrauma or acute impingement
Extensor retinacula
- holds down the anterior compartment tendons
- superior extensor retinaculum
- inferior extensor retinaculum
Fibular Retinacula
- holds down the tendons of the lateral compartment
- superior fibular retinaculum
- inferior fibular retinaculum
Knee Joint - Capsule
Fibrous Capsule
- thin and incomplete in areas
- thickened, where intrinsic ligaments occur
Synovial capsule
- lines all surfaces of the articular cavity that are not covered with cartilage
Knee Joint - Type
- modified hinge type synovial joint
- 2 degrees of freedom
Knee joint - Articulations
- femorotibial articulation
- patellofemoral articulation
Superior Tibiofibular joint - Type, Joint surfaces, Movement, Ligaments
- plane synovial joint
- articular facet for tibia on head of the fibula & fibular articular facet on the lateral tibial condyle
- slight gliding of fibula on tibia during dorsiflexion of the ankle
- Anterior ligament of fibular head
- Posterior ligament of fibular head
Inferior Tibiofibular joint - Type, Joint surfaces, Movement
- fibrous joint
- medial surface of inferior end of fibula
- fibular notch of tibia
- built for stability, only slight movement during dorsiflexion of ankle
Inferior Tibiofibular joint - Ligaments
- Interosseus ligament (continuation of interosseus membrane, found deep between the bones)
- Anterior inferior tibiofibular ligament
- Posterior inferior tibiofibular ligament
- inferior transverse tibiofibular ligament (forms thw posterior wall of the socket for the talus helping form the ankle joint)
Talocrual ankle joint - movements
Sagittal plane, medial-lateral axis movement
◆ Dorsiflexion
◆ Plantarflexion
Subtalar joint - movements
Frontal plane, anterior-posterior axis movement
◆ Inversion
◆ Eversion
