Lower limb bones-joints-muscles-Dr.B.B.Gosai
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This document provides an overview of the bones, joints, and muscles of the lower limb. It describes the bones that make up the pelvis and thigh, including the femur. It details the hip, knee, ankle, and subtalar joints, along with their ligaments and movements. The major muscles of the thigh, leg, and foot are also outlined, including their origins, insertions, nerve supplies, and actions. Key points include that the hip is a ball and socket joint, the knee is a hinge joint, and the ankle is also a hinge joint. The hamstring and quadriceps muscles act on the knee joint, while the calf muscles plantarflex the foot.
Lower limb bones-joints-muscles-Dr.B.B.Gosai
- 1. HIP REPLACEMENT SURGERY Fracture-Neck Femur My Favourite Quote: I profess to learn and to teach anatomy not from books but from dissections, not from the tenets of Philosophers but from the fabric of Nature !!! - William Harvey….Founder of Systemic Circulation.
- 2. Bones, Joints and Muscles Dr.B.B.Gosai Anatomy of Lower limb-Movement Appratus
- 3. What we will learn today? Bones of Lower limb: Characteristics and their relation to each other. Bones forming Pelvis and Movements at Sacroiliac joint Joints of Lower limb- Hip joint, Knee andAnkle jonits and overview of small joints Muscles of Thigh Muscles of leg References: Clinical Oriented Anatomy by Keith Moore : Ch 3 & 5 Atlas of Anatomy by Gilroy: Ch 26
- 4. Parts of Lower limb The gluteal region : between the trunk and free lower limbs. The femoral region (thigh) is the region lies between the gluteal, abdominal, and perineal regions proximally and the knee region distally. The knee region: includes the prominences (condyles) of the distal femur and proximal tibia, the head of the fibula, and the patella. The leg region is the part that lies between the knee and ankle. The ankle includes the medial and lateral prominences (malleoli) on side of the ankle (talocrural) joint The foot is the distal part of the lower limb containing the tarsus, metatarsus, and phalanges (toe bones).
- 5. Hip bone Large, irregularly shaped bones, each of which develops from the fusion of three bones, the ilium, ischium, and pubis. All three parts converge at Acetabulum Join with femur to form hip joint Hamstring muscles Sartorius muscle Rectus femoris muscle Adductor longus muscle
- 6. Bones forming Pelvis: The two hip bones are joined anteriorly at the pubic symphysis and articulate posteriorly with the sacrum at the sacroiliac joints to form the pelvic girdle.
- 7. The sacroiliac joints are strong, weight-bearing compound joints: • Anterior : synovial joint (between the ear shaped auricular surfaces of the sacrum and ilium, covered with articular cartilage) • Posterior : syndesmosis (between the tuberosities of the same bones) • The auricular surfaces of this synovial joint have irregular elevations and depression interlock. limited mobility but role in transmitting the weight
- 8. Narrow (<70°) Male Wide (>80°) Pubic arch and subpubic angle Female Most Important Difference between Male and Female Pelvis
- 9. Head join with acetabulum of hip bone to form hip joint Most common site of fracture Femur: Long bone of thigh Muscular attachment Shaft Condyles join with condyles of tibia to form Knee joint Articulate with patella Linea aspera
- 10. Condyles join with condyles of femur to form Knee joint Tibia and Fibula Attachment of Patellar ligament (Tendon of Quadriceps muscle) Syndesmosis Malleoli join with talus to form Ankle joint Medial and thicker Lateral and thinner
- 11. Bones of Foot: 7 -Tarsals 5 -Metatarsals 14 -Phalanges Talus (Form Ankle and subtalar joint) Calcaneum (Subtalar joint) Cuboid, Navicular, Medial, Intermediate and Lateral cuneiform (Other joints of foot)
- 12. Hip Joint Type: Ball and socket type of synovial joint Tiraxial (Multiaxial joint –Movement in three axes and hence 3 degrees of freedom -3 df) Bones forming joint (Joint partners): Acetabulum of hip bone (deepened byAcetabular labrum) and Head of Femur.
- 13. Ligaments of Hip joint: Acetabular labrum: fibrocartilaginous ring deepens the acetabulum to receive large head of femur. Pubofemoral ligament: from pubis to femur Iliofemorall ligament: (Y shape) from ilium to femur (Strongest ligament of body) Ischiofemoral ligament: From ischium to femur. Anterior view Posterior view
- 14. Flexion and Extension: against Transverse axis in Sagittal plane. Circumduction: combination of all possible movements at this joint. Movements at Hip joint Medial rotation and lateral rotation: against Vertical axis in the Transverse plane. Abduction and Adduction: against Anteroposterior axis in Frontal plane
- 15. Knee Joint Type: Hinge type of synovial joint (Primarily a Hinge type of synovial joint, allowing flexion and extension; however, the hinge movements are combined with gliding and rolling and with rotation about a vertical axis, hence some text book mention it as Condyloid joint) Uniaxial joint –Movement in one axis (Transverse axis) and hence 1 degrees of freedom -1 df) Bones forming joint (Joint partners): Femoral condyles articulate withTibial condyles.Anteriorly lower end of femur also articulate with Patella.
- 16. Ligaments of Knee joint: Anteriorly: Patellar tendon Laterally: Fibular collateral ligament Medially: Tibial collateral ligament Within the joint holding femur and tibia together and form cross like arrangement are Anterior and Posterior cruciate ligaments. Ligaments of Knee joint: Menisci: Medial meniscus: semilunar shape Lateral meniscus: oval/round shape Importance: 1. Makes articular surface congruent (Matching) 2. Divide joint in upper and lower compartment
- 18. Movements at Knee joint: Flexion and Extension: against the transverse axis in sagittal plane. Some rotation can occur in flexed leg. Locking of Knee: During fully extended knee, the knee passively “locks” because of medial rotation of the femoral condyles on the tibial plateau (the “screw-home mechanism”). This position makes the lower limb a solid column and more adapted for weight-bearing Unlocking of Knee: Reverse of locking and initiated by Popliteus muscle
- 19. Injuries at Knee joint
- 20. Tibio-Fibular joints: Superior Tibio-fibular joint: Plane synovial joint Middel tibio-fibular and Inferior Tibio-fibular joint: Syndesmosis Movements: Sliding/Gliding Fibula is spare bone in lower limb as most of the weight transmission occur through tibia only. Hence Fibula is taken for bone grafting in severe fractures at other places.
- 21. Talocrural (Ankle) Joint Type: Hinge type of synovial joint Uniaxial joint –Movement in one axis (Transverse axis) and hence 1 degrees of freedom -1 df) Bones forming joint (Joint partners): Inferior end of tibia, Medial Malleolus , Lateral Malleolus and Body of talus. Ligaments of Ankle: Deltoid ligament (Medially) Talo-fibular and calcaneo-fibular ligament (Laterally). Movements at Ankle joint: Planterflexion and Dorsiflexion (The transverse axis in sagittal plane ) Malleolar fracture
- 23. Talocalcaneonavicular (Subtalar) Joint Bones forming joint:Talus, Navicular and Calcaneum Type: Talonavicular part: Ball and Socket type Talocalcaneal part: Plane type Movements: Inversion: Medial border of foot is raised Eversion:. Lateral border of foot is raised Ankle Sprains: due to excessive movements tearing of ligaments takes place
- 24. Quadriceps Muscle: Rectus femoris and three vasti
- 25. Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius Origin Straight head: Anterior inferior iliac spine Reflected head: Ilium above acetabulum Lateral lip of linea aspera Medial lip of linea aspera Anterior surface of femur Insertion Directly to Base of patella and Indirectly through patellar tendon toTibial tuberosity Nerve supply Femoral Nerve Actions (Knee joint) All these muscle responsible for Extension of leg at Knee Joint Patellar tendon Relfex
- 26. Muscle Origin Insertion Nerve supply Action Sartorius Strap Parallel muscle (Sartor :Tailor) Anterior superior iliac spine Medial aspect of Tibial condyle Femoral nerve (At Hip joint) Flexion,Abduction and lateral flexion (At Knee joint) Flexion and Medial rotation (Sitting posture for tailor: Palathi posture)
- 27. Muscle Origin Insertion Nerve supply Action Adductor longus Body of Pubis (Hip bone) Middle third of linea aspera Obturator nerve (At Hip joint) Adduction of thigh Forms boundary of Femoral triangle
- 29. Hamstring muscles Biceps femoris, Semitendinosus, Semimembranosus Biceps femoris Semitendinosus Semimembranosus Origin Long head: Ischial tuberosity Short head: linea aspera Ischial tuberosity Ischial tuberosity Insertion Lateral aspect of head of fibula Medial surface of tibia Medial condyle of tibia (Posteriorly) Actions Extension of Thigh at Hip joint Flexion of leg at Knee joint Additional actions Lateral rotation of leg Medial rotation of leg Medial Rotation of leg Nerve supply All are supplied byTibial division of Sciatic nerve except short of biceps is supplied by Common Peroneal division of sciatic nerve.
- 31. Soleus Plantaris Achilles- Greek Warrior – Killed by Arrow on Heel Story of Troy !!!! Triceps Surae: Gastrocnemius, Soleus and Plantaris
- 32. Triceps Surae Gastrocnemius, Soleus and Plantaris Gastrocnemius Soleus Plantaris Origin Lateral head: Lateral condyle of femur Medial head: Medial condyle of femur Posterior part of fibula, Soleal line of tibia and Medial border of tibia Lateral supracondylar line of femur Insertion Calcaneum through AchillesTendon (Calcaneal tendon) Actions Planter flexion of foot (Ankle Joint) Soleus is like first gear to overcome inertia (to start walking) and Gastrocnemius is like top gear for speed (Running) Soleus also known as peripheral heart (Due to its action for venous return) Nerve supply Tibial Nerve
- 33. Muscle Origin Insertion Nerve supply Action Tibialis Anterior Lateral condyle, Lateral surface of tibia Medial surface of Medial cuneiform and Base of 1st Metatarsal Deep peroneal nerve (At Ankle joint) Dorsiflexion of foot (At Subtalar joint) Inversion of foot Tibialis Posterior Posterior surface of tibia and fibula Tuberosity of Navicular bone Tibial nerve (At Ankle joint) Planterflexion of foot (At Subtalar joint) Inversion of foot
- 34. Muscle Origin Insertion Nerve supply Action Peroneus (Fibularis) longus Upper part of lateral surface of fibular Lateral surface of Medial cuneiform and base of 1st metatarsal Superficial peroneal nerve (At Ankle joint) Planterflexion of foot (At Subtalar joint) Eversion of footPeroneus (Fibularis) Brevis Lower part of lateral surface of fibula Base of 5th Metatarsal