Hip joint Type: Articulating bones:
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1 Ana (242 )
2 Hip joint Type: Synovial, ball & socket Articulating bones: Formed between head of femur and lunate surface of acetabulum of hip bone. Capsule: it is a strong fibrous sleeve connecting the articulating bones. Attachment of capsule: Proximally : ½ cm above labrum acetabluare. Distally: to intertrochantric line anteriorly, and neck of femur So neck of femur is completely inside the capsule from the anterior view, but from the posterior view Only the medial half is inside the capsule while the lateral half is outside the capsule. Function of capsule: Carry the blood supply to the head. Retain the fragmented segments in the fracture neck of femur
3 Ligaments: A. Anteriorly: Iliofemoral ligament (strongest ligament in the body): inverted Y-shaped ligament. It attaches proximally to (AIIS)and distally by two branches to intertrochanteric line. Function: It strengthens the anterior aspect of the capsule. It prevents hyperextension and excessive lateral rotation of the hip joint. Pubofemoral ligament: triangular shaped ligament. It attaches proximally to iliopubic eminence of hip bone and distally to lesser trochanter. Function: It strengthens the inferomedial aspect of the capsule. It prevents over abduction of the hip joint.
4 B. Posteriorly Ischiofemoral ligament: it is weakest ligament of the hip. It arises from posterior inferior margin of the acetabulum, ischium and it twist around the femoral neck. Function: C. Centrally: It screws the femoral head medially into the acetabulum, preventing over medial rotation Ligament of head of femur (round ligament): it is very weak ligament. it is a triangular flat ligament. It arises from fovea of the femoral head to the transverse acetabular ligament. Function: It transmits arteries to the head of femur. It has no role in stabilizing the hip joint.
5 Movements allowed: Flexion: 120 o with flexed knee. Flexion: 90 o with extended knee. Extension: 0 o. Hyper extension 15 o Abduction: 45 o Adduction:30 o Int. rotation: 40 o Ext. rotation: 45 o
6 Knee joint Type: Synovial, modified hinge joint. Bony articulation: Tibiofemoral joint: Formed between lower end of femur and upper end of tibia. Patellofemoral joint: between posterior surface of patella and patellar surface of the lower end of femur. Capsule: It is thin and deficient anteriorly where it is replaced by the quadriceps, patella, and patellar ligament. It is strengthened by expansions from the surrounding muscles: semimembranosus (posteriorly), vastus lateralis and iliotibial band(laterally), and vastus medialis(medially) 6
7 Ligament of knee joint: A. Extracapsular: Tibial (medial) collateral ligament. Fibular (lateral) collateral ligament. Patellar ligament. Oblique popliteal ligament. B. Intracapsular: Anterior cruciate ligament. Posterior cruciate ligament. Medial meniscus. Lateral meniscus. Transverse ligament. Coronary ligament. Function of knee ligaments: Medial collateral ligament: 1. it resist the valgus stresses across the knee joint especially when knee is extended. 2. It control lateral rotation of the tibia. 3. It restricts pure anterior displacement of the tibia when the primary restraint of the anterior cruciate ligament is absent. 4. It resists hyperextension of knee joint as ligament is taut during extension. Function of knee ligaments: Lateral collateral ligament: 1. it resist the varus stresses across the knee joint. 2. It control lateral rotation of the tibia. 3. It restricts pure posterior displacement of the tibia. Anterior cruciate ligament: 1. Prevent the anterior displacement of the tibia on the femoral condyles. 2. It control medial rotation of tibia. 3. It restrains both varus and valgus stresses across the knee. Posterior cruciate ligament: 1. Prevent the posterior displacement of the tibia on the femoral condyles. 2. It restrains both varus and valgus stresses across the knee.
8 Two asymmetric fibrocartilaginous disc-like called menisci or semilunar cartilages are located on the tibial condyles. Each meniscus has : Outer border: thick, convex &fixed to capsule. Inner border: thin, concave& free. Upper surface: is concave for femur. Lower surface: flat attached to peripheral 2/3 of tibial condyles. Anterior horn: attached to ant. Intercondylar area Posterior horn:attached to post. Intercondylar area Note that both menisci are not covered by synovial membrane. the medial meniscus is more likely to be injured as it is more fixed. It is crushed Between condyles when the knee joint is twisted while it is semiflexed and weight Bearing (as during hitting a free kick in foot ball) Menisci of the knee Function of menisci: 1. They deepen the articular surfaces of the tibial condyles. 2. They act as shock absorbers. 3. They increase the elasticity of the joint and assist in its lubrication. 4. They prevent post. Capsule from being entrapped between joint surface.
9 Lateral meniscus Shape: it is nearly closed circuit & smaller than medial meniscus. Attachment: Anteriorly: anterior horn attached to the intercondylar area just behind the ACL. Posteriorly: posterior horn attached to the intercondylar area just anterior to posterior horn of medial meniscus. Mobility: it is more mobile and less liable to injury because it can adapt itself to sudden rotatory movements. Medial meniscus Shape: C-shaped & broader posteriorly than anteriorly. Attachment: Anteriorly: anterior horn attached to most anterior part of the intercondylar area just anterior to ACL. Posteriorly: posterior horn attached to the intercondylar area just anterior to PCL. Mobility: it is more fixed and more liable to injury because it can not adapt itself to sudden rotatory movements.
10 Movement allowed: Flexion: 155 o. Extension: 0 o.
11 Type: synovial, plane joint. Bony articulation: Lateral aspect of the upper end of tibia and head of fibula. Capsule & ligaments: it attached around margins of the articular surface and it strengthened by ant. & post. Tibiofibualr ligaments Movements allowed: sliding movements.
12 Type: fibrous joint. Bony articulation: fibular notch of the lower end of tibia and medial surface of lower part of the shaft of fibula. ligaments: Interosseus tibiofibular ligament (very strong ligament) Anterior tibio-fibualr ligament posterior tibio-fibualr ligament Movements allowed: it is an immobile joint to prevent the separation of the 2 bones under the effect of the body weight
13 It is considered as fibrous joint. It connect the Interosseous borders of tibia & fibula. Its fibers are directed downward and laterally from tibia to fibula. Muscle arising from it: Anteriorly: 4 muscles (tibialis anterior extensor digitorum longus extensor hallucis longus peroneus tertius) Posteriorly: 1 muscles only (tibialis posterior)
14 Ankle joint Type: Synovial, hinge joint Articular surface: Formed between talus and lower end of both tibia and fibula. Capsule: it attached to margins of the articular surface. It is weak in front & behind but thick medially & laterally. Ligaments: Medial ligament of the ankle (deltoid ligament). It is one of the strongest ligament of the body which compensate natural shortening of medial malleolus. It is broad, thick triangular band. It attach superiorly to tip of medial malleolus and inferiorly to navicular bone, medial border of spring ligament, neck of talus, and body of talus. Its attachment to the spring ligament helps to maintain the medial longitudinal ligament by supporting the head of talus.
15 Lateral ligament. It formed of three separate bands: anterior talofibular ligament: weak band extend from anterior border of lateral malleolus to the neck of talus. Calcaneofibular ligament: is strong band extending downwards and backwards from the inferior tip of the lateral malleolus to the lateral surface of calcaneus. Posterior talofibular ligament: is strong band extending from the lateral malleolus to the posterior process of talus.
16 Movement allowed: Dorsiflexion: 20 o. Planterflexion: 45 o.
17 Talo - calcaneo - navicular joint Type: Synovial, modified ball and socket Articular surface: Formed between talus(represent ball), calcaneus and navicular bones (forming socket). Talo- calcanean joint (subtalar joint): Type: synovial plane joint Articular surface: if formed between talus and calcaneus Capsule: it attached to the margins of the articular surface of both bones. Ligament: the most important ligament is interosseous ligament between talus and calcaneous.
18 Calcaneo Cuboid Joint Type: Synovial, saddle. Articular surface: Formed between anterior surface of calcaneous and posterior surface of cuboid. Capsule: it attached around the margins of the articular surface. Ligaments: Inversion : 30 o. Eversion : 20 o.
19 Movement allowed for all three joint : Inversion : 30o. Eversion : 20o.
20 Tarsometarsal joints (TMT): between 3 cuniform, cuboid and base of metatarsal bones(1 st to 5 th ). Metatarsophlangeal joint(mtp) : between the metatarsal heads and proximal phalages for toes Interphalangeal joint of the big toe (IP): between proximal and phalages of big toe. Proximal interphlageal joints (PIP): between proximal phalanges of 4 lateral toes and middle phalanges of 4 lateral toes Distal interphlageal joints (DIP): between middle phalanges of 4 lateral toes and distal phalanges of 4 lateral toes
21 Arches of foot Classifications: Medial longitudinal arch. lateral longitudinal arch. Transverse arch. Function of the arches of the foot: Distribution of body weight on the bones of the foot (all body weight is fallen on the talus, half of weight move backward to calcaneus and remaining half move forward to metatarsal heads). Giving the foot elasticity and resilience during movement. Absorption of shocks when falling on the feet. Adaptation of foot to uneven surface. Protection of planter nerves and vessels
22 Arches of foot 1.Medial longitudinal arch: Formation: Formed by 9 bones (Calcaneus, talus, navicular, 3 cuniforms, medial 3 metatarsal bones). Function: Elastic propulsion of foot during walking. 2.Lateral longitudinal arch: Formation: Formed by 4 bones (Calcaneus, cuboid, lateral 2 metatarsal bones). Function: Transmission of body weight 3. Transverse arch: Formation: Formed by 4 bones (cuboid, 3 cuniforms, base of metatarsal bones). Function: Transmission of body weight Elastic propulsion of foot during walking. 22 Ana (242 )
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