Osteology of the Tibia and Fibula Flashcards

1
Q

Tibia (“shin bone”)

A
  • Long bone with a diaphysis and a proximal and distal epiphyses
  • Transfers majority (~ 85%) of weight between femur and talus
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2
Q

Tibia articulates with

A
  • Femur proximally
  • Fibula proximal and distal
  • Talus inferiorly
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3
Q

Anterior proximal structures of tibia

A
  • Medial/lateral condyles
  • Intercondylar eminence
  • Anterior/posterior intercondylar fossae (surface)
  • Tibial tuberosity
  • Gerdy’s tubercle (tubercle of iliotibial tract)
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4
Q

Medial condyle

A
  • Larger with larger articular surface
  • Oval shaped
  • Palpable
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5
Q

Lateral condyle

A
  • Smaller than medial
  • Circular shaped articular surface
  • Palpable
  • Contains fibular facet
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6
Q

Fibular facet

A
  • Inferior surface of lateral condyle

- Articulates with fibular head

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7
Q

Intercondylar eminence

A
  • Located between condyles

- Medial and lateral intercondylar tubercles

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8
Q

Anterior and posterior intercondylar fossae (surface)

A
  • Anterior and posterior to intercondylar eminence

- Attachment of cruciate ligaments and horns of menisci

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9
Q

Tibial tuberosity

A
  • Attachment of patellar ligament

- Palpable

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10
Q

Gerdy’s tubercle (tubercle of the iliotibial tract)

A
  • Small projection
  • Lateral to tibial tuberosity and patellar apex (when knee is extended)
  • IT tract attaches
  • Palpable
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11
Q

Posterior proximal structures of tibia

A
  • Groove for semimembranosus tendon

- Fibular articular facet

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12
Q

Groove for semimembranosus tendon

A
  • Posteromedial edge of medial condyle
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13
Q

Fibular articular facet

A
  • Facet on lateral condyle

- Articulates with fibular head

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14
Q

Tibial shaft

A
  • From tibial tuberosity to the fibular notch

- 3 borders

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15
Q

3 borders of the tibial shaft

A
  • Anterior (shin)
  • Lateral (interosseous)
  • Medial border
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16
Q

Anterior (shin) border of tibia

A
  • Subcutaneous

- Very palpable

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17
Q

Lateral (interosseous) border of tibia

A
  • Attachment of interosseous membrane
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18
Q

Medial border of tibia

A
  • Palpable
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19
Q

3 surfaces of tibial shaft

A
  • Medial
  • Lateral surface
  • Posterior surface
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20
Q

Medial surface of tibial shaft

A
  • Between anterior and medial border
  • Faces anteromedially
  • Subcutaneous and very palpable
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21
Q

Lateral surface of tibial shaft

A
  • Between anterior and lateral borders

- Site of anterior leg compartment muscle attachment

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22
Q

Posterior surface of tibial shaft

A
  • Between medial and lateral borders
  • Soleal line
  • Vertical line
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23
Q

Nutrient foramen (canal) is usually located

A
  • Inferior to soleal line

- Canal is angled distally

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24
Q

Soleal line (posterior tibial shaft)

A
  • From fibular facet to medial border of junction of proximal and middle 1/3s of shaft
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25
Q

Vertical line (posterior tibial shaft)

A
  • Descends from center of soleal line
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26
Q

Distal structures of tibia

A
  • Medial malleolus
  • Tibial plafond
  • Posterior process
  • Fibular notch
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27
Q

Distal tibia articulates with

A
  • Talus
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28
Q

Medial malleolus structures

A
  • Subcutaneous, palpable
  • Medial malleolar articular facet
  • Anterior/posterior colliculus
  • Intercollicular groove
  • Groove for tibialis posterior and flexor digitorum longus tendons
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29
Q

Medial malleolar articular facet

A
  • Pear shaped facet
  • Lateral surface of medial malleolus
  • Covered with articular (hyaline cartilage)
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30
Q

Medial malleolar articular facet articulates with

A
  • Medial talar body
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31
Q

Anterior colliculus of medial malleolus

A
  • Anterior projection
  • Extends further inferiorly
  • Ligament attachment
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32
Q

Posterior colliculus of medial malleolus

A
  • Ligament attachment
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33
Q

Intercollicular groove of medial malleolus

A
  • Separates colliculi
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34
Q

Tibial plafond

A
  • Rectangle shaped, inferior articular surface
  • Lined with articular cartilage
  • Continuous with articular facet of medial malleolus
  • Articulates with talus
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35
Q

Posterior process

A
  • Posterolateral prominence (3rd malleolus)

- Groove for flexor hallucis longus (depression over process)

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36
Q

Fibular notch

A
  • Triangular depression on lateral surface

- Articulates with fibula (tibiofibular syndesmosis)

37
Q

Fibula

A
  • Long slender bone
  • IMPORTANT for ankle stability
  • Transmits small amounts of weight (~15%)
  • Site of muscle attachment
38
Q

Fibula is palpable at

A
  • Head and lateral malleolus
39
Q

Fibula articulates with

A
  • Articulates with talus and tibia
40
Q

Proximal fibular structures

A
  • Head of fibula
  • Articular facet
  • Apex of fibula (styloid process)
41
Q

Head of fibula

A
  • “Square-ish” in shape
  • Subcutaneous, easily palpated
  • Common fibular nerve passes around fibular head/neck (easily damaged)
42
Q

Fibular articular facet

A
  • Articulation with lateral condyle of tibia
43
Q

Apex of fibula (styloid process)

A
  • Site of ligament attachment
44
Q

Fibula shaft borders

A
  • Spiral from proximal to distal
  • Anterior
  • Interosseous (medial border)
  • Posterior
  • Middle crest (crista medialis)
45
Q

Fibula anterior border

A
  • Begins at the anterior aspect of the head
  • Curves laterally moving toward lateral malleolus
  • Splits distally
46
Q

Fibula anterior border splits distally to

A
  • Enclose a lateral triangular area above lateral malleolus

- Subcutaneous and palpable

47
Q

Fibula anterior border function

A
  • Attachment of anterior intermuscular septum

- Separates anterior and lateral compartments

48
Q

Fibula interosseous (medial) border

A
  • Medial side, posterior to anterior border
  • Extends from head to triangular area distally
  • Attachment of interosseous membrane
49
Q

Fibula posterior border

A
  • Begins at head and ends as posterior border of lateral malleolus
  • Faces laterally proximally and posterior distally
  • Attachment of posterior intermuscular septum
50
Q

Fibula medial crest (crista medialis)

A
  • Oblique line that begins on medial side
  • Becomes continuous with interosseous border distal ¼ of fibula
  • Aponeurosis attachment that separates muscles
51
Q

Surfaces of fibula

A
  • Medial (sometimes called anterior)
  • Lateral
  • Posterior
52
Q

Medial (anterior) surface of fibula

A
  • Between anterior and interosseous borders

- Site of muscle attachment, anterior compartment muscles

53
Q

Lateral surface of fibula

A
  • Between anterior and posterior borders
  • Faces anteriorly at proximal end and more posterior distally
  • Attachment of lateral compartment muscles
54
Q

Posterior surface of fibula

A
  • Between posterior and interosseous borders
  • Continuous with area that articulates with tibia
  • Faces posterior proximally and medial distally
  • Attachment for some posterior compartment muscles
55
Q

Fibular nutrient foramen

A
  • Located on middle 1/3 of posterior surface
56
Q

Distal fibula structures

A
  • Lateral malleolus
  • Lateral malleolar articular facet
  • Lateral malleolar fossa
  • Lateral malleolar sulcus
  • Summit of lateral malleolus
  • Medial triangular surface
57
Q

Lateral malleolus

A
  • Subcutaneous and palpable
  • More distal and posterior than medial malleolus
  • Resists eversion
58
Q

Lateral malleolar articular facet

A
  • Triangular facet on medial surface

- Articulates with talus

59
Q

Lateral malleolar fossa

A
  • Fossa posterior to articular facet (on medial surface)

- Ligament attachment (transverse tibfib and posterior talofibular)

60
Q

Lateral malleolar sulcus

A
  • Groove on posterior border

- Fibularis longus and brevis tendons pass

61
Q

Summit of lateral malleolus

A
  • Rounded, distal end
  • Calcaneofibular ligament attaches
  • Can be site of avulsion fracture
62
Q

Medial triangular surface

A
  • Articulates with fibular notch of tibia to form distal tibiofibular joint
  • Syndesmotic joint, strong ligament
63
Q

Tibia primary ossification center

A
  • Shaft about 7th –8th fetal week
64
Q

Tibia secondary ossification centers

A
  • Proximal epiphysis
  • Distal epiphysis
  • Medial malleolus
  • Tibial tuberosity
65
Q

Proximal epiphysis ossification (tibia)

A
  • Appears around birth

- Fuses about 18 years of age

66
Q

Distal epiphysis ossification (tibia)

A
  • Appears around age 1

- Fuses about 16 years of age

67
Q

Medial malleolus ossification

A
  • Appears between 8-13 yrs of age
  • Not always a separate ossification center
  • Fuses ~ 15 in females, 17 in males
68
Q

Tibial tuberosity ossification

A
  • Appears around ages 10-12

- Fuses between 14-18

69
Q

Fibula primary ossification center

A
  • Shaft about 8th fetal week
70
Q

Fibula secondary ossification centers

A
  • Distal

- Proximal

71
Q

Distal fibula secondary ossification

A
  • Appears 1st year of life

- Fuses around 15-17 years of age

72
Q

Proximal fibula secondary ossification

A
  • Appears during the 3rd year

- Fuses around 17-19 years of age

73
Q

2⁰ centers fuse

A
  • In the order of appearance

- Different pattern of fusion than other long bones

74
Q

Superior (proximal) tibiofibular joint

A
  • Between head of fibular and lateral tibial condyle
  • Gliding (planar) synovial joint
  • Functionally a diarthrosis
75
Q

Ligaments of superior (proximal) tibiofibular joint

A
  • Anterior and posterior proximal tibiofibular ligaments
76
Q

Tibiofibular joint blood supply

A
  • Tibial recurrent arteries

- Inferior lateral genicular arteries

77
Q

Tibiofibular joint innervation

A
  • Common fibular nerve

- Nerve to popliteus

78
Q

Tibiofibular joint motion

A
  • Gliding movements occur when the ankle joint moves in dorsiflexion and plantarflexion
79
Q

Interosseous membrane of tibiofibular joint

A
  • Attaches to the interosseous borders of the tibia and fibula
  • The fibers are angled inferolaterally
80
Q

Openings of tibiofibular joint interosseous membrane

A
  • Superior (proximal) opening

- Inferior (distal)

81
Q

Superior (proximal) opening of interosseous membrane (tibiofibular joint)

A
  • Passage of anterior tibial artery
82
Q

Inferior (distal) opening of interosseous membrane (tibiofibular joint)

A
  • Passage of perforating branch of fibular artery
83
Q

Distal (inferior) tibiofibular joint

A
  • Between fibular notch and medial triangular area of fibula

- Syndesmosis, amphiarthrosis

84
Q

Ligaments of the tibiofibular joint function

A
  • Prevent separation of tibia and fibula, and talar wedging
85
Q

Ligaments of the tibiofibular joint (names)

A
  • Distal anterior tibiofibular ligament
  • Interosseous tibiofibular ligament
  • Distal posterior tibiofibular ligament
  • Inferior transverse tibiofibular ligament
86
Q

Talocrural joint

A
  • Between tibial plafond, lateral malleolar articular facet, medial malleolar articular facet and talus
87
Q

Midtarsal Joint (Chopart’s joint, transverse tarsal joint)

A
  • Between rearfoot and midfoot
88
Q

Lisfranc’s joint (tarsometatarsal joint)

A
  • Between the midfoot and forefoot