Snell Femur Fractures and Neck Anatomy

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Questions and Answers

What is the primary function of the tibia in the leg?

Facilitates articulation at the knee joint

Supports weight bearing (correct)

Acts as a support for patellar dislocation

Attaches muscles for movement

Which feature is associated with the upper end of the fibula?

Medial malleolus

Lateral condyle of the tibia (correct)

Soleal line

Tuberosity of the tibia

Where is the soleal line located on the tibia?

On the anterior surface

At the junction of the upper end

On the posterior surface (correct)

At the medial malleolus

The interosseous membrane is primarily associated with which features of the leg?

Borders of the fibula Signup and view all the answers

What is the major characteristic of the lower end of the tibia?

It has a saddle-shaped articular surface for the talus Signup and view all the answers

The patellar ligament attaches to which part of the tibia?

Anterior border Signup and view all the answers

What happens at the triangular facet of the lower fibula?

Articulates with the talus Signup and view all the answers

Which muscle's attachment is indicated by the soleal line on the tibia?

Soleus Signup and view all the answers

What is the primary cause of fractures in the neck of the femur?

Pull of powerful muscles Signup and view all the answers

Which characteristic position does the foot adopt when there is an outward rotation of the leg due to a neck of femur fracture?

Points laterally Signup and view all the answers

Which part of the femur is typically associated with fractures caused by the gastrocnemius muscle?

Lower third of the femoral shaft Signup and view all the answers

What is the role of the prepatellar bursa in relation to the patella?

Reducing friction between the patella and skin Signup and view all the answers

What are the condyles of the tibia most commonly associated with?

Articulating with the condyles of the femur Signup and view all the answers

What connects the apex of the patella to the tibia?

Patellar ligament Signup and view all the answers

What anatomical feature lies between the anterior and posterior intercondylar areas on the tibia?

Intercondylar eminence Signup and view all the answers

Which of the following muscles is NOT involved in causing fractures of the femoral shaft?

Gluteus maximus Signup and view all the answers

What is the typical angle of inclination at the neck of the femur in an adult?

125 degrees Signup and view all the answers

Which condition is characterized by an increased angle at the neck of the femur?

Coxa valga Signup and view all the answers

What type of fracture is most common in elderly individuals and typically occurs from minor trauma?

Subcapital fracture Signup and view all the answers

Which group of muscles is primarily responsible for laterally rotating the distal fragment in femoral neck fractures?

Gluteus maximus and piriformis Signup and view all the answers

What complication is commonly associated with fractures of the neck of the femur?

Avascular necrosis Signup and view all the answers

Which of the following statements accurately describes coxa vara?

It occurs in fracture of the femoral neck Signup and view all the answers

Which muscle group is primarily responsible for flexing the proximal fragment in fractures of the upper third of the femur?

Iliopsoas Signup and view all the answers

What is the common position of the leg following a neck of femur fracture when the distal fragment is pulled upward?

Shortened and laterally rotated Signup and view all the answers

In which type of femoral fracture is the fracture line extracapsular?

Trochanteric fracture Signup and view all the answers

What is a potential consequence if the bone fragments from a neck of femur fracture are not impacted?

Considerable displacement Signup and view all the answers

Which structure is NOT located on the anterior surface of the femur?

Gastrocnemius (medial head) Signup and view all the answers

What is the significance of the medial femoral circumflex artery in femoral neck fractures?

It supplies the upper neck of the femur with a profuse blood supply. Signup and view all the answers

Tenderness over which area typically indicates arthritis of the hip joint?

Head of the femur Signup and view all the answers

Which of the following muscles is associated with the posterior surface of the femur?

Gluteus maximus Signup and view all the answers

Avascular necrosis of the head of the femur can occur after fractures of which part?

Neck of the femur Signup and view all the answers

Which ligament is associated with the head of the femur?

Ligament of the head of femur Signup and view all the answers

What is the role of the intertrochanteric crest?

Attachment site for both muscles and ligaments. Signup and view all the answers

Which of the following is located on the posterior surface of the femur?

Lateral supracondylar ridge Signup and view all the answers

What mechanism primarily leads to traumatic dislocation of the patella?

Direct trauma to the quadriceps attachments Signup and view all the answers

Which statement accurately describes patellar fractures due to direct violence?

The bone typically breaks into several small fragments. Signup and view all the answers

In cases where only one of the tibia or fibula is fractured, what is the usual outcome?

Minimal displacement due to the other bone acting as a splint Signup and view all the answers

What is a common complication when fractures occur in the distal third of the tibia?

Delayed union or nonunion Signup and view all the answers

What causes intraosseous tibia infusion to be necessary in infants?

Inability to obtain an intravenous line Signup and view all the answers

Which injury mechanism is associated with fractures of the proximal end of the tibia?

Direct violence from lateral impact Signup and view all the answers

What is a characteristic of a fracture line caused by indirect violence to the patella?

The fracture line is usually transverse. Signup and view all the answers

Which anatomical feature helps prevent lateral displacement of the patella during knee extension?

The vastus medialis muscle's orientation Signup and view all the answers

Which condition might result from underdevelopment of the lateral femoral condyle?

Congenital recurrent patellar dislocation Signup and view all the answers

What technique is essential for performing intraosseous tibia infusion?

Blocking the infrapatellar nerve branch with anesthetic Signup and view all the answers

Which muscle is NOT primarily responsible for movements associated with the posterior aspect of the right os coxae?

Adductor Magnus Signup and view all the answers

Which structure is associated with the superior attachment of the Sacrotuberous Ligament?

Posterior Superior Iliac Spine Signup and view all the answers

Which of the following muscles attaches to the anterior surface of the right os coxae?

Psoas Signup and view all the answers

What is the primary function of the Obturator membrane?

Form the obturator canal Signup and view all the answers

Which ligament is located at the attachment point of the Ischial Spine?

Sacrospinous Ligament Signup and view all the answers

Which of the following options represents a characteristic feature of the medial surface of the os coxae?

Ischial Ramus Signup and view all the answers

Which of these muscles would most likely NOT be involved in hip lateral rotation?

Adductor Longus Signup and view all the answers

Which structure is located inferiorly to the Anterior Superior Iliac Spine?

Inguinal Ligament Signup and view all the answers

What is the role of the sacroiliac joints in the stability of the lower limbs?

They connect the limb to the vertebral column securely. Signup and view all the answers

Which compartments are specifically mentioned as part of the lower limb organization?

Gluteal region and foot. Signup and view all the answers

Which of the following conditions is NOT typically associated with lower limb problems?

Cardiac arrhythmia. Signup and view all the answers

What structure forms the lower limb girdle that connects to the vertebral column?

The os coxae. Signup and view all the answers

Which skeletal elements comprise the os coxae?

Ilium, ischium, and pubis. Signup and view all the answers

What is a primary function of the lower limbs?

Supporting the body's weight. Signup and view all the answers

How are the thigh and leg categorized in the context of lower limb anatomy?

Each is divided into compartments with distinct functions. Signup and view all the answers

Which function is associated with the stability of the lower limbs?

Create a foundation for upright posture. Signup and view all the answers

Which structure is primarily involved in the articulation at the hip joint?

The acetabulum Signup and view all the answers

What is the location of the iliac tubercle relative to the anterosuperior iliac spine?

2 inches behind Signup and view all the answers

Which part of the ischium is responsible for the projection of the ischial spine?

The body Signup and view all the answers

Which of the following structures contributes to the formation of the greater and lesser sciatic foramina?

The sacrospinous ligament Signup and view all the answers

What covers the articular surface of the acetabulum?

Hyaline cartilage Signup and view all the answers

In the anatomic position, which two structures lie in the same vertical plane?

Symphysis pubis and anterosuperior iliac spine Signup and view all the answers

Which muscle or ligament attachment is specifically located at the fovea capitis of the femur?

The ligament of the head of the femur Signup and view all the answers

Which part of the femur is NOT involved in the formation of the knee joint?

The greater trochanter Signup and view all the answers

What is the role of the acetubular notch?

It marks the inferior margin of the acetabulum Signup and view all the answers

Which feature of the femur undergoes a notable difference in angle between males and females?

The neck Signup and view all the answers

Which structure is primarily associated with the foot's propulsive action during locomotion?

Medial longitudinal arch Signup and view all the answers

What is the primary function of the gluteal muscles during locomotion?

Stabilizing the pelvis Signup and view all the answers

What anatomical feature marks the division between the anterior and posterior compartments of the leg?

Intermuscular septum Signup and view all the answers

Which of the following statements accurately describes the femoral sheath?

It houses the femoral artery, femoral vein, and lymphatics. Signup and view all the answers

What is the anatomical basis for a femoral hernia?

Enlargement of the femoral canal Signup and view all the answers

Which joint action is primarily performed at the knee during the mechanics of 'locking'?

Extension Signup and view all the answers

Which neurovascular structure is most likely to be affected by intragluteal injections into the wrong quadrant?

Sciatic nerve Signup and view all the answers

What is the primary role of the cruciate anastomosis in the lower limb?

Providing collateral circulation Signup and view all the answers

Which compartment of the thigh primarily contains muscles that extend the knee?

Anterior compartment Signup and view all the answers

Which of the following statements about the lymphatic drainage of the lower limb is correct?

It is facilitated by superficial and deep lymphatic vessels. Signup and view all the answers

Which structure serves as the primary boundary for the popliteal fossa?

Biceps femoris muscle Signup and view all the answers

Which of the following is a correct statement regarding the contents of the anterior fascial compartment of the leg?

Contains the extensor digitorum longus muscle Signup and view all the answers

What is the primary function of the superficial veins in the thigh region?

Drain blood from the deep veins Signup and view all the answers

Which feature distinguishes the lateral fascial compartment in the leg?

Innervation by the superficial fibular nerve Signup and view all the answers

Which joint is primarily involved in the ankle inversion and eversion movements?

Talocrural joint Signup and view all the answers

What anatomical feature is considered the 'functional unit' of the foot?

Arches of the foot Signup and view all the answers

Which of the following components primarily contributes to the arterial blood supply around the knee joint?

Arterial anastomosis Signup and view all the answers

In relation to the gluteal region, which statement is accurate?

Involves several muscles and nerves, including the gluteal muscles Signup and view all the answers

Study Notes

Neck Fractures

Avascular necrosis can result from neck of femur fractures.
In youth, the head epiphysis receives blood supply from a small artery branch.

Neck of the Femur

The neck is angled differently in children (about 160 degrees) compared to adults (about 125 degrees).
Coxa valga (increased angle) limits hip adduction, often seen in congenital dislocation.
Coxa vara (decreased angle) restricts hip abduction and can arise from neck fractures or slipping of the femoral epiphysis.
Shenton's line is useful for radiographic assessment of the femoral neck angle.

Femur Fractures

Two primary types of neck fractures: subcapital and trochanteric.
Subcapital fractures typically affect the elderly from minor falls, especially post-menopausal women due to bone density loss.
Common complications include significant displacement and avascular necrosis of the head.
Trochanteric fractures predominantly occur in younger individuals from direct trauma, often with good blood supply to fragments.

Fractures of the Shaft of the Femur

Occur mainly in younger, healthier individuals.
Upper third fragment flexed by iliopsoas and abducted by gluteal muscles; lateral rotation by several thigh muscles.
Middle third fractures experience considerable shortening due to muscle pulls.
Distal third fractures show rotation and displacement from gastrocnemius muscle pull.

Patella (Kneecap)

The largest sesamoid bone, triangular in shape, connects to the tibia via the ligamentum patellae.
It articulates with femoral condyles on its posterior surface and is easily palpable due to its exposed position.
The prepatellar bursa reduces friction between the patella and skin.

Tibia

The major weight-bearing bone, articulating with femur and fibula.
Upper end includes lateral and medial condyles, accessing the menisci, with a prominent anterior border forming the shin.
Distal end has saddle-shaped articular surface for the talus and extends into a medial malleolus.

Fibula

Slender bone that does not participate in knee joint articulation but contributes to the ankle.
Acts as a muscle attachment point and maintains stability during tibia fractures.

Clinical Notes

Patellar Dislocations

The patella’s location within the quadriceps tendon limits lateral displacement due to the anatomy of the femur.
Congenital dislocations stem from underdeveloped lateral femoral condyle.
Traumatic dislocation often results from direct trauma impacting quadriceps tendon attachments.

Patellar Fractures

Caused by direct trauma, leading to multiple fragments; can be open due to proximity to skin.
Sudden quadriceps contraction can also cause transverse fractures, often resulting in fragment separation.

Tibia and Fibula Fractures

Commonly occurring fractures; intact fibula provides splinting support.
Shaft fractures are often open due to minimal coverage over the skin.
Distal tibia fractures may lead to delayed healing because of compromised blood supply.

Intraosseous Tibia Infusion in Infants

Utilized for fluid/blood administration when IV access is challenging.
Quick procedure involving localized anesthesia and careful needle insertion into the tibial medulla using a specialized bone marrow needle.

Overview of the Hip Joint

Os coxae articulate at the acetabulum with the femur, forming the hip joint.
Essential pelvic anatomy includes the ilium, ischium, and pubis, featuring various muscle and ligament attachments for mobility and stability.

Femur

Articulates with acetabulum to form hip joint and with the tibia/patella at the knee joint.### Lower Limb Anatomy
The lower limbs provide stability and support for the body, enabling upright posture, walking, and running.
Hip bones connect to the trunk at sacroiliac joints posteriorly and symphysis pubis anteriorly.
Each lower limb region includes the gluteal region, thigh, popliteal fossa, leg, ankle, and foot.
Thigh and leg compartments contain unique muscle groups, nerves, and blood supply.

Common Conditions

Common lower limb conditions include arthritis, varicose veins, vascular deficiencies, fractures, dislocations, sprains, lacerations, knee effusions, leg pain, ankle injuries, and peripheral nerve injuries.

Osteology

Lower limb bones consist of the os coxae (hip bone), femur, patella, tibia, fibula, metatarsal bones, tarsal bones, and phalanges.
Os coxae is formed from three elements: ilium, ischium, and pubis, serving as the lower limb girdle.

Joint Anatomy

Tarsal joints allow for flexibility and movement in the ankle and foot.
Joints include tarsometatarsal, intermetatarsal, metatarsophalangeal, and interphalangeal joints.

Functional Aspects of the Foot

Foot structure features arches, crucial for shock absorption and propulsion during movement.

Radiographic and Surface Anatomy

Important for diagnosing and understanding anatomical landmarks in the gluteal and inguinal regions.

Inguinal Region

The femoral triangle is crucial for understanding vascular and nerve relationships.
The adductor canal allows passage of the femoral vessels and nerve.

Blood and Nerve Supply

The flow of blood from the common iliac artery is significant, noting branches and functional territories.
Recognizing the lumbosacral plexus is essential for understanding peripheral nerve innervation.

Compartmentalization

Deep fascia arrangements and osseofascial compartments regulate muscle function and blood flow in the lower limb.

Knee Mechanics

Important movements include locking and unlocking mechanisms during normal locomotion.

Learning Objectives

Identify primary lower limb regions and their defining features.
Understand the bones of the lower limb, their major features, and functional aspects.
Recognize gluteal muscle anatomy and function during movement.
Describe neurovascular relationships and implications of intragluteal injections.
Outline the boundaries, contents, and clinical relevance of the femoral triangle and popliteal fossa.
Trace venous and lymphatic drainage patterns in relation to common clinical conditions.
Comprehend movements at the knee joint during activity.

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Description

This quiz covers key concepts related to femur fractures, specifically neck of femur injuries, and anatomical differences in angles between children and adults. Explore conditions like avascular necrosis and types of neck fractures, including subcapital and trochanteric. Assess your understanding of these critical orthopedic topics.