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Joints of Lower Limb

Joints of Lower Limb. By Dr.Pardeep Kumar. JOINTS OF LOWER LIMB. Joints of pelvic girdle Sacroiliac joint Bones: auricular surface of sacrum and ilium Capsule: very tight and strengthened by ligaments. Vertebropelvic ligaments

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Joints of Lower Limb

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  1. Joints of Lower Limb By Dr.Pardeep Kumar

  2. JOINTS OF LOWER LIMB Joints of pelvic girdle • Sacroiliac joint • Bones: auricular surface of sacrum and ilium • Capsule: very tight and strengthened by ligaments

  3. 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

  4. Pubic symphysis • Articulation: symphysial surface and interpubic disc (fibrocartilage) • Ligaments: superior pubic ligament and arcuate pubic ligament • Obturator membrane obturator canal

  5. BONY PELVIS Composition: 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

  6. 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

  7. Main difference between male and femal pelvis

  8. Main difference between male and female pelvis Male Female Pelvic inlet Pelvic outet Pelvic cavity Pubic arch 90~1000 70~750

  9. Main difference between male and female pelvis

  10. 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

  11. Acetabulum labrum Ligament of head of femur Transverse acetebular lig. • 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

  12. Pubofemoral lig. Iliofemoral lig. Ischiofemoral lig. Zona orbicularis

  13. ★Knee joint • Bones: lower end of femur, upper end of tibia and patella • Articular capsule: superapatellar bursa, deep infrapatellar bursa, ala folds

  14. Fibular collateral lig. Patellar lig. Tibial collateral lig. • Accessory structures • ligaments • Patellar lig. • Fibular collateral lig. • Tibial collateral lig.

  15. Oblique popliteal ligament • Anterior cruciate ligment • Posterior cruciateligament

  16. Medial meniscus(C-shaped) • lateral meniscus(O-shaped) • Movements: flexion and extension; flexed knee joint may be passively rotated through 700 lateral Medial

  17. Tibiofibular syndesmosis • Tibiofibular joint • interosseous membrane • Anterior and posterior tibiofibular ligaments

  18. Joint of foot Talocrural 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

  19. 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

  20. Intertarsal joints • Talocalcaneal joint • Talocalcaneonavicular joint • Calcaneocuboid joint • Tarsometatarsal joints • Intermetatarsal joints • Metatarsophalangeal joints • Interphalangeal joints transverse tarsal joint

  21. 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

  22. Lateral longitudinal arch: formed by calcaneus, cuboid, fourth and fifth metatarsals; cuboid is is the keystone of this arch

  23. 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

  24. Normal arch Flatfoot

  25. THANK YOU VERY MUCH

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