Bones, Ligaments, and Joints of the Lower Limb

Where does the weight of the body rest during dorsiflexion? During plantar flexion?

During dorsiflexion "digging in the heels," body weight rests on the calcaneous During plantar flexion"standing on tiptoe," the talus and calcaneous transfer the weight to the metatarsal bones and the phalanges via more anterior tarsal bones.

T/F The fibula is part of the knee joint and transfer weight to the ankle and foot.

False, the fibula is NOT part of the knee joint and DOES NOT transfer weight to the ankle and foot, however an important site for muscle attachment

What is the name of the distal tip of the fibula that provides stability to the ankle joint by preventing medial sliding of the tibia across the surface of the talus?

Lateral malleolus

Which two extracapsular ligaments tighten only at full extension and help stabilize the knee joint in this position?

MCL & LCL

What are the two tubercles on the intercondylar eminence?

Medial and Lateral tubercles

What are the two fibrous cartilages pads that lie btw the femoral and tibial surfaces within the knee?

Medial and lateral menisci

What condylar foot joints permit flexion/extension and adduction/abduction between the metatarsal bones and phalange?

Metatarsophalangeal joints

a large sesamoid bone that forms within the tendon of the quadriceps femoris is called?

Patella

Which two ligaments limit the anterior and posterior movement of the femur and maintain the alignment of the femoral and and tibial condyles?

1) Anterior cruciate ligament (ACL) 2) Posterior cruciate ligament (PCL)

congenital talipes equinovarus (clubfoot)

A congenital deformity affecting one or both feet. It develops secondary to abnormalities in neuro muscular development.

Which of the following is most unique to the knee? A) menisci B) tendons C) ligaments D) joint capsule E) bursae

A) menisci

Describe the extension mechanism that locks the knee?

At full extension a slight lateral rotation of the tibia tightens the anterior cruciate ligament and jams the meniscus between the tibia and femur.

on the posterior and proximal surface of the tibia, this structure marks the attachment of leg muscles

Soleal Line (Popliteal Line)

What is the name of the medial portion of the longitudinal arch?

Talar

Th inferior surface of the tibia forms a hinge joint with what proximal bone of the ankle?

Talus

What are the seven tarsal bones of the tarsus (ankle)?

Talus, Calcaneus, Navicular, Medial cuneiform, Intermediate cuneiform, Lateral cuneiform, Cuboid (The Circus Needs More Interesting Little Clowns)

What are the joints btw the tarsal bones and the metatarsals?

Tarsometatarsal joints

Why are fractures of the femoral neck or btw the trochanters more common than hip dislocations?

The Hip Joint is extremely stable

Which joint have the largest range of motion (up to 160 degrees), lacks large muscles that supports and strengthens the hip, and lack strong ligaments that support the ankle joint?

The Knee Joint (hinge-joint)

The medial and lateral condyle of the proximal end of the tibia articulate with what two structures of the femur?

The medial and lateral condyles of the femur

What is claw feet?

The median longitudinal arch becomes exaggerated b/c the plantar flexors overpower the dorsiflexors.

The distal surfaces of the cuboid and the cuneiform bones articulate with which bones of the foot?

The metatarsal bones of the foot

What does the term arthritis refer to?

The term encompasses all the rheumatic diseases that affect synovial joints. Arthritis always involves damage to the articular cartilages, but the specific cause can vary.

The distal surface of the navicular articulates with which bones of the tarsus?

The three Cuneiform bones

T/F There is no single unified capsule in the knee

True

What does the phrase "trick knee" refers to?

a knee that feels unstable

Adductor Tubercle

a rough projection on the superiormost portion of the medial condyle

Fibular Head

articulates along the lateral margin of the tibia on the inferior and posterior surface of the lateral tibia condyle

Cuboid

articulates with the anterolateral surface of the calcaneus

What factors constricts hip mobility?

combination of ligaments, capsular fiber, the depth of the bony socket, and the surrounding muscles

_______ ______ ______ is a joint formed btw the distal faces of the tibia and the fibula

distal tibiofibular joint

Articular capsule of Hip

extremely dense, strong, which stabilizes the hip

______ _______ is a joint formed btw the lateral malleolus of the fibula & lateral articular surface of the talus.

fibulotalar joint

What is the function of the quadriceps tendon and the patellar ligament?

Provide support to the anterior surface of the knee, where there is no continuous capsule

Navicular

located on the medial side of the ankle, articulates with the anterior surface of the talus

Femur

longest and heaviest bone in the body

Describe the flexion mechanism that unlocks the knee?

loosening of the anterior cruciate ligament and a slight medial rotation of the tibia.

Trochlea of talus

has medial surfaces for articulation with the medial malleolus of the tibia and a lateral surface that articulate with the lateral malleolus of the fibula

What is the function of the elasticity of the medial portion of the longitudinal arch (talar)?

helps absorbs the shocks that accompany sudden changes in body weight loading (e.g. the stresses involved with running or ballet dancing are cushioned by the elasticity of the medial portion of the longitudinal arch)

Ligament of the femoral head (ligamentum capitis femoris)

originates along the transverse acetabular ligament and attaches to the center of the femoral head, tenses only when the thigh is flexed

Lesser Trochanter of femur

originates on the posteromedial surface of the femur

Greater Trochanter of femur

projects laterally from the junction of the neck and the shaft

What is the function of the medial malleolus (distal tibia)?

provides medial support for the talocrural joint (ankle joint) by preventing lateral sliding of the tibia across the talus

______ ______ ______is a plane joint formed btw the the posterolateral surface of the tibia and the head of the fibula

proximal tibiofibular joint

Linea Aspera

runs along the center of the posterior surface of the femoral shaft. This ridge marks the attachment site of other powerful adductor hip muscles

What is the function of the Talus?

second largest bone of the foot, transmits the weight of the body from the tibia anteriorly, toward the toes

What is the function of the metatarsal bones?

support the weight of the body during standing, walking, and running

Dancer's fracture

the proximal portion of the fifth metatarsal is broken; a sudden shift in weight from the medial portion of the arch to the lateral, less elastic border breaks the fifth metatarsal.

Intertrochanteric crest (posterior of femur)

the rounder ridge that connects the greater & lesser trochanter on the posterior aspect of the femur

What is the primary weight-bearing articulation of the ankle?

tibiotalar joint

Intertrochanteric Line (anterior of femur)

on the anterior surface of the femur which marks the distal edge of the articular capsule

The posterior patellar surface is composed of what two structures that articulate with the medial and lateral condyles of the femur?

1) Medial facet 2) Lateral facet

What are the two major ligaments that strengthen the sacro-iliac joint and divide the gap between the sacrum and the ischium into two openings: the greater sciatic foramen and the lesser sciatic foramen?

1) Sacrotuberous ligament: arises on the back of the sacrum and inserts on the ischial tuberosity 2) Sacrospinous ligament: lies in front of the sacro-tuberous ligament: arises on the edge of the sacrum and inserts on the ischial spine.

What are the two joints of inversion and eversion?

1) Subtalar Joint (talocalcaneal joint) 2) talo-calcaneo-navicular joint

What are the name of the two joints that encloses the knee within synovial capsule?

1) Tibiofemoral joint: btw tibia and femur 2) Patellofemoral joint: btw the patella and the patellar surface

What are the functions of the menisci?

1) cushion 2) conform to shape as the femur change positions 3) increase surface area of the tibiofemoral joint 4) provide lateral stability to joint

What are the four ligaments that reinforce the articular capsule and contribute to hip stability?

1) iliofemoral ligament 2) pubofemoral ligament 3) ischiofemoral ligament 4) transverse acetabular ligament

What are the two epicondyles of the distal femur?

1) lateral epicondyle 2) medial epicondyle

What are the two condyles on the the inferior end of the femur

1) medial condyle 2) lateral condyle

What are the seven ligaments that stabilize the knee joint?

1) patellar ligament 2) tibial (medial) collateral ligament/(MCL) 3) fibular (lateral) collateral ligament (LCL) 4) popliteal ligaments 5) anterior cruciate ligament (ACL) 6) posterior cruciate ligament (PCL)

What three joints provide medial and lateral ankle stability?

1) proximal tibiofibular joint 2) distal tibiofibular joint 3) fibulotalar joint

What are the two functions of the arches of the foot?

1) support the weight of the body while simultaneously adapting to uneven surfaces 2) function as a stable platform that is able to support the weight of the body while standing & walking

The fibula does to participate in the knee joint, nor does it bend; but when it is fractured, walking is difficult. Why?

Although the fibula is not a part of the knee joint and does not bear weight, it is an important attachment for many leg muscles. When the fibula is fractured, these muscles cannot function properly to move the leg, and walking is difficult and painful. The fibula also help stabilize the ankle joint.

________ ______ is a hinge joint formed by articulations among the tibia,, fibula, and talus.

Ankle Joint (Talocrural joint)

The knee joint differs from other large, complex synovial joints of the body in which of the following features? A) It is reinforced by ligaments. B) It is rarely dislocated. C) It does not have a single unified capsule or a common synovial cavity. D) It is a hinge joint. E) The knee joint does not differ from other joints

C) It does not have a single unified capsule or a common synovial cavity.

Most of the weight of the body pushes down on the ________ joint. A) fibulotalar B) lateral malleolar C) tibiotalar D) tibiofibular E) All of the above support the weight of the body.

C) tibiotalar

What is the name of the lateral portion of the longitudinal arch that carries most of the body weight while standing?

Calcaneal portion

The posterior surface of the calcaneus is a rough, knob-shaped projection that is the attachment site for which tendon that arises from the calf muscles?

Calcaneal tendon (Achilles tendon)

Which hindfoot ligament goes from the lateral malleolus to the side of the calcaneus?

Calcaneo-fibular ligament

While jumping off the back steps of his house , 10-year old Mark lands on his right heel and breaks his foot. What foot bone is most likely broken?

Calcaneous (heel bone)

the largest of the tarsal bones, when standing most weight is transmitted from the tibia to the talus to the calcaneus, and then to the ground

Calcaneus (Heel bone)

which retinaculum is on the front of the ankle

Extensor retinaculum

What structure provide padding around the margins of the knee joint and assist the bursae in reducing friction btw the patella and other tissues?

Fat Pads

What bones make up the lower limbs?

Femur, Patella (kneecap), Tibia, Fibula, Tarsal bones of the ankle, Metatarsal and Phalanges of the foot

What bone parallels the lateral border of the tibia?

Fibula

which retinaculum is on the medial side and fans out from the back of the medial malleolus

Flexor retinaculum

A stabilizing ligament (the ligament of the head) attaches to the femoral head at a depression called the _____?

Fovea

Phalanges (toe bones)

Hallux: has two phalanges (proximal & distal) and the other four toes have three phalanges

What is the name of the ridge that separates the medial & lateral condyles of the tibia?

Intercondylar Eminence

The two condyles are separated by what structure?

Intercondylar fossa/notch

What structure bounds the medial border of the shaft of the fibula to the tibia and provides additional surface area for muscle attachment?

Interosseous membrane of the leg

Which hindfoot ligament goes from the calcaneus to the talus?

Interosseous talo-calcaneal ligament

What hinge joints permit flexion and extension btw the phalanges of the foot?

Interphalangeal joints

What joints permit limiting sliding and twisting movements btw the tarsal bones?

Intertarsal Joints

What is the name of the arch of the foot in which body weight transfer occurs along?

Longitudinal arch

What is the function of the lower limb?

Lower limb must transfer body weight to the ground

On the lateral aspect, behind the malleolus, this structure accommodates the tendons of two peroneal muscles as they pass around the lateral malleolus.

Peroneal retinaculum

What are the name of the ligaments that extends btw the femur and the heads of the tibia and fibula and function to reinforce the back of the knee joint?

Popliteal ligaments

Metatarsal bones

Proximally, the first three articulates with the three cuneiform bones, and the last two articulate with the cuboid Distally, each metatarsal bone articulates with a different proximal phalanx

Pulley-like structures of the ankle joint that are made up of thickenings of deep fascia that are attached to ankle bones are referred to as?

Retinaculum

What is the general term that indicates pain and stiffness affecting the skeletal system, the muscular system, or both?

Rheumatism

What major ligaments reinforce the lateral and medial surface of the ankle?

Stout Ligaments: 1) Medial Deltoid Ligament 2) 3 lateral ligaments

What is the name of the large bone of the leg?

Tibia

Distally the femur articulates with the __________ and proximally the rounded head of the femur articulates with the __________?

Tibia of the leg at the knee joint, Pelvis at the acetabulum

What structure on the anterior surface of the tibia marks the attachment of the stout patellar ligament?

Tibial Tuberosity (Tibia Tubercle)

What ligament prevents the ankle bones from sliding from side to side?

Tibiofibular ligament

Describe flat feet.

absence or loss of the longitudinal arch, tendons and ligaments become less elastic

What is the most common ankle sprain?

forceful inversion of the foot that stretches the lateral ligament

Distally the line aspera divides into a ______ and ________ ________ _______ to form a flattened triangular area, the _______

medial, lateral supracondylar ridge, popliteal surface

What is the function of the patella?

strengthens the quadriceps tendon, protects the anterior surface of the knee joint, and serves as an pulley that increases the contraction force of the quadricep femoris