THE LOWER LIMB

THE LOWER LIMB HAIMANOT HAILU(MSc). The Lower Limb Haimanot Hailu(msc).

Regions of the lower limb 1. Gluteal region - transitional region b/n the trunk and free lower limb 2. Thigh or femoral region -lies between the gluteal regions proximally and the knee region distally. 3. Knee region :- distal femur and proximal tibia, the head of the fibula and the patella and region of popliteal fossa 4. Leg:- lies between the knee and the rounded medial and lateral prominences (malleoli) 5. Ankle region:- includes the medial and lateral prominences (malleoli). 6. Foot region distal part of the lower limb containing the tarsus, metatarsus, and phalanges (toe bones)..

Functions of the lower limb 1. Support the body weight 2. Locomotion.

Movements of the lower limb. Movements of the lower limb.

[Audio] Bones of the lower limb 1. Hip region Hip bone 2. Thigh – Femur 3. Knee Patella 4. Leg Tibia and Fibula 5. Foot 7 Tarsal bones 5 Metatarsal bones 14 Phalanges.

[Audio] Bony pelvis Attaches the free lower limb to the axial skeleton The sacrum being common to the axial skeleton and the pelvic girdle. Sacrum and right and left hip bones joined anteriorly at the pubic symphysis..

[Audio] Each pelvic bone is formed by three bones ilium, ischium, and pubis. The ilium is superior and the pubis and ischium are anteroinferior and posteroinferior, respectively. These bones fuse during childhood..

[Audio] Ilium Is the largest of the three components of the hip bone. Thick near the hip joint and expands into a large curved plate of bone superiorly. Upper fan shaped part of the ilium is associated on its inner side with the abdomen and on its outer side with the lower limb..

[Audio] Surface Features A superior ala and an inferior body comprise the ilium. The body is one of the components of the acetabulum, the socket for the head of the femur. The superior border of the ilium, the iliac crest, ends anteriorly in a blunt anterior superior iliac spine (A-S-I-S-)..

[Audio] Posteriorly, the iliac crest ends in a sharp posterior superior iliac spine (P-S-I-S-). Below this spine is the posterior inferior iliac spine (P-I-I-S-). Below the posterior inferior iliac spine is the greater sciatic notch, through which the sciatic nerve pass..

[Audio] The medial surface of the ilium contains the iliac fossa, a concavity where the tendon of the iliacus muscle attaches. On its lateral surface are three arched lines called the posterior gluteal line, the anterior gluteal line, and the inferior gluteal line. The gluteal muscles attach to the ilium between these lines..

Ligament attachments Articular surface for sacrum Iliac fossa Arcuate line Body of ilium Obturator groove Pectineal line Superior pubic ramus Pubic tubercle Pubic crest Body of pubis Iliac tuberosity Posterior superior iliac spine Posterior inferior iliac spine Body of ischium Ischial spine Lesser sciatic notch Iliac crest Inferior pubic ramus Ischial tuberosity Ramus of ischium Ischial tuberosity Tuberculum of iliac crest Gluteal surface Anterior superior iliac spine Anterior inferior iliac spine Superior pubic ramus Inferior pubic ramus Ramus of ischium.

[Audio] Ischium Theinferiorandposteriorportionofthehipbone,issituatedbetweenthebodyoftheiliumandtheinferiorramusofthepubis. Theischiumisasideways archedorU-shapedstructure,withitsconcave,notchedmargincontributingtotheposteriortwo thirdsoftheobturatorforamen(thelargeholeontheanteriorsurfaceofthehipbone).

[Audio] Surface Features The ischium is comprised of a superior body and an inferior ramus. The ramus joins the pubis. Features of the ischium include the prominent ischial spine, a lesser sciatic notch below the spine, and a rough and thickened ischial tuberosity. Together, the ramus and the pubis surround the obturator foramen..

Posterior Greater sciatic notch Ischial spine Lesser sciatic notch Ischial tuberosity Anterior Anterior superior iliac spine Anterior inferior iliac spine Acetabulum Pubic tubercle Obturator canal Obturator membrane 1..

[Audio] Pubis Thepubisistheinferior,anteriorportionofthehipboneand,liketheischium,hastheformofasidewaysarchoraU-shape. Consistsofsuperiorramus,aninferiorramus,andabodybetweentheramicomprisethepubis..

[Audio] The anterior, superior border of the body is the pubic crest, and at its lateral end is a projection called the pubic tubercle. This tubercle is the beginning of a raised line, the pectineal line which extends superiorly and laterally along the superior ramus to merge with the arcuate line of the ilium..

[Audio] The pubic symphysis is the joint between the pubes of the two hip bones. It consists of a disc of fibrocartilage. Inferior to this joint, the inferior rami of the two pubic bones converge to form the pubic arch..

[Audio] The acetabulum Is a deep fossa formed by the ilium, ischium, and pubis. Functions as the socket that accepts the rounded head of the femur. Together, the acetabulum and the femoral head form the hip joint. On the inferior side of the acetabulum, a deep indentation, the acetabular notch, forms a foramen through which blood vessels and nerves pass..

[Audio] The wall of the acetabulum consists Non articular part: is rough and forms a shallow circular depression (the acetabular fossa) in central and inferior parts of the acetabular floor. Articular surface: is broad and surrounds the anterior, superior, and posterior margins of the acetabular fossa..

[Audio] The acetabular fossa provides attachment for the ligament of the head of the femur, whereas blood vessels and nerves pass through the acetabular notch..

Pubis Acetabular notch I liurn Lunate surface (articular) Acetabu lar fossa I sch i u rn.

[Audio] Boneofthethigh. BONE OF THE THIGH.

[Audio] Femur The femur is the longest, heaviest, and strongest bone in the body. Proximal end articulates with the acetabulum (hip). Distal end articulates with the tibia and patella..

[Audio] Proximal End and Surface Features Femoral head: This is the spherical, articulating end that fits into the acetabulum of the pelvic bone. Fovea capitis: non articular pit on medial surface of the head for ligament attachment. Femoral neck: The cylindrical structure that connects the head to the shaft of the femur.

View Femur (e) Medial view of proximal end of femur HEAD FOVEA GREATER TROCHANTER NECK INTERTROCHANTERIC CREST LESSER TROCHANTER (f) Medial view.

[Audio] Greatertrochanter:extendssuperiorlyfromtheshaftofthefemurjustlateraltotheregionwheretheshaftjoinstheneckofthefemur Lessertrochanter:smallerthanthegreatertrochanterandprojectsposteromediallyfromtheshaftofthefemurjustinferiortothejunctionwiththeneck..

[Audio] Intertrochanteric line : is a ridge of bone on the anterior surface of the upper margin of the shaft that descends medially from a tubercle on the anterior surface linea aspera on the posterior aspect of the femur. Intertrochanteric crest: on the posterior surface of the femur and descends medially across the bone from the posterior margin of the greater trochanter to the base of the lesser trochanter..

Greater trochanter line Lateral epicondyle Patel surface Anterior view Fovea of head Neck Lesser trochanter Body (shaft) aspera Adductor tubercle Medial epicondyle Greater trochanter epicondyle •ntercondylar Posterior.

Gluteus rninimus Fovea Quadrate tubercie Lesser trochanter Pectineal line (spiral line) Medial rnargin Of linea aspera Linea aspera Neck Greater trocha-jter Gluteus rnedius Attachment site for gluteus crest GI uteaJ Lateral rnargin Of linea aspera Lesser trochanter @ Elsevier. Drake et a': Gray's Anatorny for Students — www.studentconsult.com.

[Audio] DistalEndFeatures Medialandlateralcondyles:Articulatewithtibialcondyles. Medialandlateralepicondyles:Ligamentattachmentsites. Intercondylarfossa:Posteriordepressionbetweencondyles. Patellarsurface:Anteriorarticulationwithpatella. Adductortubercle:Attachmentforadductormagnusmuscle..

GREATER TROCHANTER INTERTROCHANTERIC LINE LATERAL EPICONDYLE LATERAL CONDYLE HEAD NECK LESSER TROCHANTER BODY (SHAFT) LINEAASPERA ADDUCTOR TUBERCLE MEDIAL EPICONDYLE MEDIAL CONDYLE (d) Posterior view GREATER TROCHANTER INTERTROCHANTERIC CREST GLUTEAL TUBEROSITY INTERCONDYLAR FOSSA LATERAL EPICONDYLE LATERAL CONDYLE (c) Anterior view.

[Audio] Thepatella Thepatella(kneecap)isasmall,triangularsesamoidboneanteriortothekneejoint. Functions: ✓Itsupportsthemuscles,tendons,andligamentsassociatedwithkneemovement. ✓Maintainstendonpositionduringkneeflexion. ✓Protectsthekneejoint..

[Audio] Surface Features: Base: Broad proximal end. Apex: Pointed distal end. Posterior surface: Two articular facets for femoral condyles. Patellar ligament: Connects patella to tibial tuberosity. Forms patellofemoral joint as part of knee joint..

'atelia (g) Anterior view (i) Anterior view Base Articular facet for medial femoral condyle Base Articular facet for medial femoral condyle (h) Posterior view (j) Posterior view Articular facet for lateral femoral condyle Articular facet for lateral femoral condyle.

[Audio] Bonesoftheleg. BONES OF THE LEG.

[Audio] Tibia The tibia, or shin bone, is the larger, medial, weight bearing bone of the leg. The tibia articulates at its proximal end with the femur and fibula and at its distal end with the fibula and the talus bone of the ankle..

[Audio] Surface features Proximal end has lateral and medial condyles that articulate with femoral condyles to form tibiofemoral (knee) joints. The inferior surface of the lateral condyle articulates with the head of the fibula. The slightly concave condyles are separated by an upward projection called the intercondylar eminence..

[Audio] The tibial tuberosity on the anterior surface is a point of attachment for the patellar ligament. Anterior border (crest): Inferior to and continuous with the tibial tuberosity is a sharp ridge that can be felt below the skin. Medial malleolus: Distal prominence articulating with talus, forms medial ankle bulge. Fibular notch: Articulates with fibula to form distal tibiofibular joint..

LATERAL CONDYLE HEAD LATERAL MALLEOLUS INTERCONDYLAR EMINENCE MEDIAL CONDYLE TIBIAL TUBEROSITY ANTERIOR BORDER (CREST) MEDIAL MALLEOLUS LATERAL CONDYLE LATERAL MALLEOLUS Fibula Tibia (c) Anterior vievv Tibia (d) Fibula Posterior vievv.

[Audio] Fibula Thefibulaisaslender,splint likebonethatisslightlyexpandedatbothends. Thefibulaisparallelandlateraltothetibia,butisconsiderablysmaller. Unlikethetibia,thefibuladoesnotarticulatewiththefemurandisnonweight bearing,butitdoeshelpstabilizetheanklejoint..

[Audio] Surface features The head of the fibula: the proximal end, articulates with the inferior surface of the lateral condyle of the tibia below the level of the knee joint to form the proximal tibiofibular joint. The lateral malleolus: distal end has a projection that articulates with the talus of the ankle. This forms the prominence on the lateral surface of the ankle..

head Of fibula tibL.aa mech lateral malleus medial condyle tibial b..heroety media'.

[Audio] Bonesofthefoot. BONES OF THE FOOT.

[Audio] Tarsals The tarsus is the proximal region of the foot and consists of seven tarsal bones. The tarsal bones are much greater in size than the small carpal bones..

[Audio] The tarsals include the talus and calcaneus, located in the posterior part of the foot. The calcaneus is the largest and strongest tarsal bone. The anterior tarsal bones are the navicular, three cuneiform bones called the third (lateral), second (intermediate), and first (medial) cuneiforms, and the cuboid. The talus, the most superior tarsal bone, is the only bone of the foot that articulates with the fibula and tibia..

S u perior Vievv Inferior View Ta rsals M eta tarsa s Phalanges LATERAL TARSALS: Cuboid Head POSTERIOR MEDIAL TARSALS: Talus Navicular Third (lateral) cu neiforrn (i n terrnediate) First (rnedial) cuneift)rrn METATARSALS: S rnoid bones PHALANGES: P roxi Middle Distal G t toe (hallux) POSTERIOR Inferiorviev LATERAL TARSALS: 11 Suoerior view.

[Audio] Metatarsals ThemetatarsusistheintermediateregionofthefootandconsistsoffivemetatarsalbonesnumberedItoV(or1–5)frommedialtolateral. Theyareconvexdorsallyandconcaveontheirplantarsurfaces. Likethemetacarpalsofthepalm,eachmetatarsalconsistsofaproximalbase,anintermediateshaft,andadistalhead..

[Audio] The metatarsals articulate proximally with the first, second, and third cuneiform bones and with the cuboid to form the tarsometatarsal joints. Distally, they articulate with the proximal row of phalanges to form the metatarsophalangeal joints. The first metatarsal is thicker than the others because it bears more weight..

TARSALS: Cuboid Third (lateral) cuneiforrn TARSALS : Talus Navi cular Second cuneiform First (rnedial) METATARSALS: bones PHALANGES TARSALS: Cuboid Third (lateral) cune iforrn (c) Superior View (d) inferior view.