LRA: 219 Lower Limb Anatomy

sesamoid bones:

-found in the hands/feet -embedded in certain tendons -present near various joints

how many total phalanges are there in each foot?

14 phalanges in each foot

the pelvic girdle contains how many bones?

2

body doesn't stop growing bones until..

21- females 25- men

how many bones are in one foot?

26 bones

the 1st digit/big toe only has ___ phalages

2: proximal phalanx and the distal phalanx

how many bones make up the girdle at birth?

3

digits 2-5 have ___ phalanges

3 phalanges (proximal phalanx, middle phalanx , distal phalanx)

there are ____ digits in each foot

5

the metatarsals consist of ___ bones in each foot

5 bones (1-5) 1: medial 5: lateral

there are ___ tarsal bones in each foot

7

pubic arch (men)

< 90 degrees acute angle narrow, deeper, less flare

pubic arch (women)

> 90 degrees oblique angle flare and very wide

The Tibia

one of the larger bones of the body, is the weight-bearing bone of the lower leg. The tibia can be felt easily through the skin in the anteromedial part of the lower leg. It is made up of three parts: the central body (shaft) and two extremities.

babys cant walk or crawl for a while because their bones haven't?

ossified

facets are aka

padding for the femur

Largest sesamoid bone in the body

patella (kneecap) located in the lower limb

The most distal bones of the foot are called

phalanges- which make up the toes/digits

fibular sesamoid

sesamoid bone on the lateral side of the lower limb

tibial sesamoid

sesamoid bone on the medial side of the lower limb

symphysis pubis joint

slightly moveable cartilage synovial

the sacroiliac joints

slightly moveable synovial

the ankle joint requires:

strong collateral ligaments that extend from the medial and lateral malleoli to the calcaneus and talus. Lateral stress can result in a "sprained" ankle with stretched or torn collateral ligaments and torn muscle tendons leading to an increase in parts of the mortise joint space. AP stress views of the ankle can be performed to evaluate the stability of the mortise joint space.

The superior articulation with the talus forms the

subtalar (talocalcaneal) joint.

The ankle joint is a ___________ joint

synovial flexion and extension (dorsiflexion and plantar flexion) movements only

the 1 tarsal bone involved with the ankle is the

talus: it is involved with the ankle joint

the base of each metatarsal are known as the ________________ joints

tarsometatarsal joint (TMT)

The distal tibial joint surface that forms the roof of the ankle mortise joint is called

the tibial plafond (ceiling).

The ankle joint is formed by three bones, such as:

the two long bones of the lower leg, the tibia and fibula, and one tarsal bone, the talus.

how many joints do digits 2-5 have?

they have 2 joints each

articular facets making up the tibial plateau slope posteriorly from 10° to 20° in relation to the long axis of the tibia. T/F?

true

the joints of articulations of the digits of the foot are important to identify because fractures may involve the joint surfaces. true or false?

true

the mnemonic for the tarsal bones:

Come- calcaneous To- talus Colorado- cuboid Next- navicular 3 Christmases- 3 cuniforms

what happens to the patella when knee is flexed/ extended out?

FLEX: patella slides down the intercondylar sulcus to protect the open knee joint EXTENDED: patella sits of the femur

When joints of the foot are described, the name of the joint should be stated first, followed by the digit or metatarsal, and finally the foot.

For example, an injury or fracture may be described as near the DIP joint of the fifth digit of the left foot

Longitudinal Arch

a strong, shock-absorbing support for the weight of the body. The springy, longitudinal arch comprises a medial and a lateral component, with most of the arch located on the medial and mid aspects of the foot.

The calcaneus articulates with two bones:

anteriorly with the cuboid and superiorly with the talus.

why is the base of the 3rd metatarsal(3rd metatarsal phalangeal) joint so important?

because it the centering point or Central Ray(CR) location for AP/Oblique foot projection.

interphalangeal joint (IP)

between distal and proximal phalanx of the 1st digit

proximal interphalangeal joint (PIP)

between proximal and middle phalanges

Distalinterphalangeal Joint (DIP)

between the middle and distal phalanx

union of acetabulum joint

cartilaginous doesnt move

the tuberosity on the 5th metatarsal is also known as the

common trauma site for the foot

navicular covers

cuniforms

fibular notch of tibia

distal end of tibia

ACl runs through

eminence

the pelvis in general contains how many bones?

everything.. ALL 4

the patella is a ____ bone

free floating bone sesamoid bone

total phalanges in each foot are similar to the total phalanges in the..

hand

the metatarsal bones consist of 3 parts such as:

head, body, base

men inlet:

heart shaped

what can't be palpated on a patients pelvis?

iliac spine

Intercondylar Eminence (also known as the tibial spine)

includes two small pointed prominences, called the medial and lateral intercondylar tubercles, which are located on the superior surface of the tibial head between the two condyles.

The anterior tubercle

is an expanded process at the distal anterior and lateral tibia that has been shown to articulate with the superolateral talus, while partially overlapping the fibula anteriorly

the base of the 5th metatarsal:

is expanded laterally has a rough tuberosity that provides attachment for tendon

the tarsal bones on the foot are

larger and less mobile than the hand because they provide a basis of support for the body in an erect position sometimes referred to as ankle bones although only 1 tarsal is involved with the ankle

Transverse Arch

located primarily along the plantar surface of the distal tarsals and the tarsometatarsal joints. The transverse arch is primarily made up of the wedge-shaped cuneiforms, especially the smaller second and third cuneiforms, in combination with the larger first cuneiform and the cuboid

women inlet:

longer, oval, rounder, wider

The bones of the foot are arranged in

longitudinal and transverse arches

medial and lateral condyles

medial and lateral condyles are the two large processes that make up the medial and lateral aspects of the proximal tibia.

The medial elongated process of the tibia that extends down alongside the medial talus is called the

medial malleolus.

the head of each metatarsal are known as the ________________ joints

metatarsal interphalangeal joint (MTP)

joint spaces are open on what position?

mortise position

The inferior portions of the tibia and fibula form a deep "socket," or three-sided opening, called a

mortise, into which the superior talus fits.

talus covers

navicular

Why are sesamoid bones important?

Sesamoid bones are important radiographically because fracturing these small bones is possible. Because of their plantar location, such fractures can be quite painful and may cause discomfort when weight is placed on that foot. Special tangential projections may be necessary to demonstrate a fracture of a sesamoid bone,

remember the T in Talus=

T in Tibia

TRUE OR FALSE? The greater trochanter lies at the same level as the pubic symphysis?

TRUE

TRUE/FALSE? Don't usually shield women bc of their gonads so need to expose.. compared to men for pelvic/hip xrays.

TRUE

The body of the Tibia

The body (shaft) is the long portion of the tibia between the two extremities. Along the anterior surface of the body, extending from the tibial tuberosity to the medial malleolus, is a sharp ridge called the anterior crest or border. This sharp anterior crest is just under the skin surface and often is referred to as the shin or shin bone.

The cuboid

The cuboid is located on the lateral aspect of the foot, distal to the calcaneus and proximal to the fourth and fifth metatarsals. The cuboid articulates with five bones: the calcaneus proximally, the lateral cuneiform and navicular medially, and the fourth and fifth metatarsals distally.

The Navicular

The navicular is a flattened, oval bone located on the medial side of the foot between the talus and the three cuneiforms. The navicular articulates with five bones: posteriorly with the talus, laterally with the cuboid, and anteriorly with the three cuneiforms

The Fibula

The smaller fibula is located laterally and posteriorly to the larger tibia. The fibula articulates with the tibia proximally and the tibia and talus distally. The proximal extremity of the fibula is expanded into a head, which articulates with the lateral aspect of the posteroinferior surface of the lateral condyle of the tibia. The extreme proximal aspect of the head is pointed and is known as the apex of the head of the fibula. The tapered area just below the head is the neck of the fibula. The body (shaft) is the long, slender portion of the fibula between the two extremities. The enlarged distal end of the fibula can be felt as a distinct "bump" on the lateral aspect of the ankle joint and, as described earlier, is called the lateral malleolus.

The talus:

The talus, the second largest tarsal bone, is located between the lower leg and the calcaneus. The weight of the body is transmitted by this bone through the important ankle and talocalcaneal joints. The talus articulates with four bones: superiorly with the tibia and fibula, inferiorly with the calcaneus, and anteriorly with the navicular.

The 3 Cuniforms

The three cuneiforms (meaning "wedge shaped") are located on the medial and mid aspects of the foot between the first three metatarsals distally and the navicular proximally. The largest cuneiform, which articulates with the first metatarsal, is the medial (first) cuneiform. The intermediate (second) cuneiform, which articulates with the second metatarsal, is the smallest of the cuneiforms. The lateral (third) cuneiform articulates with the third metatarsal distally and with the cuboid laterally. All three cuneiforms articulate with the navicular proximally. The medial cuneiform articulates with four bones: the navicular proximally, the first and second metatarsals distally, and the intermediate cuneiform laterally. The intermediate cuneiform also articulates with four bones: the navicular proximally, the second metatarsal distally, and the medial and lateral cuneiforms on each side. The lateral cuneiform articulates with six bones: the navicular proximally; the second, third, and fourth metatarsals distally; the intermediate cuneiform medially; and the cuboid laterally.

Articular Facet/Tibial Plateau

The upper articular surface of the condyles includes two smooth concave articular facets, commonly called the tibial plateau, which articulate with the femur.

Tibial Tuberosity

Tibial tuberosity on the proximal extremity of the tibia is a rough-textured prominence located on the midanterior surface of the tibia just distal to the condyles. This tuberosity is the distal attachment of the patellar tendon, which connects to the large muscle of the anterior thigh. Sometimes in young persons the tibial tuberosity separates from the body of the tibia, a condition known as Osgood-Schlatter disease

Certain types of fractures of the ankle in children and youth involve the distal tibial epiphysis and the tibial plafond. True or False?

True