Notes on Lower Extremity Bones

Lower Extremity Bones

Pelvis

  • Composed of the following bones:

    • 22 Innominate Bones: Also known as os coxae or hip bones.

      • Ilium: The largest and most superior part of the innominate bone.

        • Iliac Crest: The superior border of the ilium.

        • Iliac Fossa: The large, smooth, concave surface on the inner side of the ilium, forming the entire body of the ilium.

        • Anterior Superior Iliac Spine (ASIS): A prominent projection at the anterior end of the iliac crest.

        • Anterior Inferior Iliac Spine (AIIS): Located inferior to the ASIS.

        • Posterior Superior Iliac Spine (PSIS): A prominent projection at the posterior end of the iliac crest.

        • Posterior Inferior Iliac Spine (PIIS): Located inferior to the PSIS.

        • Greater Sciatic Notch: A large indentation inferior to the PSIS, through which blood vessels and nerves pass.

        • Lesser Sciatic Notch: A smaller indentation located below the ischial spine.

        • Ischial Spine: A sharp projection dividing the greater and lesser sciatic notches.

      • Ischium: The inferoposterior part of the innominate bone.

        • Ischial Tuberosities: The rough, bony prominences, often referred to as the "sit bones."

        • Obturator Foramen: A large hole in the middle of the innominate bone, largely covered by a membrane.

        • Ramus of Ischium: A part of the ischium that extends medially.

      • Pubis: The anteroinferior part of the innominate bone.

        • Superior Pubic Ramus: Part of the pubis extending superiorly.

        • Inferior Pubic Ramus: Part of the pubis extending inferiorly.

        • Pubic Tubercle: A small projection that divides the superior and inferior rami of the pubis.

        • Pectineal Line: A ridge on the superior ramus of the pubis.

    • Sacrum: A large, triangular bone at the base of the spine, formed by the fusion of five sacral vertebrae.

    • Coccyx: The tailbone, a small triangular bone at the end of the sacrum.

  • Femoral Acetabular Joint: The hip joint, formed by the articulation of the head of the femur with the acetabulum of the innominate bone.

Femur

  • Head of Femur: The spherical proximal end that articulates with the acetabulum.

  • Neck of Femur: The constricted region connecting the head to the shaft.

  • Anterior Intertrochanteric Line: A ridge on the anterior aspect of the femur, connecting the greater and lesser trochanters.

  • Posterior Intertrochanteric Crest: A prominent ridge on the posterior aspect of the femur, connecting the greater and lesser trochanters.

  • Greater Trochanter: A large, irregular quadrilateral eminence at the upper part of the femur, serving as an attachment for various muscles.

  • Lesser Trochanter: A conical eminence projecting from the posteromedial part of the base of the femoral neck, serving as an attachment for the iliopsoas muscle.

  • Gluteal Tuberosity: A roughened ridge on the posterior surface of the femoral shaft, where the gluteus maximus muscle inserts.

  • Pectineal Line: A ridge on the posterior aspect of the femoral shaft, medial to the gluteal tuberosity.

  • Shaft: The long, central part of the femur.

  • Abductor Tubercle: A small indent on the medial side of the distal femur, specifically on the medial epicondyle.

  • Epicondyles: More pointy projections located medially and laterally above the condyles, serving as attachment points for ligaments and muscles.

  • Condyles: The entire smooth, rounded bottom portion of the distal femur (medial and lateral condyles) that articulate with the tibia.

Patella

  • Base: The top, wider portion of the patella.

  • Apex: The bottom, pointy portion of the patella.

  • Articulation: The patella articulates with the femur.

  • Function: It is important to note that the patella does not directly make the knee flex and extend; rather, it increases the leverage of the quadriceps femoris muscle.

  • Patellofemoral Joint: The articulation between the posterior surface of the patella and the patellar surface of the femur.

  • Medial and Lateral Borders: The edges of the patella.

  • Posterior Surface: Features two articular facets:

    • Medial Articular Facet: Articulates with the medial condyle of the femur.

    • Lateral Articular Facet: Articulates with the lateral condyle of the femur.

Tibia

  • Tibiofemoral Joint: The articulation between the tibia and the femur, considered the largest joint in the body.

  • Position: Sits more medially than the fibula.

  • Tibial Plateaus: The flat surfaces on the superior aspect of the tibia that articulate with the femoral condyles.

  • Medial Condyle: The larger, medial articular surface of the proximal tibia.

  • Lateral Condyle: The smaller, lateral articular surface of the proximal tibia.

  • Intercondylar Eminence: A raised area between the medial and lateral condyles of the tibia.

    • Medial Intercondylar Tubercle: Part of the intercondylar eminence.

    • Lateral Intercondylar Tubercle: Part of the intercondylar eminence.

  • Tibial Tuberosity: A large, roughened projection on the anterior aspect of the proximal tibia, serving as the attachment site for the patellar ligament.

  • Gerdy's Tubercle: A lateral tubercle on the proximal tibia, serving as the attachment for the iliotibial (IT) band.

  • Tibial Shaft: The long, central part of the tibia.

  • Medial Malleolus: A prominent projection on the medial side of the distal tibia, forming the medial ankle bone.

  • Fibular Notch: An indentation on the lateral side of the distal tibia, where the fibula articulates.

Fibula

  • Position: Sits more laterally than the tibia.

  • Apex: The very top, pointy tip of the fibula (stylus).

  • Head of Fibula: The enlarged proximal end of the fibula, articulating with the lateral condyle of the tibia.

  • Neck: The constricted region inferior to the head.

  • Shaft of Fibula: The long, slender central part of the fibula.

  • Lateral Malleolus: A prominent projection on the lateral side of the distal fibula, forming the lateral ankle bone.

Foot Bones

  • Divisions of the Foot:

    • Hindfoot: Comprises the talus and calcaneus.

    • Midfoot: Comprises the cuboid, navicular, and the three cuneiforms.

    • Forefoot: Comprises all 55 metatarsals and all phalanges.

  • Specific Bones:

    • Talus: The uppermost tarsal bone, articulating with the tibia and fibula to form the ankle joint. It is superficial to the calcaneus.

    • Calcaneus: The heel bone, the largest tarsal bone.

      • Calcaneal Tuberosity: The posterior prominence of the calcaneus, where the Achilles tendon attaches.

      • Sustentaculum Tali: A shelf-like projection on the medial side of the calcaneus, supporting the talus.

      • Peroneal/Fibular Trochlea: A small projection on the lateral aspect of the calcaneus, located between the tendons of the fibularis (peroneus) longus and brevis muscles.

    • Sinus Tarsi: A tunnel or canal located between the calcaneus and the talus, containing ligaments and blood vessels.

    • Navicular: A boat-shaped tarsal bone located on the medial side of the foot, anterior to the talus.

      • Navicular Tuberosity: A prominent projection on the medial aspect of the navicular.

    • Cuneiforms: Three wedge-shaped tarsal bones (medial, intermediate, and lateral cuneiforms), articulating with the navicular posteriorly and the metatarsals anteriorly.

    • Metatarsals: Five long bones in the mid-foot, each consisting of:

      • Base: The proximal end, articulating with the tarsals.

      • Shaft: The body of the metatarsal.

      • Head: The distal end, articulating with the phalanges.

    • First Metatarsal: The shortest and thickest metatarsal.

      • Sesamoid Bones: Two small, pea-shaped bones embedded in the plantar surface (bottom) of the first metatarsal head, near the big toe joint. They aid in movement and protect tendons.

    • Phalanges: The bones of the toes. There are 1414 phalanges in each foot (two in the great toe, three in each of the other toes).