Anatomy Exam 3

hip bone

• fusion of 3 bones

  • ilium

  • ischium

  • pubis

• all 3 hip bones contrib to acetabulum

bony landmarks of the hip

• iliac crest

• ASIS

• greater sciatic notch

• lesser sciatic notch

• acetabulum

• ala (wing) of ilium

• ischial spine

• ischial tuberosity

• obturator foramen

• pubic tubercle

pubic symphysis

• pt of articulation between R and L hip bone

anterior features of the femur

• head

• fovea for ligament of head

• neck

• greater trochanter (laterally)

• lesser trochanter (medially)

• lateral epicondyle

• medial epicondyle

• adductor tubercle

• patellar surfaces

posterior features of the femur

• gluteal tuberosity

• medial condyle

• lateral condyle

• intercondylar fossa

• linea aspera

  • longitudinal ridge/crest on middle third of the bone

patella

• articulates w/ femur at patellar surfaces

• base = sup. border

• lateral and medial borders

• apex = inf. aspect

• post. aspect covered w/ articular cartilage for articulation w/ femur

tibia

• larger, medial, weight-bearing bone

• articulates w/

  • femur (proximal)

  • fibula (prox & dist)

  • talus (distal)

• connected to fibula via interosseous membrane on shaft

tibia bone markings

• medial condyle

• lateral condyle

• intercondylar) area

• medial malleolus

• fibular notch

• soleal line (posterior)

fibula

• smaller & lateral bone

• not weight bearing

  • source of attachment

• connected to tibia via interosseous membrane on shaft

fibula bone markings

• head

• neck

• lateral malleolus

ankle & foot

• 7 tarsal bones

• 5 metatarsals

• 14 phalanges

arterial supply of lower limb

• femoral artery (continuation of external iliac)

  • profunda femoris = branch

    • deep artery of thigh

• femoral artery continues = popliteal artery

• popliteal artery divides into

  • ant. & post. tibial artery

• post tibial artery → fibular artery

deep venous drainage of the lower limb

• same names as arterial supply

• ant tibial vein

• post tibial vein

• fibular vein

• = all flow into popliteal vein

• which becomes femoral vein

• profunda femoris vein flows into femoral

superficial venous drainage of the lower limb: great

• superficial to deep fascia

• great saphenous vein

  • medial side of leg

• union of dorsal vein of great toe & dorsal venous arch of foot

• traverses saphenous opening into fascia lata to empty into femoral vein

• used in coronary bypass grafts

superficial venous drainage of the lower limb: small

• superficial to deep fascia

• small saphenous vein

  • arises from lateral side of foot

• penetrates deep fascia midway up leg & ascends between heads of gastrocnemius muscle

• empties into popliteal vein in popliteal fossa

innervation of the lower limb

• anterior

  • femoral nerve

  • obturator nerve

• posterior

  • sciatic nerve

    • tibial nerve

    • common fibular (peroneal) nerve

femoral nerve

• arises from lumbar plexus

• innervates flexors of the hip & extensors of knee

• located mainly in ant. compt of thigh

obturator nerve

• arises from lumbar plexus

• innervates adductors of hip

• located in medial comp of thigh

sciatic nerve

• arises from sacral plexus

• descends into post. compt of thigh

• 2 comps

  • tibial nerve

    • supplies extensor of hip joint & flexors of knee joint

  • common fibular (peroneal) nerve

    • supplies short head of biceps muscle on post compt of thigh

anterior and medial thigh: fascia

• fascia lata = sleeve-like deep fascia of thigh

• saphenous opening = opening in fascia lata inferior to medial part of inguinal ligament

  • where saphenous and femoral vein unites

iliotibial tract

• IT band

• broad band of fibers = shared aponeurosis of tensor fasciae latae & glut maximus muscles

• extends from iliac tubercle to anterolateral tubercle of tibia

3 compartments of thigh muscles

• anterior, medial, & posterior

• walls formed by fascia lata & intermuscular septa

  • medial, lateral, and posterior septa

femoral triangle

subfascial space inf to inguinal ligament

femoral triangle borders

• inguinal ligament

• adductor longus

• sartorius

femoral triangle roof

fascia lata

femoral triangle contents

• lateral to medial:

• femoral nerve

• femoral artery

• femoral vein

  • great saphenous & profunda femoris

• deep inguinal lymph nodes

innervations of thigh compartments

• ant compt = femoral nerve

  • except psoas part of iliopsoas = L1-L3

• medial compt = obturator nerve

  • except adductor magnus = tibial division of sciatic

• post compt = tibial division of sciatic

  • except short head of biceps femoris = common fibular division

hip joint

• acetabular labrum

• fovea for ligament of head

• ligament of head of femur

• artery to head of femur

• transverse acetabular ligament / acetabular notch

3 major ligaments of hip joint

• iliofemoral ligament

• pubofemoral ligament

• ischiofemoral ligament

fascia of lower leg

• layer of deep fascia covering leg

• continuous w/ fascia of thigh region

• crural fascia

• extensor retinacula (sup and inf)

extensor retinacula

• strong bands of fascia that cover tendons passing from ant compt of leg to foot

• prevent bowstring of tendons

• like wrist tendons

division of compartments of lower leg

• intermuscular septa, interosseous memb, bones & crural fascia sep leg in 3 compts

• anterior, posterior & lateral

innervation of the lower leg

• sciatic nerve

  • arises from sacral plexus

  • descends into post. compt of thigh

• two comps

  • tibial nerve

  • common fibular (peroneal) nerve

arterial supply and venous drainage of leg

• femoral artery continues as popliteal artery posteriorly

• pop artery divides

  • ant. tibial artery

  • post tibial artery

• post tibial artery branches into: fibular artery

• veins = opposite direction

popliteal fossa boundaries

• diamond-shaped space post. to knee

• borders:

  • biceps femoris

  • semimembranosus

  • heads of gastrocnemius

• roof

  • popliteal fascia

    • covers back of knee

contents of popliteal fossa

• passageway for structures from thigh to leg

• contents

  • termination of small saphenous vein

  • popliteal vein

  • popliteal artery

  • tibial nerve

  • common fibular nerve

knee joint

• 2 femorotibial articulations

  • lateral and medial

  • between lateral and medial femoral and tibial condyles

• 1 femoropatellar articulation

• fibula does not participate in articulations

menisci

• medial and lateral

• crescent shaped cartilage on tibia that strengthen joint and act as shock absorbers

  • keep distal part of femur in place

medial collateral ligament

medial epicondyle of femur to superior tibia

lateral collateral ligament

lateral epicondyle of femur to head of fibula

cruciate ligaments

• cruciate = cross one another

• anterior & posterior

• join femur & tibia

  • crossing in their paths

compartment syndrome

• devastating lower extremity condition where compt pressure rises to a level that decreases perfusion of leg

  • blood flow & nerve signaling cut off from inflammation

• may lead to irreversible muscle & neurovascular damage

• treatment = emergent fasciotomy

osteology: tarsals

• talus

• calcaneus

• cuboid

• navicular

• cuneiforms

  • medial (1st)

  • intermed (2nd)

  • lateral (3rd)

talus

• superior surface: trochlea of talus

• articulates w/ tibia & fibula

  • only foot bone that articulates w/ bones in limb

• articulates w/ navicular

calcaneus

• articulates w/ cuboid

• contains groove for flexor hallucis longus tendon

  • wraps around calcaneus

tarsals acronym

• Tiger

  • talus

• Cubs

  • calcaneus

• Need

  • navicular

• MILC

  • medial cune

  • intermed cune

  • lateral cune

  • cuboid

phalanges

• hallux = digit 1 = great toe

  • only proximal and distal phalanges

• digits 2-5

  • proximal, middle, and distal phalanges

sesamoid bones of great toe

• two pea-shaped bones located in the ball of the foot

  • beneath the big toe joint

• acts as pulley for tendons

  • help big toe move normally

  • provide leverage when big toe pushes off during walking & running

hindfoot

• calcaneus

• talus

midfoot

• cuboid

• navicular

• cuneiforms (3)

forefoot

• metatarsals

• phalanges

foot fascia

• dorsal fascia

  • contin w/ crural fascia (inf. extensor reticulum)

• plantar aponeurosis: thick central part of plantar fascia

  • extends from calcaneus to phalanges

  • continuous w/ fibrous digital sheaths that enclose flexor tendons

• medial plantar fascia

• lateral plantar fascia

foot compartments

• medial

• central

• lateral

• sole = medial, central, lateral

• interosseous

• dorsal

medial foot compt

• part of sole of foot

• muscles that control hallux

• covered by medial plantar fascia

• (pink outline)

central compt of foot

• part of sole of foot

• muscles controlling lateral four digits

• covered by plantar aponeurosis

• (blue/green outline)

lateral compt of foot

• part of sole of foot

• muscles controlling 5th digit

• covered by lateral plantar fascia

• (orange/red outline)

interosseous compt of foot

• muscles that contrib to movement of lateral 4 digits

• (pink outline)

dorsal compt of foot

• muscles contrib to extension of digits

• (green outline)

nerves of foot (main)

• tibial nerve divides posterior to medial malleolus into

  • medial plantar nerve

  • lateral plantar nerve

• 2 nerves innervate all intrinsic foot muscles except dorsal compt

nerves of foot (dorsal)

• deep fibular nerve

• passes from ant. compt of leg to dorsum of foot

• innervates 2 extensor muscles of toes in dorsal compt

arterial supply of foot (dorsal)

• from ant. part of leg

• anterior tibial artery continues as dorsalis pedis artery

  • branches into lateral tarsal artery

  • runs laterally

• both arteries come tg to feed arcuate artery

arterial / nervous supply of foot (plantar)

• sole of foot supplied by posterior tibial artery

• branches into:

  • medial plantar artery

  • lateral plantar artery

• nerves = corresponding names

ankle joint

• located between distal ends of tibia & fibula & sup. part of talus

  • only tibia and fibula articulate w/ talus (of leg bones)

• trochlea = articulates w/ rounded superior surface of talus

major ligaments of the ankle

• medial (deltoid) ligament of ankle

  • connects tibia to tarsals

• lateral ligament of ankle

  • connects fibula to tarsals

orientation of the cranium

• inf margin of the orbit

• sup margin of the external acoustic opening of the external acoustic meatus

number of bones in the cranium

• contains 22 bones

• 6 singular bones at midline

• 8 sets of paired bones that are bilateral

• majority are fused at suture joints

  • immobile joints

neurocranium

• bony case of the brain, membranous coverings, & cranial meninges

• formed by series of 8 bones

  • 4 singular bones centered on midline

    • frontal, ethmoid, sphenoid, occipital

  • 2 sets of bones occurring as bilateral pairs

    • temporal and parietal

viscerocranium

• forms the ant. part of cranium

• consists of bones surrounding the mouth (upper & lower jaws), nose/nasal cavity, & most of the orbits

• consists of 15 irregular bones

  • 3 singular bones centered on or lying in the midline

    • mandible, ethmoid, vomer

  • 6 bones as bilateral pairs

    • mandible, inferior nasal conchae, zygomatic, palatine, nasal, & lacrimal bones

anterior (facial) aspect of cranium

• frontal & zygomatic bones

• orbits

• nasal region

• maxillae

• mandible

frontal bone

• forms skeleton of forehead

• articulates inf. w/ nasal & zygomatic bones

• intersection of frontal & nasal bones = nasion

  • bridge of nose

nasion

bridge of nose

zygomatic bones

• = cheek bones, malar bones

• forms prominences of cheeks

• lies on inferolateral sides of orbits

• rest on maxillae

maxillae

• form upper jaw

• supporting bone for maxillary teeth

• maxillae surround most of piriform aperture

  • forms infra-orbital margins medially

• infra-orbital foramen

  • inf to each orbit for passage of infra-orbital nerve & vessels

mandible

• only moveable bone in skull

• U-shaped bone that supports mandibular teeth

• consists of horizontal (body) and vertical (ramus) parts

• mental foramina

  • mental nerves & vessels

• mental protuberance

  • forms prominence of chin

  • triangular bony elevation inf. to mandibular symphysis

lateral aspect of cranium

• includes lateral aspects of frontal, parietal, zygomatic, sphenoid bones & temporal bones

• temporal fossa

  • bounded sup. & post. by sup & inf temporal lines

  • bounded ant. by frontal & zygomatic bones

  • bounded inf. by zygomatic arch

• zygomatic arch

  • anterolateral projection of temporal bone & lateral aspect of zygomatic

lateral aspect of cranium (temporal bone)

• external acoustic meatus opening

  • entrance to external acoustic meatus (canal)

  • leads to tympanic membrane (eardrum)

• mastoid process

  • postero-inf to external acoustic meatus opening

• styloid process

  • anteromedial to mastoid process of temporal bone

  • slender needle-like, pointed projection

pterion

• part of lateral aspect of cranium

• ant. part of temporal fossa

• 3-4 cm sup. to midpoint of zygomatic arch

• usually indicated by H-shaped formation of sutures that unite frontal, parietal, sphenoid, & temporal bones

• pterion fracture

  • can be life-threatening

  • rupture of branches of middle meningeal artery & epidural hematoma

occipital aspect of cranium

• post or occipital aspect of cranium

• composed of occipital bone, parts of parietal bones, mastoid parts of temporal bones

• external occipital protuberance

  • easily palpable in median plane

• sup. nuchal line

  • marks sup. limit of neck

  • extends laterally from each side of external protuberance

• lambda

  • jxn of lamboid & sagital sutures

    • can be palpated

sup. aspect of cranium

• coronal suture

  • separates frontal and parietal bones

• sagittal suture

  • separates parietal bones

• bregma

  • landmark formed by intersection of sagittal & coronal sutures

• vertex

  • most sup part of cranium

external surface of cranial base

• cranial base = basicranium

• inf portion of neurocranium & viscerocranium

  • minus mandible

external surface of cranial base (part 1)

• incisive fossa

  • post. to central incisor teeth

• mandibular fossae

  • accommodate mandibular condyles when mouth is closed

• foramen magnum

  • major structures like spinal cord pass thru

contents of foramen magnum

• spinal cord

• meninges

• vertebral arteries

• ant. & post. spinal arteries

external surface of cranial base

• occipital condyles

  • how cranium articulates w/ vert column

• jugular foramen

  • large opening between occipital & temporal bone

• entrance to carotid canal

• stylomastoid foramen

jugular foramen contents

• internal jugular vein

• cranial nerves (CN 9-11)

occipital condyles

articulates cranium w/ vert column

carotid canal contents

internal carotid arteries

stylomastoid foramen contents

• facial nerve (CN VII)

internal surface of cranial base

• 3 large depressions at dif levels

  • anterior

  • middle

  • posterior

• form bowl-shaped floor of cranial cavity

  • space enclosed w/in neurocranium occupied by brain

anterior cranial fossa

• occupied by inf & ant parts of frontal lobes

• cribriform plate of ethmoid bone

  • has numerous tiny foramina = transmit olfactory nerves (CN 1) branches

    • from olfactory areas of nasal cavities to olfactory bulbs of brain

middle cranial fossa contents

• lateral parts support temporal lobes of brain

• hypophysial fossa (pituitary fossa)

• foramina

  • optic canals

  • foramen lacerum

  • sup. orbital fissure

  • foramen rotundum

  • foramen ovale

  • foramen spinosum

hypophysial fossa (pituitary fossa)

• median depression in body of sphenoid

• accommodates pituitary gland

optic canals

optic nerves (CN II) & ophthalmic arteries

foramen lacerum

• contains internal carotid artery

• continuous w/ carotid canal

  • dif name than exit

superior orbital fissure

• ophthalmic nerve (CN V1) → 1st branch of CN V

• also CN III, IV, and VI

foramen rotundum

maxillary nerve (CN V2)

foramen ovale

mandibular nerve (CN V3)

foramen spinosum

meningeal branch of CN V3