Questions and Answers
What does the acetabulum articulate with to form the hip joint?
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?
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What is the largest sesamoid bone in the body?
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What attaches to the lateral epicondyle of the tibia?
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The patella has a rough non-articular posterior surface.
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What is the triangular area continuous with the lateral surface of the lateral malleolus called?
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The anterior border of the tibia extends from the tibial tuberosity above to the __________ below.
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The interosseous or medial border of the shaft lies just medial to the ________ border.
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The talus is gripped on the sides by the 2 ________.
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The calcaneus is the smallest tarsal bone.
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Match the following tarsal bones with their descriptions:
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What divides the ischial tuberosity into upper and lower areas?
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Which ligament attaches to the sharp medial margin of the ischial tuberosity?
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The pelvic surface of the ischium forms part of the lateral wall of the true pelvis.
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The acetabulum is lined with ______ cartilage.
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Match the femur feature with its corresponding description:
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Which muscle is inserted on the tuberosity of the 5th metatarsal?
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When does the ossification of the first metatarsal bone primary center occur?
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The shaft of the Phalanges ossify by 2 primary centers.
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The lumbar plexus is formed by the ventral rami of upper 4 lumber nerves (L1,2,3,4) and a branch from ____.
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Match the nerve with its corresponding root value:
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What are the muscles of the posterior abdominal wall?
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Which nerve is a part of the lumbar plexus?
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What is the composition of the thoracolumbar fascia?
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The lumbosacral trunk is formed by the union of the descending branches of L4 with nerve L__.
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The deep peroneal nerve pierces which muscle in the leg?
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Which nerve is the largest nerve in the body?
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The superior gluteal nerve takes a lateral course leaving the pelvis via the greater sciatic foramen above which muscle?
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Match the following hip joint ligaments with their corresponding names:
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What is the chief palpable artery of the dorsum of the foot?
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Which artery arises opposite the medial cuneiform and ends by anastomosing with the lateral tarsal and lateral plantar arteries?
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The lateral plantar artery is the smaller terminal branch of the posterior tibial artery.
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The plantar arch is formed by the direct continuation of the ______ artery.
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Name the types of arches in the foot based on the classification mentioned.
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Which bones are included in the formation of the Medial Longitudinal Arch of the foot?
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The Medial Longitudinal Arch is considered the big arc of a small circle.
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The summit of the Medial Longitudinal Arch is formed by the superior articular surface of the body of the _______.
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Match the components with the description: Femoral Triangle Contents
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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.
NAVICULAR BONE
- 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.
- On the bases of proximal phalanges:
- 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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Description
Learn about the structure and parts of the hip bone, including the ilium, pubis, and ischium, and how they form the hip joint.