Lower limb osteology Flashcards
What are the bony landmarks of a hip bone?
- Iliac crest
- Anterior Superior Iliac Spine
- Ischial spine
- Ischial tuberosity
- Acetablum
- Obturator foramen
What three bones fuse to form the hip bone?
- Ilium
- Ischium
- Pubis
What is the sacroiliac joint?
-The articulation between the sacrum and the ilium
What ligament runs between the sacrum and the ischial spine?
-Sacrospinous ligament
What stabilises the three bones which make the hip when unfused?
-Triradiate cartilage
Where anatomically does the acetablum lie?
-Laterally
How can a fracture of neck of femur be identified on an xray?
- Greater trochanter will appear larger due to lateral rotation
- Toes point laterally
What articulates with head of femur?
-Acetabulum
What is the angle of inclination?
- Angle between midline of head and midline of shaft
- Approx. 125 degrees
Where is the intertrochanteric line?
-Anterior between the two trochanters
Where is the intertrochanteric crest?
-Posterior between the two trochanters
What bones make the pelvic girdle?
- 2 hip bones
- Sacrum
- Coccyx
What runs between the sacrum and the ischial tuberosity?
-Sacrotuberous ligament
What lines are present on the posterior of the femur?
-Pectineal line which blends into linear aspera which splits into lateral and medial supra-condylar lines
What are the bony landmarks of the femur?
- Greater and lesser trochanter
- Epicondyles
- Condyles
- Adductor tubercle
- Intercondylar fossa
- Gluteal tuberosity
- Linear aspera
- Patella surface
What articulates with the tibia?
-Medial and lateral condyles
What is the fovea capitis?
-Central depression in head of femur where the ligament of head of femur attaches
Where does the femur often fracture?
-Neck of femur (Hip Fracture)
Where is the adductor tubercle located?
-Immediately above the medial epicondyle
Which way does the neck of femur project?
-Superio-medially
What is the beneit of the shat running slightly medially?
-Increases stability
What attaches in the intercondylar fossa?
-Cruciate ligaments
When do fractures of the shaft occur?
-They are uncommon, have to be high force such as RTA
Why is it important to check the blood supply when examining fracture of shaft of femur?
-Femoral artery supplies the whole limb
Which bone bears weight in the leg?
-Tibia
-What does the tibia articulate with?
- Condyles of femur
- Fibula
- Talus
What are the bony landmarks of the tibia?
- Tibial condyles forming the tibial plateau
- Intercondylar eminence with intercondylar tubercles
- Tibial tuberosity
- Medial malleolus
- Soleal line
What attaches to the intercondylar eminence?
- Cruciate ligaments
- Menisci
What is the main articulation of the knee?
-Tibial plateau with condyles of femur
Where do the intercondylar tubercles lie during articulation with the femur?
-In the Intercondylar fossa of the femur
What ligament attaches to tibial tuberosity?
-Patella ligament
What articulates with medial malleolus of tibia?
-Talus
What lies between tibia and fibula?
-Interosseous membrane
Who most commonly fractures the tibia?
-Middle aged/elderly
Which part of the tibia most commonly fractures?
-Proximal
Why can there be minimal displacement during a tibial fracture?
-If the fibula is not involved in the fracture it supports the tibial fragment
At which side of the tibia does the fibula lie?
-Lateral
-How does the fibula contribute to the ankle?
-Lateral malleolus articulates with talus
What are the articulations of the fibula?
- Talus distally
- Tibia proximally and distally
What are the bony landmarks of the fibula?
- Head
- Neck
- Leteral malleolus
Where does the common fibula nerve lie in relation to fibula?
-Posteriolaterally to fibula neck
Where are common fractures of the fibula?
-Lateral malleolus
What are the most common causes of fractures to lateral malleolus?
- Forced external rotation (spiral fracture)
- Eversion (transverse fracture)
What is indicated if osteophytes appear in the joint of the knee?
-Osteoarthritis
Name the groups of bones of the foot
- Tarsals (7)
- Metatarsals (5)
- Phalanges (3 on each digit except 1st which has 2)
Name the tarsal bones
- Talus
- Calcaneus
- Navicular
- Lateral, intermediate and medial cuneiform
- Cuboid
What does talus articulate with?
-Tibia and fibula (medial and lateral malleolus)
Where is the subtalar joint?
-Between talus and calcaneus
How is neck of talus often fractured?
-Forced dorsiflexion pushes neck against tibia causing fracture
What is a possible complication of fracture of neck of talus?
-Avascular necrosis if blood supply disrupted
Why is there little displacement in talar fractures?
-Malleolus holds in place
How is body of talus usually fractured?
-Jumping from a height causing a crush-type injury as talus is driven into calcaneus
What is a comminuted fracture?
-Bone breaks into several fragments
What are the most frequently fractured tarsals?
- Talus
- Calcaneus
How is calcaneus usually fractured?
-Jumping from a height causing a comminuted fracture
What is the calcaneocuboid joint?
-Articulation between calcaneus anteriorly and cuboid
Which tarsals articulate with metatarsals?
- cuneiforms
- Cuboid
How do metatarsal fractures commonly occur?
- Direct blow to foot
- Excessive inversion of foot
- Stress fractures
What is a stress fracture?
-Incomplete fracture caused by repeated stress to the bone
