Topic 7: Hip and pelvis. Parts of the hip. Parts of the femur

Transcription

1 Topic 7: Hip and pelvis Parts of the hip Parts of the femur

2 Classifying the hip joint

3 Ball and socket Synovial Multiaxial Movements of the hip: Abduction/adduction Flexion/extension Medial/lateral rotation Articular surfaces of the hip: Acetabulum (lunate surface is covered in hyaline cartilage + acetabular fossa à articulates with the femoral head and neck) Ligaments of the hip:

4 Muscles of the hip Muscle Origin Insertion Action Innervation Image Gluteus maximus Posterior illium, Gluteal tuberosity of Extension of Inferior sacrum + femur hip joint gluteal coccyx Illiotibial tract Lateral rotation

5 Gluteus medius Between anterior & posterior gluteal lines on illium Lateral greater trochanter Abduction Medial rotation Superior gluteal Gluteus minimus Illium between anterior and posterior gluteal lines Greater trochanter of femur (anteriorly) Abduction Medial rotation of hip Superior gluteal

6 Tensor fasciae late Anterior superior iliac spine Anterior part of iliac crest Lateral condyle of tibia Flexes hip joint Stabilisation of hip joint Superior gluteal Posterior thigh muscles

7 Biceps femoris Ischial tuberosity & linea aspera and lateral supracondylar line of femur Lateral side of fibula Flexion of knee joint Rotation of knee when knee is flexed Extension of hip joint Sciatic Semitendinous Ischial tuberosity Medial surface superior part of tibia Extend hip joint Flex knee joint Rotate leg medially when knee is flexed Sciatic

8 Semimembranosus Ischial tuberosity Posterior part of medial condyle of tibia Extend hip joint Flex knee joint Rotate leg medially when knee is flexed Sciatic Medial thigh muscles

9 Adductor magnus Ischial tuberosity Adductor tubercle of femur Extension of hip joint Hip adduction Obturator Tibial

10 Adductor longus Body of pubis Middle linea aspera Adduct hip Obturator

11 Adductor brevis Pubis (body and inferior ramus) Proximal linea aspera Adduct hip Obturator

12 Gracilis Pubis (body and inferior ramus) Medial surface of tibia Adduct hip joint Flex knee joint Medial rotation Obturator Anterior thigh muscles hip flexion & knee extension

13 Sartorius Anterior superior iliac spine Superior medial tibia Flexion of hip Abducts hip Lateral rotation of hip Flexion of knee Femoral Illiopsoas (psoas major + illiacus) LV, SV, IV discs Lesser trochanter of femur Flex thigh/hip Lateral flexion of vertebral column Trunk flexion Lumbar plexus Iliac fossa Lesser trochanter of femur Flex thigh Stabilise hip Femoral Quadriceps femoris à rectus femoris + vastus lateralis + vastus intermedius+ vastus medialis +

14 Rectus femoris Iliac spine + illium superior to acetabulum Patella, tibial tuberosity Extend knee joint Hip flexion Femoral Topic 8: Bones, joints, muscles and movement of the knee and leg: Tibia: Fibula: The articular facet on the head of the fibula is covered in cartilage This forms one of the articulating surfaces within the knee joint (fibula + lateral condyle of tibia) The patella:

15 the patella helps to protect the knee joint when it is exposed when the joint flexes The knee joint: Articular surfaces: Tibiofemoral à medial and lateral condyles of femur articulate with the tibia Patellofemoral à anterior and distal part of femur articulate with the patella Fibula head + tibia Medial and lateral menisci: Menisci are fibrocartilage structures in the knee They deepen the articular surface of the tibia à this increases congruence and stability of the knee joint They act as shock absorbers Ligaments: Patellar ligament à Quadriceps femoris tendon to tibial tuberosity

16 Collateral ligaments Tibial collateral ligament Medial epicondyle femur to medial surface tibia Fibular collateral ligament Lateral epicondyle of femur to lateral surface fibular head Cruciate ligaments Anterior cruciate ligament Anterior intercondylar region of tibia to posteriorly attach on the intercondylar fossa on the femur

17 Posterior cruciate ligament Posterior intercondylar region of tibia to anteriorly attach on the intercondylar fossa on the femur Muscles of the thigh that act at the knee Anterior group: Muscle: Origin Insertion: Innervation: Actions: Image:

18 Sartorius ASIS/superior notch inferior to ASIS Superior medial tibia Femoral Knee flexion Flex, abduct, laterally rotate hip joint

19 Rectus femorali s AIIS Quadriceps tendon to patella Patella via quadriceps tendon Femoral Knee extension Hip flexion

20 Vastus lateralis Greater trochanter/linea aspera Quadriceps tendon to patella Patella via quadriceps tendon Femoral Knee extension Hip flexion

21 Vastus medialis Intertrochanteric line/linea aspera Quadriceps tendon to patella Patella via quadriceps tendon Femoral Knee extension Hip flexion

22 Vastus intermed ius Anterior/lateral femoral shaft Quadriceps tendon to patella Patella via quadriceps tendon Femoral Knee extension Hip flexion Posterior group: (hamstrings) à already on butcher s paper notes

23 Biceps femoris Ischial tuberosity Medial superior tibia Sciatic Knee flexio n

24 Semitendi nosus Ischial tuberosity Medial condyle tibia Sciatic Knee flexio n

25 semimem branosus Ischial tuberosity/lin ea aspera/lateral supracondylar line of femur Lateral fibula head Sciatic Knee flexio n

26 Topic 9: Bones, joints, muscles and movements of the ankle/foot: Tibia/fibula Bone groups in the articulated foot Tarsals Collection of seven bones à calcaneus, talus, cuboid, navicular and 3 cuneiforms

27 Only the talus articulates with the leg bones Proximal group à calcaneus + talus Intermediate group à navicular Distal group à cuboid + cuneiform (lateral, intermedialis + medius) Metatarsals 5 long bones à connect the tarsus and phalanges numbered 1-5 from medial to lateral sides Phalanges 14 phalanges 1 st digit (big toe) has two phalanges digits 2-5 have 3 phalanges Individual tarsal bones and their specific markings Cute Tina Never Could Cooperate Tarsal bone Image: Specific marking Calcaneus à heel bone Calcaneal tubercle Calcaneal tuberosity

28 Talus Head Neck Body (trochlea of talus) Navicular tuberosity Cuboid tuberosity Cuneiform (medial, intermediate, lateral)

29 Parts of metatarsals and phalanges

30 Ankle (talocrural) joint Classification: Synovial Multiaxial Hinge Articular surfaces: Medial malleous (Tibia) + articular facet (fibula) à malleolar mortise (deep socket) Trochlea of talus articulates with the deep socket Ligaments: Deltoid ligament à deltoid is on the medial side of the joint Anterior talofibular à flat, weak band from lateral malleolus to neck of talus

31 Posterior talofibular à thick, strong from malleolar fossa of fibula to talus tubercle Calcaneofibular à round cord from lateral malleolus to calcalneus The other ligaments are on the lateral side of the joint Muscles of the leg Anterior group Tibialis anterior Lateral condyle, superior 2/3 tibia, IM Medial cuneiform 1 st metatarsal base fibular dorsiflexion

32 Extensor hallucis longus Middle anterior fibula, IM Dorsal base of distal big toe phallanx Fibula r Extension great toe Dorsiflexion Extensor digitorum longus Lateral condyle tibia 2/3 Anterior fibula IM Middle/dista l phalanges of other toes Fibula r Dorsiflexion Extension of other toes

33 Peroneus teritius 1/3 anterior fibula IM Doral base 5 th metatarsal Fibula r Dorsiflexion Foot eversion Lateral group Peroneus/fibulari s longus Fibula head 2/3 lateral fibula base 1 st metatarsal medial cuneiform fibular eversion weak plantar flexion

34 Peroneus/fibulari s brevis Middle lateral fibular Dorsal base 5 th metatarsal tuberosity Fibula r eversion weak plantar flexion Posterior group Superficial layer

35 Gastrocnemius Lateral condyle femur Popliteal surface femur Posterior calcaneus via calcaneal tendon Tibial Plantar flexion Knee flexion

36 Soleus Posterior fibula head ¼ posterior fibula medial border tibia Posterior calcaneus via calcaneal tendon Tibial Plantar flexion

37 plantaris interior lateral supracond ylar line femur oblique popliteal ligament Posterior calcaneus via calcaneal tendon Tibial plantar flexion Deep group

38 Tibialis posterior IM Posterior tibia Posterior fibula Tuberosity navicular Cuneiforms Cuboid Bases MT 2-4 Tibial Plantarflexio n at ankle Flexor digitorum longus Medial posterior tibia Fibula via tendon Bases distal phalanges of lateral 4 digits Tibial Flex other toes Plantar flexion

39 Flexor hallcius longus Inferior posterior fibula Inferior IM Base of distal phalanx of big toe Tibial Flexion of big toe Plantar flexion Nerves of the lower limb Nerve Innervates the Image Femoral (lumbar plexus) Quadriceps Sartorius Pectineus Iliopsoas musckes Skin for anteromedial thigh Medial surface of leg and foot Sciatic (sacral plexus) Semimembranosus Semitendinosus Adductor magnus Branch into tibial and fibular s Tibial Posterior leg muscles past knee joint

40 Gastrocnemius Soleus Plantaris Popliteus Flexor hallicus longus Flexor digitorum longus Tibialis posterior Fibula s Anterior leg muscles past knee joint Tibialis anterior Extensor hallicus longus Extensor digitorum longus Fibularis tertius Fibularis longus Fibularis brevis Vessels of the lower limb Vessel Innervates the image

41 Femoral artery/vein thigh

42

43 Tibial artery/vein (anterior) Anterior compartment of leg Tibial artery/vein (posterior) Posterior leg muscles à follows tibial

44 Great saphenous vein Anteromedial aspect of leg Small saphenous vein Posterolateral aspect of leg