Lower Limb

Question 1

What bones is the lower limb composed of?

Answer 1

Femur, tibia, fibula, patella, tarsals, metatarsals, phalanges

Question 2

What is the hip joint?

Answer 2

Ball and socket synovial joint

Articulation between head of femur and acetabulum

Question 3

Function of hip joint

Answer 3

Increases stability and is weight bearing as it forms connection between lower limb and pelvis

Question 4

Movement of hip joints

Answer 4

Flexion, extension, abduction, adduction, lateral and medial rotation

Question 5

Dislocations of hip joint

Answer 5

Developmental dysphagia of the hip bone (DDH) - congenital, hip does not develop properly in uterus

Acquired dislocation - usually occur as result of trauma, uncommon:

Posterior: femoral head forced posteriorly, tears through inferior and posterior part of joint capsule. Sciatic nerve at risk of damage
Anterior: caused by traumatic extension, abduction and lateral rotation, head displaced anteriorly and inferiorly

Question 6

What is the femur?

Answer 6

Longest and strongest bone in body, long bone, aka thigh bone

Question 7

function of femur

Answer 7

Transmit force from tibia to hip joint

Site for attachment and origin for many muscles and ligaments

Question 8

Areas of the femur

Answer 8

Proximal, shaft, distal

Question 9

Anatomical features of proximal femur

Answer 9

Head - articulates with acetabulum of the pelvis to form the hip joint. Has smooth surface with a depression of medial aspect for attachment of ligament of head of femur

Neck - connects head of femur with shaft. Projects superior and medially allowing for increased range of movement at the hip joint

Greater trochanter - originates from anterior aspect, lateral to neck, angled superiorly and posteriorly. Found in anterior and posterior sides. Site of attachment for many muscles in gluteal region

Lesser trochanter - smaller than greater trochanter, projects from posteromedial side of femur just inferior to neck-shaft junction. Attachment site for psoas major and iliacus muscle

Intertrochanteric line - ridge of bone running inferimedial direction on anterior surface connecting two trochanter. Known as pectineal line after it passes the lesser trochanter, attachment site for iliofemoral ligament

Intertrochanteric crest - similar to line, located posterior surface, rounded tubercle on its superior half called the quadrate tubercle where quadratics femoris attaches.

Question 10

Anatomical features of shaft of femur

Answer 10

Descends in slight medial direction bringing knees closer to body’s centre of gravity increasing stability.

Posterior - roughened ridges of bone called linea aspera
Proximal - medial border of linea aspera becomes pectineal line. Lateral border becomes gluteal tuberosity where gluteus maximus attaches

Distal - linea aspera widens and forms floor of popliteal fossa. Medial and lateral borders becomes medial and lateral supracondylar lines. Medial supracondylar line stops at adductor tubercle where adductor Magnus attaches

Question 11

Anatomical features of distal femur

Answer 11

Medial and lateral condyles - rounded areas at end of femur. Posterior and inferior surfaces articulate with tibia and menisci of knee. Anterior surface articulates with the patella

Medial and lateral epicondyles - bony elevations on the non-articular areas of the condyles. Attachment of some muscles and collateral ligaments of knee joint

Intercondylar fossa - depression found on posterior surface of femur, lies between two condyles. Contains 2 facets for attachment of internal knee ligament

Facet for attachment of posterior cruciate ligament - found on medial wall of intercondylar fossa, large rounded flat face where posterior cruciate ligament attached

Facet for attachment of anterior cruciate ligament - lateral wall of intercondylar fossa, smaller than facet on the medial wall, anterior cruciate ligament of knee attaches

Question 12

What is the patella?

Answer 12

Sesamoid bone with quadriceps tendon

Knee joint

Question 13

Where is the patella located?

Answer 13

At front of knee joint within patellofemoral groove of knee

Question 14

Bony landmarks of patella

Answer 14

Triangular shape with anterior and posterior surfaces
Apex - inferior, connected to tibial tuberosity by the patella ligament
Base - superior, attachment for quadriceps tendon
Posterior surface articulates with the femur. Marked by 2 facets, medial facet articulates with condyle of femur, lateral facet articulates with lateral condyle of femur

Question 15

function of patella

Answer 15

Leg extension - enhances leverage the quads tendon can exert on femur increasing efficiency of muscle
Protection - protects anterior aspect of knee joint from physical trauma