Chapter 6 Lower Extremity Anatomy

Bone of the leg that is the second largest bone in the body; it is situated on the medial side of the leg is a weight-bearing bone

tibia

Is the larger of the two bones of the leg and consists of one body and two expanded extremities

tibia

What four bones does talus articulate with?

tibia, fibula, calcaneus, and navicular

The superior surfaces of the condyles form smooth facets for articulation with the condyles of the femur; they are flatlike and slope posteriorly about 10 to 20 degrees; they are called ________________________________________

tibial plateaus

On the anterior surface of the tibia just below the condyles, is a prominent process called the __________________________________ which the ligamentum patellae attaches

tibial tuberosity

Many patients with knee injuries do not have fractures, but they may have one or more ________________________________

torn ligaments

Runs from side to side and assists in supporting the longitudinal arch

transverse arch

The lateral surface of the calcaneus contains the ________________________

trochlea

The superior surface of the talus which articulates with the tibia and connects the foot to the leg

trochlea surface

The triangular area superior to the intercondylar fossa on the posterior femur is the ______________________________ over which the popliteal blood vessels and nerves pass

trochlear groove

Articulations between the lateral malleolus of the fibula and the inferior surface and medial malleolus of the tibia Joint type: Movement:

Ankle mortise synovial hinge flexion, extension, small amount of rotation, abduction-adduction, inversion, and eversion

The ankle joint is commonly called the ____________________________________ , or _____________________________ joint

Ankle mortise or mortise joint

Articulation between the cuboid and the navicular tarsal bones Joint type: Movement:

Cuboidonavicular joint Fibrous syndesmosis slightly moveable

Articulation between the lateral cuneiform with the cuboid Joint type:: Movement

Cuneocuboid joint synovial gliding slight gliding movement between the bones

The joints between the distal and middle phalanges

Distal interphalangeal (DIP) joints

Knee joint that is the largest joint of the body; Articulation between the femur and tibia Joint type: Movement:

Femorotibial joint synovial modified-hinge flexion, extension, medial and lateral rotation in flexed position

The small, rounded distal end of the metatarsal

Head

Where and when does the patella develop?

In the tendon of the quadriceps femoris muscle between 3 and 5 years of age

Articulations between the cuneiforms Joint type: Movement:

Intercuneiform joint synovial gliding slight gliding movement between the bones

Articulations between the proximal bases of the metatarsals with one another Joint type: Movement:

Intermetatarsal synovial gliding flexion, extension, adduction, and abduction

The great toe only has two phalanges , the joint between them is known simply as the ______________________________

Interphalangeal (IP) joint

Articulations between the phalanges Joint type: Movement:

Interphalangeal (IP) joints Synovial Hinge Flexion and Extension

Articulations between the tarsals Joint type: Movement:

Intertarsal joints synovial gliding or synovial ball-and-socket slight gliding movements between the bones

The articulations between the middle and proximal phalanges

Proximal interphalangeal (PIP) joints

The head of the fibula articulates with the posteroinferior surface of the lateral condyle of the tibia, which forms the ______________________________ joint Joint type:

Proximal tibiofibular synovial gliding

The fibula articulates with the tibia at its distal and proximal ends these joints are known as ______________ Joint type: Movement:

Proximal tibiofibular and Distal tibiofibular joints synovial gliding and fibrous syndesmosis (slight movement)

Parts of the phalanx

a body and two articular ends (proximal base and distal head)

The femur, tibia, fibula, and patella are held together by _________________________________________ that work together to provide stability for the knee joint

a complex group of ligaments

The bones of the foot are shaped and joined together to form ____________________________________________

a series of longitudinal and tranverse arches

The superior portion of the femur articulates with the ______________________________ of the hip joint

acetablulum

Each foot has how many phalanges

14 2 in great toe (distal and proximal) 3 in each of the other toes (proximal, middle, and distal)

Viewed axially, the lateral malleolus lies approximately ___________________________ degrees more posterior then the medial malleolus (is how much you have to angle part for mortis joint)

15 - 20

Which metatarsal is the shortest and the thickness

1st metatarsal

Tarsal that lies on the lateral side of the foot between the calcaneus and the fourth and fifth metatarsals

cuboid

Tarsal bones that lie at the central and medial aspect of the foot between the navicular bone and the first, second, and third metatarsals

cuneiforms

Tarsal bone which is the sight of many bone spurs

calcaneus

The largest and strongest tarsal bone

calcaneus (os calcis)

How many bones are in the foot?

26

Which metatarsal is the longest

2nd metatarsal

The long axis of the calcaneus is directed inferiorly and forms an angle of approximately ______________________ degrees

30

When the femur is vertical, the medial condyle is lower than the lateral condyle about a _______________________ degree difference exists between the two condyles and because of this difference, on the lateral radiographs of the knee the CR is angled ________________________degrees cephalic to open the joint space of the knee

5-7 degrees

Why is the adductor tubercle important to identify on the lateral knee radiographs?

Because it assists in identifying overrotation or underrotation

Anteriorly, the calcaneus articulates with the cuboid at the ______________________________________ joint Joint type:

Calcaneocuboid joint synovial gliding

7 tarsals of the foot:

Calcaneus, Talus, Navicular, Cuboid, Medial cuneiform, Intermediate cuneiform, Lateral cuneiform

The ___________________________ are commonly torn during injury and a knee arthrogram or a MRI must be performed to visualize a tear

Menisci

Articulations between the navicular tarsal bone and the cuneiforms Joint type Movemant

Naviculocuneiform synovial gliding slight gliding movement between the bones

How are the metatarsals arranged in the foot:

Numbered 1-5 beginning at the medial or great toe side of the foot

The patella articulates with the patellar surface of the femur and protects the front of the knee joint, this articulation is called ____________________________________ Joint type: Movement:

Patellofemoral joint synovial gliding freely moveable over the patellar surface of the femur when knee is extended and relaxed, when the knee is flexed the patella is locked in position in front of patellar surface

Divisions of the bones of the foot:

Phalanges (14) Metatarsals (5) Tarsals (7)

4 important ligaments of the knee:

Posterior cruciate ligament Anterior cruciate ligament Tibial collateral ligament Fibular collateral ligament

Articulation between the three-faceted joint surface of the calcaneus and the talus Joint type: Movement:

Subtalar joint synovial gliding freely moveable

The talus rests on top of the calcaneus creating the _____________________________ joint Joint type: Movement:

Talocalcaneal joint synovial gliding freely moveable

The calcaneus and talus articulates with the navicular tarsal bone anteriorly forming the ________________________________ joint Joint type: Movement:

Talocalcaneonavicular joint synovial ball-and-socket freely moveable

Articulation between the talus and the fibula Joint type: Movement:

Talofibular joint synovial hinge Flexion and extension

Tarsal that is irregular in form and occupying the superiormost position of the foot and is the second largest tarsal bone

Talus

Articulations between the proximal bases of the metatarsals and the tarsals Joint type: Movement:

Tarsometatarsal (TMT) joints synovial gliding flexion, extension, adduction, and abduction

These bones are designed to bear weight and are considerable differences in thickness

The bones of the foot

What is the function of the menisci?

They provide stability of the knee and act as a shock absorber

2 bones of the leg:

Tibia Fibula

Articulation between the tibia and the talus Joint type Movement

Tibiotalar joint synovial hinge flexion and extension

These joints form a socket type structure that articulates with the superior portion of the talus

Tibotalar and Talofibular joints

The medial condyle of the femur contains the __________________________________ which is located on the posterolateral aspect; it is a raised bony area that receives the tendon of the adductor muscle

adductor tubercle

Extending along the anterior surface of the tibial body, beginning at the tuberosity, is a sharp ridge called the ______________________________

anterior crest

The anterolateral surface of the tibia contains the _________________________________ which overlays the fibula

anterior tubercle

3 articular facets of the calcaneus that join with the talus

anterior, middle, and posterior facets

At the lateroposterior aspect of the head of the fibula is a conic projection called the ______________________

apex

Part of the patella that is directed inferiorly and lies 1/2 inch above the joint space of the knee, and is attached to the tuberosity of the tibia by the patellar ligament

apex

The knee joint is enclosed in an ____________________________ and is held together by _______________________________

articular capsule numerous ligaments

The five heads of the metatarsals form the _____________________ of the foot

ball

The expanded proximal end of the metatarsal

base

The superior border of the patella is called the __________________

base

The ______________________ of the femur is cylindric, is slightly convex anteriorly, and slants medially 5-15 degrees

body

Between the middle and posterior talar articular facets of the calcaneus is a groove called _____________________ which corresponds to a similar groove on the inferior surface of the talus

calcaneal sulcus

Sesamoid bone on the posterior area of the knee, between the condyles of the femur, present in 3% to 5% of people and is only seen on the lateral projection of the knee

fabella

The superior surface of the foot is termed the ________________________

dorsum or dorsal surface

The longest, strongest, and heaviest bone in the body, consists of one body and two articular extremities

femur

Bone of the leg slightly posterior to the tibia on the lateral side of the leg; it does not bear any body weight

fibula

Leg bone that is slender compared with its length and consists of the body and two articular extremities

fibula

The lateral surface of the tibia is flattened and contains the triangular __________________________________ for articulation with the fibula

fibular notch

4 divisions of the lower extremity:

foot, leg, thigh, and hip

Division of the foot that includes the metatarsals and toes

forefoot

3 divisions of the foot:

forefoot, midfoot, and hindfoot

The ____________________ of the talus is directed anteriorly and has articular surfaces that join the navicular bone and calcaneus

head

The lateral condyle of the tibia has a facet at its distal posterior surface for articulation with the _____________________ of the fibula

head

The proximal end of the fibula is expanded into a ______________________, which articulates with the lateral condyle of the tibia

head

3 parts of the metatarsals:

head, body, and base

Division of the foot that includes the talus and the calcaneus

hindfoot

Between the tibial plateaus is a sharp projection called _____________________________________ which terminates in two peaklike processes called _______________________________________

intercondylar eminence medial and lateral intercondylar tubercles

Posteriorly, the condyles of the femur are separated by a deep depression called the __________________________________

intercondylar fossa

The smallest of the three cuneiform bones

intermediate cuneiform

What ligament passes through the calcaneal sulcus?

interosseous ligament

These joints spaces are narrow and obliquely situated. When they are in question, it is necessary to angle the x-ray tube or adjust the foot to place the joint spaces parallel with the CR

intertarsal joint spaces

One of the most complex joints in the human body

knee joint

2 large eminences at the distal,broadened end of the femur:

larger medial condyle smaller lateral condyle

Two prominent process of the proximal end of the tibia

lateral and medial condyles

A slight prominence above and within the curve of each condyle forms the ________________________________

lateral and medial epicondyles

The knee joint contains two fibrocartilage disks called ____________________________________________; they lie on the tibial plateaus and are circular in shape; they are thick at the outer margin of the joint and taper off toward the center of the tibial plateau

lateral and medial meniscus

The enlarged distal end of the fibula is the ___________________________________ which is pyramidal and is marked by several depressions at its inferior and posterior surfaces

lateral malleolus

Function as a shock absorber to distribute the weight of the body in all directions, which permits smooth walking

longitudinal arch

The largest of the three cuneiform bones

medial cuneiform

The distal end of the tibia is broad, and its medial surface is prolonged into a large process called the ________________________________

medial malleolus

Beginning at the medial side of the foot, the cuneiforms are described as ____________________________________

medial, intermediate, and lateral

Articulations between the distal heads of the metatarsals and the proximal ends of the phalanges Joint type: Movement:

metatarsophalangeal (MTP) joints synovial ellipsoidal flexion, extension, and slight adduction and abduction

Division of the foot that includes five tarsal (cuneiforms, navicular, and cuboid bones)

midfoot

Tarsal bone that lies on the medial side of the foot between the talus and the three cuneiforms

navicular

Is the largest and most constant sesamoid bone in the body; it is a flat, triangular bone situated at the distal anterior surface of the femur

patella

Anteriorly,the condyles of the femur are separated by the ___________________________________, which is a shallow, triangular depression

patellar surface

The inferior or posterior aspect of the foot is termed the __________________________________

planter surface

The posterior and inferior portions of the calcaneus contain the _________________________ for the attachment of the Achilles tendon

posterior tuberosity

The base of the fifth metatarsal contains a _________________________________________, which is a common site of fractures

prominent tuberosity

Two small bones located beneath the head of the first metatarsal; they are detached from the foot and embedded within two tendons; they are seen on most adult foot radiographs and are a common site of fractures and must be shown radiographically

sesamoid bones

The calcaneal sulcus and the sulcus tali on the inferior surface of the talus make up the _________________________________

sinus tarsi

Located on the inferior surface of the talus is a groove called ______________________ which forms the roof of the sinus tarsi

sulcus tali

The medial aspect of the calcaneus extends outward as a shelflike overhang and is termed the ____________________________________

sustentaculum tali

2 Divisions of the mortise joint:

talofibular joint tibiotalar joint