bones and joints - anatomy of lower extremity
TRANSCRIPT
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Bones & Joints of the Bones & Joints of the Lower ExtremitiesLower Extremities
Reynaldo V. Lopez, M.D.Senior LecturerDepartment of AnatomyAngeles University School of Medicine
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Pelvic GirdlePelvic Girdle
• Attaches lower limbs to the spine
• Supports visceral organs
• Attaches to the axial skeleton by strong ligaments
• Acetabulum is a deep cup that holds the head of the femur
• Lower limbs have less freedom of movement
•Are more stable than the arm
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Pelvic GirdlePelvic Girdle
• Consists of paired hip bones (coxal bones)
• Hip bones unite anteriorly with each other
• Articulates posteriorly with the sacrum
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Bony PelvisBony Pelvis
• A deep, basin-like structure
• Formed by coxal bones, sacrum, and coccyx
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Bony PelvisBony Pelvis
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Coxal BonesCoxal Bones
• Consist of three separate bones in childhood
• Ilium, ischium, and pubis
• Bones fuse – retain separate names to regions of the coxal bones
• Acetabulum – deep hemispherical socket on lateral pelvic surface
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IliumIlium
• Large, flaring bone
• Forms the superior region of the coxal bone
• Site of attachment for many muscles
• Articulation with the sacrum forms sacroiliac joint
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IschiumIschium
• Forms posteroinferior region of the coxal bone
• Anteriorly – joins the pubis
• Ischial tuberosities – the strongest part of the hip bone
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PubisPubis
• Forms the anterior region of the coxal bone
• Lies horizontally in anatomical position
• Pubic symphysis
• The two pubic bones are joined by fibrocartilage at the midline
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Lateral and Medial Views of the Hip BoneLateral and Medial Views of the Hip Bone
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Lateral and Medial Views of the Hip BoneLateral and Medial Views of the Hip Bone
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True and False PelvesTrue and False Pelves
• Bony pelvis is divided into two regions
• False (greater) pelvis – bounded by alae of the iliac bones
• True (lesser) pelvis – inferior to pelvic brim
•Forms a bowl containing the pelvic organs
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True and False PelvesTrue and False Pelves
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Pelvic Structures and ChildbearingPelvic Structures and Childbearing
• Major differences between male and female pelves
• Female pelvis is adapted for childbearing
•Pelvis is lighter, wider, and shallower than in the male
•Provides more room in the true pelvis
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Female and Male PelvesFemale and Male Pelves
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Hip JointHip Joint
• The bones of the hip are the femur (the thighbone) and the pelvis.
• The top end of the femur is shaped like a ball called the femoral head.
• The femoral head fits into a round socket on the side of the pelvis called the acetabulum.
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Hip JointHip Joint
• A small ligament connects the very tip of the femoral head to the acetabulum.
• This ligament, called the ligamentum teres, doesn't play a role in controlling hip movement like the main hip ligaments.
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Hip JointHip Joint
• A special type of ligament forms a unique structure inside the hip called the labrum.
• The labrum is attached almost completely around the edge of the acetabulum.
• The shape and the way the labrum is attached create a deeper cup for the acetabulum socket.
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The Lower LimbThe Lower Limb
• Carries the entire weight of the erect body
• Bones of lower limb are thicker and stronger than those of upper limb
• Divided into three segments
• Thigh, leg, and foot
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ThighThigh
• The region of the lower limb between the hip and the knee
• Femur – the single bone of the thigh
• Longest and strongest bone of the body
• Ball-shaped head articulates with the acetabulum
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Structures of the FemurStructures of the Femur
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PatellaPatella
• Triangular sesamoid bone
• Imbedded in the tendon that secures the quadriceps muscles
• Protects the knee anteriorly
• Improves leverage of the thigh muscles across the knee
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Knee JointKnee Joint
• The end of the femur joins the top of the tibia to create the knee joint.
• Two round knobs called femoral condyles are found on the end of the femur.
• These condyles rest on the top surface of the tibia.
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Knee JointKnee Joint
• This surface is called the tibial plateau.
• The outside half is called the lateral tibial plateau, and the inside half is called the medial tibial plateau.
• The patella glides through a special groove formed by the two femoral condyles called the patellofemoral groove.
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Knee JointKnee Joint
• Capsule of knee joint
• Covers posterior and lateral aspects of the knee
• Covers tibial and femoral condyles
• Does not cover the anterior aspect of the knee
•Anteriorly – covered by three ligaments
–Patellar, medial, and lateral retinacula
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Anterior View of KneeAnterior View of Knee
Figure 9.12c
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Knee JointKnee Joint
• Ligaments of the knee joint
• Become taut when knee is extended
• 4 extracapsular ligaments:
•Fibular and tibial collateral ligament
•Oblique popliteal ligament
•Arcuate popliteal ligament
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Knee JointKnee Joint
• Two extracapsular ligaments are found on either side of the knee joint.
• They are the medial collateral ligament (MCL) and the lateral collateral ligament (LCL).
• The MCL and LCL prevent the knee from moving too far in the side-to-side direction.
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Knee JointKnee Joint
• Intracapsular ligaments
• Cruciate ligaments – cross each other like an “X”
• Each runs from the proximal tibia to the distal femur
• anterior cruciate ligament (ACL) in front,
• posterior cruciate ligament (PCL) in back.
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Knee JointKnee Joint
• The ACL and PCL control the front-to-back motion of the knee joint.
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Knee JointKnee Joint
• Two special types of ligaments called menisci sit between the femur and the tibia.
• Functions:
(1) they work like a gasket to spread the force from the weight of the body over a larger area
(2) they help the ligaments with stability of the knee.
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Knee JointKnee Joint
• The largest tendon around the knee is the patellar tendon.
• This tendon connects the patella (kneecap) to the tibia.
• This tendon covers the patella and continues up the thigh.
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Knee JointKnee Joint
• There it is called the quadriceps tendon since it attaches to the quadriceps muscles in the front of the thigh.
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Knee JointKnee Joint
• The hamstring muscles on the back of the leg also have tendons that attach in different places around the knee joint.
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LegLeg
• Refers to the region of the lower limb between the knee and the ankle
• Composed of the tibia and fibula
• Tibia – more massive – medial bone of the leg
•Receives weight of the body from the femur
• Fibula – stick-like – lateral bone of the leg
• Interosseous membrane – connects the tibia and fibula
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LegLeg
• Tibia articulates with femur at superior end
• Forms the knee joint
• Tibia articulates with talus at the inferior end
• Forms the ankle joint
• Fibula does not contribute to the knee joint
• Stabilizes the ankle joint
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Structures of the Tibia and FibulaStructures of the Tibia and Fibula
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Ankle JointAnkle Joint
• The ankle joint is formed by the connection of three bones.
• The ankle bone is called the talus.
• The top of the talus fits inside a socket that is formed by the lower end of the tibia and the fibula.
• The bottom of the talus sits on the heelbone, called the calcaneus.
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Ankle JointAnkle Joint
• The talus works like a hinge inside the socket to allow your foot to move up (dorsiflexion) and down (plantarflexion).
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Ankle JointAnkle Joint
• Woodworkers and craftsmen are familiar with the design of the ankle joint.
• They use a similar construction, called a mortise & tenon, to create stable structures.
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Ankle JointAnkle Joint
• 3 ligaments make up the lateral ligament complex on the lateral side of the ankle.
• These include the:
• anterior talofibular ligament (ATFL)
• calcaneofibular ligament(CFL)
• posterior talofibular ligament (PTFL).
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Ankle JointAnkle Joint
• A thick ligament, called the deltoid ligament, supports the medial side of the ankle.
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Ankle JointAnkle Joint
• The large Achilles tendon is the most important tendon for walking, running, and jumping.
• It attaches the calf muscles to the calcaneus and allows us to raise up on our toes.
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Ankle JointAnkle Joint
• The posterior tibial tendon attaches one of the smaller muscles of the calf to the underside of the foot.
• This tendon helps support the arch and allows us to turn the foot inward.
• The anterior tibial tendon allows us to raise the foot.
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Ankle JointAnkle Joint
• Two tendons run behind the lateral malleolus of the ankle.
• These two tendons, called the peroneals, help turn the foot down and out.
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The FootThe Foot
• Foot is composed of:
• Tarsus, metatarsus, and the phalanges
• Important functions
• Supports body weight
• Acts as a lever to propel body forward when walking
• Segmentation makes foot pliable and adapted to uneven ground
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TarsusTarsus
• Makes up the posterior half of the foot
• Contains seven bones called tarsals
• Body weight is primarily borne by the talus and calcaneus
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MetatarsusMetatarsus
• Consists of five small long bones called metatarsals
• Numbered 1–5 beginning with the hallux
(great toe)
• First metatarsal supports body weight
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Phalanges of the ToesPhalanges of the Toes
• 14 phalanges of the toes
• Smaller and less nimble than those of the fingers
• Structure and arrangement are similar to phalanges of fingers
• Except for the great toe, each toe has three phalanges
•Proximal, middle, and distal
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Bones of the FootBones of the Foot
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Bones of the FootBones of the Foot
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Bones of the FootBones of the Foot
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Arches of the FootArches of the Foot
• Foot has three important arches
• Medial and lateral longitudinal arch
• Transverse arch
• Arches are maintained by:
• Interlocking shapes of tarsals
• Ligaments and tendons
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Arches of the FootArches of the Foot