Lower Limb Bones Flashcards

1
Q

Pelvic Girdle

A
  • Sacroiliac joints
  • Pubic symphysis
  • Complete bony ring (closed posteriorly) : stability
  • Transfers body weight from spine to femurs
  • Supports lower limbs
  • Protects abdomen, pelvis & perineum
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2
Q

Ilium

A
  • thick medial body: joins ischium & pubis to form acetabulum
  • thin lateral ala: ASIS, PSIS, AIIS, PIIS
  • gluteal lines: origins of gluteal muscles
  • PIIS marks superior border of greater sciatic notch
  • medial surface- iliac fossa –> iliacus muscle
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3
Q

Ischium

A
  • thick upper body contributes to acetabulum
  • ischial spine: lower border of greater sciatic notch, upper border to lesser sciatic notch
  • ischial tuberosity: lower border of lesser sciatic notch, sits bone
  • Ramus: joins inferior ramus of pubis, inferior border of obturator foramen
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4
Q

Pubis

A
  • medial bodies articulate at symphysis pubis: bear pubic crest & tubercles
  • laterally projecting superior & inferior rami: contribute anterior portion of acetabulum, complete obturator foramen
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5
Q

Obturator Foramen

A
  • mostly covered by obturator membrane & muscles

- obturator nerve & vessels

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6
Q

Acetabulum

A

Acetabular notch, “chipped cup”

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7
Q

Sacrotuberous Ligament

A
  • posterior ilium, lateral sacrum, & coccyx to ischial tuberosity
  • converts sciatic notches into sciatic foramen
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8
Q

Sacrospinous Ligament

A
  • lateral sacrum & coccyx to ischial spine

- subdivides sciatic foramen into greater and lesser sciatic foramina (GSF & LSF)

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9
Q

Greater Sciatic Foramina (GSF)

A

-between true pelvis & gluteal region

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10
Q

Lesser Sciatic Foramina (LSF)

A

-between gluteal region & perineum

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11
Q

Femur

A
  • longest and heaviest
  • proximal: head, neck (weakest), greater/lesser trochanters
  • shaft
  • distal: medial/lateral condyles
  • patella: large sesamoid bone within quadriceps tendon, protects tendon when kneeling
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12
Q

Proximal Femur

A
  • head/neck angled in relation to shaft
  • 125 degrees
  • mechanical advantages for bipedal walking
  • head/neck angled in relation to condyles
  • angle of declination/torsion (7-12 degrees)
  • lesser trochanter projects posteromedial: illiopsoas
  • greater trochanter projects superior & posterior
  • intertrochanteric line anterior
  • intertrochanteric crest posterior
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13
Q

Femoral Shaft

A
  • slightly convex anteriorly

- posterior ridge: linea aspera

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14
Q

Linea Aspera

A
  • insertion of adductors
  • medial & lateral lips
  • medial lip –> spiral lip –> intertrochanteric line
  • lateral lip –> gluteal tuberosity
  • intermediate lip (pectineal line) –> lesser trochanter
  • medial & lateral supracondylar lines
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15
Q

Distal Femur

A
  • medial & lateral condyles
  • convex inferiorly & posteriorly
  • allows tibial condyles to glide
  • separated by intercondylar fossa
  • medial & lateral epicondyles, adductor tubercle
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16
Q

Proximal Tibia

A
  • proximal widening
  • medial & lateral condyles
  • tibial plateau
  • intercondylar eminence
  • tibial (gerdy) tubercle: iliotibial tract
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17
Q

Triangular Shaft of Tibia

A
  • anterior tibial tuberosity (patellar ligament)
  • lateral interosseous membrane
  • posterior soleal line
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18
Q

Distal Widening of Tibia

A
  • medial malleolus

- articulates with talus

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19
Q

Fibula

A
  • non weight bearing

- attachment for 9 muscles

20
Q

Proximal Fibula

A

-common fibular nerve compression

21
Q

Distal Expansion of Fibula

A
  • lateral malleolus
  • more prominent & distal than medial malleolus
  • malleoli form mortise for talus
22
Q

Talus

A
  • gripped by 2 malleoli
  • transmits weight to calcaneus & metatarsals
  • only tarsal with no muscle attachments
  • Head: keystone of medial arch
  • Body: medial & lateral tubercles, groove for flexor hallucis longus tendon
23
Q

Calcaneus

A
  • transmits weight to ground through calcaneal tuberosity
  • shelf-like medial sustentaculum tali
  • Calcaneal (achilles) tendon insertion
24
Q

Sustantaculum tali

A
  • supports head of talus

- pulley for flexor hallucis longus

25
Q

Lateral Fibular Trochlea

A

-pulley for fibularis longus & brevis

26
Q

Navicular

A
  • boat-shaped
  • medial longitudinal arch
  • inferior navicular tuberosity: tibialis posterior
27
Q

Cuboid

A
  • cube-shaped
  • lateral longitudinal arch
  • groove for fibularis longus (on plantar aspect)
28
Q

Cuneiforms

A
  • 1st medial, largest
  • 2nd intermediate, smallest
  • 3rd lateral
  • medial longitudinal arch
29
Q

Metatarsals

A

1st: shortest, widest, distal, medial & lateral sesamoid bones
2nd: longest
1st-3rd: articulates with corresponding cuneiforms
4th-5th: articulates with cuboid
5th: proximal tuberosity overlaps cuboid

30
Q

Hallux

A

Proximal & distal

Short & strong

31
Q

2nd-5th phalanges

A

-proximal, middle & distal

32
Q

Sacral Plexus

A

Ventral rami L4-S4

  1. Sciatic
  2. Pudendal
  3. Superior Gluteal
  4. Inferior Gluteal
  5. Nerve to quadratus femoris
  6. Nerve to obturator internus
  7. Posterior cutaneous nerve of the thigh
33
Q

Gluteus Maximus

A

-Largest heaviest muscle
O: ilium, sacrotuberous ligament
I: iliotibial tract (75%), gluteal tuberosity (25%)
A: extends, laterally rotates thigh
N: innervated by inferior gluteal nerve (L5-S2)

34
Q

Tensor Fascia Latae

A

O:ASIS, anterior iliac crest
I: IT band, tibial tubercle
A: Flexes, abducts, medially rotates thigh (weakly)
N: superior gluteal nerve

35
Q

Iliotibial Tract

A
  • lateral thickening of fascia lata
  • shared aponeurosis of gluteus maximums & tensor fascia latae
  • extends to anterolateral tibial plateau (Gerdy tubercle)
  • fixed to linea aspera via lateral intermuscular septum
  • common insertion of gluteus maximus & tensor fascia latae onto linea aspera & Gerdy’s tubercle
36
Q

Gluteus Medius

A

O: between anterior & posterior gluteal lines
I: greater trochanter
A: abduct & medially rotate thigh
N: superior gluteal nerve

37
Q

Gluteus Minimus

A

O: between anterior and inferior gluteal lines
I: greater trochanter
A: abduct & medially rotate thigh
N: superior gluteal nerve

38
Q

Piriformis

A

O: anterior sacral surface
I: greater trochanter
A: laterally rotates thigh
N: innervated by ventral rami of s1 & s2
-Key gluteal landmark for superior and inferior gluteal artery/nerve
-leaves pelvis via greater sciatic foramen

39
Q

Triceps Coxae

A

Obturator internus, gemellus superior, gemellus inferior

-all are incapable of independent action

40
Q

Obturator Internus

A

O: pelvic surface of obturator membrane
I: intertrochanteric fossa
A: laterally rotate thigh
N: nerve to obturator internus

41
Q

Gemellus Superior

A

O: ischial spine
I: intertrochanteric fossa
A: laterally rotate thigh
N: nerve to obturator internus

42
Q

Gemellus Inferior

A

O: Ischial tuberosity
I: intertrochanteric fossa
A: laterally rotates thigh
N: nerve to quadratus femoris

43
Q

Quadratus Femoris

A

O: ischial tuberosity
I: intertrochanteric crest
A: laterally rotates thigh
N: nerve to quadratus femoris

44
Q

Obturator Externus

A

O: anterior surface of obturator membrane
I: trochanteric fossa of femur
A: lateral rotates thigh

45
Q

Femoral Fractures

A
  • common
  • femoral neck
  • common in >60 y/o F with osteoporosis
  • intracapsular involvement: risk for avascular necrosis, hip arthroplasty
46
Q

What is inferior to the piriformis?

A
  • pudendal nerve
  • internal pudendal artery
  • nerve to obturator internus
  • inferior gluteal artery & nerve
  • posterior cutaneous nerve of thigh
  • sciatic nerve
47
Q

Gluteal Injections

A

-caution sciatic & superior gluteal nerve
-thickest part of region is unsafe
-upper outer quadrant
Bony landmarks: greater trochanter, PSIS (skin dimple), ASIS (TFL)