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Lower Limb joints

Joints of the Lower Limb

What two bones articulate at the hip joint? The head of the femur and the acetabulum of the hip bone
The acetabulum is deficient in which side? Inferiorly (it is horseshoe shaped)
What bridges the acetabular notch? The transverse acetabular ligament
Iliogemoral ligament one of the strongest in body; resists hyperextension
ischiofemoral ligament thinnest of three main ligaments; resists hyperextension
Pubofemoral ligament blends with lower portion of iliofemoral ligament; resists abduction
Ligament of the head of the femur runs between acetabular fossa and transverse ligament to the fovea capitus of the femur; probably of not imporance to adults; may help stabilize join in young children
* * What muscles are involved in flexion of the hip joint? iliopsoas, rectus, femoris, sartorius
* * What muscles are involved in extension of the hip joint? gluteus maximus, hamstring muscles
* * What muscles are involved in abduction of the hip joint? gluteus medius, gluteus minimus, sartorius, tensor fascia latae
* * What muscles are involved in adduction of the hip joint? adductor longus, adductor brevis, adductor magnus, gracilus, pectineus
* * What muscles are involved in lateral rotation of the hip joint? piriformis, obturator internus and externus, superior and inferior gemelli, quadratus femoris, gluteus maximus
* * What muscles are involved in medial rotation of the hip joint? gluteus medius, gluteus minimus, tensor fasciae latae
* * What muscles are involved in circumduction? combination of the above movements
Congenital dislocation of the hip joint common (mostly girls); upper lip of acetabulum fails to develop and head of femur rises up out of acetabulum onto gluteal surface of ilium, maing affect limb appear shorter
Traumatic dislocation of the hip joint RARE because of strength of joint; usually high energy injury when person seated and joint is FLEXED and ADDUCTED; sciatic nerve may be injured if there's injury to femoral head (head pushed posteriorly, tearing capsule)
* * * How does the bones of the knee joint articulate? condyles of the femur and tibia (tibial condyles = tibial plateus); modified hinge joint
Patellar ligament patella to tibial tuberosity; extension of quadriceps femoris tendon; helps stabilize knee joint throughout range of movement
Tibial collateral ligament Medial femoral condyle to tibia; FIRMLY ATTACHED TO THE MEDIAL MENISCUS (by deep part of ligament)
Fibular collateral ligament lateral femoral condyle to fibula; separated from lateral meniscus by popliteus tendon
Oblique popliteal ligament Expansion of semimembranosus tendon; posterior support
Arcuate popliteal ligament posterior thickening of the capsule at the upper edge of the popliteus tendon; posterior support
Describe the menisci wedge shaped semilunar pieces of fibrocartilage; Attached to the intercondylar area of the tibia medially and to the fibrous capsule laterally; medial meniscus (c-shaped) lateral meniscus (o-shaped)
What ligament joints the menisci lanteriorly? The transverse ligament
Medial meniscus firmly attached to the tibial collateral ligament
Lateral meniscus separated from the fibular collateral ligament by popliteus tendon
What is the chief function of the menisci? maintain congruence of the tibial and femoral condyles throughout range of movement
Cruciate ligament (anterior) attached to anterior intercondylar area of tibia, passes UPWARD, BACKWARD, and LATERALLY to be attached to the posterior part of the MEDIAL surface of the LATERAL femoral epicondyle
What is the function of the anterior cruciate ligament? Extended leg: prevents posterior displacement of the femur on tibia; flexed leg: prevents anterior displacement of the tibia
Cruciate ligament (posterior) Attached to the posterior intercondylar area of the tibia, passes UPWARD, FORWARD, and MEDIALLY to be attached to the ANTERIOR part of the lateral surface of the medial femoral epicondyle
What is the function of the posterior cruciate ligament? Extended leg: prevents anterior displacement of the femur on the tibia; flexed leg: prevents posterior displacement of the tibia
Extension of the leg results in the round femoral condyles rolling forwad like wheel on ground; ___ cruciate ligament becomes tensed and inhibits ____ movement of the femur; further extension accompanied by ___ rotation of the ____. posterior; forward; medial; femur
Extension of the leg results in ____ of all the ligamens and knee becomes a mechanically ____ structure tightening; rigid; this is known as a "screwing home movememnt"
Before flexion of the leg can be accomplished, the ligaments of the knee must be... relaxed
Flexion of the leg is accomplished by the ___ muscle, which ___ rotates the ___ or ___ rotates the ___. Popliteus; laterally, femur; medially tibia
* * * What muscles are involved in the flexion of the knee joint? Biceps femoris, semitendinosus, semimembranosus, gracilis, sartorius, popliteus
* * * What muscles are involved in the extension of the knee joint? quadriceps femoris
* * * What muscles are involved in the medial rotation of the knee joint? sartorius, gracilis, semitendinosus, semimembranosus,
* * * What muscles are involved in the lateral rotation of the knee joint? biceps femoris
Which are more common: ACL or PCL injuries? Anterior cruciate ligament is more common when excessive force is applied to the joint
What other structures might be compromised in an anterior cruciate ligament injury? tibial collateral ligament and medial meniscus
What would you see in a patient with an anterior cruciate ligament injury? Anterior drawer sign: tibia can be pulled excessively FORWARD ON THE FEMUR when leg is FLEXED at the knee joint
What would you see in a patient with a posterior crucaite ligament injury? Posterior drawer sign: tibia could be pulled excessively BACKWARD ON THE FEMUR when the leg is flexed at the knee joint
Which is more commonly injured, the medial or the lateral meniscus? The MEDIAL, since the lateral has a strong attachment to the tibial collateral ligament
What is the unhappy triad of knee injuries (common in football)? Tearing of the tibial collateral ligament, tearing of the medial meniscus, tearing of the anterior cruciate ligament
Describe the articulation of the ankle joint Distal ends of tibia and fibula (plus malleoli) and trochlea of the talus; allos for dorsiflexion and plantar flexion; joints most stable during dorsiflexion
Medial deltoid ligament very strong; attached above medial malleolus and below to the talus, the sustenaculum tali, plantar calcaneonavicular ligament, and the navicular bone
Lateral ligament Weaker than the medial deltoid ligament; has three bands: anterior taleofibular lig., calcaneofibular, and posterior taleofibular
Name the movements of the ankle joint dorsiflexion and plantar flexion
What muscles are involved in dorsiflexion of the foot tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius
What muscles are involved in plantar flexion of the foot gastrocnemius, plantaris, fibularis longus, fibularis brevis, tibialis posterior, flexor digitorum longus, flexor hallucis longus
When do most acute sprains to the foot occur? Excessive inversion of the foot with plantar flexion of the ankle
What ligament is usually torn during an acute sprain of the ankle? ANTERIOR TALOFIBULAR LIGAMENT; calcaneofibular ligament may also be hurt
The __ joint is the joint between the talus and the calcaneus subtalar
What are the main joints responsible for eversion and inversion of the foot? The transverse tarsal joint and subtalar joints
What are the arches of the foot? The medial longitudinal arch, the lateral longitudunal arch, and the transverse arch
This arch spans the calcaneus, talus, navicular, three cuneiforms, and medial three metatarsals Medial longitudunal arch
This arch spans the calcaneus, cuboid, and lateral two metatarsals Lateral longitudunal arch
This arch spans the cuboid, three cuneiforms, and the bases of the medial three metatarsals Transverse arch
What area does the plantar calcaneonavicular ligament support? sustentaculum tali to navicular bone
What area does the long plantar ligament support? The calcaneus to the cuboid
What area does the short plantar ligament support? Calcaneus to the cuboid
What is the thickest aponeurosis? The plantar sheath
Created by: karkis77



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