Osteology & Joints of the Lower Limb Flashcards
What is the longest and heaviest bone in the body?
Femur
The femur is approximately what length of a persons height?
approx 1/4 of persons height
What makes up the proximal end of the femur?
Head of the femur
Neck of the femur
Trochanters
Greater trochanter
Lesser trochanter
Intertrochanteric line
Intertrochanteric crest
Trochanteric fossa
What makes up the body of the femur?
Linea aspera (medial & lateral lips)
Spiral line, pectineal line and gluteal tuberosity
Supracondylar lines (medial & lateral)
What makes up the distal end of the femur?
Femoral condyles
Femoral epicondyles
Patellar surface
Adductor tubercle
Intercondylar fossa
What is the largest sesamoid bone in the body?
Patella
Patella is broad and thick at the base which makes it ideal for which muscle to attach?
quadriceps femoris muscle
Which area of the knee articulates with the femur?
Posterior surface articulates with femur and has medial and lateral facets which slope away from a smooth ridge
Which is bigger, the lateral or medial facet of the patella?
Lateral facet is larger than the medial facet for articulation with the larger corresponding surface on the lateral condyle of the femur
What way will the patella tilt, when the posterior side is placed onto a smooth surface?
Patella will tilt to lateral side when the posterior side is placed onto a smooth surface, useful for identifying if it is a left or right bone
How are the tibia and fibula connected?
by an interosseous membrane and proximal and distal tibiofibular joints
What makes up the proximal end of the tibia?
Tibial plateau
Medial and lateral condyles
Intercondylar eminence
What makes up the body of the tibia?
Borders and surfaces
Tibial tuberosity (distal attachment for patella ligament)
Soleal line
What is the name of the Distal end articular facets?
Medial Malleolus
What bone in the leg is non weight bearing?
Fibula
What is the main purpose of the fibula?
Mainly serves for muscle attachment
What is the name of the proximal end of the fibula?
Head of the fibula
What makes up the body of the femur?
3 surfaces and 3 borders
What is the name of the distal end of the fibula?
Lateral Malleolus
Head of femur articulates with what?
Round head of femur articulates with the cup-like acetabulum of the hip bone
What are the movements of the hip joint?
flexion, extension, abduction, adduction, medial and lateral rotation, and circumduction
The rim of acetabulum is raised slightly by a what?
fibrocartilaginous collar
What does the non-articular acetabular fossa contain?
fat and loose connective tissue. And the attachment of the ligament of the head of femur.
What ligament is anterior to hip joint. Attaches between ilium (between AIIS and margin of acetabulum) and intertrochanteric line of femur?
Iliofemoral ligament
What ligament is anteroinferior to hip joint. Attaches from the iliopubic eminence and obturator membrane, and blends into the joint capsule laterally?
Pubofemoral ligament
What ligament is posterior to hip joint. Attaches between ischium (posteroinferior to acetabulum) and greater trochanter?
Ischiofemoral ligament
What ligament sits Inferiorly, labrum bridges across acetabular notch as transverse acetabular ligament & converts notch into foramen?
Transverse acetabular ligament
What ligament is a flat band of delicate connective tissue. Attaches between fovea on head of femur and acetabular fossa, transverse acetabular ligament and margin of acetabular notch?
Ligament of the head of the femur
What are the 5 Extracapsular Ligaments of the knee?
- Patella ligament
- Lateral collateral ligament
- Medial collateral ligament
- Oblique popliteal ligament
- Arcuate popliteal ligament
What tendon/ligament is the anterior ligament of the knee?
Patellar Ligament/Tendon
Where is the Patellar Ligament/Tendon located to and from?
From: Apex and margins of patella
To: Tibial tuberosity
Blends with medial and lateral patella retinacula (expansions of vastus medialis and lateralis that support the capsule laterally)
What does a patella tendon/ligament rupture result in?
Rupture results in patella alta (displaced superiorly)
Where is the Lateral Collateral Ligament located?
From: lateral epicondyle of femur
To: Lateral surface of head of fibula
Tendon of popliteus passes deep, separating it from the lateral meniscus
Describe the Medial Collateral Ligament?
Strong flat band, but is weaker than the fibular collateral ligament and often damaged during sports
Where is the medial collateral ligament located?
From: Medial epicondyle of femur
To: Medial condyle of tibia
At its midpoint, the deep fibres of the medial collateral ligament are firmly attached to the medial meniscus
What are the Intra-Articular Structures of the knee?
- Anterior Cruciate Ligament
- Posterior Cruciate Ligament
- Medial Meniscus
- Lateral Meniscus
What are menisci?
Crescent shaped plates of fibrocartilage
What do menisci look like and what is their function?
Thicker at their external margins and taper to thin unattached edges in the interior of the joint
Attached at their ends to the intercondylar area of the tibia
External margins attach to the capsule (coronary ligaments)
Transverse ligament joins their anterior edges, allowing them to move together
Deepens the surface and acts like shock absorbers
What is the medial meniscus?
“C” shaped
Anterior and posterior ends attach to the anterior and posterior intercondylar areas of the tibia
Firmly adheres to the deep surface of the medial collateral ligament
What is the medial meniscus?
“C” shaped
Anterior and posterior ends attach to the anterior and posterior intercondylar areas of the tibia
Firmly adheres to the deep surface of the medial collateral ligament
What is the lateral meniscus?
“O” shaped
Anterior and posterior ends attach to the anterior and posterior intercondylar areas of the tibia
Smaller and more freely movable
Posterior meniscofemoral ligament joins the lateral meniscus to the PCL and the medial femoral condyle
What are the cruciate ligaments?
In the centre of the joint, crossing each other to form an ‘X’
Where does the Anterior Cruciate Ligament go from and to?
From: Anterior intercondylar area of the tibia posterior to attachment of medial meniscus
To: Posterior part of medial side of the lateral condyle of the femur
Is slack when the knee is flexed, and taut when it is fully extended
What does the ACL prevent?
Prevents posterior displacement of the femur on the tibia and hyperextension of the knee joint.
It also prevents excessive tibial medial and lateral rotation, as well as varus and valgus stresses.
True or False? The ACL provides approximately 85% of total restraining force of anterior translation of the tibia.
true
Which is stronger, the ACL or PCL?
PCL
The PCL is twice as thick as theACL which results in less injuries than the ACL due to the stronger nature. As a result, PCL injuries are less common thanACLinjuries.
Where does the Posterior Cruciate Ligament go from and to?
From: Posterior intercondylar area of the tibia
To: Anterior part of lateral surface of medial condyle of the femur
What does the PCL prevent?
Prevents anterior displacement of the femur on the tibia, or posterior displacement of the tibial on the femur
Helps prevent hyperextension of the knee
What is the role of the PCL?
It acts as the major stabilizing ligament of the knee and prevents the tibia from excessive posterior displacement in relation to the femur.
It also functions to prevent hyper-extension and limits internal rotation, adduction and abduction at the knee joint.
What are the names of the bursae anterior to the knee?
supra-patella bursa
prepatellar bursa
superficial infra-patellar bursa
deep infrapatellar bursa
What are the names of the bursae posterior to the knee?
popliteus bursa
semimembrenosus bursa
semitendinosus bursa
gastrocnemius bursa
gracilis bursa
biceps bursa
sartorius bursa
What type of joint is the Proximal Tibiofibular Joint?
plane-type synovial joint
How does the Proximal Tibiofibular Joint work?
Facet on fibular head articulates with a facet located posterolaterally on the lateral tibial condyle
What are ligaments associated with the Proximal Tibiofibular joint?
Anterior tibiofibular
Posterior tibiofibular
Which joint is weakest and most prone to injury in plantarflexion?
Talocrural joint
What do the lateral ligaments of the foot stabilize?
the ankle during inversion
Which ligament is described as - Weak, flat band extending from lateral malleolus to neck of the talus?
Anterior talofibular (ATFL)
Which ligament is described as - Strong, thick band from the malleolar fossa to the lateral tubercle of the talus?
Posterior talofibular
Which ligament is described as -Round cord from the tip of the lateral malleolus to the lateral surface of the calcaneus ?
Calcaneofibular (CFL)
(High ankle sprain) Forced hyperflexion of the talocrural joint causes damage to the?
Anterior Inferior Tibiofibular ligament (AITFL)
What do the medial ligaments of the foot stabilize?
the ankle during eversion
The deltoid ligament is made up of what ligaments?
- Tibionavicular
- Anterior tibiotalar
- Posterior tibiotalar
- Tibiocalcaneal
Describe the Distal Tibiofibular Joint?
Fibrous joint
Rough triangular area on medial surface of distal end of fibula articulates with facet on distal end of tibia
Ligaments
Interosseous,
Anterior inferior tibiofibular,
Posterior inferior tibiofibular
What are the names of the 7 tarsal bones?
Calcaneus
Talus
Navicular
Cuboid
3 Cuneiforms
Medial
Intermediate
Lateral cuneiform
How many metatarsal bones are there?
5
What are the most important joints of the foot?
Subtalar
Transverse tarsal joints which are two in number:
Talocalcaneonavicular
Calcaneocuboid
Where is the subtalar joint located and what is it’s actions?
Between inferior surface of the talus the superior surface of the calcaneous
Supported by the medial, lateral and posterior and interosseous talocalcaneal ligaments
Inversion and eversion of the foot mainly occur at this joint
Where is the transversetalar joints and what articulates with what?
Transversetalar joints
Talocalcaneonavicular
Talus articulates with navicular and calcaneous
Where is the Calcaneocuboid located?
Between anterior surface of calcaneus and posterior surface of cuboid
Where is the Interphalangeal joint of the foot?
Between the head of one phalanx and the base of the one distal to it
Where is the Metatarsophalangeal joint?
Heads of the metatarsals articulate with the bases of the proximal phalanges
Sesamoid bones in the two tendons of flexor hallucis brevis
Where is the Tarsometatarsal joint?
Four anterior tarsal bones articulate with the bases of the metatarsal bones
What are the roles of the arches of the foot?
Bones of the foot arranged in longitudinal and transverse arches
Act as shock absorbers
Support weight of the body
Propels body forward during gait
What is the longitudinal arch of the foot composed of?
Composed of medial and lateral parts
Acts with the transverse arch to spread the weight in all directions
What is the medial arch (part) of the foot composed of?
Higher and more important than the lateral longitudinal arch
Composed of calcaneus, talus, navicular, three cuneiforms, and three metatarsals
Tibialis anterior and fibularis longus tendon helps to strengthen this arch
What is the lateral arch (part) of the foot composed of?
Flatter and rests on the ground during standing
Composed of calcaneus, cuboid, and lateral two metatarsals
What is the transverse arch of the foot composed of?
Formed by cuboid, cuneiforms, and bases of the metatarsals
Medial and lateral parts of the longitudinal arch act as pillars for the transverse arch
Tendon of fibularis longus helps maintain the arch
Integrity of Arches is maintained by?
Shape of interlocking bones
Muscle tendons:
1. Tibialis anterior
2. Tibialis posterior
3. Fibularis longus
Plantar ligaments
1.Plantar cacaneonavicular ligament
2.Long and short plantar ligaments
Plantar aponeurosis
Describe the Plantar calcaneonavicular (“spring”) ligament?
Main supporter of medial longitudinal arch
From sustentaculum tali to posteroinferior surface of the navicular
Describe the Long plantar ligament?
Main supporter of lateral longitudinal arch
From plantar surface of calcaneus to groove on cuboid and slips to the metatarsals forming a tunnel for the tendon.
Describe the Short plantar (calcaneocuboid) ligament?
Aids the above ligaments in supporting the longitudinal arch
From calcaneus to the cuboid
What are the functions of Plantar Aponeurosis (Plantar fascia)?
Holds parts of the foot together
Maintains the longitudinal arch
Protects the plantar surface from injury
What are the attachments of the Plantar Aponeurosis (Plantar fascia)?
Arises from the posterior surface of calcaneus and split into 5 bands that are attached to the fibrous digital sheaths.
Lateral part extends from tuberosity of calcaneous to tuberosity of 5th metatarsal bone
Aids long plantar ligament to maintain lateral longitudinal arch
Medial part attaches to sesamoid bones
Strengthens the medial longitudinal arch when standing on the toes
