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Lower Limb joints
Joints of the Lower Limb
| Question | Answer |
|---|---|
| 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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