Lower Limb 1.1 Flashcards
What are the 3 hip bones?
- Ilium
- Ischium
- Pubsi
What do the 3 fused bone contribute to?
Acetabulum
What does the fused hip bone articulate with?
- Femur
2. Vertebral column
What is the acetabulum lined with?
C shaped articular area lined with hyaline cartilage
What does the cartilage have?
labrum of fibrocartilage around edge that deepens the hip socket
What is a hip pointer?
bruising over the iliac crest (often from an asthmatic injury)
Where do the 2 pubic bones articulate with one another?
At pubic symphysis
What separates the 2 bones?
Fibrocartilage disc which allows some movement
What is the difference between the female and male pelvis?
- Female pelvis smaller, lighter and thinner
- Female pelvic inlet is oval and outlet is larger, pelvic cavity wider and shallower, pubic arch is wife
- OF oval or triangle in female and round in male
What type of joint is the hip joint?
multi-axial balla nd socket synovial joint between acetabulum and head of femur
Where does the ligament of the head of the femur attach in the acetabulum?
to femoral head and provides pathway for acetbaulur brach they arises from obturator artery
What movement does the hip allow?
- Abduction
- Adduction
- Flexion
- Extension
- Rotation
- Cirumduction
How common are congenital hip dislocation?
- About 1.5 in 1000 infants are born with a congenital hip dislocation
- girls are affected more than boys
What does the iliofemoral ligament limit?
- hyperextension
- lateral rotation
What does the pubofemoral ligament limit?
- Extension
- Abduction
What does the ischiofemoral ligament limit?
- Extension
- Medial rotation
What is the strongest and weakest ligaments of the three?
Iliofemoral strongest and ischiofemoral weakest
What is the longest bone in the body?
femur
How is the weight of the body transmitted when standing?
femur transmits wight of body from hip to tibia
What is the femoral neck a common site of?
fractures, young for trauma nd elderly oesteroperosis and associated fall
What is the greater trochanter a point of attachment for?
several of the gluteal muscles (abductors of the thigh at the hip)
What is the lesser trochanter an attachment site for?
iliopsoas tendon, a strong flexor of the thigh at the hip
What are complications of a femur fracture?
- related to nonunion of the bone
- especially with intracapsular fractures
- avascular necrosis of the femoral head may occur as a result
What does the tibia articulate with?
- condyles of the femur
- is the weight-bearing bone of the leg
Where is the fibula?
- osterolateral to the tibia
2. exists largely for muscle attachment
What is the tibial tuberosity the insertion site for?
patellar ligament
What inserts into the patella?
- . tendon of attachment for the quadriceps muscles of the anterior thigh that extend the leg at the knee joint inserts into the patella
- which then attaches to the tibia via the patellar ligament
What type of joint is the proximal tibiofibular joint?
plane synovial joint
What movement does the proximal tibiofibular joint allow?
limited gliding movement
What type of joint is the distal tibiofibular joint?
fibrous joint (syndesmosis)
What movement does the distal tibiofibular joint allow?
no movement
What are the most common fractures of a long bone?
tibial shaft
Why are tibial shaft fractures common?
- tibia lies just beneath the skin along the medial border of the leg
- tibial shaft fractures often are open injuries (in which the skin is perforated)
What type of joint is the knee joint?
- biaxial condylar synovial joint between the condyles of the femur and tibia
- also includes a saddle joint between the femur and patella
What type of movement does the knee allow?
- flexion and extension
- When flexed, it also participates in some gliding and rotation movements
- When the knee extends fully, the femur rotates slightly and medially on the tibia, pulling each of the ligaments taut and stabilizing the joint
What are intracapsular ligaments?
- medial and lateral menisci
- cruciate ligaments
- transverse ligament
What does transverse ligament do?
binds and stabilizes the menisci
What is most of the blood supply to the knee?
from genicular branches of the popliteal artery
Which curate ligament is torn more often and why?
- Anterior
- Posterior shorter and stronger
What is the knee surrounded by?
thin, fibrous capsule that is stabilized by the surrounding muscle attachments and intracapsular and extracapsular ligaments
What are the extra capsular ligaments?
- medial and lateral collateral ligaments
- patellar ligament
- arcuate and oblique popliteal ligaments
What does the anterior cruciate ligament do?
- weaker
- taut when knee fully extended preventing hyperextension
- usually torn in hyperextension with the tibia medially (internally) rotated
When does the posterior circulate tighten the most?
- during flexion of the knee
- preventing excessive anterior displacement of the femur on the tibia
- or excessive posterior displacement of the tibia on the femur
What do both of the curate ligaments do?
maintain some level of tautness during movements of the knee
What does the tibial collateral ligament limit?
extension and abduction of the leg and is attached to the medial meniscus
What does fibular collateral ligament limit?
extension and adduction of the leg
What could rupture of the tibial collateral ligament lead to?
- May tear medial meniscus as attached to medial meniscus
- Medial meniscus is later than lateral meniscus
What is rupture of the anterior cruciate ligament associated with?
- common athletic injury
- with a sharp turn when the knee is twisted medially while in extension and the foot is firmly on the groun
What does the anterior drawer test do?
- test assesses this injury
- If the anterior cruciate ligament has been injured, the tibia will move anteriorly more than 5 mm, indicating a positive test result
Which of the 7 tarsal bone articulates with the leg bones?
Talus
What do the five metatarsal bone articulate proximally with?
tarsals
What do the five metatarsal bone articulate distally with?
phalanges
How many phalanges does the big toe have?
2
What does the trochlea of the talus (ankle bone) articulate with?
tibia and fibula
What does the head of the talus articulate with?
navicular bone
What does the calcaneus (heel bone) articulate with?
talus, superiorly and cuboid anteriorly
What is the most common fractured tarsal bone?
calcaneus
How do most calcaneus fractures happen?
- forceful landing on a heel, in which the talus is driven down into the calcaneus
- bone density of the calcaneus is less than that of the talus, which also contributes to its being fractured more often
What type of joint is the ankle (talocrural) joint?
hinge-type uniaxial synovial joint between tibia and fibula and trohclea of talus
What movement does the ankle joint allow?
- Dorsifelxion (extension)
2. Plantarfelxion
What is the thin fibrous capsule of the ankle joint reinforced by?
- medial (deltoid) ligament: 4 parts
- lateral collateral ligament: 3 parts
What is the talocalcaneal (subtalar) joint?
plane synovial joint between the talus and calcaneus
What does the talocalcaneal (subtalar) joint allow?
inversion and eversion of foot
What is the talocalcaneonavicular joint?
- partial ball-and-socket synovial joint
- between the head of the talus and the calcaneus and navicular bones (along with the calcaneocuboid joint, it forms the transverse tarsal joint)
What does the talocalcaneonavicular joint allow and supported by?
- supported by the spring ligament
- important in gliding and rotational movements of the foot
Which collateral ligament is often sprained?
lateral collateral ligament (weak)
Why does the lateral collateral ligament get sprained?
- resists inversion of the foot 2. One or more of its parts may tear in the common inversion ankle injury
- when this happens, the ligaments usually tear from anterior to posterior, with the anterior talofibular ligament being torn first
What is the medial (deltoid) ligament do?
- limits eversion of the foot 2. helps maintain the medial long arch of the foot
What does the plantar calcaneonavicular (spring) ligament provide?
strong plantar support for the head of the talus (which maintains the arch of the foot)
What is the twisting like in most ankle injuries? What does it cause?
- talus rotates in a frontal plane and impinges on either the lateral or medial malleolus
- fracture of malleolus and places tension on supporting ligaments of the opposite side
What type of joints are the tarsometatarsal joints?
plane synovial joints
What do tarsometatarsal joints consist of? What are the strengthened by?
- articular capsules
- strengthened by plantar, dorsal, and interosseous ligaments
What does the tarsometatarsal joints permit?
gliding and sliding movements
What type of joints are metatarsophalangeal joints?
multiaxial condyloid synovial joints
What are metatarsophalangeal joints surrounded by and strengthened by?
- surrounded by articular capsules
- strengthened by plantar and collateral ligament
- plantar (plate) ligaments are part of the weight-bearing surface of the foot
What does the metatarsopahalngeal joints allow?
- flexion
- extension
- some abduction
- some adduction
- some circumduction
Why type of joints are interphalangeal joints?
uniaxial hinge-type (ginglymus) synovial joints
What are interpahalngeal joints enclosed by and strengthen by?
- enclosed by capsules
- strengthened by plantar and collateral ligaments
What do interphalangeal joints allow?
- flexion
2. extension
What does direct trauma to the foot result in?
fracture of the metatarsals and phalanges
How are these fractures usually treated?
immobilization because the extensive ligament attachments that stabilize these joints prevent the fragments from becoming displaced