DMI 181 MIDTERM: LOWER EXTREMITY ( FOOT, LEGS, PELVIC GIRDLE)

Phalanges

• 14 on each foot just like the hand

• 1st toe is known as the “great toe” / Hallux

Distal Interphalangeal (DIP) joint

between the distal and middle phalanges

Proximal interphalangeal ( PIP) joint

between the proximal and middle phalanges

MetaTARSALS

• TARSALS TAKES YOU TO THE TOES.

• Sesamoids: Under the 1st metatarsal, two small round bones embedded in tendons

• 5 each foot, 10 total

Metatarsophalangeal (MTP)

between the heads of the metatarsals and bases of the proximal phalanges.

Calcaneus

Also known as “Os calcis,” Most posterior and largest; it forms the heel of the foot. Superior surface is a shelf called Sustentaculum Tali

Talus

Sits on top of the calcaneus; ONLY tarsal bone that participates in forming the ankle bone; smooth upper surface= trochlea. Articulates Tibia, and where achilles attaches

Navicular

Located anterior to the talus, posterior to the cuneiform on the medial

Cuneiforms

3 small bones located anterior to the navicular.

*First ( medial)- articulates with the 1st metatarsal

• Second ( intermediate)- articulates with the 3rd metatarsal

• Third ( lateral)- articulates with the 3rd metatarsal

Cuboid

Located anterior to the calcaneus and posterior to the 4th and 5thmetatarsal on the lateral side of the foot.

Arches

• stable bases and absorbers

Medial longitudinal

• runs along the medial side of the foot ; calcaneus, navicular, cuneiforms, and metatarsals

Lateral longitudunal

• runs along the lateral side; calcaneus, cuboid, and 4th and 5th metatarsals

Transverse

• Cuboid, cuneiforms, and all the metatarsals

Pes planus

flat foot

Tarsometatarsal

between the proximal ends of the metatarsals, cuneiforms, and cuboid, with the bases of the metatarsals.

Intertarsal

between the tarsals

Subtalar

Inferior surface of the talus with the superior surface of the calcaneus. 3 facets: anterior, middle, posterior

Calcaneus tuberosity

Posterior surface of calcaneus

Tuberosity of 5th metatarsal

commonly breaks

Anterior surface Calcaneus

Middle surface Calcaneus

When articulated with the Talus, the Talus will sit superior to the Calcaneus

“ Shelf” of calcaneus

Horizontal shelf that arises from the anteromedial portion of the calcaneus

Talus Articulates with 4 bones

• Inferiorly with Tib + Fib

• Superiorly with Calcaneus

• Anteriorly the Navicular

Hallux Valgus ( bunion)

Bony projection on the joint at the base of the big toe. It grows gradually and your toe turns inward over time.

Hallux

Also known as “ The great toe”, contains distal and proximal phalanges.

Tibia

• Medial side

• Parallel to the fibula; bears weight

• Extends from the knee joint to the ankle joint

Medial Condyle ( Tibia) ( POSTERIOR)

• Medial half of the proximal end

Lateral Condyle ( Tibia) ( POSTERIOR)

Lateral half of the proximal end.

Tibial plateau

Flat superior surface of the condyles.

Intercondylar eminences (tubercles, spine)

Two small projections on top of the tibial plateau

Tibial tuberosity

• Located on the anterior surface, just inferior to the condyles.

• Tendons are attached to it.

Tibial spine

Anterior/ crest

sharp ridge along the anterior surfcae

Medial malleolus

Process that extends inferiorly from the medial side.

Fibular notch

depression on the lateral border from articulation with the fibula.

Tibial plafond

• Fracture at the most distal portion of the tibia

Distal Tibiofibular joint

fibular notch of tibia with lateral malleolus of fibula

Proximal tibiofibular joint

lateral tibia condyle with the head of the fibula ( near the knee)

Fibula

• Lateral to the tibia, parallel to the tibia, under the lateral condyle

• Part of the ankle joint, but does not reach the knee joint

Head of Fibula

upper expanded part on the proximal end

Lateral malleolus

most distal portion

Styloid process ( apex)

process that sits on top of the head

Ankle mortise ( ankle joint, mortise joint)

• Medial malleolus of the tibia

• Lateral malleolus of the fibula

• Superior surface of the talus

Femur

• Extends from the hip to the knee. The longest bone in the body.

Femoral head

• Round structure on the proximal end

• Articulation with the hip

• Sits in the pelvis

Femoral neck

• Lateral to head

Greater Trochanter

• Large prominence superiorly and lateral to the femoral shaft

• Palpable landmark

• MORE PROMINENT POSTERIOR

Lesser trochanter

• Smaller process that projects medially and posteriorly from the junction of the neck and shaft

• MORE PROMINENT POSTERIOR

Tibia and Femur articulate. What about the Fibula?

Fibula does NOT articulate with femur!

Intertrochanteric crest ( FEMUR)

• Line/ ridge of bone between the greater and lesser trochanters on the posterior side.

• POSTERIOR

Medial Condyle

• Rounded process that forms the medial half of the lower femur.

Lateral Condyle

Rounded process on the lateral side of the FEMUR

Intercondylar fossa ( notch)

• Deep depression between the condyles

• POSTERIOR

Patellar surface

• Smooth area between the condyles anteriorly

• Slight depression where the patella sits

• ANTERIOR

• Also referred to as the “trochlear groove surface”

Medial epicondyle

• Small rounded prominence above the medial condyle

Lateral epicondyle

• Small rounded process that sits above the lateral condyle

Popliteal surface

• POSTERIOR

• ABOVE the intercondylar fossa

Patella ( kneecap)

• Flat triangular, 2inch diameter

• Anterior surface convex and rough

• Inner, POSTERIOR surface smooth and oval-shaped

Sesamoid

• attaches to tibial tuberosity by patellar ligament

Apex of Patella

• pointed INFERIOR part

Base

• Pointed SUPERIOR part

Femorotibial joint

• between 2 condlyes of femur and corresponding condyles of tibia

Patellofemoral joint

• patella articulates with anterior surface of distal femur

Condyle of distal femur articulates…

tibia plateau

Fat pads

• located several areas of body.

• protection

• Burst/ calcify when trauma

Articular Capsule

• holds joint together

• Bursa cushions and reduces friction

Fovea Capitis

• Opening in the femoral head where the blood vessels would go in (before fused) to supply blood to the femoral head/ neck

Instep

• raised middle of the top of the foot

Ribs

• 12 pairs, 24 total

• Protect heart

• Attach to costal cartilage—> to sternum

True ribs

• 1-7, direct attachment through their pwn costal cartilage

False Ribs

• 8-10

• Indirect attachment through the cartilage of the rib abovr

Floating ribs

• 11-12

• No anterior attachment to sternum

Tarsals

• 7 each foot, 14 total

Osgood Schlatter

• Condition that causes the tuberosity to separate from the tibia

Sinus Tarsi

• Small, tunnel- like shape located between the talus and calcaneus

• Lateral view

Pelvic Girdle

• Consists of four bones: 2 hip bones ( Os Coxae, Innominate bone), 1 sacrum, 1 coccyx

Acetabulum

• Deep, cup-shaped cavity that accepts the head of the femur to form the hip joint.

• Consists of 3 bones : illium, Pubis, Ischium

illium

• Largest of three, superior to the acetabulum

Wing ( ala)

• Thin, flared-shaped superior part of illium

Body of illium

• Inferior portion near the acetabulum

illiac crest

• upper curved border and most peak of the crest

ASIS

• located at the anterior end of the crest.

• palpable landmark

AIIS (Anterior inferior illiac spine)

• Small process below the AIIS

PSIS (Posterior superior illiac spine)

• Located on the POSTERIOR end of the crest

PIIS ( Posterior inferior illiac spine)

Ischium

• Lies inferior AND posterior to the acetabulum

Body of Ischium

Ramus of Ischium

• Projecting anteriorly from the ischial tuberosity

Ischial tuberosity

• Large rounded process on the POSTERIOR surface on the superior ramus ( lowest part of the pelvis)

• what we sit on

Ischial Spine

• Bony projection posterior to the acetabulum. A small part of it is also visible on a frontal view of the pelvis

Greater sciatic notch

• Directly SUPERIOR to the ischial spine is a deep notch

• Posteriorly, between the PIIS and ischial spine

Lesser sciatic notch

• INFERIOR to the ischial spine is a smaller notch

Pubis/ pubic bone

• Anterior and inferior to the acetabulum and includes the anteroinferior one-fifth of the acetabulum

Superior ramus (pubis)

• Extending anteriorly and medially from the body of each pubis

Symphysis pubis

• midline a cartilage joint between the two superior rami

Inferior ramus ( pubis)

• Passes down and posterior from the symphysis pubis to join the ramus of the respective ischium

Obturator foramen

• A large opening formed by the ramus and body of each ischium and the pubis.

• Largest foramen in the human skeletal system