Upper and Lower Limbs

Dr. Estrada || August 9, 2016
Lecture Outline:
I. Upper Limb
A. Pectoral Girdle
B. Humerus
C. Radius and Ulna
D. Carpals
E. Metacarpals
F. Phalanges
G. Joints
H. Radiographs
II. Lower Limb
A. Innominate bone
B. Femur
C. Patella
D. Tibia and Fibula
E. Tarsals
F. Metatarsals
G. Phalanges
H. Joints
I. Plantar Arches
J. Radiographs
K. Abnormalities


UPPER LIMB
Multijointed lever that is freely movable on the trunk at
the soulder joint.
Divided into the bones of the shoulder, arm, elbow,
forearm, wrist and hand

PECTORAL GIRDLE

Composed of the clavicle and the scapula
a. Clavicle
- long, slender bone that lies horizontally
across the root of the neck
- acts as strut that holds arm away from trunk
- Transmits forces from upper limb to the axial
skeleton
- Provides attachment for muscles
- Articulations:
1. Medially: with sternum and first costal
cartilage
2. Laterally: Acromion process of the
scapula
Medial two thirds convex forward
Lateral third: concave forward
PARTS:
1. Conoid tubercle – bony prominence on
the inferior surface of the lateral third of
the clavicle; marks insertion of the
conoid ligament
2. Sternal facet – articulating part with the
manubrium of the sternum and first
costal cartilage
3. Subclavian groove – site of attachment
of the subclavius muscle
4. Shaft/body of the clavicle – double
curve in a horizontal plane
5. Deltoid tubercle – lateral 1/3 of clavicle;
origin of deltoid bundle

Trans # 3 [Ace, Lace, James, Jovi, Chelsy]

6.
7.
8.

b.

Trapezoid line – where trapezoid
ligament attaches; the lateral part of the
coracoclavicular ligament
Acromial facet – articulates with the
acromion
Impression of costoclavicular
ligament – inferiorly, at the median
aspect, slightly posterior

Scapula
- flat triangular bone that lies on the
posterior chest wall between the 2nd and
7th ribs
- together with clavicle and head of the
humerus forms the shoulder girdle
PARTS
1. Coracoid process – projects upward
and forward above glenoid cavity; site of
attachment
2. S u p e r o l a t e r a l a n g l e – f o r m s
pearshaped glenoid cavity; articulates
with head of humerus
3. Inferior angle – can be palpated easily;
at level of 7th rib, spine of 7th thoracic
vertebra
4. Suprascapular notch – medial to the
base of the coracoid process
5. Subscapular fossa – anterior surface;
concave and shallow; anterior landmark
6. Spine of scapula – posterior landmark
7. Supraspinous/suprascapular fossa –
origin of supraspinatus muscle
8. Acromion process – forms the
subcutaneous point of the shoulder and
articulates with the acromial end of the
clavicle
9. Glenoid fossa – articulates with head of
humerus
10. Medial border of scapula
11. Lateral border of scapula
12. Neck of scapula
13. Superior border of scapula
14. Superior angle

HUMERUS

bone of the arm

articulates with scapula at shoulder joint

articulates with radius and ulna at elbow joint

1

of

15

bind radius and ulna together e) Ulnar notch – medial surface. lies along interosseus space which is covered by interosseus membrane. Proximal end: with humerus at the elbow joint and with head of radius at radioulnar joint 5.shorter than ulna . Radius and Ulna Anterior (Left) and Posterior (Right) Views 2 of 15 . for articulation with head of radius i) Trochlea – pulley-shaped for articulation with trochlear notch of ulna j) Radial fossa – above the capitulum. proximal end. circular. Distal end with scaphoid and lunate S1 T3 PARTS: 1) Olecranon process – large. attachment of muscles and ligaments h) Capitulum – rounded. Proximal end with humerus at elbow joint 2. Ulna at proximal radioulnar joint 3. Ulna . articulates with glenoid cavity of the scapula b) Anatomic neck – immediately below head and separates it from greater and lesser tubercles c) Greater and lesser tuberosities – below antomic neck. articulation for radius 5) Interosseus border 6) Head – distal. receives coronoid process of ulna l) Olecranon fossa – above trochlea posteriorly. rounded 7) Styloid process – projectin on its medial aspect ! Figure 2. concave upper part − articulates with capitulum and radial notch of ulna b) Neck – underneath head c) Radial/Bicipital tuberosity – distal to neck. Distal end: radius at the distal radioulnar joint . anterior d) Interosseus border – medial. accommodates radial nerve g) Medial and lateral epicondyles – at lower end of humerus. Radius .Excluded from wrist joint by articular disc Figure 1. receives head of radius k) Coronoid fossa – above trochlea anteriorly. articulates with round head of ulna f) Styloid process – distal end of radius. forms prominence of elbow 2) Trochlear notch − notch of olecranon process at the anterior surface − articulates with trochlea of humerus 3) Coronoid process – triangular.Upper and Lower Limbs ! PARTS: a) Head of radius (flat surface) − small. receives olecranon process of ulna m) Lateral supracondylar ridge n) Medial supracondylar ridge RADIUS AND ULNA • Bones of the forearm A. separated from each other by bicipital groove d) Surgical neck – where upper end of humerus joins shaft e) Deltoid tuberosity – roughened elevation at the lateral aspect halfway down the shaft f) Spiral groove – behind and below deltoid tuberosity. projects distally from its lateral margin B. below trochlear notch 4) Radial notch – on lateral surface of coronoid process.Articulations: 4.medial bone of forearm . Humerus (w/ zoomed distal end) PARTS: a) Head of humerus – proximal part.lateral bone of the forearm .Articulations: 1. insertion of biceps.

Carpal bones METACARPALS • 10 bones all in all • Numbered from 1-5 from thumb to little finger (lateral to medial) • First metacarpal bone of the thumb is the shortest and most mobile. except for the thumb (1st) which has only two. Its surfaces are posterior. and Distal S1 T3 ! Figure 5. c. lateral. Sternoclavicular Joint 2. articulate with the proximal phalanges PHALANGES • 28 bones • Each finger has three phalanges.Upper and Lower Limbs CARPALS • Bones of the wrist • 2 rows: proximal and distal rows • 4 bones each row Proximal Row Distal row Scaphoid Trapezium Lunate Trapezoid Triquetral Capitate Pisiform Hamate − − Flexor retinaculum – tissue that covers the anterior surface. forming a roof Carpal tunnel – formed by carpal bones at the floor. and medial. Base: articulates with the distal row of the carpal bones b. Middle. Acromioclavicular Joint • Morphological Classification: Synovial joint • Functional Classification: Plane joint • Articulation: Lateral End of Clavicle ad Acromion of Scapula • Ligaments: Superior and inferior acromioclavicular ligament. • Parts of the 2nd-5th phalanges: Proximal. Shaft: slightly concave forward and is triangular in transverse section. Sternoclavicular Joint • Morphological Classification: Synovial joint • Functional Classification: Saddle joint • Articulation: Sternal end of clavicle and the manubrium sterni and the first costal cartilage • Ligaments: Costoclavicular ligament is a strong ligament that runs from the junction of the first rib with the first costal cartilage covering the articular surfaces • Movements: Forward (anterior) and backward (posterior) movement of the clavicle (medial compartment) and Elevation and depression of the clavicle in the lateral compartment Figure 3. where median nerve passes ! Figure 4. Head: form the knuckles. Coracoclavicular ligament (accessory) • Movements: Gliding movement (when the scapula rotates or when the clavicle is elevated or depressed) 3 of 15 . • Attached to the carpal bones PARTS: a. Metacarpals and Phalanges JOINTS 1.

• The acromion is seen above the head of the humerus and is continuous with spine of the scapula.strengthens the capsule and bridges the gap between the 2 tuberosities) b. Wrist Joint • Morphological Classification: Synovial joint • Functional Classification: Ellipsoid joint • Articulation: Distal end of the radius and the articular disc above Scaphoid. ➢ Movements: abduction. Transverse humeral ligament .passes from the medial epicondyle of the humerus to the medial side of the olecranon o Transverse band . Its function is to protect the superior aspect of the joint a.Upper and Lower Limbs • ! Figure 6. Glenohumeral Joint 4. Movements: Flexion. Intercarpal Joint • Morphological Classification: Synovial joint • Functional Classification: Plane joint • Articulation: Carpal Bones • Movements: Gliding and Sliding Figure 9. Elbow Joint • Morphological Classification: Synovial joint • Functional Classification: Hinge joint • Articulation: Humerus (trochlea &capitulum) with Ulna • (trochlear notch) and Radius (head) Ø Ligaments: S1 T3 RADIOGRAPHS a. separated from the acromion of the scapula by a gap that represents the acromioclavicular joint. Coracohumeral ligament . Medial rotation & circumduction o Lateral ligament .extends between the coracoid process and the acromion. circumduction 6.triangular and attached by its apex to the lateral epicondyle of the humerus and by its base to upper margin of the annular ligament o Medial ligament. extension. Shoulder Joint/ Glenohumeral Joint • Morphological Classification: Synovial joint • Functional Classification: Ball and Socket joint • Articulation: Rounded head of the humerus and the glenoid fossa • Ligaments: Glenohumeral ligaments a. Abduction. 4 of 15 . Intercarpal Joint ! Figure 7.strengthens the capsule above and stretches from the root of the coracoid process to the greater tuberosity of the humerus) c. Shoulder region . Lateral rotation. Coracoacromial ligament (accessory) . and Adduction. Acromioclavicular Joint 3.triangular and consists primarily of 3 strong bands: o Anterior band .passes from the medial epicondyle of the humerus to the medial margin of the coronoid process o Posterior band . adduction.passes between the ulnar attachments of the 2 preceding bands Movements: Flexion and Extension (one axis) 5. Extension.Anteroposterior view • The view shows the outer two thirds of the clavicle. Lunate and Triquetral bones Ø Ligaments: o Anterior and posterior ligaments (strengthen the capsule) o Medial ligaments (attached to the styloid process of the ulna and the triquetral bone) lateral ligaments (attached to the styloid process of the radius and to the scaphoid bone) Flexion.

• The greater part of the scapula is projected behind the upper part of the thoracic cage. • The head. flexor pollicis brevis tendons. Elbow region . Elbow Region . may be recognized by tracing the long axis of the radius superiorly The olecranon and coronoid process of the ulna – may be seen The greater part of the head may be visualized ! d.Lateral view • Elbow joint flexed to 90 degrees • Shoulder joint – adbucted to a right angle S1 T3 Wrist and hand . ! c.Anteroposterior view • Lateral and occipital epicondyles of the humerus – clearly seen • Olecranon and coronoid fossa of the humerus produce an area of transradiancy • A parallel translucent gap extends across the joint between the rounded capitulum and the upper surface of the radius and between the trochlea and coronoid process.Lateral view • The articulation of the radius and the lunate – well shown • The concave distal surface of the lunate articulating with the capitate – seen 5 of 15 . • Lesser tuberosity – seen face on • Bicipital groove – cannot be seen • Surgical neck – well seen • • • • Medial and lateral supracondylar ridges superimposed Medial and lateral epicondyles of the humerus – superimposed. first palmar interosseous muscles – can be recognized • Sesamoid bones overlap the first metacarpophalangeal joint Wrist and hand . b. • The proximal third of the humerus is well visualized Ø Greater tuberosity projects laterally. • The distal row of carpal bones is also seen • Hook of the hamate – small oval area of increased density • Carpus – cartilaginous at birth • Capitate – begins to ossify during the first year • Metacarpal bones and phalanges – may be seen • Sesamoid bones of the abductor pollicis brevis.Posteroanterior view • The distal ends of the radius and ulna. tendons of the adductor pollicis. • The glenoid fossa is not seen in complete profile and is overlapped to a variable extent by the head of the humerus. with their styloid process – seen to extend farther distally than that of ulna • The proximal row of carpal bones is seen with the pisiform bone superimposed on the triquetral bone.Upper and Lower Limbs • The coracoid process of the scapula is seen projecting upward and forward. neck and bicipital tuberosity of the radius – clearly seen • The olecranon and coronoid processes of the ulna are seen • Proximal radioulnar joint can be visualized ! e.

being concave inward in front. and pubis. which is the uppermost and largest bone in the pelvis. ischium. The innominate bone S1 T3 h) i) j) Iliac crest – a long curved ridge along the border of the ilium. concave surface. the acetabulum. the thigh. the knee. which are distinct from each other in the young. and is often altogether lost as it passes downward to the upper part of the greater sciatic notch. palpable Anterior Superior Iliac spine .Upper and Lower Limbs • Pisiform bone – visualized anteriorly and may overlap the scaphoid bone ! 1. it o Anterior Gluteal line − the longest 6 of 15 . where it ends. which is situated near the middle of the outer surface of the bone. 4 cm. walking and running become specialize for locomotion The lower limbs are divided into the hip girdle. and medialward Greater Sciatic notch – above and behind the acetabulum.uppermost. flattened. convex in its general outline but is sinuously curved. the leg. rounded border which runs downward. about 5 cm in front of its posterior extremity − distinctly marked at first. constricted in the center and expanded above and below. • • • LOWER LIMB The primary function of the lower limb is to support the weight of the body and to provide a stable foundation in standing. Gluteal lines – attachment for muscles o Posterior Gluteal line − the shortest − begins at the crest. they articulate with one another anteriorly at the symphysis pubis. forward.below the iliac fossa is a smooth. smooth.corresponds with the posterior extremity of the auricular surface Iliac fossa. but becomes less distinct. • Hip bones articulate with the sacrum at the sacroiliac joints and form the anterolateral walls of the pelvis. below the posterior inferior spine Iliac tubercle . which gives origin to the Iliacus and is perforated at its inner part by a nutrient canal Arcuate line . and together they form the sides and anterior wall of the pelvic cavity. irregularly shaped bone.a large. • Consists of three parts: the ilium. the ankle and the foot.serves for the attachment of the oblique portion of the posterior sacroiliac ligaments and the multifidus Posterior Inferior Iliac spine . concave outward behind. situated at the junction of the crest and anterior border. the union of the three parts takes place in and around a large cup shaped articular cavity. for the attachment of the posterior sacroiliac ligaments and for the origins of the Sacrospinalis and Multifidus. • It meets its fellow on the opposite side in the middle line in front. Table 1. Figure 10.elevated and rough. but are fused in the adult. more prominent in women Anterior Inferior Iliac spine – below a notch (where Sartorius takes origin) and ends in the upper lip of the acetabulum Posterior Superior Iliac spine . from superior iliac spine. The bones of the lower extremity PARTS: Ilium − supports the flank − superior broad and expanded portion which extends upward from the acetabulum a) b) c) d) e) f) g) ! INNOMINATE BONE • a large.

forms one-fifth of the acetabulum. cup-shaped. and joins the inferior ramus of the pubis—the junction being indicated in the adult by a raised line Lesser Sciatic notch . which winds over it S1 T3 ! Figure 12. the inferior crus of the subcutaneous inguinal ring (external abdominal ring). sharp margin. and posterior. also called middle gluteal line o Inferior Gluteal line − the least distinct − begins in front at the notch on the anterior border − ends near the middle of the greater sciatic notch 3. Ischium and Pubis 2. PARTS: Pubis − forms the front of the pelvis and supports the external organs of generation − extends medial ward and downward from the acetabulum and articulates in the middle line with the bone of the opposite side Ischium − the lowest and strongest portion − it proceeds downward from the acetabulum.Upper and Lower Limbs − begins at the crest. forms. viz. and forward 5. The inferior ramus is the thin. PARTS: a) Body .the continuation on the superior ramus pubis of the linea terminalis. the surface of which presents two or three ridges corresponding to the subdivisions of the tendon of the Obturator internus. internal. a large aperture.projects forward. pectin pubis) . it extends from this process to the medial end of the bone e) Pubic tubercle . forming a sharp ridge g) Obturator crest – medial. a medial flattened part and a narrow lateral prismoid portion c) Inferior ramus . hemispherical depression. contributing by its external surface both to the lunate surface and the acetabular fossa b) Superior ramus . curving forward. flattened part of the ischium. forming part of the circumference of the obturator foramen. laterally. prominence in the body. and giving attachment to the obturator membrane ! Figure 11. and the inguinal ligament (Poupart’s ligament) are attached to it. the obturator foramen a) b) c) d) Ischial tuberosity – forms the posterior aspect of the lower part of the body of the bone. Innominate bone (Lateral view) 4. Ilium.is smooth. expands into a large tuberosity.is thin and flattened. Obturator Foramen − A large aperture. surface detaches in sitting position Ischial spine – projects from the posterior border of the ischium and intervenes between the greater and lesser sciatic notches Ischial ramus . it becomes narrower as it descends and joins with the inferior ramus of the ischium below the obturator foramen d) Pubic crest – forms the upper body of the pubis. It passes lateralward and downward from the medial end of the superior ramus.extends from the body to the median plane where it articulates with its fellow of the opposite side. Acetabulum − Point of attachment of the head of femur − Deep.the superior ramus projects downward and backward from the body and presents for examination three surfaces: external. prominence on the body f) Pecten (pectinial line. and gives origin to the Gluteus medius. with the pubis. coated in the recent state with cartilage.. which ascends from the superior ramus. situated between the ischium and pubis 7 of 15 . It is conveniently described in two portions. about 4 cm behind its anterior extremity − ends at the upper part of the greater sciatic notch − the space between the anterior and posterior gluteal lines and the crest is concave. medial to the pubic tubercle. directed downward. and then.

PARTS: Head − Forms about two-thirds of a sphere − Articulates with the acetabulum of the hip bone to form the hip joint b) Fovea Capitis − A small depression along the center of the head − serves as an attachment for the ligament of the head − part of the blood supply to the head of the femur from the obturator artery is conveyed along this ligament and enters the bone at fovea c) Neck − Connects the head to the shaft − Passes downward. − The lateral margin continues below with the lateral supracondylar ridge. triangular area on its posterior surface between the two epicondyles g) PATELLA • Largest sesamoid bone • Triangular in shape • Separated from skin by subcutaneous bursa S1 T3 8 of 15 . j) Lateral and Medial Epicondyles − Found immediately below the two epicondyles − Separated posteriorly by the intercondylar notch / intercondylar fossa. Femur and Patella Gluteal Tuberosity − On the posterior surface of the shaft below the greater trochanter − Site of attachment of the gluteus maximus muscle h) Shaft − Smooth and rounded on its anterior surface − Posteriorly. a deep groove. patellar surface. it has a ridge called Linea aspera to which are muscles attached i) Lower Part of the Femur − The medial margin continues below as the medial supracondylar ridge to the adductor tubercle (small prominence on medial epicondyle) on the medial condyle. k) Popliteal Surface − A flat. the obturator groove. − Anterior surface is joined by an articular surface for patella. superiorly. to which a strong membrane is attached. − Takes part in the formation of the knee joint. backward and laterally − Makes an angle of about 125ᵒ (slightly less in female) with the long axis of the shaft o Size of the angle can be altered by disease o Common site of fractures especially in the elderly d) Greater and Lesser trochanter − Large eminences situated at the junction of the neck and the shaft e) Intertrochanteric Line − Connects the two trochanters anteriorly where the iliofemoral ligamentis attached f) Intertrochanteric Crest − A prominence that posteriorly joins the two trochanters on which an elevation is found. its longest diameter slanting obliquely from before backward − In the female it is smaller. • Articulates below with tibia and the patella to form the knee joint. and more triangular − bounded by a thin. and presents. which runs from the pelvis obliquely medially and downward FEMUR • Thigh bone • Articulates with the acetabulum to form the hip joint. uneven margin. quadrate tubercle a) ! Figure 13.Upper and Lower Limbs − In the male it is large and of an oval form.

Anterior and posterior intercondylar areas − Separates the upper articular surfaces of the tibial condyles − Lies between these areas is the intercondylar eminence − Articulates with the condyles of the femur and the head of the fibula above and with the talus and the distal end of the fibula below. and a shaft. ! Figure 14. Tibia • The large weight-bearing medial bone of the legs. a smaller lower end. • Articulates with the condyles of the femur and the head of the fibula above and with the talus and the distal end of the fibula below.Upper and Lower Limbs 2. where it becomes continuous with the medial malleolus d) Tuberosity − Located at the junction of the anterior border with the upper end of the tibia − Receives the attachment of the ligamentum patellae e) Lateral/Interosseous border − Gives attachment to the interosseous membrane S1 T3 Soleal line − An oblique line located at the posterior surface of the shaft − For the attachment of the soleus muscle − The lower end of the tibia is slightly expanded and on its inferior aspect shows a saddle-shaped articular surface for the talus g) Medial malleolus − Lateral surface articulates with the talus Fibula • A slender lateral bone of the leg • Takes no part in the articulation at the knee joint • Below: forms the lateral malleolus of the ankle joints • Takes no part in the transmission of body weight • Provides attachment for muscles PARTS: a) Head − The upper end − Surmounted by a styloid process − Possesses an articular surface for articulation with the lateral condyle of the tibia PARTS: a) Lateral and medial condyles located at the upper end − aka lateral and medial tibial plateaus − Articulate with the lateral and medial condyles of the femur and the lateral and medial menisci intervening o Lateral condyle ▪ Possesses on its lateral aspect a small circular articular facet for the head of the fibula o Medial condyle ▪ Has on its posterior aspect the insertion of the semimembranosus muscle b) f) b) Shaft − Long and slender − Has 4 borders and 4 surfaces − Medial/Interosseous border ▪ Gives attachment to the interosseous membrane c) Lower end of the femur − Forms the triangular lateral malleolus d) Articular facet − Located on the medial surface of the lateral malleolus − For articulation with the lateral aspect of the talus e) Malleolar fossa − Depression below and behind the articular facet ! 9 of 15 . Patella TIBIA AND FIBULA 1. presenting 3 borders and 3 surfaces − Anterior border forms the shin. c) Shaft − Triangular in cross section. • Has an expanded upper end. − Becomes rounded below.

and in front with the navicular bone possesses a head. • It has six surfaces: o Anterior surface .almost flat. o The sulcus tali and the sulcus calcanei in the articulated foot form a tunnel. Talus.Upper and Lower Limbs Figure 15.5 cm) in front of and below the medial malleolus • it gives attachment to the main part of the tibialis posterior tendon Cuboid Bone • deep groove on the inferior aspect of the cuboid bone • lodges the tendon of the peroneus longus muscle Cuneiform Bones • Composed of three small. and Cuboid bones METATARSALS AND PHALANGES • resemble the metacarpals and phalanges of the hand • each possesses a head distally. a shaft. the peroneal tubercle (small elevation on its anterior part) separates the tendons of the peroneus longus and brevis muscles o Talus • • articulates above at the ankle joint with the tibia and fibula. and a body ➢ Head o directed distally and has an oval convex articular surface for articulation with the navicular bone o articular surface is continued on its inferior surface. o Lateral surface.dominated by two articular facets for the talus. ➢ Neck o lies posterior to the head and is slightly narrowed o upper surface is roughened and gives attachment to ligaments. shelflike process. and a base proximally 10 of 15 . Calcaneum. Navicular. below with the calcaneum. Navicular Bone • tuberosity can be seen and felt on the medial border of the foot 1 in. Navicular. Talus. termed the sustentaculum tali. and its lower surface shows a deep groove. a neck. separated by a roughened groove.possesses a large. (2. the sinus tarsi.forms the prominence of the heel and gives attachment to the tendo calcaneus (Achilles tendon) o Superior surface. where it rests on the sustentaculum tali behind and the calcaneonavicular ligament in front. wedge-shaped bones • articulate proximally with the navicular bone and distally with the first three metatarsal bones • wedge shape contributes greatly to the formation and maintenance of the transverse arch of the foot ! Figure 16. Tibia and Fibula TARSALS • Calcaneum. S1 T3 lateral surface presents a triangular articular facet for articulation with the lateral malleolus of the fibula medial surface has a small. separated by a groove for the flexor hallucis longus tendon.has an anterior tubercle in the midline and a large medial and a smaller lateral tubercle at the junction of the inferior and posterior surfaces o Medial surface. Cuboid. Cuneiform (3) bones • Only the talus articulates with the tibia and the fibula at the ankle joint o o Calcaneum • largest bone of the foot and forms the prominence of the heel • articulates above with the talus and in front with the cuboid.small and forms the articular facet that articulates with the cuboid bone o Posterior surface. which is occupied by the strong interosseous talocalcaneal ligament ➢ Body o Cuboidal o superior surface articulates with the distal end of the tibia. comma-shaped articular facet for articulation with the medial malleolus of the tibia posterior surface is marked by two small tubercles. the sulcus calcanei o Inferior surface. which assists in the support of the talus. convex from before backward and slightly concave from side to side. the sulcus tali.

which possesses only two • o o ! Figure 18. phalanges (superior view) JOINTS OF THE LOWER LIMBS 1. Anterior sacroiliac ligament Iliolumbar ligament Movements Limited ! S1 T3 11 of 15 . ! Figure 17. Tarsals. plays an important role in supporting the weight of the body − head is grooved on its inferior aspect by the medial and lateral sesamoid bones in the tendons of the flexor halluces brevis Fifth metatarsal has a prominent tubercle on its base that can be easily palpated along the lateral border of the foot The tubercle gives attachment to the peroneus brevis tendon • Each toe has three phalanges except the big toe. Sacroiliac joint Classification Symphisis pubis Classification Cartilaginous Articulating bones Pubis ! Pubis Ligaments Superior and inferior pubic ligament Movements Almost no movement Synovial on the anterior Syndesmosis on the posterior Articulating bones Sacrum ! 2 Ilium Ligaments a. metatarsals.Upper and Lower Limbs The five metatarsals are numbered from the medial to the lateral side First metatarsal bone − large and strong . Posterior and interosseous sacroiliac ligament b. Pelvic girdle with Lumbosacral joint (encircled) 2.

Ball and Socket Multiaxial Articulating bones Head of femur ! Acetabulum (ilium. Medial ligament of ankle Movements a. Anterior and posterior cruciate ligaments ! Figure 22. Knee Joint 5. Ligamentum patellae b. Rotation (medial and lateral) ! Figure 21. Calcaneofibular ligament d. Medial rotation e. Acetabulofemoral joint 4. Talocrural Joint 6. Dorsiflexion b. ischium. Plantarflexion ! Figure 20. Pubofemoral ligament c. Oblique popliteal ligament e. Talocrural joint (Ankle joint) Classification Synovial. pubis) Ligaments a. Medial collateral ligament d. Iliofemoral ligament b. Flexion-extension b. Hinge A r t i c u l a t i n g a.Upper and Lower Limbs Figure 19. femur ! patella Ligaments S1 T3 a. Ischiofemoral ligament d. Transverse acetabular e. Pelvic girdle with pubic symphysis (encircled) 3. Knee Joint Classification Synovial. Lateral rotation d. Anterior talofibular ligament b. Ligament head of femur Movements a. Acetabulofemoral joint (Hip joint) Classification Synovial. Posterior talofibular ligament c. Hinge A r t i c u l a t i n g Medial malleolus ! medial surface bones of talus Ligaments a. Medial and lateral condyles of bones femur ! condyles of tibia b. Flexion-extension b. Lateral collateral ligament c. Abduction-adduction c. Subtalar/Talocalcareal joint 12 of 15 . circumduction Movements a.

Cuboid 3. Talus 3.Upper and Lower Limbs Classification Synovial.continuous curve formed by the upper margin of the obturator foramen and Inferior margin of the neck of the femur Knee Joint 13 of 15 . Sacrum and coccyx obscured by pubic symphysis Hip Joint ! Figure 23. Plane RADIOGRAPHS 1. 3 cuneiform S1 T3 ! • 3. Calcaneum 2. Shentons’s Line . 3 cuneiform bones 5. Posterior talocalcaneal ligaments Binds bones together: Interosseous talocalcaneal ligament Movements Inversion Eversion ! • 2. Bases of metatarsal 2. 4th and 5th metatarsal Transverse Arch 1. Pelvis A r t i c u l a t i n g Inferior surface bones of body of talus (posterior calcaneal Articular facet) articulates with superior surface (posterior talar articular surface) of calcaneus Ligaments Capsule support: a. Calcaneum 2. Navicular bone 4. Cuboid 3. Talocalcareal joint PLANTAR ARCHES • Supports the body on an erected posture by: a) Distribution of weight b) Acting as shock absorber c) Adapting to changes in surface contour Parts: Medial Longitudinal Arch: 1. Medial. Lateral. First 3 metatarsals Lateral Longitudinal Arch: 1.

Clubfoot − Foot twisted out of shape − The foot is inverted − the ankle is plantarflexed − the forefoot is adducted ! 5.Upper and Lower Limbs ABNORMALITIES IN THE LOWER LIMBS 1. (L-R) Genu valgum. Feet ! Figure 25. Genu Valgus (Knock Knee) − Distal tibia directed towards median sagittal plane 2. Genu varum 3. Genu Varus (Bow-legged) − Medial angulation of leg in relation to thigh − Outward curvature of femur and tibia ! 4. degeneration with age − Head of the talus displaces inferomedially and becomes prominent ! S1 T3 14 of 15 . Flatfoot − Flexible: result from loose or degenerated intrinsic ligaments − Rigid: bone deformity (such as a fusion of adjacent tarsal bones) − Acquired: due to trauma. Clubfeet 4. Normal knees. Ankle ! Figure 24.

(Snell) PPT S1 T3 15 of 15 . 2. Clinical Anatomy by Regions 9th Ed.Upper and Lower Limbs ! Figure 26. Normal foot (left) vs Flatfoot (right) REFERENCES: 1.

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