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Anatomy of the Hip Bone
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Anatomy of the Hip Bone

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@AmusingHydrogen

Questions and Answers

What does the acetabulum articulate with to form the hip joint?

  • Head of Femur (correct)
  • Head of Fibula
  • Head of Tibia
  • Head of Humerus

    • What are the three parts that make up the hip bone?

    Ilium, Pubis, Ischium

    The obturator foramen is the oval opening that separates the ________ and ________.

    pubis, ischium

    The iliac crest is a concave ridge?

    <p>False</p> Signup and view all the answers

    What is the largest sesamoid bone in the body?

    <p>Patella</p> Signup and view all the answers

    What attaches to the lateral epicondyle of the tibia?

    <p>Fibular collateral ligament</p> Signup and view all the answers

    The patella has a rough non-articular posterior surface.

    <p>True</p> Signup and view all the answers

    What is the triangular area continuous with the lateral surface of the lateral malleolus called?

    <p>shaft</p> Signup and view all the answers

    The anterior border of the tibia extends from the tibial tuberosity above to the __________ below.

    <p>anterior border of the medial malleolus</p> Signup and view all the answers

    The interosseous or medial border of the shaft lies just medial to the ________ border.

    <p>anterior</p> Signup and view all the answers

    The talus is gripped on the sides by the 2 ________.

    <p>malleoli</p> Signup and view all the answers

    The calcaneus is the smallest tarsal bone.

    <p>False</p> Signup and view all the answers

    Match the following tarsal bones with their descriptions:

    <p>Navicular = Boat-shaped bone located between the talus and cuneiforms Cuboid = Lateral bone of the distal row of the tarsus Calcaneus = Forms the prominence of the heel and is roughly cuboidal</p> Signup and view all the answers

    What divides the ischial tuberosity into upper and lower areas?

    <p>transverse ridge</p> Signup and view all the answers

    Which ligament attaches to the sharp medial margin of the ischial tuberosity?

    <p>Dacrotuberous ligament</p> Signup and view all the answers

    The pelvic surface of the ischium forms part of the lateral wall of the true pelvis.

    <p>True</p> Signup and view all the answers

    The acetabulum is lined with ______ cartilage.

    <p>hyaline</p> Signup and view all the answers

    Match the femur feature with its corresponding description:

    <p>Greater Trochanter = Large quadrangular prominence at the upper part of the junction of neck with the shaft Lesser Trochanter = Conical eminence directed medially and backwards from the junction of the neck with the shaft Intertrochanteric Line = Roughened ridge marking the junction of the anterior surface of the neck with the shaft Intertrochanteric Crest = Smooth-rounded ridge marking the junction of the posterior surface of the neck with the shaft</p> Signup and view all the answers

    Which muscle is inserted on the tuberosity of the 5th metatarsal?

    <p>Peroneus brevis</p> Signup and view all the answers

    When does the ossification of the first metatarsal bone primary center occur?

    <p>10th week of foetal life</p> Signup and view all the answers

    The shaft of the Phalanges ossify by 2 primary centers.

    <p>False</p> Signup and view all the answers

    The lumbar plexus is formed by the ventral rami of upper 4 lumber nerves (L1,2,3,4) and a branch from ____.

    <p>T12</p> Signup and view all the answers

    Match the nerve with its corresponding root value:

    <p>Iliohypogastric = L1,2,3,4 Obturator = L2,3,4 Femoral = L2,3,4 Sciatic = L4,5,S1,2,3</p> Signup and view all the answers

    What are the muscles of the posterior abdominal wall?

    <p>psoas major, psoas minor, iliacus, quadratus lumborum</p> Signup and view all the answers

    Which nerve is a part of the lumbar plexus?

    <p>femoral nerve</p> Signup and view all the answers

    What is the composition of the thoracolumbar fascia?

    <p>3 layers: posterior, middle, anterior</p> Signup and view all the answers

    The lumbosacral trunk is formed by the union of the descending branches of L4 with nerve L__.

    <p>5</p> Signup and view all the answers

    The deep peroneal nerve pierces which muscle in the leg?

    <p>Tibialis Anterior</p> Signup and view all the answers

    Which nerve is the largest nerve in the body?

    <p>Sciatic nerve</p> Signup and view all the answers

    The superior gluteal nerve takes a lateral course leaving the pelvis via the greater sciatic foramen above which muscle?

    <p>piriformis</p> Signup and view all the answers

    Match the following hip joint ligaments with their corresponding names:

    <p>1 = Iliofemoral ligament 2 = Pubofemoral ligament 3 = Ischiofemoral ligament 4 = Ligament of the head of femur</p> Signup and view all the answers

    What is the chief palpable artery of the dorsum of the foot?

    <p>Dorsalis Pedis Artery</p> Signup and view all the answers

    Which artery arises opposite the medial cuneiform and ends by anastomosing with the lateral tarsal and lateral plantar arteries?

    <p>Branches of the Arcuate Artery</p> Signup and view all the answers

    The lateral plantar artery is the smaller terminal branch of the posterior tibial artery.

    <p>False</p> Signup and view all the answers

    The plantar arch is formed by the direct continuation of the ______ artery.

    <p>lateral plantar</p> Signup and view all the answers

    Name the types of arches in the foot based on the classification mentioned.

    <p>Longitudinal, Medial, Lateral, Transverse, Anterior, Posterior</p> Signup and view all the answers

    Which bones are included in the formation of the Medial Longitudinal Arch of the foot?

    <p>Calcaneus, Talus, Navicular, 1st-3rd metatarsals</p> Signup and view all the answers

    The Medial Longitudinal Arch is considered the big arc of a small circle.

    <p>True</p> Signup and view all the answers

    The summit of the Medial Longitudinal Arch is formed by the superior articular surface of the body of the _______.

    <p>talus</p> Signup and view all the answers

    Match the components with the description: Femoral Triangle Contents

    <p>Femoral artery and its branches = Muscular branches, podenda femoris artery Femoral vein and its branches = Nerves, deep inguinal lymph nodes Femoral sheath = The nerve to the pectineus, femoral branch of genitofemoral nerve</p> Signup and view all the answers

    Study Notes

    The Hip Bone

    • Composed of three parts: ilium, pubis, and ischium
    • The ilium forms the groin area, pubis forms the genital area, and ischium forms the hip joint area
    • The acetabulum is the junction point of the three parts, forming the hip joint with the head of the femur
    • The pubic parts of both hip bones meet anteriorly to form the pubic symphysis
    • The two hip bones form the pelvic or hip girdle with the sacrum and coccyx
    • The acetabulum is directed laterally

    Ilium

    • The upper end is called the iliac crest, a broad concave ridge
    • The iliac crest has a ventral and dorsal segment
    • The ventral segment forms the anterior two-thirds of the crest and has an outer lip, inner lip, and intermediate area
    • The dorsal segment forms the posterior one-third of the crest and has lateral and medial borders
    • The ASIS (anterior superior iliac spine) is the anterior end of the iliac crest
    • The PSIS (posterior superior iliac spine) is the posterior end of the iliac crest

    Attachments on Iliac Crest

    • ASIS gives attachment to the lateral end of the inguinal ligament, origin to Sartorius, and origin to tensor fascia lata
    • The outer lip of the iliac crest provides attachment to the fascia lata
    • The intermediate area gives origin to internal oblique muscle
    • The inner lip provides origin to transverse abdominis muscle and quadratus lumborum muscle
    • The dorsal segment gives origin to gluteus medius and erector spinae

    Posterior Border of Ilium

    • The posterior border extends from PSIS to the upper end of the posterior border of ischium
    • It presents a prominence called the PIIS (posterior inferior iliac spine)

    Medial Border of Ilium

    • The medial border extends on the inner or pelvic surface from the iliac crest to the iliopubic eminence
    • It separates the iliac fossa from the sacropelvic surface

    Gluteal Surface of Ilium

    • The gluteal surface is the outer surface of the ilium, convex in front and concave behind
    • It is divided into four areas by three gluteal lines
    • The attachments on the gluteal surface are:
      • Area behind the posterior gluteal line: origin to upper fibers of gluteus maximus
      • Area between anterior and posterior gluteal lines: origin to gluteus medius
      • Area between anterior and inferior gluteal lines: origin to gluteus minimus
      • Area below the inferior gluteal line: origin to gluteus maximus

    Iliac Fossa

    • The iliac fossa is a large concave area on the inner surface of the ilium
    • It gives origin to iliacus muscle from its upper two-thirds

    Sacropelvic Surface of Ilium

    • The sacropelvic surface is an uneven area on the inner surface of the ilium behind the medial border
    • It is subdivided into three parts: iliac tuberosity, auricular surface, and pelvic surface
    • The auricular surface articulates with the sacrum to form the sacroiliac joint
    • The pelvic surface is smooth and lies anteroinferior to the auricular surface

    Pubis

    • Forms the anteroinferior part of the hip bone and the anterior 1/5 of the acetabulum
    • Has a body, superior ramus, and inferior ramus
    • The body has a superior border called the pubic crest, and three surfaces: anterior, posterior, and medial

    Superior Ramus of Pubis

    • The superior border is called the pectineal line or pectin pubis
    • The pectineal line provides attachment to the conjoint tendon, lacunar ligament, pectineus muscle, and psoas minor
    • The anterior border or obturator crest is a rounded ridge extending from the pubic tubercle to the acetabular notch
    • The inferior border is sharp and forms the upper border of the obturator foramen
    • The pectineal surface is a triangular area between the anterior and superior borders, extending from the pubic tubercle to the iliopubic eminence

    Ischium

    • Forms the posteroinferior part of the hip bone and the adjoining 2/5 of the acetabulum
    • Has a body and a ramus
    • The body has an upper and lower end, three borders, and three surfaces
    • The upper end forms the postero-inferior 2/5 of the acetabulum
    • The lower end forms the ischial tuberosity

    Conjoined Ischiopubic Rami

    • The inferior ramus of the pubis unites with the ramus of ischium on the medial side of the obturator foramen
    • The conjoined rami have an upper and lower border, and inner and outer surfaces
    • The upper border forms part of the margin of the obturator foramen and gives attachment to the obturator membrane
    • The lower border forms the pubic arch along with the corresponding border of the opposite bone
    • The inner surface is convex and smooth, and is divided into three areas by two ridges
    • The outer surface is rough for attachment of muscles

    Acetabulum

    • A deep cup-shaped hemispherical cavity on the lateral aspect of the hip bone
    • Directed laterally, downwards, and forwards
    • The margin of the acetabulum is deficient inferiorly and is called the acetabular notch
    • The non-articular roughened floor is called the acetabular fossa

    Obturator Foramen

    • A large gap in the hip bone situated anteroinferior to the acetabulum, between the pubis and ischium
    • Closed by the obturator membrane which is attached to its margins, except at the obturator groove where the obturator vessels and nerve pass out of the pelvis

    Ossification of Hip Bone

    • The hip bone ossifies in cartilage from three primary and five secondary centers
    • The primary centers appear during intrauterine life
    • At birth, the hip bone is ossified except for three cartilaginous parts### Femur
    • The femur has three borders: medial, lateral, and posterior
    • The medial and lateral borders are rounded and ill-defined, while the posterior border has a broad roughened ridge called the linea aspera
    • The linea aspera has a distinct medial and lateral lip
    • In the upper 1/3rd of the shaft, the two lips of the linea aspera diverge to enclose an additional posterior surface, thus forming four borders and four surfaces
    • The gluteal tuberosity is a broad roughened ridge on the lateral part of the posterior surface

    Attachments of Femur

    • Medial and popliteal surfaces are bare except for a little extension of the origin of medial head of gastrocnemius
    • Vastus intermedius arises from the upper 3/4th of the anterior and lateral surfaces
    • Articularis genu arises just below the vastus intermedius
    • Vastus lateralis arises from the upper part of the intertrochanteric line, anterior and inferior borders
    • Gluteus maximus is inserted into the gluteal tuberosity
    • Adductor longus is inserted along the medial lip of the linea aspera between the vastus medialis and adductor brevis and magnus

    Lower End of Femur

    • The lower end of femur is widely expanded to form two large condyles, medial and lateral
    • The two condyles are partially covered by a large articular surface
    • The articular surface is divisible into patellar and tibial parts
    • The patellar surface covers the anterior surfaces of both condyles and extends more on the lateral condyle
    • The tibial surface covers the inferior and posterior surfaces of both condyles

    Lateral Condyle

    • The lateral condyle is flat laterally and more in line with the shaft
    • It transmits greater weight to the tibia
    • The lateral aspect presents a prominence called the lateral epicondyle, a popliteal groove, and a muscular impression

    Medial Condyle

    • The medial condyle is convex medially
    • The most prominent part is the medial epicondyle
    • Posterosuperior to the epicondyle is an adductor tubercle

    Intercondylar Fossa

    • The intercondylar fossa is a deep gap between the two condyles posteriorly
    • It is limited anteriorly by the patellar articular surface and posteriorly by the intercondylar line

    Ossification of Femur

    • The femur ossifies from one primary and four secondary centers
    • The primary center for the shaft appears in the 7th week of intrauterine life
    • Secondary centers appear for the lower end at 9 months, for the head during the 6th month of life, for the greater trochanter during the 4th year, and for the lesser trochanter during the 12th year

    Patella

    • The patella is the largest sesamoid bone in the body
    • It is situated in the front of the lower end of the femur, 1 cm above the knee joint
    • The patella has an apex, three borders, and two surfaces
    • The apex is directed downwards and is rough and vertically ridged
    • The posterior surface is articular and divided by a vertical ridge into a larger lateral and a smaller medial area

    Anatomical Position of Patella

    • The patella is placed with its apex pointing downwards and its posterior surface facing posteriorly

    Features of Patella

    • The patella has a larger lateral facet and a smaller medial facet
    • The articular area is divided by 2 transverse lines into 3 pairs of facets
    • During movement of the knee, different portions of the patella articulate with the femur

    Attachments of Patella

    • The superior border provides insertion to rectus femoris in front and vastus intermedius behind
    • The lateral border provides insertion to vastus lateralis and the medial border to vastus medialis
    • The non-articular area on the posterior surface provides attachment to the ligamentum patellae

    Ossification of Patella

    • The patella ossifies from several centers which appear during 3-6 years of age
    • Fusion is complete at puberty
    • One or two centers at the superolateral angle may form separate pieces of bone, known as bipartite or tripartite patella

    Tibia

    • The tibia is the medial and larger bone of the leg
    • The upper end comprises two large condyles
    • The lower end has a prominent medial malleolus

    Upper End of Tibia

    • The upper end is expanded from side to side to form two condyles
    • The medial condyle is larger than the lateral
    • The articular surface is oval and its long axis is anteroposterior
    • The central part of the surface is slightly concave and comes into direct contact with the femoral condyle

    Attachment on Medial Condyle

    • The capsular ligament of the knee joint is attached to the upper border
    • The semitendinosus is attached to the groove on the posterior surface
    • The medial patellar retinaculum is attached to the anterior surface

    Lateral Condyle

    • The lateral condyle overhangs the shaft more than the medial condyle
    • The superior surface articulates with the lateral condyle of the femur
    • The articular surface is circular
    • The central part is concave and comes into direct contact with the femur

    Intercondylar Area

    • The intercondylar area is the roughened area on the superior surface between the articular surfaces of the two condyles
    • The area is narrowest in its middle part
    • The part is elevated to form the intercondylar eminence, which is flanked by the medial and lateral intercondylar tubercles

    Attachments on Intercondylar Area

    • The anterior horn of the medial meniscus is attached just in front of the medial articular surface
    • The posterior horn of the medial meniscus is attached to the depression behind the base of the medial intercondylar tubercle
    • The anterior cruciate ligament is attached to a smooth area just behind the previous attachment
    • The posterior cruciate ligament is attached to the posterior smooth area

    Tibial Tuberosity

    • The tibial tuberosity is a prominence located on the anterior aspect of the upper end of the tibia
    • It forms the anterior limit of the intercondylar area
    • Inferiorly, it is continuous with the anterior border of the shaft
    • The tuberosity is divided into an upper smooth and a lower rough area

    Attachment on Tibial Tuberosity

    • The ligamentum patellae is attached to the upper smooth part of the tibial tuberosity
    • The lower rough area of the tuberosity is subcutaneousHere are the study notes:

    TALUS

    • The sulcus tali is a depression opposite the talar neck.
    • Body of talus:
      • Cuboidal in shape with 5 surfaces.
      • Superior surface: convex and concave, articulates with tibia to form ankle joint.
      • Inferior surface: oval and concave, articulates with calcaneum to form subtalar joint.
      • Medial surface: articular above and non-articular below, articulates with medial malleolus of tibia.
      • Lateral surface: triangular and concave, articulates with lateral malleolus of fibula.
      • Posterior surface: small and marked by an oblique groove.
    • Attachments of body of talus:
      • Medial surface: deltoid or anterior tibiotalar ligament.
      • Posterior process: tendon of flexor hallucis longus.
      • Medial tubercle: deltoid ligament and medial talocalcanean ligament.
    • Ossification: from one center which appears during the 6th month of intrauterine life.

    CALCANEUS

    • Largest tarsal bone, forms prominence of heel.
    • Roughly cuboidal in shape with 6 surfaces.
    • Anterior surface: small and bears a concavoconvex articular facet for cuboid.
    • Posterior surface: large and rough.
    • Dorsal surface: large and convex, bearing a large convex articular surface for talus.
    • Plantar surface: rough and triangular.
    • Lateral surface: flat, with a trochlea or tubercle.
    • Medial surface: concave from above downwards, bearing a sustentaculum tali.
    • Ossification: from one primary and one secondary center, with secondary center appearing during the 3rd or 8th year and fusing by 14-16 years.
    • Boat-shaped, situated on the medial side of the foot.
    • Anatomical position: held mediolaterally.
    • Features:
      • Anterior surface: convex, divided into 3 facets for 3 cuneiform bones.
      • Posterior surface: concave and oval for articulation with talus.
      • Dorsal surface: broad and rough.
    • Surfaces:
      • Plantar surface: small, concave, and rough.
      • Medial surface: blunt and prominent tuberosity, directed downwards, and separated from plantar surface by a groove.
    • Attachments:
      • Tuberosity on medial surface: insertion of tibialis posterior.
      • Groove below tuberosity: transmission of tendon of tibialis posterior.
    • Ossification: from one center which appears during the 3rd year of life.

    CUNEIFORM BONES

    • 3 cuneiform bones: medial, intermediate, and lateral.
    • Medial cuneiform:
      • Articulates with navicular, distally with base of 1st metatarsal, and laterally with intermediate cuneiform.
      • Receives insertion of tibialis anterior and a slip from tibialis posterior.
    • Intermediate cuneiform:
      • Articulates with navicular, distally with base of 2nd metatarsal, medially with medial cuneiform, and laterally with lateral cuneiform.
      • Receives a slip from tibialis posterior.
    • Lateral cuneiform:
      • Articulates with navicular, distally with base of 3rd metatarsal, medially with intermediate cuneiform, and laterally with cuboid.
      • Receives a slip from tibialis posterior.

    CUBOID BONE

    • Lateral bone of distal row of tarsus, situated in front of calcaneus and behind 4th and 5th metatarsal bones.
    • Anatomical position: held anteroposteriorly.
    • Features:
      • 6 surfaces: proximal, distal, dorsal, plantar, lateral, and medial.
      • Proximal surface: articulates with calcaneus.
      • Distal surface: articulates with bases of 4th and 5th metatarsals and medial surface with lateral cuneiform.
      • Plantar surface: provides insertion for tibialis posterior and origin for flexor hallucis brevis.
    • Ossification: from one center which appears just before birth.

    METATARSUS

    • Composed of 5 metatarsal bones, numbered from medial to lateral side.
    • Each metatarsal is a miniature long bone with a shaft, base, and head.
    • Anatomical position: held anteroposteriorly.
    • Identification:
      • 1st metatarsal: shortest, thickest, and stoutest, with a kidney-shaped facet on the proximal end.
      • 2nd metatarsal: longest, with a larger dorsal and a smaller plantar facet on the lateral side of the base.
      • 3rd metatarsal: lateral side of base has one facet placed dorsally for the 4th metatarsal bone.
      • 4th metatarsal: proximal surface of base is quadrangular, articulating with cuboid bone.
      • 5th metatarsal: lateral side of base has one large tuberosity or styloid process projecting backwards and laterally.
    • Attachments:
      • Tibialis anterior: inserted on medial side of base of 1st metatarsal.
      • Peroneus longus: inserted on lateral surface of base of 1st metatarsal.
      • Peroneus brevis: inserted on tuberosity of 5th metatarsal.
      • Flexor digiti minimi brevis: arises from base of 5th metatarsal.
    • Ossification: each metatarsal ossifies from one primary and one secondary center, with secondary center appearing between 3rd and 4th years and fusing by 18th year.

    PHALANGES

    • 14 phalanges in each foot, 2 in great toe and 3 for each of the other toes.
    • Anatomical position: held anteroposteriorly.
    • Attachments:
      • On the bases of proximal phalanges:
        • 2nd, 3rd, and 4th toes: lumbrical on medial side and interosseous muscle on each side.
        • 5th toe: plantar interosseous muscle on medial side, and abductor digiti minimi and flexor digiti minimi on lateral side.
        • Great toe: abductor hallucis and part of flexor hallucis brevis medially, and adductor hallucis and remaining part of flexor hallucis brevis laterally.
      • On the shaft and bases of middle phalanges: flexor digitorum brevis on each side of the shaft on the plantar surface, and part of extensor expansion on the dorsal surface.
      • On the bases of distal phalanges:
        • Lateral 4 toes: flexor digitorum longus on the plantar surface and extensor expansion on the dorsal surface.
        • Great toe: flexor hallucis longus on the plantar surface and part of extensor hallucis longus on the dorsal surface.
    • Ossification: shaft of phalanges ossify by one primary center, with a single secondary center in the base of each phalanx, appearing at various times and fusing by 18th year.

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