Chapter 7- Appendicular Skeleton: Pelvic Girdle and Lower Limbs (p.72-78)

Greater Trochanter of the Femur

Landmark of the femur that projects laterally from the junction of the neck and shaft. Can be palpated on the side of the hip.

Fibular Notch of the Tibia

Landmark on the distal posterolateral side of the tibia where the fibula articulates with the tibia to form the inferior tibiofibular joint.

Tibial Tuberosity of the Tibia

Landmark on the proximal anterior portion of the tibial shaft which can be palpated just inferior to the patella. It is the attachment site for the patellar ligament. Also interosseous(I.O.) infusion can be performed here to treat traumatized children.

Fibular Articular Surface of the Tibia

Landmark on the proximal posterolageral side of the tibia where the fibula articulates with the tibia to form the superior tibiofibular joint.

Auricular Surface

Large, roughened area of the ilium where the ilium articulated with the sacrum at the sacroiliac joint.

Calcaneus Bone

Largest of the tarsal bones that forms the pominence of the heel. It also serves at attachment for the the Achilles tendon.

Lateral Malleolus of the Fibula

Lateral prominence that can be palpated on the ankle.

Bones of the Pelvis

Left and right ossa coxae, sacrum, and the coccyx.

Patellar Ligament

Ligament that attaches to the Tibial tuberosity.

Posterior Superior Iliac Spine

Location of the skin dimple on the back is caused by this landmark of the ilium. The most posterior portion of the iliac crest. Also a location for bone marrow biopsies.

Shaft of the Femur

Long cylindrical portion of the femur.

True Pelvis

Lower portion of the pelvic basin and it encloses the pelvic cavity and forms a deep narrower region that contains the pelvic organs.

Pelvimetry

Measurement of the pelvic outlet to see if vaginal birth or a cesarian section is better.

Medial Malleolus of the Tibia

Medial prominence that can be palpated on the ankle.

Tibia

Medially placed bone of the crural region that bears the weight of the body.

Quadriceps Femoris

Muscle whose inferior tendon houses the patella bone.

Femoral Shaft Fracture

Often an open fracture because of the severe trauma it takes to produce this fracture. Significant blood loss and spasm of leg muscles along with internal puncture trauma from the broken ends of the bone are associated with this fracture. Hare Traction Splint is a quick treatment.

Clinical: Gas Gangrene

Often mistaken for wet gangrene. However, the bacteria typically associated with gas gangrene are Clostridium, which doesn't need oxygen. It can be diagnosed due to the cracklin sound in the tissue due to bubbles from the gas released by bacteria.

Pubic Arch or Subpubic Angle

Part of the pelvis. In females it is wider and more convex, usually greater than 100 degrees. In males it never exceeds 90 degrees.

Articular Facets of the Patella

Posterior landmarks of the patella that articulate with the medial and lateral condyles of the femur. The Lateral of the two being the larger which helps to identify which patella bone you have.

Anterior Superior Iliac Spine

Projection of the ilium where the iliac crest arises anteriorly.

Head of the Femur

Proximal portion of the femur that articulates with the acetabulum.

Hare Traction Splint

Quick treatment to stabilize the femur after a femoral shaft fracture.

Factors that help the foot maintain its arch

Shape of the bones in a wedge shape, and strong ligaments, muscles and tendons.

Obturator Foramen

Space in the os coxae that is encircled by both pubic and ischial rami. Allows passage for nerves and muscles.

Base of the Patella

Superior portion of the patella.

Superior Ramus of the Pubis

Superior portion of the pubis.

Talus Bone

Tarsal bone that articulates with both the tibia and fibula. It is the most superior of the tarsal bones.

Achilles Tendon

Tendon that attaches the calf muscles to the calcaneus bone.

Symphysis Pubis

The anterior joint between the two ossa coxae. Consists of fibrocartilage and separates the pubic bones.

Intercondylar Fossa of the Femur

The deep depression that separates the medial and lateral condyles of the femur on the posterior surface.

Bones that form the os coxae

The ilium, ischium, and pubis bones.

Femur

The longest, heaviest, and strongest bone in the body.

Calcaneus Bone

The most often fractured tarsal bone due to when a person falls or jumps from a height and lands on one or both heels.

Fibula

The non-weightbearing bone of the crural region of the lower leg. It is the long, thin, laterally placed bone of the lower leg. it does not articulate with the femur.

Ischial Tuberosity

The posterolateral border of the ishium where a roughened projection is, also commonly called the "sit bone".

Iliac Crest

The superior-most ridge of the ilium.

False Pelvis

The upper portion of the pelvic basin and is enclosed by the wing-like sides of the flared iliac bones. Houses the inferior abdominal organs.

Tibia and Fibula

Two bones of the lower leg(crural region)

Medial and Lateral Epicondyles of the Femur

Two landmarks superior to the lateral and medial condyles that serve for ligament and tendon attachment. Can be palpated on the sides of the knee.

Medial and Lateral Condyles of the Femur

Two large rounded landmarks on the distal end of the femur that articulate with the tibia.

Phalanges of the Pes

14 bones in the foot that are similar to the bones in the fingers.

Aging of the Os Coxae

20=roughened or billowed articular surfaces. 30-40=pubic articular surfaces flatten and loose their billowing. Older= the pubic articular surfaces begin to develop concavities and arthritic changes.

Number of Bones in each Lower Limb

30.

Tarsal Bones

7 bones that form the ankle. They help transfer force and provide flexibility of movement.

Linea Aspera of the Femur

A roughened midline ridge on the posterior portion of the shaft of the femur.

Pubis

Anterior bone of the os coxae that fuses with the ilium and ischium at the acetabulum.

Lateral Longitudinal Arch of the Pes

Arch on the lateral inferior portion of the foot.

Medial Longitudinal Arch of the Pes

Arch on the medial inferior portion of the foot.

Transverse Arch of the Pes

Arch that pass transversly underneath the metatarsals.

Article: Leg Length Discrepancy(LLD)

Article: Difference in the length of the legs that is common in most individuals. Can be fixed with heel lifts or sole inserts. Can be diagnosed by looking at the soles of a persons shoe and foot.

Article: Factors that Decreased Risk of Bone Fracture

Article: Gaining weight after the age of 25, and estrogen replacement therapy.

Article: Trochanteric Bursitis

Article: Inflammation of the bursae that overlie the Greater Trochanter of the femur that can be cured by an injection of cortisone and anesthetics.

Article: Functional LLD Discrepancies

Article: Leg length discrepancy caused by muscle weakness or stiffness in the pelvis, ankle or foot. The legs are the same size but function as if one is longer.

Article: Structural LLD Discrepancies

Article: Leg length discrepancy which can be congenital or the result of a fracture or hip replacement surgery. It involves an actual difference in the length of the bones.

Article:Carbonated Apatite or Dahllite

Article: Mineral from which a paste is formed that can be injected into fractured bones and promote rapid healing of fractures. The body also treats it as if it were bone, making blood vessels to go through it and shaping it to be more like bone.

Article: Referred Pain

Article: Pain in one part of the body that is caused by a completely different part of the body. Ex: Hip pain caused by stain on the lower back muscles.

Article: Ilizarov Procedure

Article: Procedure where the patients's leg is deliberately broken and affixed to a rack, with the leg stretched slightly every day so that the bones fuse together to cover the separated space, lengthening the leg. Being used in china.

Article: Factors that Increased Risk of Bone Fracture

Article: Women whose mother had suffered hip fractures, tall women who had broken any bone after the age of 50, women with overactive thyroids, the drug Benzodiazepine(used to control anxiety), Anticonvulsants(used to avoid seizures), caffiene, too little exercise, and loosing weight after the age of 25.

Hallux

Big toe that only has a proximal and distal phalanx. Also known as the first digit of the pes.

Ilium

Bone that forms the superior region of the os coxae and the acetabular surface.

Os Coxae

Bone that is commonly referred to as the hip bone.

Clinical: Wet Gangrene

Clinical: Caused by bacterial infection of tissues that have lost their blood and oxygen supply. The cells in the dying tissue rupture and release fluid. Common bacteria associated with this is Streptococcus, Staphylococcus, Enterobacter, and Klebsiella.

Clinical: Cause of Bunion

Clinical: Caused by wearing shoes that fit too tightly.

Clinical: Talipes Equinovarus

Clinical: Commonly referred to as congenital clubfoot. The foot of newborns appears to curve medially and the ankles are plantar flexed (like they're on tip toe).

Clinical: Pes Planus

Clinical: Commonly referred to as flat feet, it is a foot deformity in which the medial longitudinal arch is flattened (or "fallen) so that the entire sole touches the ground.

Clinical: Causes of Pes Planus

Clinical: Excessive weight, postural abnormalities, or weakened supporting tissue in the foot. Standing most of the day can cause slightly fallen arches as well, but they return to normal.

Clinical: Dry Gangrene

Clinical: Form of gangrene in which the involved body part is desiccated, sharply demarcated, and shriveled, usually due to constricted blood vessels as a result of exposure to extreme cold. Can be caused by frostbite or cardiovascular disease.

Clinical: Bunion

Clinical: Localized swelling at either the dorsal or medial region of the first metatarsophalangeal joint. Looks like a bump on the foot near the great toe. Causes the hallux to point in a different dirrection than normal, bone spurs, bursitis, and calluses(hyperkeratosis).

Clinical: Common cause of Talipes Euinovarus

Clinical: Not enough room in the womb causes this foot disorder.

Clinical: Pes Cavus

Clinical: Often seen in patients with neurologic disorders (such as poliomyelitis) or muscular disorders (such as atrophy of leg muscles).

Clinical: Pes Cavus

Clinical: Refered to as Clawfoot, it is characterized by excessively high longitudinal arches.

Clinical: Gangrene

Clinical: The necrosis (death) of the soft tissues of a body part due to a diminished or obstructed arterial blood supply to that region. Common in the limbs, fingers, or toes. Also caused by bacterial infection or direct mechanical injury. A major complication for diabetics.

Clinical: Metatarsal Stress Fracture

Clinical: This injury usually results when repetitive pressure or stress on the foot causes a small crack to develop in the outer surface of the bone of the metatarsal. The second and third metatarsals are most commonly involved.

Clinical: Intestinal Gangrene

Clinical: Usually occurs following an obstruction of the blood supply to the intestines, which if not treated will lead to death.

Clinical: Treatment for Metatarsal Stress Fractures

Clinical: Wearing either stiff or well-cushioned shoes are required for healing, also extended rest.

Closed Fracture of the Pelvis

Common in falls and crashes, indirect forces(impact of knees into dashboard), minor falls of elderly persons. These fractures are associated with severe internal bleeding that may be fatal. They usually break in two locations.

Acetabulum

Deep curved depression where the femur articulates with the os coxae. Made up of all three bones of the os coxae.

Pelvic Girldle

Defined to be the left and right ossa coxae.

Interosseous Membrane

Dense connective tissue between the tibia and fibula that help stabilize the bones.

Fovea of the Femur

Depression in the head of the femur where a tiny ligament connects it to the acetabulum.

Neck of the Femur

Elongated and constricted portion of the proximal end of the femur that connects the head to the shaft at an angle.

Metatarsal Bones of the Pes(foot)

Five long bones similar in arrangement and name to the metacarpal bones of the hand. They are numbered 1-5 with the big toe or "hallux" being number one.

Medial and Lateral Condyles of the Tibia

Flat surfaces on the superior portion of the tibia that articulate with the medial and lateral condyles of the femur.

Fracture of the Tibia and Fibula

Fracture can occure anywhere along the shafts of these two bones of the crural region that almost always break together. the medial of these bones is often an open fracture due to its proximity to the surface of the skin.

Fracture of the Patella

Fracture caused by falling on the knees. It usually doesn't fragment because it is embedded in the patellar tendon of the quadriceps muscle.

Potts Fracture

Fracture of the medial and lateral malleolus of the tibia and fibula. Used to be common among skiers before the invention of better boots.

"Hip Fractures" or Fractures of the Neck of the Femur

Fracture that usually involves the neck of the femur and not the os coxae. Common in elderly persons with osteoporosis, and young adults who experience traumatic injury.

Relaxin

Horomone released by the corpus luteum of the ovary. It loosens the symphysis pubis and the scroiliac joint to increase the diameter of the true pelvis and pelvic outlet to facilitate parturition.

Fracture of the Neck of the Femur

Incorrectly referred to as hip fractures. This is a common fracture location of aged persons.

Pelvic Outlet

Inferior exit from the true pelvic. Bounded by the inferior border of the pubic symphysis, the ischial tuberosities, and the coccyx. Can be widened by giving birth in the squatting position.

Ischium

Inferior lateral portion of the os coxae. Fuses with the Ilium near the superior and posterior margins of the acetabulum.

Inferior Ramus of the Pubis

Inferior part of the pubis.

Apex of the Patella

Inferior portion of the patella that is more pointed than the superior portion.

Inferior Tibiofibular Joint

Joint of the inferior articulation between the tibia and fibula.

Superior Tibiofibular Joint

Joint of the superior articulation between the tibia and fibula.

Sacroiliac Joint

Joint where the sacrum and the os coxae articulate.

Patella

Known as the kneecap, it is a large roughly triangular sesamoid bone in the tendon of the quadriceps femoris muscle.

Intercondylar Eminence of the Tibia

Landmark of the Tibia that separates the medial and lateral condyles. This prominent ridge helps prevent knee displacement.

Patellar Surface of the Femur

Landmark of the distal femur located between the medial and lateral condyles on the anterior surface where the patella articulates with the femur.

Lesser Trochanter of the Femur

Landmark of the femur that is located on the femur's posteromedial surface. Synonymous with the Lesser Tubercle of the Humerus.