Bones of lower limbs -...
Transcript of Bones of lower limbs -...
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1Bone: Lower limb -
Bones of lower limbs
Including bones of pelvic girdle (hip bones) and lower limbcompared with upper limbno equivalent movements to pronation and supination in upper limb; more stable in lower limb, for weight-bearing
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2Bone: Lower limb -
Bony pelvis
Iliumischiumpubis
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3Bone: Lower limb -
Ilium (lateral surface) ant. sup. iliac spine:
a.s.i.s. post. sup. iliac spine:
p.s.i.s. Iliac crest: a.s.i.s. –
p.s.I.s. tubercle of crest ant. inf. iliac spine:
a.i.i.s. post. inf. iliac spine:
p.i.i.s. greater sciatic notch gluteal surface
Great sciatic notch
Obturator foramen
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4Bone: Lower limb -
Ilium (medial surface)-1
obturator forameniliac fossaa.s.i.s.; p.s.i.s. iliac crest: a.s.i.s. –
p.s.i.s.greater sciatic
notch (g.s.n.) Obturator foramen
g.s.n.
a.s.i.s.
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5Bone: Lower limb -
Ilium (medial surface)-2
ala (iliac fossa)Body of iliumridge between upper and lower part of iliacarcuate line
articular surface for sacrum (auricular face)attachment for ligaments (sacroiliac joint)iliac tuberosity
Obturator foramen
g.s.n.
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6Bone: Lower limb -
Ilium (medial surface)-3
arcuate line: linea terminalis of pelvic brimbelow: pelvic
part; lesser/true pelvisabove:
abdominal part; greater/false pelvis
Abdominal part
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7Bone: Lower limb -
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8Bone: Lower limb -
Ischium
body of ischiumlesser sciatic notchischial tuberosityischial spineischial ramus: with inf.
ramus of pubis ischiopubic ramus
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9Bone: Lower limb -
Pubis: ramisup. ramus contribute to acetabuluminf. ramus join ischium (ischial ramus)
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10Bone: Lower limb -
Pubis:1
body of pubispubic crestpublic tuberclesup. pubic ramus:
pectineal line on its sup. border, continues into arcuate lineinf. pubic ramusobturator foramen
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11Bone: Lower limb -
Obturator canal
obturator canal: at the upper, posterior angle of obturator foramen (obturator n.,a.,v.)
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12Bone: Lower limb -
Iliopubic eminence
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13Bone: Lower limb -
Pubis: external
acetabulum: acetabular notch, limbusGluteal lineAnteriorPosteriorInferior
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14Bone: Lower limb -
Pubic symphysis
cartilaginous joint (fibrous cartilage)as a landmark of
pelvic cavity
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15Bone: Lower limb -
PelvisThe complete pelvis:the line (pelvic inlet)
from promontory of sacrum -- arcuate line - - pectineal line -- pubic crest separatesfalse pelvis and true
pelvissacrum + linea
terminalis + pubis symphysis
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16Bone: Lower limb -
Pelvis: anatomical position
a.s.i.s. and symphysis pubis on the same coronal plane
symphysis
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17Bone: Lower limb -
Pelvis: female vs. maleShape: circular in female (less distinct promontory,
broader alae); heart-shaped in maleAngle: larger in female; smaller in male
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18Bone: Lower limb -
Pelvis: pelvic outletbounded by symphysis pubis - ischiopubic rami - ischial
tuberosity - sacrotuberous lig. - coccyx
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19Bone: Lower limb -
Pelvic outletnot on the same plane; line joining the ischial tuberosities
of both sides divides it into two parts
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20Bone: Lower limb -
The sacro-iliac joint-1synovial joint in childhood; fibrous bands in joints of adult; > 50 years old, completely fibroussupported by many tough ligaments including: interosseous lig., ant.& post. sacroiliac lig., sacrospinous
lig. , sacrotuberous lig.
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21Bone: Lower limb -
Sacro-iliac joints-2
interosseous lig., ant. and post. sacroiliac lig.
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22Bone: Lower limb -
Sacroiliac joints and Sciatic foramensgreater sciatic foramen; lesser sciatic foramen*posterior aspect of joint heavily armed with
ligaments (to counter body weight)
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23Bone: Lower limb -
Sciatic foramen
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24Bone: Lower limb -
Sciatic foramen
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25Bone: Lower limb -
Femur: proximal end (anterior Surface)head: faces upward,
medially, slightly forward; fovea; neck:greater trochanter;
trochanteric fossa (obturator internus attachment) intertrochanteric line lesser trochanter
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26Bone: Lower limb -
Femur: angle of inclination
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27Bone: Lower limb -
Femur: proximal end (medial surface)
head; fovea; neck:greater trochanter;
trochanteric fossalesser trochanter:
(iliopsoas inserts here): on posterior aspect of femur;intertrochanteric crest:
posterior surfaceintertrochanteric line:
anterior surface
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28Bone: Lower limb -
Femur: proximal end (poeterior surface)head; fovea; neck:greater trochanterlesser trochanter:
(iliopsoas inserts here): on posterior aspect of femurintertrochanteric crest:
posterior surface
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29Bone: Lower limb -
Femur: shaft
gluteal tuberositylinea aspera (post.
surface)
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30Bone: Lower limb -
Femur: distal end-1medial epicondyle; adductor tubercle (adductor magnus m.)lateral epicondyle intercondylar notch (fossa): deep, posteriorly locatedarticular cartilage: tibial surface; patellar surface
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31Bone: Lower limb -
Femur: distal end-2medial condyleadductor tubercle
(adductor magnus m.)lateral condyle intercondylar notch
(fossa): deep, posteriorly locatedarticular cartilage: tibial
surface; patellar surface
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32Bone: Lower limb -
Tibia: proximal end-1medial condyle, lateral condyle; intercondylar area (intercondylar tubercles) for meniscus and lig.tibial tuberosity (tubercle): ligamentum patellae attachment
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33Bone: Lower limb -
Tibia: proximal end-2 intercondylar area (intercondylar tubercles): medial and lateral
attachment of cruciate lig. & horns of med. and lat. menisciarticular surface for head of fibula
post. surface
Med. Lateral
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34Bone: Lower limb -
Tibia: shaft
soleal line (oblique line): on upper 1/3 of post. surface
post. surface
Med. Lateral
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35Bone: Lower limb -
Tibia: shaft (cross-section)quadrangular in
cross sectionmed., lat., post.
surfacesant.
(subcutaneous); interosseous, posteromedial borders
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36Bone: Lower limb -
Tibia: distal end
medial malleolus: groove for tibialis posterior
(anterior view) (posterior view)
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37Bone: Lower limb -
Tibia: with Talusinferior articular facet
for talus (trochlea)
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38Bone: Lower limb -
Fibula: head
Surface anatomy of fibular headArticular surface
with tibiaapex of head
(styloid process) Common fibular nerve
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39Bone: Lower limb -
Fibula: distal end
lateral malleolusarticular facet for
talus
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40Bone: Lower limb -
Acetabulum
Acetabular fossaAcetabular notchArticular (lunate) surfaceLigaments
Transverse acetabular ligamentLigament of femroal headIliofemoral ligamentIschiofemoral ligamentPubofemoral ligament
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41Bone: Lower limb -
Transverse acetabular ligamenttransverse acetabular lig.: connecting the ant.& post.
ends of the articular cartilagevessels, n. to head run deep to this lig.
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42Bone: Lower limb -
Ligament of femoral head
lig. of the head of the femur: acetabular notch
fovea of the head of femursurrounded by
synovial sheath; conveys vessels in childhoodminimal effect for
strength
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43Bone: Lower limb -
Acetabulum: Ligaments-1
Iliofemoral lig.inverted Y; aiis, ilium
intertrochanteric linePubofemoral lig.Iliopubic eminence iliofemoral lig.
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44Bone: Lower limb -
Acetabulum: ligaments-2
Ischiofemoral lig.
ischium of
acetabulum rim med. aspect of
greater trochanter
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45Bone: Lower limb -
Knee Joint
Weight-bearing3 joint compartments:1) medial compartment:
medial condyle (femur) + tibia2) lateral compartment:
lateral condyle (femur) + tibia3) patella + femur
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46Bone: Lower limb -
Patella
ligamentum patellae (patellar lig.)Continuation of
quadriceps femoris tendon above to apex of patella, below to tibia tuberosity
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47Bone: Lower limb -
Tibio-femoral joint compartment
4 ligaments:1) medial (tibial)
collateral lig.2) lateral (fibular)
collateral lig.3) ant. cruciate lig.4) post. cruciate lig.
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48Bone: Lower limb -
Cruciate ligaments (anterior view)
ant. cruciate: ant. intercondylar area of tibia to lateral wall of intercondylar fossa of femurpost. intercondylar area
of tibia to medial wall of intercondylar fossa of femur(前外後內)
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49Bone: Lower limb -
Knee: cruciate liagaments interconnect femur and tibiaant. cruciate: ant.
intercondylar area of tibia to lateral wall of intercondylar fossa of femurpost. intercondylar area of
tibia to medial wall of intercondylar fossa of femur limitations of extreme
anterior and posterior displacements of tibia on fixed femur
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50Bone: Lower limb -
Knee: collateral ligaments
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51Bone: Lower limb -
Meniscus
Medial meniscus: fibrocartilage; wide- C shaped; periphery attaches to joint capsuleLateral meniscus:
more circular in shape
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52Bone: Lower limb -
Bones of the foot
Tarsal bonesMetatarsal bonesPhalanges (pl. of phalax)
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53Bone: Lower limb -
Tarsal bones: proximal rowProximal row: Talus, Calcaneus (Calcaneum), Navicular
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54Bone: Lower limb -
Talus-1Head: articulate with NavicularBodysuperior articular facet (trochlear)
tibiamedial facet: smaller, comma- shaped medial malleoluslateral facet: larger, triangular shape
lateral malleolus
Anterior Posterior
Medial view
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55Bone: Lower limb -
Talus-2
Inferior surface: divided by sulcus tali (for interosseous lig.) into ant. & post. partsanterior part: 2 smaller
facet Calcaneumposterior part: 1 large
facet Calcaneus (post. talocalcaneal joint)
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56Bone: Lower limb -
Talus-3 transfers body weight postero-inferiorly to calcaneum which relays it to ground antero-inferiorly to calcaneum and navicular, through which to distal
row of tarsus and metatarsus
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57Bone: Lower limb -
Calcaneus (Calcaneum)-1
heel of foot, transfer weight to groundTalar shelf (sustentaculum tali): projection on medial sidesuperior surface:posteriorly: large facet for post.
talocalcaneal jointmiddle and anterior facets for
talus (in front of sulcus calcanei)
ant. surface for Cuboidinsertion of calcaneal tendon (Achilles tendon)groove for tendon of flexor hallucis longus on its undersurface
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58Bone: Lower limb -
Calcaneus (Calcaneum)-2
calcaneal tuberosityant. surface for Cuboidinsertion of calcaneal
tendon (Achilles tendon)groove for tendon of
flexor hallucis longus on its undersurface
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59Bone: Lower limb -
Calcaneus-3
Calcaneal sulcusant. surface for Cuboidinsertion of calcaneal
tendon (Achilles tendon)
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60Bone: Lower limb -
Navicular bone
between head of talus and distal row of 3 cuneiform bonestuberosity:
attachment of Tibialis posterior
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61Bone: Lower limb -
Tarsal bones: distal row-1Distal row: Cuboid + 3 Cuneiform bones
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62Bone: Lower limb -
Cuboid
ant. surface: for 4th, 5th metatarsalsproximal: articulate
with calcaneummedial: with navicular
& lateral cuneiform
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63Bone: Lower limb -
Cuboid-2Lateral surface: tuberositygroove for fibularis (peroneus) longus tendon on underside
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64Bone: Lower limb -
Cuneiforms (Latin: wedge)
cuneiforms:med.Intermediatelat.medial: largestproximal: navicular bonedistal: metatarsus 1-3
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65Bone: Lower limb -
Metatarsus-1
all metatarsals in the same plane (different from hand)?
Base BodyHead (distal end)
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66Bone: Lower limb -
Metatarsus-2(deep) transverse
(inter)metatarsal lig. links heads (distal end) of metatarsals
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67Bone: Lower limb -
Phalanges
Big toe: proximal and distal phalanx2nd-5th toe:
proximal, middle, distal phalanx
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68Bone: Lower limb -
The arches of the foot: longitudinal archmedial view:ant.: head of metatarsals on the groundpost.: calcaneal tuberosity (tuber calcanei) on the ground
lateral view: lower longitudinal arch; apex at the ant. part of calcaneum
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69Bone: Lower limb -
The arches of the foot: transverse arch
obvious at the distal row of tarsal bones,cuboid (laterally) close to
ground; medially, medial cuneiform off the groundmovement (of foot at ankle):
dorsiflexion/plantar flexion; inversion/eversion
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70Bone: Lower limb -