LOWER LIMB

(MEMBRUM INFERIUS)

Doc. MUDr. Dáša Slížová, CSc.

Deputy head of Anatomy dept.
MEMBRUM INFERIUS – LOWER LIMB

BONES ,JOINTS, Ligaments

• PELVIS (pelvic girdle)

• Hip bone (Os coxae): ilium, ischium, pubic b.

! the sacrum, the coccyx (bones of vertebral column)

• FREE PART OF THE LOWER LIMB

• Femur (thigh bone), patella (sesamoid b.)

• tibia, fibula – bones of the leg

• Bones of the foot (tarsus, metatarsus, digits (toes)

• Tarsal bb.: talus, calcaneus,navicular b., cuboid b.,
medial, intermediate et lateral cuneiform bb.
• Metatarsal bb. (I. – V.)
• Digits I. – V. : (Hallux !) – Phalanges (14)
FEMUR

ANT.
POST.
 Femur Anterior side

• CAPUT FEMORIS 1. facies patellaris

• COLLUM 2. -
3. epicondylus lateralis
4. trochanter minor
5. linea intertrochanterica
• CORPUS ( DIAPHYSIS) 6. trochanter major
7. collum femoris
8. caput femoris
9. fovea capitis femoris
10.epicondylus medialis
11.condylus medialis

• CONDYLES
• EPICONDYLES
 Femur Posterior side
2 - condylus lateralis
4 - trochanter minor
6 - trochanter major
7 - collum femoris
8 - caput femoris
10 - epicondylus medialis
11 – condylus medialis
12 – fossa trochanterica
13 – fossa intertrochanterica
14 - linea aspera
15 – labium laterale lineae
asperae
16 – facies poplitea
17 – linea intercondylaris
10 18 – fossa intercondylaris
11
TIBIA

FIBULA

Interosseal membr.

Tibial condyles
Tibia and fibula

•Right 1. malleolus lat.

•anterior 2. caput fibulae
3. apex capitis fibulae
4. condylus lat. tibiae
5. eminentia intercondylaris
6. condylus med.
7. tuberositas tibiae
8. margo ant. tibiae
9. margo interosseus tibiae
10.malleolus med.
11.margo interosseus fibulae
FOOT – Tarsal, metatarsal bones, phalanges

T
N

Calc. cub.
Bones of the foot – skeleton pedis

1. os naviculare
2. os cuneiforme intermedium
3. os cuneiforme mediale
4. os metatarsale I.
5. phalanx proximalis
6. phalanx distalis
7. os cuneiforme laterale
8. tuberositas ossis metatars. V.
9. os cuboideum
10.talus
11.calcaneus
Pelvis

os ilium

os sacrum

os ischii
Os coxae (hip bone): ilium, ischium, pubis
 Hip bone (medially)
1. tuber ischiadicum
9 2. for. obturatum
3. incisura ischiadica minor
4. spina ischiadica
10
5. incisura ischiadica major
11 6. spina iliaca post. inf.
8
7 7. facies auricularis
12
13 6 8. spina iliaca post. sup.
5 9. crista iliaca
14 10.fossa iliaca
15 4 11.spina iliaca ant. sup.
3 12.spina iliaca ant.inf.
2 13.linea arcuata
16 1 14.eminentia iliopubica
15.sulcus obturatorius
16.facies symphysialis
Hip bone (laterally) 1. tuberculum pubicum
2. incisura acetabuli
3. spina iliaca ant.inf
4. linea glutea inf.
6
7 5. spina iliaca ant. sup.
8 6. crista iliaca
9
7. linea glutea post.
5 8. linea glutea ant.
10
11 4 9. spina iliaca post. sup.
3 10.spina iliaca post. inf.
12 11.incisura ischiadica major
13 12.facies lunata
14
2
15 13.spina ischiadica
1
16 14.fossa acetabuli
15.incisura ischiadica minor
17
16.for. obturatum
17.tuber ischiadicum
Newborn´s X-ray
PELVIS

Greater and lesser pelvis

Pubic symphysis
 LESSER AND GREATER PELVIS
PELVIC PLANES AND DIAMETERS:
External measurements:

1. Interspinous distance (26 cm)

Spina iliaca ant. sup. dx. – sin.
2. Intercristal dist. (29 cm)
Crista iliaca dx. – sin.
3. Intertrochanteric dist. (31 cm)
Trochanter major dx. – sin.
4. External conjugate (20 cm)
Symphysis pubis – vertebra L5
 External measurements:

Intercristal 29

Interspinous 26

31

Intertrochanteric
CONJUGATA EXTERNA
 LESSER PELVIS

ADITUS PELVIS

EXITUS PELVIS
DIAMETERS OF LESSER PELVIS

ADITUS PELVIS

AMPLITUDO PELVIS

ANGUSTIA PELVIS

EXITUS PELVIS
SEX DIFFERENCES

FEMALE PELVIS:

– larger lesser pelvis

- wider iliac alae

- pubic arch

( X subpubic angle in male pelvis)

- different shape ov aditus pelvis
Joints of pelvis:

• Synostoses of pelvic bone

• Pubic symphysis
• (synchondrosis)

• Sacroiliac joint
• – amphiarthrosis

• Art. coxae (hip joint)

• ball and socket
• (acetabulum + caput fem.)

• Ligaments: sacroiliac lig.

sacrotuberal lig.
obturator membrane
inguinale lig.
 Art.sacroiliaca

inguinal
lig.

Obturator membrane

Pubic symphysis
1 - lig. sacrotuberale
2 - foramen ischiadicum minus
3 - lig. sacrospinale
4 - foramen ischiadicum majus
5 - art. sacroiliaca
6 – lig. iliolumbale
7 – lig. longitudinale ant.
8 – ligg.sacroiliaca interossea
9 – lig. sacrococcygeum ant.
10 - symphysis pubica
 Joints of the free limb:
Art. coxae (hip joint)
Art. genu (knee j.)

Interosseal membrane (tibia – fibula)

Tibiofibular syndesmosis

Talocrural joint (upper ankle j.)

Lower ankle j. (subtalar j. – talocalcaneonavicular j.)
(= Chopart´s joint)*

Intertarsal joints
Tarsometatarsal j. (Lisfrank´s j.) * - lines of amputation
Intermetatarsal j.
Metatarsophalangeal j.
Interphalangeal j.
 ART. COXAE (HIP JOINT)

• ball and socket (spheroidal)

•(acetabulum + caput femoris) –limited j. (enarthrosis)
•Simple joint
•socket: lunate surface of acetabulum, labrum acetabulare (lip),
ligamentum acetabulare transversum, fatty cushion
 ART. COXAE (HIP JOINT)
Ligaments: - iliofemoral lig. (the strongest)
ischiofemoral lig.
pubofemoral lig.

Movements: flexion – 120°

extension – 13°
abduction – 40°
adduction – 10° (hyperadduction)
rotation – external – 20°
internal - 40°
ARTICULATIO GENUS
( KNEE JOINT)
Compound (3 bones and menisci), hinge joint (trochoid)
articular surfaces: femoral condyles, tibial condyles, patella, menisci
(lateral – more mobile, medial – larger)
Ligaments:
extraarticular:
patellar lig.
tibial and fibular collateral lig.
intracapsular:
anterior and posterior cruciate ligg.
intraarticular:
ant. and post. meniscofemoral ligg.

Joint space: complicated

(communicating suprapatellar bursa,
infrapatellar fatty pad, synovial folds)

Anatomical position: extension

Movements: flexion 130 – 160°
(inicial rotation)
rotation – only in flexed knee
•Talocrural joint (upper ankle j.)

• trochlear
• tibia, fibule and talus (trochlea)

• flexion (plantar flection)

• extention (dorsal flection)

• ligaments !!
• Lower ankle j. (subtalar j. –
talocalcaneonavicular j.)
(= Chopart´s joint)*
• Intertarsal joints
• Tarsometatarsal j. (Lisfrank´s j.) * -
*lines of amputation
• Intermetatarsal j.
• Metatarsophalangeal j.
• Interphalangeal j.
PLANTAR ARCH
• sagittal and transverse arches,
• supported by ligaments and muscles

• it resists the weight of the body