JOINTS OF LOWER LIMB

By

Dr.Pardeep Kumar

JOINTS OF LOWER LIMBJoints 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

Articulation: symphysial surface and interpubic disc (fibrocartilage)

Ligaments: superior pubic ligament and arcuate pubic ligament

Obturator membrane obturator canal

BONY PELVISComposition: 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 PELVISFemale Male

Pelvic inlet

Pelvic outet

Pelvic cavity

Pubic arch90~1000

70~750

MAIN DIFFERENCE BETWEEN MALE AND FEMALE PELVIS

Male Female

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

Transverse acetebular lig.

Ligament of head of femur

Acetabulum labrum

Iliofemoral lig.

Ischiofemoral lig.

Pubofemoral 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.

Patellar lig.

Fibular collateral lig. Tibial

collaterallig.

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

lateralMedial

Tibiofibular syndesmosis

Tibiofibular joint interosseous

membrane Anterior and posterior

tibiofibular ligaments

JOINT OF FOOTTalocrural 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

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

THANK YOU VERY MUCH