Ms 19: Osteology Of The Pelvis And Lower Limb

Front 1

Label this diagram

Back 1

Front 2

Find these on the following diagram (or bone):
1. Ilium:
- Ala
- Iliac fossa
- Anterior superior & inferior iliac spines
- Iliac crest
- Posterior superior & inferior iliac spines
- Tubercle of iliac crest
- Greater sciatic notch
- Arcuate line
- Gluteal lines posterior, anterior, inferior
- Tuberosity of ilium
- Auricular surface

2. Ischium:
- Body of the ischium
- Ramus of the ischium
- Ischiopubic ramus
- Obturator foramen
- Ischial spine
- Greater sciatic notch
- Lesser sciatic notch
- Ischial tuberosity

3. Pubis:
- Body of pubis
- Superior ramus
- Pectineal line (pecten pubis )
- Inferior ramus
- Pubic crest
- Pubic tubercle
- Pubic arch

Back 2

Front 3

Where do the bones of the hips come together and describe this in a juvenile

Back 3

- Ilium, ischium and pubis meet together at the acetabulum
- In the juvenile these bones are separated by a tri-radiate cartilage which appears like a Mercedes sign
- The bones fuse around that ages of 20-25 years

Front 4

Label this diagram

Back 4

1 acetabular notch
2 acetabulum
3 anterior gluteal line
4 aiis
5 asis
6 body of ilium
7 body of ischium
8 body of pubis
9 greater sciatic notch
10 iliac crest
11 iliopubic eminence
12 inferior gluteal line
13 inferior ramus of pubis
14 ischial spine
15 ischial tuberosity
17 lesser sciatic notch
19 obturator foramen
20 pectineal line
21 posterior gluteal line
23 auricular surface
24 pubic tubercle
25 ramus of ischium
27 superior ramus of pubis
28 tubercle

Front 5

How is the ischial tuberosity palpated?

Back 5

- Gluteus maximus covers the ischial tuberosity so to palpate it, the hip must be flexed similar to sitting
- The ischial tuberosity can get sore if sit down for too long → Paddler's bottom

Front 6

Label this diagram

Back 6

1 aiis
2 asis
3 arcurate line
4 auricular surface
5 body of ischium
6 body of pubis
7 greater sciatic notch
8 iliac crest
9 iliac fossa
10 iliac tuberosity
11 iliopubic eminence
12 ischial spine
13 ischial tuberosity
15 lesser sciatic notch
18 pectineal line
21 pubic crest
22 tubercle

Front 7

Labels these on a model:
- Head of femur
- Neck
- Greater and lesser trochanters
- Intertrochanteric line
- Intertrochanteric crest
- Trochanteric fossa
- Linea aspera
- Gluteal tuberosity
- Pectineal line
- Supracondylar lines
- Intercondylar fossa
- Femoral condyles
- Patella surface
- Epicondyles
- Adductor tubercle

Back 7

Front 8

Label this diagram

Back 8

2 Greater trochanter
3 head of femur
4 intertrochanteric line
5 lesser trochanter
6 neck of femur
9 shaft of femur

Front 9

Label this diagram

Back 9

2 Greater trochanter
3 head of femur
4 intertrochanteric line
5 lesser trochanter
6 neck of femur
9 shaft of femur

Front 10

Label this diagram

Back 10

2 gluteal tuberosity
3 greater trochanter
4 head of femur
5 intertrochanteric crest
8 lesser trochanter
9 linea aspera
11 femoral neck
12 quadrate (adductor) tubercle
13 spiral line (linea aspera)
134 trochanteric fossa

Front 11

Label this diagram

Back 11

1 iliac crest
2 iliac tubercle
3 ASIS
4 superior ramus pubis
5 pubic tubercle
6 symphysis pubis
7 body of pubis
8 inferior ramus
9 head of femur
10 lesser trochanter

Not that the joiunt is about 1/2 way along the inguinal ligament and inferior

Front 12

Label this diagram

Back 12

2 gluteal tuberosity
3 greater trochanter
4 head of femur
5 intertrochanteric crest
8 lesser trochanter
9 linea aspera
11 femoral neck
12 quadrate (adductor) tubercle
13 spiral line (linea aspera)
134 trochanteric fossa

Front 13

Label this diagram

Back 13

1 iliac crest
2 iliac tubercle
3 ASIS
4 superior ramus pubis
5 pubic tubercle
6 symphysis pubis
7 body of pubis
8 inferior ramus
9 head of femur
10 lesser trochanter

Note: the iliofemoral joint is about 1/2 way along the inguinal ligament and inferior

Front 14

Describe the parts of the femur bone

Back 14

Front 15

Label this diagram
What is Bryant's Triangle and what is its significance?

Back 15

1 ilium
2 ASIS
3 AIIS
4 PSIS
5 PIIS
6 ischial spine
7 iliopubic eminence
8 body of pubis
9 head of femur
10 greater trochanter
11 shaft

- Bryant's triangle = ABC
- This is constructed with the patient supine as a rough means of detecting disturbance of the normal anatomy of the femoral head and neck
- Pathology of the femoral head or neck which displaces the greater trochanter (e.g. fracture) will tend to shorten BC

Front 16

Label this diagram
What is Bryant's triangle and why is it clinically significant?

Back 16

1 ilium
2 ASIS
3 AIIS
4 PSIS
5 PIIS
6 ischial spine
7 iliopubic eminence
8 body of pubis
9 head of femur
10 greater trochanter
11 shaft

- Bryant's Triangle = ABC
- This is constructed with the patient supine as a rough means of detecting disturbance of the normal anatomy of the femoral head and neck
- The length of C is gauged on each side, and the sides compared. Pathology of the femoral head or neck which displaces the greater trochanter will tend to shorten the BC side

Front 17

Describe the distal end of the femur

Back 17

Front 18

Label this diagram

Back 18

1 adductor tubercle
5 lateral condyle
6 lateral epicondyle
8 medial condyle
9 medial epicondyle

Front 19

Label this diagram

Back 19

1 adductor tubercle
4 intercondylar fossa
5 lateral condyle
6 lateral epicondyle
7 lateral condylar line
10 medial supracondylar line
12 popliteal surface

Front 20

Describe the anatomy of the patella

Back 20

- Sesamoid Bone
- Articulates with femoral condyles
- Usually has a smooth articular side which may become pathologically roughened (quandramalasia patella) and cause pain walking up and down stairs
- Quadriceps muscles pass over the patella into the tibial tuberosity
- Patella slides up and down in its groove and may dislocate laterally in juveniles if the medial quadratus is too weak to pull the patella correctly

Front 21

Find these on a tibia:
- Medial & lateral condyles
- Intercondylar area
- Intercondylar eminence
- Tibial tuberosity
- Soleal line
- Medial, lateral & posterior surfaces
- Anterior, medial & interosseous borders
- Facet for fibula
- Medial malleolus

Back 21

Front 22

Describe the shaft of the tibia

Back 22

- 3 borders - anterior, medial and interosseous
- 3 surfaces = medial, lateral and posterior

Front 23

Briefly describe the pathology of Osgood-Schlatter's disease

Back 23

- Pain over the tibia tuberosity with overuse of the quadriceps muscles during the growing phase
- Usually in young males
- Can get necrosis and avulsion of tendon

Front 24

Describe the proximal tibia

Back 24

Front 25

Label this diagram

Back 25

1 Anterior border
4 Anterolateral tibial (Gerdy) tubercle important for attachment of iliotibial tract
5 Interosseous border
6 Lateral condyle
7 Lateral surface
8 Medial border
9 Medial condyle
10 Medial surface
13 Intercondylar eminence tubercles
14 Tibial tuberosity

Front 26

Label this diagram

Back 26

2 Articular facet for fibula
3 Groove for semimembranosus
5 Inter-osseous border
6 Lateral condyle
8 Medial border
9 Medial condyle
11 Posterior surface
12 Soleal line
13 Inter-condylar eminence tubercles
15 Vertical line

Front 27

Describe the features of the proximal fibula

Back 27

- No weight-bearing function so the shaft can be used for bone grafts
- Lateral collateral ligament inserts into its head
- Common peroneal nerve wraps around the neck of the fibula to beomce superficial in the anterior compartment of the leg → commonly injured e.g. when hit by car

Front 28

Label this diagram of the posterior proximal fibula

Back 28

1 apex of head –styloid process
4 head of fibula
8 lateral condyle of tibia
12 superior tibiofibular joint

Front 29

Label this diagram of the posterior distal tibal and fibula

Back 29

3 articular facet
6 inferior tibiofibular joint
9 lateral malleolus
10 malleolus fossa
11 medial malleolus

Front 30

Describe the bones of the foot

Back 30

- 7 tarsal bones = calcaneus, talus, navicular, cuboid, medial, intermediate and lateral cuneiforms
- Talus has a head, body and neck, articulates with the tibia at the trochlea (or body) of the talus, and articular processes either side articulate with the malleoli of the tibia and fibula
- Only the head of the talus can be seen from the inferior surface of the foot

Front 31

Label this diagram

Back 31

4 calcaneus
5 cuboid
13 head of 1st metatarsal
14 head of talus
15 intermediate cuneiform
16 lateral cuneiform
19 medial cuneiform
23 navicular
24 neck of talus
28 shaft of 1st metatarsal
31 tuberosity of 5th metatarsal
33 tuberosity of navicular

Front 32

Label this diagram

Back 32

1 anterior tubercle of calcaneus
4 calcaneus
5 cuboid
8 groove flexor hallucis longus
9 groove for peroneus longus
14 head of talus
15 intermediate cuneiform
16 lateral cuneiform
19 medial cuneiform
23 navicular
29 talar shelf
31 tuberosity base 5th metatarsal
33 tuberosity of navicular

Front 33

Label this diagram

Back 33

1 calcaneal tubercle
2 cuboid
3 1st metatarsal
4 head of talus
10 medial cuneiform
11 talus
13 calcaneus
15 navicular
16 neck of talus
18 sustentaculum tali
20 tuberosity of 5th metatarsal