Joints of Lower Limb By Dr.Pardeep Kumar

Joints of Lower limb Joints of pelvic girdle Sacroiliac joint Bones: auricular surface of sacrum and ilium Capsule: very tight and strengthened by ligaments

Vertebropelvic ligaments Iliolumbal ligament: runs from transverse process of L5 to the posterosuperior part of iliac crest ★ Sacrotuberous ligament: runs from lateral margins of sacrum and coccyx to the inner margin of ischial tuberosity ★ Sacrospinous ligament: runs from ischial spine to lateral margins of sacrum and coccyx These two ligaments convert the sciatic notches the greater and lesser sciatic foramina

Pubic symphysis Obturator membrane obturator canal Articulation: symphysial surface and interpubic disc (fibrocartilage) Ligaments: superior pubic ligament and arcuate pubic ligament Obturator membrane obturator canal

Bony pelvis Composition: formed by paired hip bones, sacrum, coccyx, and their articulations In anatomical position, anterior superior iliac spines and pubic tubercles on same vertical plane, while the tip of coccyx and superior border of pubic symphysis on same horizontal plane Terminal line: formed by promontory of sacrum, arcuate line, pectin of pubis, pubic tubercle, upper border of pubic symphysis

Lesser pelvis pelvic inlet (terminal line): Pelvic outlet : formed by tip of coccyx, sacrotuberous ligament, ischial tuberosity, ramus of ischium, inferior ramus of pubic, symphysis Pelvic cavity Pubic arch, subpubic angle

Main difference between male and femal pelvis

Main difference between male and female pelvis Pelvic inlet Pelvic outet Pelvic cavity Pubic arch 90~1000 70~750

Main difference between male and female pelvis Overall Narrow and long Wide and short Iliac ala More vertical More horizontal Inlet Oval or heart shaped Round Subpubic angle Acute angle (about 70~750) Right angle (about 90~1000) Pelvic cavity Deep narrow Shallower, wide Outlet Small Larger

Joints of free lower limb ★ Hip joint Bones: acetabulum and femoral head Articular capsule attachments Above: margins of acetabulum and transverse acetebular ligament Below: in front to intertrochanteric line; behind, to the neck of femur above 1 cm above the intertrochanteric crest

Accessory structures Acetabulum labrum; transverse acetebular ligament Ligaments Iliofemoral lig. Ligament of head of femur Pubofemoral lig. Ischiofemoral ligament Zona orbicularis:annular ligament is a ligament on the neck of the femur formed by the circular fibers of the articular capsule of the hip join Movement: flexion, extention, adduction, abduction, medial and lateral rotation, circumduction Acetabulum labrum Ligament of head of femur Transverse acetebular lig.

Pubofemoral lig. Iliofemoral lig. Ischiofemoral lig. Zona orbicularis

★Knee joint Bones: lower end of femur, upper end of tibia and patella Articular capsule: superapatellar bursa, deep infrapatellar bursa, ala folds

Accessory structures ligaments Patellar lig. Fibular collateral lig. Tibial collateral lig. Fibular collateral lig. Tibial collateral lig. Patellar lig.

Oblique popliteal ligament Anterior cruciate ligment Posterior cruciateligament

Medial meniscus (C-shaped) lateral meniscus (O-shaped) Movements: flexion and extension; flexed knee joint may be passively rotated through 700 lateral Medial

Tibiofibular syndesmosis Tibiofibular joint interosseous membrane Anterior and posterior tibiofibular ligaments

Joint of foot Talocrural joint (ankle joint) Bones: lower ends of tibia and fibula, trochlea of talus Articular capsule: thin and lax in front and behind, and supported on each side by strong collateral ligaments

Ligments Medial lig. Lateral lig. Anterior talofibular lig. Calcaneofibular lig. Posterior talofibular lig. Movements: dosiflexion (extension) and plantar flexion (flexion); when the ankle joint is fully plantar flexed, small amounts of abduction, and adduction are possible

Tarsometatarsal joints Intermetatarsal joints Intertarsal joints Talocalcaneal joint Talocalcaneonavicular joint Calcaneocuboid joint Tarsometatarsal joints Intermetatarsal joints Metatarsophalangeal joints Interphalangeal joints transverse tarsal joint

Arches of foot Medial longitudinal arch: formed by calcaneus, navicular, three cuneiforms and first to third metatarsal bones, head of talus is the keystone of this arch

Lateral longitudinal arch: formed by calcaneus, cuboid, fourth and fifth metatarsals; cuboid is is the keystone of this arch

Tranverse arch: formed by cuboid, three cuniforms and all metatarsals; the intermediate cuneiform is the keystone of this arch Function: give foot strength stability and resilience; protect plantar vessels and nerves

Normal arch Flatfoot

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