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MSK > Lower Limb Bones > Flashcards

Lower Limb Bones Flashcards

1
Q

What is the name of the only bone in the thigh? What type of bone is it?

A

Femur

Long bone (longest in the body)

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2
Q

What is the main function of the femur?

A

Transmits force from the tibia to the hip joint

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3
Q

The femur can be divided into which three portions?

A

Proximal
Shaft
Distal

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4
Q

The proximal area of the femur articulates with the…

A

Pelvis to form the hip joint

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5
Q

Name 6 landmarks on the proximal femur

A 
Head 
Neck 
Greater trochanter
Lesser trochanter 
Intertrochanteric line 
Intertrochanteric crest
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6
Q

What sort of structures are the greater and less trochanters?

A

Bony processes

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7
Q

The head of the femur articulates with…

A

The acetabulum of the pelvis to form the hip joint

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8
Q

What is the purpose of the depression on the medial aspect of the head of the femur?

A

For the attachment of the ligament of head of femur

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9
Q

The neck of the femur connects the head of the femur with the…

What shape does it have?

In which direction does it project?

What is the purpose of this angle?

A

Shaft

Cylindrical

Superomedially

Allows increased range of movement at the hip joint

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10
Q

What is the greater trochanter? Where is it located?

A

A projection of bone on the femur that originates from the anterior aspect just lateral to the neck of the femur

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11
Q

Can the greater trochanter be found on both the anterior and posterior sides of the femur?

A

Yes

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12
Q

Which muscles attach at the greater trochanter?

A

Many muscles of the gluteal region

Gluteus medius
Gluteus minimus
Piriformis

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13
Q

Where is the lesser trochanter?

A

Projection on the posteromedial side of the proximal femur - just inferior to the neck/shaft junction of the femur

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14
Q

Which muscles attach at the lesser trochanter?

A

Psoas major

Iliacus muscles

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15
Q

What is the intertrochanteric line?

A

A ridge of bone on the anterior surface of the femur connecting the two trochanters

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16
Q

When is the intertrochanteric line known as the pectineal line?

A

After its passes the lesser trochanter on the posterior surface

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17
Q

What structure attaches at the intertrochanteric line?

A

Iliofemoral ligament

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18
Q

What is the intertrochanteric crest?

A

Ridge of bone that connects the two trochanters on the posterior surface of the femur?

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19
Q

Where is the quadrate tubercle? Which muscle attaches here?

A

On the superior half of the intertrochanteric crest

Quadratus femoris

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20
Q

Fractures of the proximal femur can be classified into which two main groups?

A

Intracapsular fractures

Extracapsular fractures

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21
Q

In which group of people are intracapsular fractures of the proximal femur most common? What can cause them?

A

Elderly - especially women

A minor trip or stumble

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22
Q

What is a intracapsular fracture of the proximal femur? Which vessel can be damaged by this type of fracture? What complications can this have to the femur?

A

Fracture that occurs within the capsule of the hip joint

Femoral circumflex artery

Can result in avascular necrosis of the femoral head

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23
Q

What happens to the distal fragment of bone in an intracapsular fracture of the proximal femur? How does this clinically present?

A

Puller upwards and rotated laterally

Shorter leg length with toes pointing laterally

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24
Q

Extracapsular fractures of the proximal femur are common in which group ages of people?

A

Young

Middle aged

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25
Q

How does an extracapsular fracture of the proximal femur affect the blood supply to the femoral head?

A

Does not affect the femoral circumflex artery, so blood supply is intact and no avascular necrosis can occur

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26
Q

What are the clinical features of an extracapsular fracture of the proximal femur?

A

Same as intracapsular fractures

Toes pointing laterally
Shorter leg length

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27
Q

The shaft of the femur descends in a slightly _________ direction

What is the reason for this?

A

Medial

Knees closer to the centre of the body - increased stability

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28
Q

Where are the linea aspera located on the femur?

A

Down the posterior surface of the femoral shaft

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29
Q

What are the linea aspera?

A

Roughened ridges of bone on the posterior surface of the femoral shaft

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30
Q

Proximally, what does the lateral border of the linea aspera become?

What does the medial border become proximally?

A

Gluteal tuberosity

Pectineal line

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31
Q

What attaches at the gluteal tuberosity?

A

Gluteus maximus

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32
Q

What does the linea aspera form distally?

A

Widens and becomes the floor of the popliteal fossa

Medial border becomes medial supracondylar line

Lateral border becomes lateral supracondylar line

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33
Q

What muscle attaches at the adductor tubercle? Where is this located?

A

Adductor magnus

Where the medial supracondylar line stops

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34
Q

Are fractures of the femoral shaft relatively common or uncommon? Why? What typically causes them?

A

Uncommon

Requires a lot of force

Traumatic injury - e.g. Car crash

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35
Q

Femoral shaft fractures often occur as a _______ fracture which causes…

A

Spiral

Leg shortening

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36
Q

What causes the leg shortening seen in fractures of the femoral shaft?

A

The overriding of bony fragments of the femur as they are pulled by their attaching muscles

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37
Q

Which neurovascular structures be damaged in a high energy injury that is the fracture of the femoral shaft?

A

Femoral artery or femoral nerve

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38
Q

The distal end of the femur articulates with which bones to form the knee joint?

A

Tibia

Patella is

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39
Q

How do the medial and lateral condyles articulate?

A

Posteriorly and inferiorly articulate with the tibia and menisci of the knee

Anterior surface articulates with the patella

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40
Q

What are the medial and lateral epicondyles? What attaches here?

A

Bony elevations on the non-articular areas of the condyles

Various muscles and collateral ligaments of the knee

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41
Q

What is the intercondylar fossa? What is its function?

A

Depression between the medial and lateral condyles on the posterior surface of the femur

Contains 2 facets for attachment of internal knee ligaments

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42
Q

Where is the facet for attachment of the posterior cruciate ligament found?

A

On the medial wall of the intercondylar fossa

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43
Q

Where is the facet for the attachment of the anterior cruciate ligament found?

A

On the lateral wall of the intercondylar fossa

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44
Q

What is anther name for the patella? Where is the patella located?

A

Kneecap

Front of the knee joint in the patellofemoral groove of the femur

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45
Q

The patella attaches superiorly to which tendon?

A

Quadriceps tendon

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46
Q

The patella attaches inferiorly to which ligament?

A

Patella ligament

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47
Q

What type of bone is the patella? What rough shape does it have? What surfaces does the patella have?

A

Sesamoid bone

Triangular

Anterior and posterior

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48
Q

Where is the apex of the patella located? Where is the base of the patella located?

A

Apex - inferiorly

Base - superiorly

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49
Q

The apex of the patella is connected to the ___________ _____________ by the ___________ ligament

A

Tibial tuberosity

Patellar ligament

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50
Q

The base of the patella provides attachment for the…

A

Quadriceps tendon

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51
Q

The posterior surface of the patella consists of 2 _________ and articulates with the…

A

Facets

Femur

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52
Q

What does the medial facet on the posterior surface of the patella articulate with?

A

With the medial condyle of the femur

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53
Q

What does the lateral facet of the posterior surface of the patella articulate with?

A

With the lateral condyle of the femur

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54
Q

What are the two main functions of the patella?

A

Leg extension

Protection

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55
Q

What happens in patellar dislocation? In what direction does it usually dislocate? What commonly causes patellar dislocation?

A

Patella is displaced out of the patellofemoral groove

Laterally

High force impact on the patella or sudden twisting of the knee (common in sports)

56
Q

What usually causes patellar fracture? In what groups of people are they most common?

A

Direct trauma or sudden contraction of the quadriceps muscle

Ages 20-50, males

57
Q

What will happen if the patella fragments into proximal and distal fragments upon patellar fracture?

A

Proximal fracture will be pulled superiorly by quadriceps tendon

Distal fragment will be pulled inferiorly by the patellar ligament

58
Q

What is the main bone of the leg?

A

The tibia

59
Q

The tibia is more commonly known as the…

At its distal end it attaches to the…

At its proximal end it attaches to the…

A

Shin

Ankle

Knee

60
Q

What is an important main function of the tibia?

A

Acts as a weight bearing structure

61
Q

What is the tibial plateau? Where is it located?

A

A flat surface formed by the medial and lateral condyles on the proximal tibia

62
Q

The tibial plateau articulates with the…

A

Femoral condyles to form the major articulation of the knee joint

63
Q

What is the region between the two condyles of the proximal tibia called?

A

Intercondylar eminence

64
Q

What does the intercondylar eminence consist of? What attaches here?

A

Two tubercles

Ligaments and the menisci of the knee joint

65
Q

The tibial intercondylar tubercles fit into…

A

The intercondylar fossa of the femur

66
Q

Where is the tibial tuberosity located? What attaches here?

A

On the anterior surface of the proximal tibia, inferior to the condyles

Patella ligament

67
Q

The shaft of the tibia consists of how many borders and surfaces?

A

3 borders
3 surfaces

Anterior, Posterior, Lateral

68
Q

Which structure on the tibia marks the start of the anterior border?

A

Tibial tuberosity

69
Q

Which border of the tibial shaft can be palpated on the body as the ‘shin’?

A

Anterior border

70
Q

What causes clinical presentations of bruising in the shin area?

A

Damage to the periosteal covering of the tibia

71
Q

What is the soleal line? Where on the tibia does it run? Where does it end? What muscle originates where the soleal line ends?

A

Ridge of bone which marks the posterior surface of the tibia

Runs inferomedially

Medial border of the tibia

Soleus muscle

72
Q

What is another term for the lateral border of the tibia? What attaches here?

A

Interosseous border

Interosseous membrane which binds the tibia and fibula

73
Q

What happens to the shape of the tibia at both the proximal and distal ends?

What is the purpose of this?

A

It widens

Aids with weight bearing

74
Q

What is the name given to the bony projection on the medial side of the distal tibia?

A

Medial malleolus

75
Q

What does the medial malleolus articulate with?

A

The tarsal bones to form part of the ankle joint

76
Q

What is the function of the groove on the posterior surface of the distal tibia?

A

Where the tibialis posterior muscle attaches (space for the tendon)

77
Q

What is the fibular notch? What happens here?

A

Notch on the the lateral side of the distal tibia

Fibula is bound to the tibia

78
Q

Are fractures of the tibia relatively common or uncommon? In what groups of people do they normally occur?

A

Common

Middle aged and elderly

79
Q

If the fibula is not fractured how are fragments of the fractured tibia displaced?

A

Minimally as the fibula will support the tibia

80
Q

Which site on the tibia is most vulnerable to fracture? What is a common cause of this? What consequences can result?

A

Proximal end

Traumatic accident

Condyles may be broken up, ligaments of the knee may be damaged

81
Q

The medial mallelolus can be fractured. What is the cause of this? What type of fracture results?

A

Over-inversion of the ankle - talus of foot forced against medial malleolus
Spiral fracture

82
Q

What is the position and thickness of the fibula compared to the tibia?

A

Located laterally to the tibia

Much thinner than the tibia

83
Q

What is the main function of the fibula? Why is it not as important as a weight bearer?

A

Attachment for muscles

Does not articulate with the femur at the knee joint

84
Q

What structures are present at the proximal end of the fibula?

A

Head containing a facet for articulation with the lateral condyle of the tibia
Neck

85
Q

How does the fibula articulate with the tibia at its proximal end?

A

Facet of the head of the fibula articulates with the lateral condyle of the tibia

86
Q

Where on the fibula can the common fibular nerve be found?

A

Posterior and lateral surface of the fibular neck

87
Q

The fibular shaft consists of which surfaces?

A

Anterior, lateral and posterior

88
Q

What is the continuation of the lateral surface of the distal fibula called?

A

The lateral malleolus

89
Q

Which is more prominent, the lateral or medial malleolus?

A

Lateral malleolus

Can be palpated at the lateral ankle

90
Q

What part of the fibula is most prone to fracture?

A

The lateral malleolus

91
Q

Fractures of the lateral malleolus can be of which two types? Which is more common?

A

Spiral - more common

Transverse

92
Q

What causes a spiral fracture of the fibula?

A

Forced external rotation of the ankle

Force of the talus against the lateral malleolus causes fracture

93
Q

What causes a transverse fracture of the fibula?

A

Foot being twisted outwards (eversion)

Talus presses against the lateral malleolus causing fracture

94
Q

The bones of the foot can be divided into which three categories?

A

Tarsals
Metatarsals
Phalanges

95
Q

How many tarsal bones are there? In which area of the foot are they located?

A

7

Ankle

96
Q

How many metatarsals are there in the foot? What do they connect?

A

5 - one for each digit

Phalanges and the tarsals

97
Q

Phalanges are the bones of the _______

How many phalanges does each toe have?

A

Toes

Each toe has three phalanges except the big toe which has two

98
Q

The tarsal bones of the foot are organised into how many rows?

A

3

Proximal, Intermediate, Distal

99
Q

What are the proximal tarsal bones?

A

Talus

Calcaneus

100
Q

Which is the most superior tarsal bone?

A

Talus

101
Q

How many articulations does the talus have? Describe them.

A

3

Superior - ankle joint - tibia and fibula
Inferior - subtalar joint - calcaneous
Anterior- talonavicular joint - navicular

102
Q

What is the main function of the talus?

A

To transmit forces from the tibia to the calcaneus

103
Q

What is another name for the calcaneus?

A

The heel bone

104
Q

Do any muscles attach or originate at the talus?

A

No - only ligaments attach here

105
Q

What is the position of the calcaneus relative to the talus?

A

Located underneath the talus

106
Q

How many articulations does the calcaneus have? Describe them.

A

2

Superior - subtalar joint - talus
Anteriorly - calcaneocuboid joint - cuboid

107
Q

What is the function of the calcaneus?

A

Transmits forces from the talus to the ground

108
Q

What marks the posterior aspect of the calcaneus? What attaches here?

A

Calcaneal tuberosity

Achilles tendon

109
Q

How many bones are present in the intermediate group of the tarsals?

A

1 - Navicular

110
Q

How many articulations does the navicular make? With which bones?

A

3

Posteriorly - talus
Anteriorly - cuneiform bones
Laterally - cuboid

111
Q

Where on the navicular is a tuberosity present? What attaches here?

A

Plantar surface

Tibialis posterior tendon

112
Q

How many bones are there in the distal group of tarsal bones? Name them.

A

4

Cuboid
3 Cuneiforms

113
Q

Where is the cuboid located in the distal row of the tarsal bones? What does it articulate with?

A

Most laterally

Posteriorly - calcaneus
Anteriorly - 2 metatarsals

114
Q

A groove is present on which surface of the cuboid? What is it for?

A

Inferior surface

Fibularis longus muscle

115
Q

How many cuneiform bones are there? How are they named? What shape do they take?

A

3

Lateral, Intermediate, Medial

Wedge shaped

116
Q

Where do the cuneiform bones articulate?

A

Posteriorly - navicular

Anteriorly - 3 metatarsals

117
Q

The shape of the cuneiforms contributes to…

A

The transverse arch that exists across the foot

118
Q

What are the two most commonly fractured tarsal bones?

A

Talus

Calcaneus

119
Q

Fractures of the talus can occur in which two places?

A

Neck or body of the talus

120
Q

What causes neck fractures of the talus? What complications can occur in this type of talus fracture?

A

Excessive dorsiflexion of the foot - neck of the talus pushed against the tibia

Interrupted blood supply - avascular necrosis of the talus

121
Q

What usually causes fractures of the talus body?

A

Jumping from a height

122
Q

Why is there little displacement of fracture pieces in any fracture of the talus?

A

The malleoli of the leg bones act to hold the fragments together

123
Q

The calcaneus is often fractured in which sort of injury? What causes the fracture?

A

A crush type injury - e.g. Falling onto the heel from a height

Talus is driven into the calcaneus

124
Q

What is meant by a comminuted fracture? Is a calcaneus fracture often a comminuted fracture?

A

Fracture where the bone breaks into several pieces

Yes

125
Q

How does the calcaneus appear on X-ray when fractured?

A

Shorter and wider than normal

126
Q

What complications can result from a calcaneus fracture, even after treatment?

A

There can be disruption of the subtalar joint - causing arthritis

Therefore pain upon inversion and eversion - particularly painful when walking on uneven ground

127
Q

How are the metatarsals named?

A

Numbered I - V (medial to lateral)

128
Q

What is the common structure of a metatarsal bone?

A

Distal head
Proximal base
Joined by a shaft

129
Q

How many articulations does each metatarsal have?

A

3 or 4

130
Q

Describe the articulations of metatarsals

A

Proximally - tarsometatarsal joints - either cuneiforms or cuboid bones

Laterally - intermetatarsal joints - adjacent metatarsals

Distally - metatarsophalangeal joint - proximal phalanx

131
Q

What is the most common method of metatarsal fracture?

A

Direct blow to the foot - e.g. Heavy object dropping on the foot

132
Q

What are two less common mechanisms of metatarsal fracture?

A

Stress fracture due to repeated stress to the bone

Excessive inversion of the foot

133
Q

A stress fracture of the metatarsal is common in which group of people and which metatarsals?

A

Athletes

2,3 and 4

134
Q

How can excessive inversion the foot result in metatarsal fracture?

A

The fiburalis brevis muscle can tear off the base of metatarsal V

135
Q

How many phalanges do the toes have? How are they named?

A

All have 3, except the big toe which has 2

Proximal (Intermediate) Distal

136
Q

What is the general structure of each phalanx?

A

Each phalanx consists of a body, a proximal extremity and a distal extremity of

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