Bones of the Lower Limb PDF - 2024

BONES OF THE LOWER LIMB DR. ERDEM SÖZTUTAR  REGIONS OF THE LOWER LIMB Gluteal region Between the iliac crest and gluteal fold of the skin Thigh Anterior thigh is between the inguinal ligament and knee joint Posterio...

BONES OF THE LOWER LIMB DR. ERDEM SÖZTUTAR  REGIONS OF THE LOWER LIMB Gluteal region Between the iliac crest and gluteal fold of the skin Thigh Anterior thigh is between the inguinal ligament and knee joint Posterior thigh is between gluteal fold and the knee Leg Calf is the posterior part of the leg Ankle Foot  BONES OF THE LOWER LIMB Pelvic girdle Pelvic (hip) bone Thigh Femur (thigh bone) Patella (kneecap) Leg Tibia (shinbone) Fibula (calfbone) Ankle Tarsal bones (Tarsus) (7) Foot Metatarsal bone (Metatarsus) (5) Phalanges (14)  FEMUR Femur is the bone of the thigh Longest, largest, heaviest and strongest bone in the body Anterior  FEMUR Head of the femur Spherical Articulates with the acetabulum of the pelvic bone Hip (acetabulofemoral) joint Neck of the femur Cylindrical Projects superomedially from the shaft at an angle of 125o Right femur, anterior view  FEMUR Head of the femur Spherical Articulates with the acetabulum of the pelvic bone On the medial surface there is a nonarticular pit (fovea) For the attachment of the ligament of the head of femur Right femur, medial view  FEMUR Shaft of the femur Greater trochanter Extends superiorly from the lateral part of the shaft Attachment site for gluteus minimus, gluteus medius, obturator internus, gemelli, piriformis and lateral head of quadriceps femoris muscles Right femur, anterior view  FEMUR Shaft of the femur Greater trochanter Extends superiorly from the lateral part of the shaft At the posterior, medial surface of the greater trochanter forms the trochanteric fossa At the lateral wall of trochanteric fossa, there is an oval depression for obturator externus muscle Right femur, medial view  FEMUR Shaft of the femur Lesser trochanter Blunt conical shape Projects posteromedially Attachment site for the tendons of the psoas major and iliacus muscles Intertrochanteric crest Between greater and lesser trochanters on the posterior surface A broad smooth ridge Quadrate tubercle On the intertrochanteric crest Provides attachment for quadratus femoris muscle Right femur, posterior view  FEMUR Shaft of the femur Lesser trochanter Blunt conical shape Projects posteromedially Attachment site for the tendons of the psoas major and iliacus muscles Intertrochanteric crest Between greater and lesser trochanters on the posterior surface A broad smooth ridge Quadrate tubercle Left femur, posterior On the intertrochanteric view crest Provides attachment for quadratus femoris muscle  FEMUR Shaft of the femur Intertrochanteric line Between greater and lesser trochanters on the anterior surface It is continuous with the pectineal line Right femur, anterior view  FEMUR Shaft of the femur Descents from lateral to medial in the coronal plane at an angle of 7o from the vertical axis. Middle part of the shaft is triangular Anterior, lateral and medial surfaces Medial, lateral and posterior margins Medial and lateral margins are rounded Posterior margin forms a prominent raised crest, the linea aspera Anterior  FEMUR Shaft of the femur Descents from lateral to medial in the coronal plane at an angle of 7o from the vertical axis. Middle part of the shaft is triangular Anterior, lateral and medial surfaces Medial, lateral and posterior margin Medial and lateral margins are rounded Posterior margin forms a prominent raised crest, the linea aspera Left femur, posterior view  FEMUR Shaft of the femur Linea aspera Major site of muscle attachment in the thigh At the proximal; Medial margin of linea aspera continues as pectineal (spiral) line Lateral margin of linea aspera continues as gluteal tuberosity Pectineal (spiral) line Curves anteriorly under the lesser trochanter and joins the intertrochanteric line Gluteal tuberosity Broad linear roughening Gluteus maximus muscle is attached Right femur, posterior view  Left femur, posterior view FEMUR Shaft of the femur Linea aspera Major site of muscle attachment in the thigh At the distal region; Medial margin of linea aspera continues as medial supracondylar line Lateral margin of linea aspera continues as lateral supracondylar line Adductor tubercle Medial supracondylar line terminates at the prominent adductor tubercle  FEMUR Left femur, posterior view Distal end of the femur Two large condyles Medial condyle Lateral condyle They both articulate with the proximal head of the tibia (knee joint, tibiofemoral joint) Intercondylar fossa At the posterior surface, between the two condyles At the intercondylar fossa, there are two attachment facets for anterior and posterior cruciate ligaments  FEMUR Left femur, anterior view Distal end of the femur Two large condyles Medial condyle Lateral condyle Patellar articular surface Two condyles are joined anteriorly and articulate with the patella Medial and lateral epicondyles Bony elevations on the non-articular outer surfaces of the condyles For the attachment of collateral ligaments  FEMUR Distal end of the femur Two large condyles Medial condyle Distal end of the femur, articular surface, Lateral condyle inferior view Patellar articular surface Two condyles are joined anteriorly and articulate with the patella Medial and lateral epicondyles Bony elevations on the non-articular outer surfaces of the condyles For the attachment of collateral ligaments  PATELLA Patella (kneecap) Largest sesamoid bone in the body Develops in response to strain in the tendon Formed within the tendon of the quadriceps femoris muscle Babies have cartilage patella At the age of 3 patella becomes a bone  PATELLA Patella is triangular Apex is pointed inferiorly Posterior surface articulates with the femur Lateral and medial facets articulate with lateral and medial condyles  TIBIA Tibia is the medial and larger of the two bones in the leg Only tibia articulates with the femur (knee joint, tibiofemoral joint) Proximal end of the tibia is expanded for weight-bearing  TIBIA Proximal end of the tibia Medial and lateral condyles Both flattened in the horizontal plane Superior surfaces of the condyles are articular Intercondylar region 6 facets for ligaments  TIBIA Proximal end of the tibia Tibial plateau Articular surfaces of the medial and lateral condyles and the intercondylar region together form the plateau Superior view  TIBIA Proximal end of the tibia Medial and lateral condyles Condyles are thick horizontal discs at the top of the tibia Medial condyle is larger Superior facet of the medial condyle articulates with medial condyle of the femur Superior facet of the lateral condyle articulates with lateral condyle of the femur Anterior  TIBIA Proximal end of the tibia Medial and lateral condyles Intercondylar eminence Raised central part of the intercondylar region Medial intercondylar tubercle Lateral intercondylar tubercle Further elevations over the intercondylar eminence Anterior  TIBIA Proximal end of the tibia Medial and lateral condyles Posterior surface of the medial condyle bears a groove for semimembranosus muscle Under the lateral condyle there is a distinct circular facet for articulation with the proximal head of the fibula (proximal tibiofibular joint) Posterior view  TIBIA Proximal end of the tibia Tibial tuberosity Inferior to the condyles Palpable inverted triangular area on the anterior aspect of the tibia Site of attachment for the patellar ligament (quadriceps femoris tendon) Anterior  TIBIA Proximal end of the tibia Gerdy’s tubercle Anterolateral tubercle of the tibia Located on the lateral condyle Iliotibial tract inserts here (thick deep fascia of the thigh)  TIBIA Shaft of the tibia Triangular in cross section Medial, lateral and posterior surfaces Anterior, medial and interosseous borders Anterior border is sharp and descends from tibial tuberosity to lateral condyle Medial surface of the tibia Smooth and subcutaneous Easily palpable along its entire extend Anterior view  TIBIA Shaft of the tibia Soleal line At the posterior surface of the shaft of the tibia Roughened oblique line Origin of the soleus muscle Posterior view  TIBIA Distal end of the tibia Shaped like a rectangular box Lower surface of the distal end of the tibia (and medial malleolus) articulate with talus to form ankle joint (tibiotalar, talocrural joint) Medial malleolus A bony protuberance on the medial side Anterior view Antero-medial  TIBIA Distal end of the tibia Groove for tendon of tibialis posterior muscle On the posterior surface of the distal end Fibular notch A deep triangular notch at the lateral surface of the distal end of the tibia Articulates with the fibula (distal tibiofibular joint) Posterior view  FIBULA Lateral bone of the leg Does not take part in formation of the knee joint Does not take part in weight-bearing Small proximal head A narrow neck A delicate shaft Lateral malleolus  FIBULA Head of the fibula Round shape expansion at the proximal end of the fibula Facet for articulation with tibia On the superomedial surface of the head A circular facet for the inferior surface of the lateral condyle of the tibia (proximal tibiofibular joint) Apex Superior projection of the head Anterior  FIBULA Head of the fibula Impression for the attachment of the biceps femoris muscle Depression of the attachment of the fibular collateral ligament Neck of the fibula Between the expanded head and the shaft Common fibular nerve lies against the neck Anterior  FIBULA Shaft of the fibula Triangular in cross section Anterior, posterior and interosseous borders Lateral, medial and posterior surfaces Anterior border is sharp Posterior border is rounded Interosseous border is medial in position  FIBULA Distal end of the fibula Spade-shaped Lateral malleolus Medial surface of the lateral malleolus has a facet for articulation with the talus (ankle joint)  FIBULA Distal end of the fibula Groove for fibularis muscles The posterior surface of the lateral malleolus is marked by a shallow groove for the tendons of the fibularis longus and fibularis brevis muscles INTEROSSEOUS MEMBRANE Tough fibrous sheet of connective tissue Between the interosseous borders of the shafts of the tibia and fibula Not only links the tibia and fibula together, but also provides an increased surface area for muscle attachment  BONES OF THE FOOT Seven tarsal bones (ankle) Five metatarsal bones 14 phalanges (bones of the toes) Great toe has only two phalanges Others have three Superior view  BONES OF THE FOOT Seven tarsal bones (ankle) Five metatarsal bones 14 phalanges (bones of the toes) Great toe has only two phalanges Others have three Lateral view  TARSAL BONES Proximal group Talus (Latin for ankle) Calcaneus (Latin for heel) Intermediate tarsal bone Navicular (boat-shaped) Distal group From lateral to medial Cuboid (Greek for cube-shaped) Cuneiforms (Greek for wedge) Lateral, intermediate and medial cuneiform Superior view  TALUS Latin for ankle Lateral Most superior bone of the view foot Sits on top of the calcaneus Articular surface for tibia and fibula; articulates (above) with tibia and fibula (ankle joint, talocrural joint) Articular surface for navicular bone (anterior) Right talus, medial view  TALUS Head of talus Rounded anterior, medial projection Articular surface for navicular bone Neck of talus Short, broad Body of talus Posterior part of the talus Right talus, medial view  TALUS Anterior calcaneal surface Middle calcaneal surface Posterior calcaneal surface At the inferior surface They articulate with calcaneus bone Articular surface for calcaneonavicular ligament Articulates plantar calcaneonavicular ligament (the spring ligament) Right talus, inferior view  TALUS Sulcus tali Below the neck A deep groove passing from medial to lateral Groove for the tendon of the flexor hallucis longus muscle Passes at the inferior surface of the posterior process of the talus Right talus, inferior view  TALUS Trochlear surface Upper surface of the talus Articulates with the inferior end of the tibia with medial malleolus of the tibia with lateral malleolus of the fibula Lateral process A bony projection Medial tubercle Lateral tubercle Posterior process Medial + lateral tubercle Right foot, superior view  TALUS Trochlear surface Upper surface of the talus Articulates with the inferior end of the tibia with medial malleolus of the tibia with lateral malleolus of the fibula Anterior  CALCANEUS Largest of the tarsal bones Forms the heel Sits under and supports the talus Elongate, irregular and box-shaped bone Right foot, lateral view  CALCANEUS Calcaneal tuberosity Weight-bearing region of the heel Medial process Larger Lateral process Smaller Notch A V-shaped notch Calcaneal tubercle At the anterior end of the plantar surface Right calcaneus, inferior view  CALCANEUS Fibular trochlea At the lateral surface Tendons of the fibularis brevis and longus muscles are bound to the trochlea Tubercle for attachment of the calcaneofibular part of the lateral collateral ligament Right calcaneus, lateral view  CALCANEUS Sustentaculum tali At the medial surface A shelf of bone projecting medially and supporting the head of the talus Right calcaneus, superior view  CALCANEUS Sustentaculum tali At the medial surface A shelf of bone projecting medially and supporting the head of the talus Groove for the tendon of the flexor hallucis longus muscle Under the sustentaculum tali Right calcaneus, inferior view  CALCANEUS Anterior, middle and posterior talar articular surfaces At the superior surface They articulate with the corresponding talar facets Calcaneal sulcus Between the middle and posterior talar articular surfaces Right calcaneus, superior view  CALCANEUS Tarsal sinus The calcaneal sulcus of the calcaneus and Sulcus tali of the talus forms a large gap Right calcaneus, lateral view  NAVICULAR On the medial side of the foot Tuberosity of navicular Projects inferiorly on the medial side For attachment of the tibialis posterior muscle  CUBOID Greek for cube Groove for the tendon of the fibularis longus muscle On the anterior plantar surface  CUNEIFORMS Latin for wedge Lateral cuneiform Intermediate cuneiform Medial cuneiform  METATARSALS There are five metatarsals Numbered from I to V, from medial to lateral Metatarsal I Associated with the great toe Shortest and thickest Articulates with two sesamoid bones (on plantar surface) Metatarsal II Longest Superior Metatarsal V Tuberosity for the tendon of the fibularis brevis muscle Each metatarsal has a Base (proximal) Shaft Head (distal)  PHALANGES The phalanges are the bones of the toes Great toe has two phalanges Proximal and distal Other toes have three phalanges Proximal, middle and distal Each phalanx has A base (proximal) Shaft Superior Head (distal)  ARCHES OF THE FOOT Two arches support the weight of the body Provide spring and leverage to the foot when walking The arches flex when body weight applied Longitudinal arches Runs from calcaneus to the metatarsal heads Medial and lateral longitudinal arches Transverse arch Runs from 5th metatarsal to navicular bone  ARCHES OF THE FOOT Two arches support the weight of the body Provide spring and leverage to the foot when walking The arches flex when body weight applied Longitudinal arches Runs from calcaneus to the metatarsal heads Medial and lateral longitudinal arches Transverse arch Runs from 5th metatarsal to navicular bone  ARCHES OF THE FOOT Longitudinal arches Runs from calcaneus to the metatarsal heads Medial and lateral longitudinal arches Transverse arch Runs from 5th metatarsal to navicular bone Thank you…