Gross Anatomy Unit 4

what type of joint is the hip joint?

Ball and socket

Where does the iliofemoral joint attach?

Anterior Inferior Iliac spine and the intertrochanteric line

What is the strongest ligament in the body?

Iliofemoral ligament

When bending backwards, what muscles are brought into action?

Anterior hip and abdominal muscles

When bending forwards, what muscles are brought into action?

gluteal, hamstring, and spinal muscles

What does the Iliofemoral ligament do?

“screws” the head of the femur into the acetabulum

What is the nerve supply of the hip joint?

Femoral, obturator, and sciatic nerve

Where does the pubofemoral joint attach?

Superior ramus/pubis to the intertrochanteric line

What is the function of the pubofemoral ligament?

Prevents abduction at the joint

Where does the Ischiofemoral ligament attach?

Body/ischium to the neck and greater trochanter of the femur

What does the Ischiofemoral ligament do?

Prevents hyperextension and abduction at the joint

What type of ligament is transverse acetabular ligament?

Intrinsic ligament

What does the transverse acetabular ligament do?

Converts the acetabular notch into a tunnel for blood vessels to enter the joint

What does Capitis Femoris ligament do?

Conduct a blood vessel to the head of the femur

When leg is flexed, what is flexion at the hip joint limited by?

Limited by anterior surface of the thigh coming in contact with anterior abdominal wall

When leg is extended, what is flexion at the hip limited by?

Limited by the tendons of the hamstrings

Is developmental dysplasia more common in males or females?

females

Majority of children with developmental dysplasia have what?

Ligamentous laxity

What is ligamentous laxity?

hip becomes unstable and slips out of position

What position were most infants with developmental dysplasia in?

breech position

What is twisting of the femur called?

femoral anterversion

A posterior dislocation of the hip joint will compromise what nerve?

Sciatic nerve

An anterior dislocation of the hip joint will compromise what nerve?

obturator nerve

What’s the largest joint in the body?

knee joint

What is the articulation of the knee joint?

femur, tibia, and patella

How many joints make up the knee joint cavity?

3

Where are the three joints that make up the knee cavity?

between the patella and femur

between the lateral condyles of femur and tibia

between the medial condyles of the femur and tibia

The articulating surfaces of the tibial condyles is called?

Lateral and medial tibial plateaus

What is the joint between the femur and tibia classified as?

Ginglymus (hinge)

What is the joint between the patella and femur classified as?

plane gliding

Which knee ligament contains several bursae?

Capsular ligament

Where is the subcutaneous prepatellar bursae?

between the patella and the skin

Where is the subcutaneous infrapatellar bursae?

between the tibial tubercle and the skin

Where is the deep infrapatellar bursae found?

between the ligamentum patella and the tibial tubercle

Where is the suprapatellar bursae?

between the femur and common tendon of insertion of the quadriceps

Function of ligamentum patella ligament?

Maintaining the alignment of the patella

Function of lateral collateral ligament?

acts as a rope and prevents lateral movement (abduction)

Function of medial collateral ligament?

acts as a rope and prevents medial movement (adduction)

Function of Oblique and Arcuate Popliteal ligament?

prevents hyperextension of knee joint

What are the main bonds between the femur and tibia?

cruciate ligaments

Which cruciate ligament is stronger?

posterior cruciate

function of anterior cruciate ligament?

prevents anterior displacement of tibia

function of posterior cruciate ligament?

prevents posterior displacement of tibia

function of menisci?

deepen the articulating surface

act as a shock absorber

act as a mechanoreceptor

Are menisci highly vascular?

well-developed until infants begin to walk and then lose 75% of vascular supply

which menisci is more mobile?

lateral meniscus

function of coronary ligaments?

helps hold menisci in place

function of transverse ligament of knee?

allows menisci to work together

What happens when knee fully extends?

the knee “locks” because of lateral rotation of tibia

How do we “unlock knee”

the popliteus muscle must contract to rotate the tibia medially

what is prepatellar bursitis (housemaid’s)?

friction between the skin and the patella

what is subcutaneous infrapatellar bursitis?

excessive friction between the skin and tibial tubercle

Also known as clergyman’s knee

What is suprapatellar bursitis?

caused by bacteria from an abrasion or penetrating wound

infection may spread to the knee joint cavity

What is the unhappy triad?

blow to the lateral aspect of the knee

damage to the medial collateral, anterior cruciate, and medial meniscus

What’s the most commonly injured ligament of the knee joint?

medial collateral ligament

What meniscus is more vulnerable to injury?

medial meniscus

Symptoms of damage to medial meniscus?

complain of knee “clicking”, locking up, pain going up the stairs or getting up from chair

Damage to medial meniscus may lead to what?

osteoarthritis

Symptoms of anterior cruciate damage?

complain of hearing a pop and a sensation that their knee has “given out”

swollen knee

what is a positive anterior drawer test?

the tibia can be pulled excessively forward

What’s a positive posterior drawer test?

tibia can be pulled excessively backward under femur

What’s the criteria for knee replacements?

pain cannot be controlled

patient is functionally disabled

what is the function of the tibia?

weight bearing

where is the primary ossification center of the tibia?

shaft of the tibia

How many secondary ossification centers are in the tibia and what are they?

3

what are the secondary ossification centers of the tibia?

proximal end, distal end, and tibial tuberosity/tubercle

when does the distal end of the tibia fuse?

females- 14.5 years

males- 16.5 years

when does the proximal ends of the tibia fuse?

females- 15 years

males- 17.5 years

What is Osgood-Schlatter’s Disease?

disruption of the epiphyseal plate of the tibial tuberosity

What is an example of Osgood Schlatter’s disease?

apophyseal injury or traction apophysitis

what is apophyses?

a secondary ossification center that develops with growth

What will patients complain of with Osgood' Schlatter’s disease?

patients will complain of localized pain in the area of the tibial tubercle

Is the fibular weight bearing?

no

How many and where is the primary ossification center of the fibula?

one, for the shaft

How many and where are the secondary ossification centers for the fibula?

two, for the distal and proximal ends

When does the proximal end of the fibula fuse in men/women?

14.5 years women

16.5 years men

When do the distal ends of the fibula fuse in men/women?

15.5 years women

17 years men

What is the most commonly fractured bone of the lower extremity?

fibula

What are compound fractures from direct trauma called?

bumper fracture

What nerve could be damaged from a fibular fracture?

common fibular nerve

What part of the leg could have atrophy and paralysis if common fibular nerve is damaged?

anterior and lateral leg musculature

How many bones in the foot total?

28

What are tarsal bones comparable to?

carpal bones

What is the calcaneal tuberosity?

a large prominence that allows for the insertion of the tendon calcaneus

What is the fibular trochlear?

found on lateral side of fibula and separates the tendons of the fibularis longus and brevis from each other

What is the sustentaculum tali?

a prominent ”ledge” on the medial aspect of fibula

What is the calcaneal sulcus?

a deep groove which separates the articular facets of the bone

What tarsal bone forms the ankle joint?

talus

What is Os Trigonum?

talus may have a secondary ossification center develop for the lateral tubercle of the bone

What’s the first tarsal bone to ossify?

calcaneus

What’s the last tarsal bone to ossify?

navicular

When do tarsal bones complete ossification?

completed by puberty

How does a talus fracture occur?

occurs through the neck during severe dorsal flexion at the ankle

What’s an example of how a talus fracture can occur?

when a person is pressing extremely hard on the brake pedal during a collision

Can a talus fracture lead to avascular necrosis?

yes, if the blood supply is compromised at the head of the bone

How can a calcaneal fracture occur?

occurs from a hard fall on the tuberosity (heel)

What may a calcaneal fracture disrupt?

subtalar joint

What attaches at the tuberosity present at the base of the fifth metatarsal?

fibularis brevis and tertius muscle

What is a stress fracture?

fine hairline fractures that appear without evidence of soft tissue damage

When would stress fractures become visible?

may become visible several weeks after the fracture