Lower limb osteology

Question 1

What are the bony landmarks of a hip bone?

Answer 1

• Iliac crest
• Anterior Superior Iliac Spine
• Ischial spine
• Ischial tuberosity
• Acetablum
• Obturator foramen

Question 2

What three bones fuse to form the hip bone?

Answer 2

• Ilium
• Ischium
• Pubis

Question 3

What is the sacroiliac joint?

Answer 3

-The articulation between the sacrum and the ilium

Question 4

What ligament runs between the sacrum and the ischial spine?

Answer 4

-Sacrospinous ligament

Question 5

What stabilises the three bones which make the hip when unfused?

Answer 5

-Triradiate cartilage

Question 6

Where anatomically does the acetablum lie?

Answer 6

-Laterally

Question 7

How can a fracture of neck of femur be identified on an xray?

Answer 7

• Greater trochanter will appear larger due to lateral rotation
• Toes point laterally

Question 8

What articulates with head of femur?

Answer 8

-Acetabulum

Question 9

What is the angle of inclination?

Answer 9

• Angle between midline of head and midline of shaft

- Approx. 125 degrees

Question 10

Where is the intertrochanteric line?

Answer 10

-Anterior between the two trochanters

Question 11

Where is the intertrochanteric crest?

Answer 11

-Posterior between the two trochanters

Question 12

What bones make the pelvic girdle?

Answer 12

• 2 hip bones
• Sacrum
• Coccyx

Question 13

What runs between the sacrum and the ischial tuberosity?

Answer 13

-Sacrotuberous ligament

Question 14

What lines are present on the posterior of the femur?

Answer 14

-Pectineal line which blends into linear aspera which splits into lateral and medial supra-condylar lines

Question 15

What are the bony landmarks of the femur?

Answer 15

• Greater and lesser trochanter
• Epicondyles
• Condyles
• Adductor tubercle
• Intercondylar fossa
• Gluteal tuberosity
• Linear aspera
• Patella surface

Question 16

What articulates with the tibia?

Answer 16

-Medial and lateral condyles

Question 17

What is the fovea capitis?

Answer 17

-Central depression in head of femur where the ligament of head of femur attaches

Question 18

Where does the femur often fracture?

Answer 18

-Neck of femur (Hip Fracture)

Question 19

Where is the adductor tubercle located?

Answer 19

-Immediately above the medial epicondyle

Question 20

Which way does the neck of femur project?

Answer 20

-Superio-medially

Question 21

What is the beneit of the shat running slightly medially?

Answer 21

-Increases stability

Question 22

What attaches in the intercondylar fossa?

Answer 22

-Cruciate ligaments

Question 23

When do fractures of the shaft occur?

Answer 23

-They are uncommon, have to be high force such as RTA

Question 24

Why is it important to check the blood supply when examining fracture of shaft of femur?

Answer 24

-Femoral artery supplies the whole limb

Question 25

Which bone bears weight in the leg?

Answer 25

-Tibia

Question 26

-What does the tibia articulate with?

Answer 26

- Condyles of femur - Fibula - Talus

Question 27

What are the bony landmarks of the tibia?

Answer 27

- Tibial condyles forming the tibial plateau - Intercondylar eminence with intercondylar tubercles - Tibial tuberosity - Medial malleolus - Soleal line

Question 28

What attaches to the intercondylar eminence?

Answer 28

- Cruciate ligaments | - Menisci

Question 29

What is the main articulation of the knee?

Answer 29

-Tibial plateau with condyles of femur

Question 30

Where do the intercondylar tubercles lie during articulation with the femur?

Answer 30

-In the Intercondylar fossa of the femur

Question 31

What ligament attaches to tibial tuberosity?

Answer 31

-Patella ligament

Question 32

What articulates with medial malleolus of tibia?

Answer 32

-Talus

Question 33

What lies between tibia and fibula?

Answer 33

-Interosseous membrane

Question 34

Who most commonly fractures the tibia?

Answer 34

-Middle aged/elderly

Question 35

Which part of the tibia most commonly fractures?

Answer 35

-Proximal

Question 36

Why can there be minimal displacement during a tibial fracture?

Answer 36

-If the fibula is not involved in the fracture it supports the tibial fragment

Question 37

At which side of the tibia does the fibula lie?

Answer 37

-Lateral

Question 38

-How does the fibula contribute to the ankle?

Answer 38

-Lateral malleolus articulates with talus

Question 39

What are the articulations of the fibula?

Answer 39

- Talus distally | - Tibia proximally and distally

Question 40

What are the bony landmarks of the fibula?

Answer 40

- Head - Neck - Leteral malleolus

Question 41

Where does the common fibula nerve lie in relation to fibula?

Answer 41

-Posteriolaterally to fibula neck

Question 42

Where are common fractures of the fibula?

Answer 42

-Lateral malleolus

Question 43

What are the most common causes of fractures to lateral malleolus?

Answer 43

- Forced external rotation (spiral fracture) | - Eversion (transverse fracture)

Question 44

What is indicated if osteophytes appear in the joint of the knee?

Answer 44

-Osteoarthritis

Question 45

Name the groups of bones of the foot

Answer 45

- Tarsals (7) - Metatarsals (5) - Phalanges (3 on each digit except 1st which has 2)

Question 46

Name the tarsal bones

Answer 46

- Talus - Calcaneus - Navicular - Lateral, intermediate and medial cuneiform - Cuboid

Question 47

What does talus articulate with?

Answer 47

-Tibia and fibula (medial and lateral malleolus)

Question 48

Where is the subtalar joint?

Answer 48

-Between talus and calcaneus

Question 49

How is neck of talus often fractured?

Answer 49

-Forced dorsiflexion pushes neck against tibia causing fracture

Question 50

What is a possible complication of fracture of neck of talus?

Answer 50

-Avascular necrosis if blood supply disrupted

Question 51

Why is there little displacement in talar fractures?

Answer 51

-Malleolus holds in place

Question 52

How is body of talus usually fractured?

Answer 52

-Jumping from a height causing a crush-type injury as talus is driven into calcaneus

Question 53

What is a comminuted fracture?

Answer 53

-Bone breaks into several fragments

Question 54

What are the most frequently fractured tarsals?

Answer 54

- Talus | - Calcaneus

Question 55

How is calcaneus usually fractured?

Answer 55

-Jumping from a height causing a comminuted fracture

Question 56

What is the calcaneocuboid joint?

Answer 56

-Articulation between calcaneus anteriorly and cuboid

Question 57

Which tarsals articulate with metatarsals?

Answer 57

- cuneiforms | - Cuboid

Question 58

How do metatarsal fractures commonly occur?

Answer 58

- Direct blow to foot - Excessive inversion of foot - Stress fractures

Question 59

What is a stress fracture?

Answer 59

-Incomplete fracture caused by repeated stress to the bone