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L003 Lower Limb Bone / Lower Limb Bone .pdf

Bones of the Lower Limb 1. Hip Bone (Pelvic Bone) Each hip bone is formed by the fusion of three parts: Ilium Ischium Pubis These two hip bones articulate with: Sacrum (posteriorly) Each other at the pubic symphysis (anteriorly) 2. Bones of the Thigh Femur Longest and strongest bone in the body Parts include: head, neck, greater and lesser trochanter, shaft, medial & lateral condyles. 3. Bones of the Leg Two long bones located below the knee: Tibia The weight-bearing bone of the leg Medial and larger Forms knee joint with femur and ankle joint with talus Fibula Thin, lateral bone Mainly for muscle attachment; minimal weight-bearing Forms the lateral malleolus at the ankle 4. Bones of the Foot The foot is divided into tarsals, metatarsals, and phalanges. A. Tarsal Bones (7) Calcaneus – heel bone Talus – articulates with tibia/fibula to form ankle joint Navicular Cuboid Medial cuneiform Intermediate cuneiform Lateral cuneiform B. Metatarsals (5) Numbered 1–5 from medial (big toe) to lateral C. Phalanges Digits 2–5: Proximal, middle, distal (3 each) Hallux (big toe): Proximal and distal (2 bones)

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Ashour’s High Yield Guide USMLE Clinical Anatomy
Case report
A 45-year-old female presented with difficulty rising from a seated position and climbing stairs, accompanied by a deep ache in the groin region. Physical examination revealed weakness and discomfort during resisted hip flexion. Radiographs showed no abnormalities of the hip joint. Conservative management was initiated, including NSAIDs, activity modification, and a focused physiotherapy program. The patient reported gradual improvement over several weeks.
BONE & JOINT FEATURES
ILOs A. Identify Major Bones: Recognize and label the key bones of the lower limb, including the femur, patella, tibia, fibula, and the bones of the foot (tarsals, metatarsals, and phalanges). B. Understand Bone Structures: Describe the anatomical features of these bones, such as the femoral head, condyles, tibial tuberosity, and the structures of the ankle and foot, including their landmarks and relationships. C. Explain Functional Anatomy: Understand the functional roles of each bone in the lower limb, including weight-bearing, locomotion, and the role in providing leverage for muscle action. D. Describe Joints and Articulations: Explain the main joints of the lower limb, such as the hip joint, knee joint, and ankle joint, including their types, movements, and how the bones articulate with one another.
The lower limb is involved in a variety of movements that are essential for activities such as walking, running, and maintaining posture. These movements occur at the hip, knee, and ankle joints, and they are controlled by the muscles and ligaments of the lower limb. These movements are integral to the functionality of the lower limb, allowing for a wide range of activities and providing stability during weight-bearing tasks. Proper coordination of these movements is crucial for maintaining balance and performing various daily tasks.
BONE
Overview
The lower limb is composed of several bones that provide structural support, facilitate movement, and bear the weight of the body. These bones are categorized into four main regions: • the pelvic girdle • the thigh • the leg • the foot. the pelvic girdle the thigh the leg the foot.
1. Pelvic Girdle The pelvic girdle consists of two hip bones. 2. Thigh Femur & patella. 3. Leg Tibia & Fibula 4. Foot Tarsal Bones, Metatarsal Bones & Phalanges Hip Femur Tibia & Fibula Tarsal, Metatarsal& Phalanges
Hip bone
The hip bone, also known as the pelvic bone, is a large, complex structure that forms the primary skeletal support for the lower body. It plays a critical role in movement, support, and protection of internal organs. The hip bone is composed of three parts: • Ilium • Ischium • Pubis Ilium Ischium Pubis
Hip pointer A hip pointer is a bruise or contusion of the iliac crest, the prominent bone on the upper part of the hip. It is often accompanied by injury to the surrounding soft tissues, including muscles and ligaments. Causes: • Direct blow to the hip area (common in contact sports) • Falling onto the hip • High-impact collisions Clinical Insight
1. Ilium: Broad, flaring portion of the hip bone that forms the upper part. • Iliac crest: The curved, superior border of the ilium. • Anterior superior iliac spine (ASIS): A bony projection at the front of the ilium. • Anterior inferior iliac spine (AIIS): A bony projection at the front of the ilium. • Posterior superior iliac spine (PSIS): A bony projection at the back of the ilium. • Posterior inferior iliac spine (PIIS): A bony projection at the back of the ilium. Iliac crest ASIS AIIS
2. Ischium: The lower, posterior part of the hip bone. • Ischial tuberosity: The part that bears the body's weight when sitting. • Ischial spine: A pointed projection between the greater and lesser sciatic notches. Greater sciatic notche Ischial spine lesser sciatic notche Ischial tuberosity
3. Pubis: The anterior portion of the hip bone, which meets with the pubis of the opposite hip bone at the pubic symphysis. Important features include: • Pubic symphysis: A cartilaginous joint that unites the left and right pubic bones. • Pubic crest: The superior border of the pubic bone. • Pubic tubercle • Superior pubic ramus • Inferior pubic ramus Pubic symphysis Pubic crest Pubic tubercle Superior pubic ramus Inferior pubic ramus
Sex difference of pelvis Forensic scientists can identify the pelvic bones of females from males by the structural adaptations observed in the pelvis for childbirth. The female pelvis is usually smaller, lighter, and thinner than its male counterpart. In females the pelvic inlet is oval and the outlet is larger, the pelvic cavity is wider and shallower, and the pubic arch is wider. The obturator foramen is usually oval or triangular in the female and round in the male. Clinical Insight
Femur
The femur, also known as the thigh bone, is the longest, strongest, and heaviest bone in the human body. It plays a crucial role in supporting the weight of the body and enabling a wide range of movements. thigh bone
Proximal End: • Head:The rounded, ball-like structure that fits into the acetabulum of the pelvis, forming the hip joint. • Neck:The narrowed region below the head, which connects it to the shaft. • Greater and Lesser Trochanters connected with intertrochanteric line anteriorly and intertrochanteric crest posteriorly acetabulum Head Neck Greater Trochanter Lesser Trochanters intertrochanteric line intertrochanteric crest shaft
Shaft: The long, cylindrical middle portion of the femur. It has a slight curve and is thicker in cross-section to withstand the forces exerted during activities like walking and running. Surfaces : • Anterior Surface: The smooth, rounded front part of the shaft. • Posterior Surface: The back part of the shaft, which has a prominent line known as the linea aspera. Shaft anterior Shaft posterior
• Linea Aspera: Description: The linea aspera is a prominent longitudinal ridge running along the posterior surface of the femoral shaft. • Medial and Lateral Supracondylar Lines: Description: The linea aspera diverges distally into the medial and lateral supracondylar lines as it approaches the distal end of the femur. Linea Aspera Medial Supracondylar Line Lateral Supracondylar Line
• Gluteal Tuberosity: Description: A roughened area on the posterior surface of the femur, running from the base of the greater trochanter down toward the linea aspera. • Spiral Line: Description: The spiral line is a ridge that spirals downward and medially from the lesser trochanter to merge with the medial lip of the linea aspera. greater trochanter lesser trochanter Gluteal Tuberosity Spiral Line Linea Aspera
Distal End: • Medial and Lateral Condyles:Rounded prominences that articulate with the tibia and form part of the knee joint. • Medial and Lateral Epicondyles:Projections above the condyles where ligaments attach. Lateral Epicondyle Lateral Condyle Medial Epicondyle Medial Condyle
Tibia
The tibia, commonly known as the shinbone, is one of the major bones in the human body, playing a crucial role in supporting weight and enabling movement. Tibia
• The tibia is located in the lower leg, medial to the fibula. • It extends from the knee to the ankle, forming part of the knee joint and the ankle joint. • The tibia is the second largest bone in the human body, after the femur. knee tibia Fibula ankle
• Medial and Lateral Condyles: at proximal end. • Tibial Tuberosity: A large oblong elevation on anterior surface of tibia, just below knee. • Anterior Crest (Chin): sharp, prominent ridge on front of tibial shaft. • Medial Malleolus: prominence on inner side of ankle at distal end. • Soleal line:situated on posterior surface Lateral Condyle Medial Condyle Soleal line Tibial Tuberosity Anterior Crest (Chin) Medial Malleolus
Tibial shaft fracture Fractures of the tibial shaft are the most common fractures of a long bone. Because the tibia lies just beneath the skin along the medial border of the leg, these fractures often are open injuries (skin perforated). If you suspect a tibial fracture, especially an open one, it's essential to seek immediate medical attention to reduce the risk of infection and ensure proper treatment. Clinical Insight
Fibula
The fibula is one of the two bones in the lower leg, the other being the tibia. Fibula
• Head: The proximal end of the fibula, which articulates with the lateral condyle of the tibia. • Neck: The narrow region just below the head. • Shaft: The long, slender middle portion of the fibula. • Lateral Malleolus: The distal end of the fibula, forming the outer part of the ankle joint. Head Neck Shaft Lateral Malleolus
Tarsal bones
The tarsal bones are a group of seven irregularly shaped bones located in the foot, specifically in the ankle and midfoot region. These bones are crucial for movement and support as they form the ankle joint and help distribute weight across the foot. Tarsal bones
1. Talus The uppermost tarsal bone, it sits between the calcaneus and the tibia and fibula of the lower leg. 2. Calcaneus The largest tarsal bone, located beneath the talus and at the back of the foot (heel). 3. Navicular Positioned in the middle of the foot, anterior to the talus and posterior to the cuneiform bones. Talus Calcaneus Navicular
4. Cuboid Lateral side of the foot, in front of the calcaneus and behind the fourth and fifth metatarsal bones. 5. Medial Cuneiform Medial side of the foot, in front of the navicular and behind the first metatarsal. 6. Intermediate Cuneiform Between the medial and lateral cuneiforms, in front of the navicular and behind the second metatarsal. 7. Lateral Cuneiform Lateral to the intermediate cuneiform Cuboid Cuneiform
Metatarsal
The metatarsal bones are a group of five long bones in the foot located between the tarsal bones of the hind- and mid-foot and the phalanges of the toes. These bones are crucial for weight-bearing and movement. Meta- Tarsal bones
Five Metatarsals: Numbered I to V from the medial (inner) to the lateral (outer) side. • Base: The proximal end that articulates with the tarsal bones. • Shaft: The long, central portion of the bone. • Head: The distal end that articulates with the proximal phalanges of the toes. Base Shaft Head 1 2 3 4 5
Foot fracture Direct trauma to the foot can result is fracture of the metatarsals and phalanges. These are usually treated by immobilization, because the fragments are often not displaced owing to the extensive ligament attachments that stabilize these joints. Clinical Insight
Clinical Insight Foot fracture are usually treated by immobilization
Phalanges of foot
The phalanges are the bones that make up the toes of the foot, similar to how phalanges in the hand make up the fingers. Each toe consists of several phalanges, contributing to the structure and function of the foot. Phalanges
• Total Number: There are 14 phalanges in each foot. • Toes: Each toe has a specific number of phalanges: • Big Toe (Hallux): 2 phalanges (proximal and distal). • Other Toes: Each has 3 phalanges (proximal, middle, and distal). 1. Proximal Phalanges: These are the closest to the metatarsals and are present in all toes. 2. Middle Phalanges: These are absent in the big toe and present in the other four toes. 3. Distal Phalanges: These are at the tips of the toes. Proximal Phalanges Middle Phalanges Distal Phalanges Proximal Phalanges Distal Phalanges
MOVEMENTS
Hip Joint
The hip joint is a ball-and-socket joint allowing for a wide range of movements: 1. Flexion- Decreasing the angle between the thigh and the pelvis (lifting the leg forward). 2. Extension - Increasing the angle between the thigh and the pelvis (moving the leg backward). 3. Abduction - Moving the leg away from the midline of the body. 4. Adduction - Moving the leg toward the midline of the body. 5. Internal Rotation (Medial Rotation)- Rotating the thigh inward toward the midline. 6. External Rotation (Lateral Rotation)- Rotating the thigh outward away from the midline. 7. Circumduction- A combination of flexion, extension, abduction, and adduction, resulting in a circular motion of the leg.
Flexion Hip Joint
Extend Hip Joint
Adduction Hip Joint
Abduction Hip Joint
Rotation Hip Joint
Knee Joint
The knee joint is a hinge joint primarily allowing for: 1. Flexion- Bending the knee, decreasing the angle between the thigh and the lower leg. 2. Extension - Straightening the knee, increasing the angle between the thigh and the lower leg. 3. Slight Medial Rotation - Rotating the lower leg inward when the knee is flexed. 4. Slight Lateral Rotation - Rotating the lower leg outward when the knee is flexed.
Extension of knee joint
Flex knee
Knee medial rotation at full standing Knee lateral rotation at initiation of knee flexion
Ankle Joint
The ankle joint allows for: 1. Dorsiflexion - Lifting the foot upwards towards the shin. 2. Plantarflexion - Pointing the foot downward away from the shin.
Planter flexion of ankle
Dorsiflexion of ankle joint
Subtalar Joint
The subtalar joint enables: 1. Inversion - Turning the sole of the foot inward. 2. Eversion - Turning the sole of the foot outward.
Inverter Subtalar Joint
Everted Subtalar Joint
Metatarsophalangeal and Interphalangeal Joints)
The toe joints, including the metatarsophalangeal joints (MTP) and the interphalangeal joints (IP), allow for: 1. Flexion - Curling the toes downward. 2. Extension - Lifting the toes upward. 3. Abduction - Spreading the toes apart. 4. Adduction - Bringing the toes together.
Flexion - Curling the toes downward
Extension - Lifting the toes upward.
Abduction - Spreading the toes apart
Formative Quiz
Q1. What movement occurs when you move leg up at the knee joint? a) Flexion b) Abduction c) Extension d) Circumduction
Q2. A 55-year-old male presents to the clinic with complaints of difficulty rising from a seated position and climbing stairs. He reports feeling a deep ache in her groin region, exacerbated by activities involving lifting leg. Physical examination reveals weakness during hip flexion and pain with resisted flexion. Radiographic imaging reveals no abnormalities in the hip joint. Which muscle is primarily responsible for hip flexion? a) Quadriceps femoris b) Gluteus maximus c) Hamstring muscles d) Iliopsoas
Q3. A 32-year-old male presents to the clinic with complaints of recurrent ankle sprains during physical activity. Upon examination, it is noted that his ankle tends to roll outward frequently, especially during running and jumping. Which of the following planes primarily facilitates ankle inversion and eversion? a) Sagittal plane b) Frontal plane c) Transverse plane d) Oblique plane
Q4. When you move your foot upward toward your shin, what motion are you performing? a) Dorsiflexion b) Plantarflexion c) Inversion d) Eversion
Q5. A 35-year-old female presents to the clinic complaining of pain in her left hip. Upon examination, the physician observes weakness in her left hip muscles and limited range of motion. Further assessment reveals tenderness over the hip joint. The patient reports no history of trauma but mentions recent vigorous exercise routines. Which of the following movements involves bringing the thigh toward the midline of the body? a) Abduction b) Adduction c) Rotation d) Extension
Q6 A 32-year-old woman in labor is being assessed for pelvic adequacy. The obstetrician palpates a sharp bony projection between the greater and lesser sciatic notches during a vaginal exam. This projection serves as a landmark for anesthetic nerve blocks and separates the two sciatic foramina. Which bony feature is being palpated? A. Ischial tuberosity B. Pubic crest C. Ischial spine D. Iliac spine E. Obturator crest
Q7 A patient suffers a traumatic dislocation of the hip following a car accident. Imaging shows that the head of the femur has been displaced from a concave hemispherical socket formed by the ilium, ischium, and pubis. This cavity allows articulation with the femoral head. What is the name of this bony socket? A. Obturator foramen B. Acetabulum C. Fovea capitis D. Femoral neck E. Iliac crest
Q8 A 21-year-old football player sustains a knee injury. MRI shows damage between the medial and lateral condyles of the femur, where both the anterior and posterior cruciate ligaments attach. This deep depression lies on the posterior aspect of the distal femur. What is this bony feature? A. Popliteal surface B. Tibial plateau C. Intercondylar fossa D. Patellar surface E. Adductor tubercle
Q9 A skier falls and injures the knee. Imaging reveals a fracture of the flat superior surface of the tibia, where the femoral condyles rest and articulate with the tibia. This horizontal surface is critical to knee stability and weight- bearing. Which bony structure is involved? A. Tibial tuberosity B. Intercondylar eminence C. Tibial plateau D. Medial malleolus E. Fibular articular facet
Q10 Ankle X-ray reveals a fracture of a prominent bony projection at the distal tibia, seen medially. This structure is clinically important due to its close proximity to tendons and neurovascular bundles. Which bony feature is fractured? A. Sustentaculum tali B. Lateral malleolus C. Medial condyle D. Medial malleolus E. Tibial crest
Q11 A patient presents with lateral ankle pain after twisting her ankle. Radiographic imaging shows a fracture of the prominent distal end of the fibula. This structure forms part of the ankle joint and articulates with the talus. Which structure is this? A. Fibular neck B. Lateral malleolus C. Peroneal tubercle D. Fibular head E. Interosseous border
Q12 A patient complains of midfoot pain. Palpation reveals tenderness over a small bony prominence on the medial aspect of foot. This tubercle is a common site of stress fractures and accessory bone formation. What is the name of this bony prominence? A. Calcaneal tuberosity B. Sustentaculum tali C. Navicular tuberosity D. Medial cuneiform E. Talus neck
Q13 During pelvic imaging, a radiologist identifies a large curved indentation on the posterior border of the ilium. This bony landmark allows passage of the sciatic nerve from the pelvis to the gluteal region. What is the name of this notch? A. Obturator notch B. Lesser sciatic notch C. Greater sciatic notch D. Ischial spine E. Auricular surface
Q14 X-ray scan of the hindfoot reveals a fracture in a horizontal projection of the calcaneus located medially. This bony structure supports the talus and plays an important role in the medial longitudinal arch. What is this structure? A. Talus neck B. Sustentaculum tali C. Calcaneal tubercle D. Navicular ridge E. Sinus tarsi
Q15 A medical student examines a dry tibia and notes a sharp ridge along its lateral surface. This ridge is the site where a fibrous membrane connects the tibia and fibula. It also helps identify the lateral side of the bone. What is the name of this ridge? A. Anterior crest B. Soleal line C. Medial border. D. Interosseous border E. Popliteal line
MCQ Answer 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 SCORE 15
Q1. c) Extension Q2. d) Iliopsoas Q3. b) Frontal plane Q4. a) Dorsiflexion Q5. b) Adduction Q6 Ischial spine Q7 Acetabulum Q8 Intercondylar fossa Q9 Tibial plateau Q10 Medial malleolus Q11 Lateral malleolus Q12 Navicular tuberosity Q13 Greater sciatic notch Q14 Sustentaculum tali Q15 Interosseous border
List of Texts and Recommended Readings • Last's Anatomy, Regional and Applied. Chummy S. Sinnatamby. 12th edition 2011, ISBN:13 - 978 0 7020 3394 0 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3-s2.0- C2009060533X) • Estomih Mtui, Gregory Gruener and Peter Dockery. Fitzgerald's Clinical Neuroanatomy and Neuroscience. 7th edition; 2016, ISBN: 13 - 978-0-7020- 6727-3 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3-s2.0- C20130134113 • Drake, Richard L. Gray's Anatomy for Students, Third Edition, Elsevier Saunders 2015. ISBN-13: 978-0702051319 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3- s2.0-C20110061707). • Sobotta Atlas of Human Anatomy. F. Paulsen. Vol.1, 15th Edition; 2013, ISBN: 9780702052514 (Available in ClinicalKey: https://www.clinicalkey.com/#!/content/book/3- s2.0-B9780702052514500067) • Sobotta Atlas of Human Anatomy. F. Paulsen. Vol.2, 15th Edition; 2013, ISBN:13 - 978-0-7020-5252-1 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3- s2.0-C20130046919)
Recap
L003 Lower Limb Bone / Lower Limb Bone .pdf

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L003 Lower Limb Bone / Lower Limb Bone .pdf

  • 1.
    Ashour’s High YieldGuide USMLE Clinical Anatomy
  • 2.
  • 3.
    A 45-year-old femalepresented with difficulty rising from a seated position and climbing stairs, accompanied by a deep ache in the groin region. Physical examination revealed weakness and discomfort during resisted hip flexion. Radiographs showed no abnormalities of the hip joint. Conservative management was initiated, including NSAIDs, activity modification, and a focused physiotherapy program. The patient reported gradual improvement over several weeks.
  • 4.
  • 5.
    ILOs A. Identify MajorBones: Recognize and label the key bones of the lower limb, including the femur, patella, tibia, fibula, and the bones of the foot (tarsals, metatarsals, and phalanges). B. Understand Bone Structures: Describe the anatomical features of these bones, such as the femoral head, condyles, tibial tuberosity, and the structures of the ankle and foot, including their landmarks and relationships. C. Explain Functional Anatomy: Understand the functional roles of each bone in the lower limb, including weight-bearing, locomotion, and the role in providing leverage for muscle action. D. Describe Joints and Articulations: Explain the main joints of the lower limb, such as the hip joint, knee joint, and ankle joint, including their types, movements, and how the bones articulate with one another.
  • 6.
    The lower limbis involved in a variety of movements that are essential for activities such as walking, running, and maintaining posture. These movements occur at the hip, knee, and ankle joints, and they are controlled by the muscles and ligaments of the lower limb. These movements are integral to the functionality of the lower limb, allowing for a wide range of activities and providing stability during weight-bearing tasks. Proper coordination of these movements is crucial for maintaining balance and performing various daily tasks.
  • 8.
  • 9.
  • 10.
    The lower limbis composed of several bones that provide structural support, facilitate movement, and bear the weight of the body. These bones are categorized into four main regions: • the pelvic girdle • the thigh • the leg • the foot. the pelvic girdle the thigh the leg the foot.
  • 11.
    1. Pelvic Girdle Thepelvic girdle consists of two hip bones. 2. Thigh Femur & patella. 3. Leg Tibia & Fibula 4. Foot Tarsal Bones, Metatarsal Bones & Phalanges Hip Femur Tibia & Fibula Tarsal, Metatarsal& Phalanges
  • 12.
  • 13.
    The hip bone,also known as the pelvic bone, is a large, complex structure that forms the primary skeletal support for the lower body. It plays a critical role in movement, support, and protection of internal organs. The hip bone is composed of three parts: • Ilium • Ischium • Pubis Ilium Ischium Pubis
  • 14.
    Hip pointer A hippointer is a bruise or contusion of the iliac crest, the prominent bone on the upper part of the hip. It is often accompanied by injury to the surrounding soft tissues, including muscles and ligaments. Causes: • Direct blow to the hip area (common in contact sports) • Falling onto the hip • High-impact collisions Clinical Insight
  • 15.
    1. Ilium: Broad,flaring portion of the hip bone that forms the upper part. • Iliac crest: The curved, superior border of the ilium. • Anterior superior iliac spine (ASIS): A bony projection at the front of the ilium. • Anterior inferior iliac spine (AIIS): A bony projection at the front of the ilium. • Posterior superior iliac spine (PSIS): A bony projection at the back of the ilium. • Posterior inferior iliac spine (PIIS): A bony projection at the back of the ilium. Iliac crest ASIS AIIS
  • 16.
    2. Ischium: Thelower, posterior part of the hip bone. • Ischial tuberosity: The part that bears the body's weight when sitting. • Ischial spine: A pointed projection between the greater and lesser sciatic notches. Greater sciatic notche Ischial spine lesser sciatic notche Ischial tuberosity
  • 17.
    3. Pubis: Theanterior portion of the hip bone, which meets with the pubis of the opposite hip bone at the pubic symphysis. Important features include: • Pubic symphysis: A cartilaginous joint that unites the left and right pubic bones. • Pubic crest: The superior border of the pubic bone. • Pubic tubercle • Superior pubic ramus • Inferior pubic ramus Pubic symphysis Pubic crest Pubic tubercle Superior pubic ramus Inferior pubic ramus
  • 18.
    Sex difference ofpelvis Forensic scientists can identify the pelvic bones of females from males by the structural adaptations observed in the pelvis for childbirth. The female pelvis is usually smaller, lighter, and thinner than its male counterpart. In females the pelvic inlet is oval and the outlet is larger, the pelvic cavity is wider and shallower, and the pubic arch is wider. The obturator foramen is usually oval or triangular in the female and round in the male. Clinical Insight
  • 19.
  • 20.
    The femur, alsoknown as the thigh bone, is the longest, strongest, and heaviest bone in the human body. It plays a crucial role in supporting the weight of the body and enabling a wide range of movements. thigh bone
  • 21.
    Proximal End: • Head:Therounded, ball-like structure that fits into the acetabulum of the pelvis, forming the hip joint. • Neck:The narrowed region below the head, which connects it to the shaft. • Greater and Lesser Trochanters connected with intertrochanteric line anteriorly and intertrochanteric crest posteriorly acetabulum Head Neck Greater Trochanter Lesser Trochanters intertrochanteric line intertrochanteric crest shaft
  • 22.
    Shaft: The long, cylindricalmiddle portion of the femur. It has a slight curve and is thicker in cross-section to withstand the forces exerted during activities like walking and running. Surfaces : • Anterior Surface: The smooth, rounded front part of the shaft. • Posterior Surface: The back part of the shaft, which has a prominent line known as the linea aspera. Shaft anterior Shaft posterior
  • 23.
    • Linea Aspera: Description:The linea aspera is a prominent longitudinal ridge running along the posterior surface of the femoral shaft. • Medial and Lateral Supracondylar Lines: Description: The linea aspera diverges distally into the medial and lateral supracondylar lines as it approaches the distal end of the femur. Linea Aspera Medial Supracondylar Line Lateral Supracondylar Line
  • 24.
    • Gluteal Tuberosity: Description:A roughened area on the posterior surface of the femur, running from the base of the greater trochanter down toward the linea aspera. • Spiral Line: Description: The spiral line is a ridge that spirals downward and medially from the lesser trochanter to merge with the medial lip of the linea aspera. greater trochanter lesser trochanter Gluteal Tuberosity Spiral Line Linea Aspera
  • 25.
    Distal End: • Medialand Lateral Condyles:Rounded prominences that articulate with the tibia and form part of the knee joint. • Medial and Lateral Epicondyles:Projections above the condyles where ligaments attach. Lateral Epicondyle Lateral Condyle Medial Epicondyle Medial Condyle
  • 26.
  • 27.
    The tibia, commonlyknown as the shinbone, is one of the major bones in the human body, playing a crucial role in supporting weight and enabling movement. Tibia
  • 28.
    • The tibiais located in the lower leg, medial to the fibula. • It extends from the knee to the ankle, forming part of the knee joint and the ankle joint. • The tibia is the second largest bone in the human body, after the femur. knee tibia Fibula ankle
  • 29.
    • Medial andLateral Condyles: at proximal end. • Tibial Tuberosity: A large oblong elevation on anterior surface of tibia, just below knee. • Anterior Crest (Chin): sharp, prominent ridge on front of tibial shaft. • Medial Malleolus: prominence on inner side of ankle at distal end. • Soleal line:situated on posterior surface Lateral Condyle Medial Condyle Soleal line Tibial Tuberosity Anterior Crest (Chin) Medial Malleolus
  • 30.
    Tibial shaft fracture Fracturesof the tibial shaft are the most common fractures of a long bone. Because the tibia lies just beneath the skin along the medial border of the leg, these fractures often are open injuries (skin perforated). If you suspect a tibial fracture, especially an open one, it's essential to seek immediate medical attention to reduce the risk of infection and ensure proper treatment. Clinical Insight
  • 31.
  • 32.
    The fibula isone of the two bones in the lower leg, the other being the tibia. Fibula
  • 33.
    • Head: Theproximal end of the fibula, which articulates with the lateral condyle of the tibia. • Neck: The narrow region just below the head. • Shaft: The long, slender middle portion of the fibula. • Lateral Malleolus: The distal end of the fibula, forming the outer part of the ankle joint. Head Neck Shaft Lateral Malleolus
  • 34.
  • 35.
    The tarsal bonesare a group of seven irregularly shaped bones located in the foot, specifically in the ankle and midfoot region. These bones are crucial for movement and support as they form the ankle joint and help distribute weight across the foot. Tarsal bones
  • 36.
    1. Talus The uppermosttarsal bone, it sits between the calcaneus and the tibia and fibula of the lower leg. 2. Calcaneus The largest tarsal bone, located beneath the talus and at the back of the foot (heel). 3. Navicular Positioned in the middle of the foot, anterior to the talus and posterior to the cuneiform bones. Talus Calcaneus Navicular
  • 37.
    4. Cuboid Lateral sideof the foot, in front of the calcaneus and behind the fourth and fifth metatarsal bones. 5. Medial Cuneiform Medial side of the foot, in front of the navicular and behind the first metatarsal. 6. Intermediate Cuneiform Between the medial and lateral cuneiforms, in front of the navicular and behind the second metatarsal. 7. Lateral Cuneiform Lateral to the intermediate cuneiform Cuboid Cuneiform
  • 38.
  • 39.
    The metatarsal bonesare a group of five long bones in the foot located between the tarsal bones of the hind- and mid-foot and the phalanges of the toes. These bones are crucial for weight-bearing and movement. Meta- Tarsal bones
  • 40.
    Five Metatarsals: NumberedI to V from the medial (inner) to the lateral (outer) side. • Base: The proximal end that articulates with the tarsal bones. • Shaft: The long, central portion of the bone. • Head: The distal end that articulates with the proximal phalanges of the toes. Base Shaft Head 1 2 3 4 5
  • 41.
    Foot fracture Direct traumato the foot can result is fracture of the metatarsals and phalanges. These are usually treated by immobilization, because the fragments are often not displaced owing to the extensive ligament attachments that stabilize these joints. Clinical Insight
  • 42.
    Clinical Insight Foot fractureare usually treated by immobilization
  • 43.
  • 44.
    The phalanges arethe bones that make up the toes of the foot, similar to how phalanges in the hand make up the fingers. Each toe consists of several phalanges, contributing to the structure and function of the foot. Phalanges
  • 45.
    • Total Number:There are 14 phalanges in each foot. • Toes: Each toe has a specific number of phalanges: • Big Toe (Hallux): 2 phalanges (proximal and distal). • Other Toes: Each has 3 phalanges (proximal, middle, and distal). 1. Proximal Phalanges: These are the closest to the metatarsals and are present in all toes. 2. Middle Phalanges: These are absent in the big toe and present in the other four toes. 3. Distal Phalanges: These are at the tips of the toes. Proximal Phalanges Middle Phalanges Distal Phalanges Proximal Phalanges Distal Phalanges
  • 46.
  • 47.
  • 48.
    The hip jointis a ball-and-socket joint allowing for a wide range of movements: 1. Flexion- Decreasing the angle between the thigh and the pelvis (lifting the leg forward). 2. Extension - Increasing the angle between the thigh and the pelvis (moving the leg backward). 3. Abduction - Moving the leg away from the midline of the body. 4. Adduction - Moving the leg toward the midline of the body. 5. Internal Rotation (Medial Rotation)- Rotating the thigh inward toward the midline. 6. External Rotation (Lateral Rotation)- Rotating the thigh outward away from the midline. 7. Circumduction- A combination of flexion, extension, abduction, and adduction, resulting in a circular motion of the leg.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
    The knee jointis a hinge joint primarily allowing for: 1. Flexion- Bending the knee, decreasing the angle between the thigh and the lower leg. 2. Extension - Straightening the knee, increasing the angle between the thigh and the lower leg. 3. Slight Medial Rotation - Rotating the lower leg inward when the knee is flexed. 4. Slight Lateral Rotation - Rotating the lower leg outward when the knee is flexed.
  • 56.
  • 57.
  • 58.
    Knee medial rotationat full standing Knee lateral rotation at initiation of knee flexion
  • 59.
  • 60.
    The ankle jointallows for: 1. Dorsiflexion - Lifting the foot upwards towards the shin. 2. Plantarflexion - Pointing the foot downward away from the shin.
  • 61.
  • 62.
  • 63.
  • 64.
    The subtalar jointenables: 1. Inversion - Turning the sole of the foot inward. 2. Eversion - Turning the sole of the foot outward.
  • 65.
  • 66.
  • 67.
  • 68.
    The toe joints,including the metatarsophalangeal joints (MTP) and the interphalangeal joints (IP), allow for: 1. Flexion - Curling the toes downward. 2. Extension - Lifting the toes upward. 3. Abduction - Spreading the toes apart. 4. Adduction - Bringing the toes together.
  • 69.
    Flexion - Curlingthe toes downward
  • 70.
    Extension - Liftingthe toes upward.
  • 71.
    Abduction - Spreadingthe toes apart
  • 72.
  • 73.
    Q1. What movementoccurs when you move leg up at the knee joint? a) Flexion b) Abduction c) Extension d) Circumduction
  • 74.
    Q2. A 55-year-oldmale presents to the clinic with complaints of difficulty rising from a seated position and climbing stairs. He reports feeling a deep ache in her groin region, exacerbated by activities involving lifting leg. Physical examination reveals weakness during hip flexion and pain with resisted flexion. Radiographic imaging reveals no abnormalities in the hip joint. Which muscle is primarily responsible for hip flexion? a) Quadriceps femoris b) Gluteus maximus c) Hamstring muscles d) Iliopsoas
  • 75.
    Q3. A 32-year-oldmale presents to the clinic with complaints of recurrent ankle sprains during physical activity. Upon examination, it is noted that his ankle tends to roll outward frequently, especially during running and jumping. Which of the following planes primarily facilitates ankle inversion and eversion? a) Sagittal plane b) Frontal plane c) Transverse plane d) Oblique plane
  • 76.
    Q4. When youmove your foot upward toward your shin, what motion are you performing? a) Dorsiflexion b) Plantarflexion c) Inversion d) Eversion
  • 77.
    Q5. A 35-year-oldfemale presents to the clinic complaining of pain in her left hip. Upon examination, the physician observes weakness in her left hip muscles and limited range of motion. Further assessment reveals tenderness over the hip joint. The patient reports no history of trauma but mentions recent vigorous exercise routines. Which of the following movements involves bringing the thigh toward the midline of the body? a) Abduction b) Adduction c) Rotation d) Extension
  • 78.
    Q6 A 32-year-oldwoman in labor is being assessed for pelvic adequacy. The obstetrician palpates a sharp bony projection between the greater and lesser sciatic notches during a vaginal exam. This projection serves as a landmark for anesthetic nerve blocks and separates the two sciatic foramina. Which bony feature is being palpated? A. Ischial tuberosity B. Pubic crest C. Ischial spine D. Iliac spine E. Obturator crest
  • 79.
    Q7 A patientsuffers a traumatic dislocation of the hip following a car accident. Imaging shows that the head of the femur has been displaced from a concave hemispherical socket formed by the ilium, ischium, and pubis. This cavity allows articulation with the femoral head. What is the name of this bony socket? A. Obturator foramen B. Acetabulum C. Fovea capitis D. Femoral neck E. Iliac crest
  • 80.
    Q8 A 21-year-oldfootball player sustains a knee injury. MRI shows damage between the medial and lateral condyles of the femur, where both the anterior and posterior cruciate ligaments attach. This deep depression lies on the posterior aspect of the distal femur. What is this bony feature? A. Popliteal surface B. Tibial plateau C. Intercondylar fossa D. Patellar surface E. Adductor tubercle
  • 81.
    Q9 A skierfalls and injures the knee. Imaging reveals a fracture of the flat superior surface of the tibia, where the femoral condyles rest and articulate with the tibia. This horizontal surface is critical to knee stability and weight- bearing. Which bony structure is involved? A. Tibial tuberosity B. Intercondylar eminence C. Tibial plateau D. Medial malleolus E. Fibular articular facet
  • 82.
    Q10 Ankle X-rayreveals a fracture of a prominent bony projection at the distal tibia, seen medially. This structure is clinically important due to its close proximity to tendons and neurovascular bundles. Which bony feature is fractured? A. Sustentaculum tali B. Lateral malleolus C. Medial condyle D. Medial malleolus E. Tibial crest
  • 83.
    Q11 A patientpresents with lateral ankle pain after twisting her ankle. Radiographic imaging shows a fracture of the prominent distal end of the fibula. This structure forms part of the ankle joint and articulates with the talus. Which structure is this? A. Fibular neck B. Lateral malleolus C. Peroneal tubercle D. Fibular head E. Interosseous border
  • 84.
    Q12 A patientcomplains of midfoot pain. Palpation reveals tenderness over a small bony prominence on the medial aspect of foot. This tubercle is a common site of stress fractures and accessory bone formation. What is the name of this bony prominence? A. Calcaneal tuberosity B. Sustentaculum tali C. Navicular tuberosity D. Medial cuneiform E. Talus neck
  • 85.
    Q13 During pelvicimaging, a radiologist identifies a large curved indentation on the posterior border of the ilium. This bony landmark allows passage of the sciatic nerve from the pelvis to the gluteal region. What is the name of this notch? A. Obturator notch B. Lesser sciatic notch C. Greater sciatic notch D. Ischial spine E. Auricular surface
  • 86.
    Q14 X-ray scanof the hindfoot reveals a fracture in a horizontal projection of the calcaneus located medially. This bony structure supports the talus and plays an important role in the medial longitudinal arch. What is this structure? A. Talus neck B. Sustentaculum tali C. Calcaneal tubercle D. Navicular ridge E. Sinus tarsi
  • 87.
    Q15 A medicalstudent examines a dry tibia and notes a sharp ridge along its lateral surface. This ridge is the site where a fibrous membrane connects the tibia and fibula. It also helps identify the lateral side of the bone. What is the name of this ridge? A. Anterior crest B. Soleal line C. Medial border. D. Interosseous border E. Popliteal line
  • 88.
  • 89.
    Q1. c) Extension Q2.d) Iliopsoas Q3. b) Frontal plane Q4. a) Dorsiflexion Q5. b) Adduction Q6 Ischial spine Q7 Acetabulum Q8 Intercondylar fossa Q9 Tibial plateau Q10 Medial malleolus Q11 Lateral malleolus Q12 Navicular tuberosity Q13 Greater sciatic notch Q14 Sustentaculum tali Q15 Interosseous border
  • 90.
    List of Textsand Recommended Readings • Last's Anatomy, Regional and Applied. Chummy S. Sinnatamby. 12th edition 2011, ISBN:13 - 978 0 7020 3394 0 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3-s2.0- C2009060533X) • Estomih Mtui, Gregory Gruener and Peter Dockery. Fitzgerald's Clinical Neuroanatomy and Neuroscience. 7th edition; 2016, ISBN: 13 - 978-0-7020- 6727-3 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3-s2.0- C20130134113 • Drake, Richard L. Gray's Anatomy for Students, Third Edition, Elsevier Saunders 2015. ISBN-13: 978-0702051319 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3- s2.0-C20110061707). • Sobotta Atlas of Human Anatomy. F. Paulsen. Vol.1, 15th Edition; 2013, ISBN: 9780702052514 (Available in ClinicalKey: https://www.clinicalkey.com/#!/content/book/3- s2.0-B9780702052514500067) • Sobotta Atlas of Human Anatomy. F. Paulsen. Vol.2, 15th Edition; 2013, ISBN:13 - 978-0-7020-5252-1 (Available in ClinicalKey: https://www.clinicalkey.com/#!/browse/book/3- s2.0-C20130046919)
  • 91.