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We will try to review the anatomy of the lower limb with a more familiar and practical approach then we have been used to. We will do our best to keep.

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Presentation on theme: "We will try to review the anatomy of the lower limb with a more familiar and practical approach then we have been used to. We will do our best to keep."— Presentation transcript:

1 We will try to review the anatomy of the lower limb with a more familiar and practical approach then we have been used to. We will do our best to keep in mind that we are addressing technicians / orthoprosthetists and their work related for this part of the theory. LOWER LIMB ANATOMY

2 OSTEOLOGY Bones of the body ARTHROLOGY Junctions of bones in the body & joints elements [ligaments, tendons, fibrocartilaginous structure (shock absorber), capsule synovial (lubrication)] MYOLOGY Muscles PHYSIOLOGY Movements at the joints LOWER LIMB ANATOMY

3 OSTEOLOGY_LOWER LIMB

4 The human foot is composed of 26 individual bones divided in 3 groups TARSAL (7 bones)  Calcaneus  Talus  Cuboid  Navicular  3 Cuneiforms METATARSAL (5 bones)  5 Metatarsals PHALANGES (14 bones):  3 for the 2nd, 3rd, 4th and 5th  2 for the 1st FOOT BONES (26 Bones+2 Sesamoids) & 2 Sesamoids

5 FOOT BONES (26 Bones+2 Sesamoids) Talus Calcaneus Cuboid Navicular Cuneiforms Metatarsals Distal Phalanx Middle Phalanx Proximal phalanx DORSAL VIEW

6 Talus Calcaneus Navicular Cuboid Cuneiforms Metatarsals Sesamoids Phalanges PLANTAR VIEW FOOT BONES (26 Bones+2 Sesamoids)

7 Talus Calcaneus Cuboid Cuneiforms Navicular Metatarsals Phalanges LATERAL VIEW FOOT BONES (26 Bones+2 Sesamoids)

8 Talus Calcaneus Cuneiforms Navicular Metatarsals Phalanges MEDIAL VIEW FOOT BONES (26 Bones+2 Sesamoids)

9 Tarsometatarsal Lisfranc Amputation Midtarsal (Transverse tarsal) (Preserve the Talus & Calcaneum) Chopart Amputation As prosthetist we do come across those two types of amputation which do give problem to fit SOME FAMILIAR FOOT AMPUTATIONS

10 SQUELETTON OF A CHOPART AMPUTATION LATERAL VIEW

11 SHIN (LEG) BONES: TIBIA & FIBULA POSTERIOR VIEWANTERIOR VIEW

12 The Tibia, the main shin bone is connected with: - the femur at the upper extremity. - the fibula and the talus at the lower extremity. The Fibula, located on the lateral aspect of the shin is jointed with: - the tibia proximally - the tibia and talus distally. Reminder : The Fibula is not part of the knee joint SHIN'S (LEG) BONES: TIBIA & FIBULA ANTERIOR VIEW

13 Tibial crest Medial Malleolus Lateral Malleolus Tibial tuberosity Medial tibial flare Head of fibula Gerdi tubercle Important anatomical shin bony references for the ortho Tibial plateau ANTERIOR VIEW

14 Other anatomical shin bony terminologies The upper epiphysis : Tibial Spines Tibial plateau Glenoïd Areas medial and lateral ANTERIOR VIEW

15 The lower epiphysis : Other anatomical shin bony terminologies ANTERIOR VIEW

16 Pirogoff Amputation Syme Amputation SOME FAMILIAR ANKLE AMPUTATIONS Pirogoff Syme

17 THIGH'S BONE: FEMUR POSTERIOR VIEWANTERIOR VIEW

18 Important anatomical thigh bony references + others terminologies Femur head Femur neck Greater trochanter Lesser trochanter Medial Condyle Adductor tubercle Lateral condyle Anterior view Medial epicondyle Lateral epicondyle

19 POSTERIOR VIEW Linea aspera: important muscle insertion area. Medial condyle Lateral condyle Intercondylar Fossa Lesser trochanter Femur head Greater trochanter Medial epicondyleLateral epicondyle Adductor tubercle Important anatomical thigh bony references + others terminologies

20 Upper extremity : upper epiphysis Corpus tibiae Lower extremity : lower epiphysis Others anatomical thigh bony terminologies ANTERIOR VIEW Patellar surface

21 The patella is small flat triangular shape bone with 2 sides: - a posterior side jointed to the femur. - an anterior side on which the Quadriceps Femoris tendon is inserted. PATELLA: NO SHIN NOR THIGH BONE Patella apex (on bottom) Patella base (on top) ANTERIOR VIEW

22 Articulation areas to the femur Condyles Patella apex Patella base POSTERIOR VIEW PATELLA: NO SHIN NOR THIGH BONE

23 Patella base KNEE: WHERE TIBIA, FEMUR & PATELLA MEET POSTERIOR VIEWANTERIOR VIEWSAGITAL CUT VIEW

24 Iliac bone Pubic bone Ischial bone THE THREE PELVIC (COXAL) BONES: ILIUM, PUBIS & ISCHIUM ANTERIOR VIEW

25 Iliac crest Antero Superior Iliac Spine ( ASIS) Cavity Cotyloïd Ischial tuberosity Pubic Tubercle Important hip bony references for the ortho + others terminologies ANTERIOR VIEW

26 Iliac crest Postero Superior Iliac Spine ( PSIS) Cavity Cotyloïd Ischial tuberosity LATERAL VIEW: RIGHT HIP BONE Antero Superior Iliac Spine ( ASIS) Postero Inferior Iliac Spine ( PIIS) Antero Inferior Iliac Spine ( AIIS) Ischiopubic ramus Important hip bony references for the ortho + others terminologies

27 HIP: WHERE FEMUR & COXAL BONES MEET POSTERIOR VIEW ANTERIOR VIEW OPEN JOINT VIEW

28 ARTHROLOGY of LOWER LIMB

29 Fibula Tibia Talus Medial Malleolus 15 to 20 mm higher then the lateral malleolus Lateral malleolus located more posterior than Medial malleolus CORONAL SECTION VIEW ANKLE JOINT 3 BONES

30 Anterior talofibular ligament Calcaneofibular ligament Posterior talofibular ligament Three lateral ligaments of the ankle joint LATERAL VIEW

31 3-Tibiocalcaneal 2-Tibionavicular 1-Posterior Tibiotalar Deltoid ligament Parts of medial (deltoid) ligaments of the ankle joint MEDIAL VIEW

32 This is the largest joint of the body, it allows forward progression of the body, and acts as a shock absorber. It is composed of: The junction of three bones Tibia, Femur & Patella Four main ligaments Lateral (Fibular) collateral ligament Medial (Tibial) collateral ligament Anterior cruciate ligament Posterior cruciate ligament Two meniscus Lateral meniscus ("O" shape) Medial meniscus ("C" shape) KNEE JOINT

33 -Distribute the weight bearing forces over a larger area. -Increase the knee stability. Medial CondyleLateral Condyle Medial Meniscus ( "C" shape) Lateral Meniscus ("O" shape) Anterior Cruciate ligament Posterior Cruciate Ligament Meniscus Main Functions POSTERIOR VIEW

34 Medial Tibial Condyle Lateral Tibial Condyle Medial Meniscus ( "C" shape) Lateral Meniscus ("O" shape) Anterior Cruciate ligament Posterior Cruciate Ligament Meniscus Over Tibia TRANVERSAL VIEW

35 Femur Head of fibula Tibia Medial Condyle Lateral Condyle Medial Meniscus ( "C" shape) Lateral Meniscus ("O" shape) Anterior Cruciate ligament Posterior Cruciate Ligament KNEE: INSIDE VIEW ANTERIOR VIEW (FEMUR FLEXES 90°)

36 Quadriceps femoris Tendon ANTERO-MEDIAL VIEW Some important knee references & terminologies for the ortho Medial (tibial) collateral ligament Patellar Ligament Bursa Tibial Tuberosity Medial Condyle

37 Popliteus Medial head of Gastrocnemius Lateral head of Gastrocnemius Ligamentum Popliteum Femur FibulaTibia Medial (tibial) collateral ligament Lateral (fibular) collateral ligament Semi Membranosus POSTERIOR VIEW Some important knee terminologies for the ortho + others term. Adductor Magnus Tendon

38 HIP JOINT POSTERIOR VIEW ANTERIOR VIEW OPEN JOINT VIEW

39 Meeting of two bones (femur and illiac bone) attached with 5 ligaments. The illiac bone is composed of 3 bones:  illium  ischium  the pubis The acetabulum, cavity concave is located at the junction of these three bones, and connected to the spheric head of femur. The head of femur is rotating inside the acetabulum. The 5 ligaments ensuring the connection between the femur and the illiac bone:  the transverse acetabular ligament  the ligament of the head of the femur (ligamentum Teres)  the iliofemoral ligament ( Y-ligament)  the pubofemoral ligament  the ischiofemoral ligament HIP JOINT

40 Head of femur Neck of the femur Great trochanter Ischial Tuberosity Ligamentum Teres Acetabulum HIP JOINT OPEN JOINT VIEW

41 Great trochanter Ischial Tuberosity Iliofemoral (Y) Ligament HIP JOINT ANTERIOR VIEW Lesser trochanter Antero Inferior Iliac Spine Pubofemoral Ligament

42 HIP JOINT POSTERIOR VIEW Great trochanter Ischial Tuberosity Acetabular Rim Lesser trochanter Ischiofemoral Ligament

43 MYOLOGY of LOWER LIMB

44 MYOLOGY of SHIN Tibialis anterior Peroneus Longus Extensor Digitorum Longus ANTERIOR VIEW

45 Triceps Surae Gastrocnemius  Lateral head  Medial head & Soleus POSTERIOR VIEW MYOLOGY of SHIN Popliteus Tibialis Posterior Flexor Digitorum Longus Calcaneal (Achilles) Tendon Peroneus Longus

46 MYOLOGY of SHIN Gastrocnemius Medial head Gastrocnemius Lateral head Soleus Peroneus Longus

47 MYOLOGY of THIGH & HIP

48 ANTERIOR THIGH MUSCLES Vastus Intermedius is (Behind Rectus Femoris) Sartorius Tensor of Fascia Lata Pectineus Adductors  Longus  Magnus Quadriceps  Rectus Femoris  Vastus Lateralis  Vastus Medialis Gracilis

49 QUADRICEPS MUSCLES Vastus Intermedius is (Behind Rectus Femoris) Vastus Lateralis Vastus Medialis Rectus Femoris

50 Adductor Magnus ADDUCTORS MUSCLES Adductor Brevis Adductor Longus Adductor Magnus

51 ANTERIOR HIP MUSCLES Sartorius Tensor of Fascia Lata Pectineus Adductor Longus Gracilis Psoas Minor Iliopsoas  Iliacus  Psoas Major

52 POSTERIOR THIGH MUSCLES (HAMSTRING) Gracilis Lateral Hamstring Biceps Femoris  Long Head  Short Head Medial Hamstring  Semitendinosus  Semimembranosus

53 POSTERIOR HIP MUSCLES (GLUTEUS) & others Piriformis Gemellus  Superior  Inferior Gluteus Minimus Quadratus Femoris Gluteus Medius (Origin) Gluteus Maximus (Origin) Gluteus Medius (Ending) Gluteus Maximus (Ending) Obturator Internus


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